Understanding arthritis in pets

As our beloved pets age, many will experience pain in their joints caused by everyday wear and tear resulting in a chronic degenerative disease called arthritis – the most common form being osteoarthritis (OA). Since animals are stoic and attempt to mask their pain, it may not be easy to pick up the subtle signs that your pet is suffering.

Although arthritis cannot be cured, there are treatment options available to reduce the discomfort and pain caused to your dogs or cats which may prevent the disease from worsening. Dr Karin Wilson, a vet at Teva Veterinary Clinic in Somerset West, has provided some information below to flag the signs that your pet is suffering from joint pain and to help improve our understanding of arthritis in dogs and cats.

Osteoarthritis (OA), also known as degenerative joint disease (DJD) or degenerative arthritis, is a progressive and permanent disorder of the joints caused by gradual loss of cartilage, resulting in the development of bony spurs at the margins of the joints, causing pain and inflammation. OA is the most common chronic condition of the joints, affecting about 1 in 5 adult dogs and 4 in 5 geriatric dogs (over the age of 8 years old) and 1 in 4 cats older than 10 years.

What are the signs?

Both the soft tissue and the bones of a joint are affected in pets with osteoarthritis, causing inflammation, decreased flexibility, and pain in that joint region but also causing discomfort from compensational movements.

Signs to look out for in your dog (the signs will typically be worse in the mornings, after lying down for extended periods, and in the cold weather):

• Becomes less active (‘getting old’).
• Gets up slowly.
• Walks stiffly or limps.
• Has swollen joints.
• Yelps.

Signs to look out for in your cat:

• Decreased grooming.
• Reluctance to jump.
• Inability to jump as high as before.
• Urinating or soiling outside of the litter box.
• Increased or decreased sleep.
• Avoiding human interaction.
• Hiding.
• Dislike of being stroked or brushed.

What can you do?

1. Weight control: Arthritis is a greater problem in pets that are overweight. An overweight, sore pet on medication can often manage unmedicated once it has reached its ideal weight.

2. Nutrition: Good nutrition is imperative as it needs to be calorie-controlled to prevent weight gain. The correct food will benefit your pets greatly. Their diet should provide quality protein sources, marine-source omega-3s, anti-inflammatories, antioxidants, and joint-supportive ingredients. Talk to your vet about a prescription joint diet that will be best suited to your pet.

3. Supplements: Many natural supplements on the market will help your pet, some of which are listed below. Where possible, use products specifically made for pets as they will have the correct dosage and tested bioavailability. Only use human products on your vets’ recommendation.

• Joint supplements: Products like GCS Advanced contain natural ingredients that provide the building blocks for the synthesis of cartilage. They also help to attract water to the joint tissue, which helps the cartilage to remain elastic. It also assists in blocking the action of enzymes that break down cartilage tissue when inflammation is present. If you are feeding your pet a diet that does not already provide a high source of these ingredients, this supplement is highly recommended. Note that human products contain chondroitin molecules that are too large for animals to absorb properly. It is, therefore, important to use an animal product for this supplement.

• Omega-3 fatty acid supplements: A good quality and high dose of marine-source omega-3s (herring, salmon, krill) are particularly beneficial for joint pain and inflammation. You can dose as high as 600 mg of combined eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) per 10 kg body weight, but introduce this gradually if your pet has a sensitive stomach. Note that flaxseed oil is often promoted as an alternative to fish oil but it contains a substance called alpha‑linolenic acid (ALA) which needs to be converted to EPA and DHA and dogs and cats cannot do this effectively. 

• Pentosan polysulphate (PPA): This is an injectable product that provides chondroprotective and anti-inflammatory properties. Injections are done weekly for a series of 4 weeks and then maintained on a 4 to 6-week basis.

• Kaprex is a natural plant-derived supplement to relieve pain and inflammation. Although this is a human product, it can be used at the following dose in dogs:  <15 kg – one capsule daily; >15 kg – one capsule twice daily. Tip: Do not break open the capsule and mix it in the food. It is terribly bitter.

• Traumeel and Zeel tablets are a homeopathic treatment for musculoskeletal conditions. The veterinary range is no longer available but the human tablets can be used at a dose of:  <15 kg -1/2 tablet twice daily; >15 kg – 1 tablet twice daily.

We often see better results in different dogs with different products. We, therefore, suggest that you try a few out to see which work best for you and your pet. Keep in mind, however, that the therapeutic effect of a supplement may take 4 to 6 weeks to become evident, so don’t swop between products too quickly.

4. Exercise: Moderate, controlled exercise is important to maintain the strength of the ligaments and muscles and, therefore, provide support for the joints so that they take less of the weight-bearing load directly. No “weekend warriors” please. The key to good exercise for an arthritic pet is “little and often” so that your pet does not overdo it. If your pet is collapsing toward the end of a walk or is stiffer the next day, your walk was too long. If your pet is too sore to exercise, hydrotherapy is a great way to exercise in an environment where there is decreased weight bearing due to the buoyancy of the warm water. This spares the joints and works the muscles. The underwater treadmill is especially effective in activating lazy muscles and building strength. For further information about the benefits of physiotherapy, physical rehabilitation, and hydrotherapy for your pet, you can visit organisations such as Pets in Balance.

5. Non-slip flooring: Laminates, woods, bamboo, and tiles can be extremely hazardous for an arthritic pet. Arthritic pets generally have muscle weakness which means that they do not have the strength to stabilise their legs on slippery floors. They tend to lose confidence and can slip and injure themselves. The following is recommended:

• Non-slip matting or rugs, especially where they lie down and eat.

• Sticky Pawz (rubber socks) – these help with traction and will prevent slipping.

• Trim the long hair between the paws that can interfere with the paw to ground contact.

• Trim long nails: Your pet’s nails should just touch the ground when your pet is standing. Any longer and they will interfere with the way the pet walks making it especially challenging on slippery floors. If your pet does not like having its nails trimmed, see Teva’s pet resource article here.

6. Environmental changes:  There are many hazards that your arthritic dog will encounter in your house and garden daily.  A few simple changes can make a big difference in your pet’s quality of life.

• Block the stairs: We would not expect an 80-year old arthritic granny to walk up and down the stairs daily. This goes for our pets too. Our pets like to be with us all the time. They will follow us when we go upstairs to fetch something we left behind. Going up and down the stairs in a controlled fashion is one of the exercises which we do to help build muscle strength, but excessive stair climbing can cause tight muscles and flare up inflammation of joints. Pets can also fall or slip causing other injuries.

• Raise your pet’s food and water bowls: We want to make it as easy as possible for your pet to eat and they should not have to counter slipping or try to balance when they are eating.

• Special pet stairs: These can make it easier for your pet to climb onto couches and beds, especially for smaller dogs.

• Beds for arthritic pets: Movement on a firmer bed is more controlled and your pet doesn’t need to keep correcting as the body moves. A slightly raised bed makes it easier, especially for large breed dogs as they find it easier to stand up from a raised bed than from one on the floor. One can also try heated mats or pet pads that apply therapy while your pet sleeps, e.g. magnetic therapy pet pads. Make sure your pet is warm and lying in a draft-free area.

• Ramps vs stairs: Going up and down the garden steps can be challenging when your pet is weak and arthritic. Consider erecting a ramp with non-slip rubber matting. This is also advised for use when getting in and out of the car. If this is not practical then consider a full-body harness to assist your pet. These can be left on for 24-hours a day if they are of good quality. The two handles allow you to give your pet a helping hand when needed. Harnesses must distribute the weight evenly through the pelvis. Avoid using a towel under the belly. This compresses the abdominal organs and causes pressure at the lumbosacral joint.

7. Other changes:

• Massage: This increases flexibility and improves circulation, comfort, and performance. There are online massage courses that you can do to learn how to do this effectively or your vet can teach you some simple methods that you can use.

• Downtime: Old pets need to rest. Try giving them some time every day to relax without young children or puppies bothering them.

• Grooming: It can be difficult for old pets to groom themselves especially in those hard to reach places. Make sure you brush them or have them groomed regularly. Be sure the groomer has experience with grooming older pets or arrange a home groomer.

8. Alternative therapies: Veterinary physiotherapy, underwater treadmill, chiropractic, acupuncture:

• Speak to your vet (or an organisation such as Pets in Balance)  about the benefits of individualised exercise and pain‑relief programmes (including therapeutic laser, tens machine, massage/manual therapy, strengthening exercises and underwater treadmill) to help your pet maintain or build muscle mass and reach its full movement potential.  

• Another useful modality to manage pain and compensatory strain is veterinary chiropractic and acupuncture. Dr Angela Vorster has a particular soft spot for golden oldies. Visit this Facebook page for more information.

What medical treatments are available?

Analgesic (pain-killing) medications used to relieve arthritic pain in pets fall into one of four groups of medications, namely nonsteroidal anti-inflammatories (nsaids), neuropathic pain medication, opiate analgesics, and mild anti-inflammatories.

Your vet will typically start your pet on an NSAID which works quickly to decrease prostaglandins that cause pain, allowing pets to move more easily again. Correct use of NSAIDs can slow down the progression of OA by protecting cartilage and helping maintain muscle mass due to retained movement. It is vital to only ever use a veterinary-prescribed NSAID as human versions can be dangerous for pets. A simple Panado, for example, can be fatal to cats. The veterinary NSAIDs are usually safe enough to use chronically but can affect your pet’s kidneys and liver. It is, therefore, important to do baseline blood tests and regular check-ups to monitor the function of these organs. If your pet vomits or experiences stomach upsets after having an NSAID for the first time, please stop the medication and contact your vet. Other forms of painkillers can be added to your pet’s treatment regime if nsaids become ineffective in end-stage OA, but your vet will walk that journey with you.

Authored by Dr Karin Wilson (not a SAFREA member)

Proofread and Copyedited by Delilah Sao Joao (SAFREA member)