You may or may not know it, but your canine or feline could be suffering from arthritis.
Pain resulting from arthritis is a common reason cat and dog owners pursue evaluation and treatment with a veterinarian. Day-to-day wear and tear and trauma (slipping, falling, being subject to blunt force, etc.) are some of the common reasons pets develop arthritis. Arthritis also results from other health conditions, like infection with tick or flea-borne bacteria, immune-mediated (i.e. “autoimmune”) disease, cancer, and others. When untreated, arthritis can progress to osteoarthritis (OA, a term that’s interchangeable with arthritis) where the cartilage that surfaces lining joints are damaged and normal range of motion (ROM) is compromised. For the purposes of this article, I am going to focus on OA.
Is Arthritis More Common in Some Cats and Dogs Than Others?
Although arthritis is commonly associated with senior pets age seven or greater, juveniles (puppy and kittens) and adults are also prone to the condition. Some pure-breed dogs are more prone to arthritis than their mixed-breed counterparts, but all breeds and their mixes can be affected by joint inflammation. Being a particular breed known to have arthritis doesn’t sentence your dog to a lifetime of pain. Bulldogs (English, French, etc.), German Shepherds, Golden Retrievers, Great Danes, Labrador Retrievers, Mastiffs, Rottweilers, and other large and giant-breeds are some examples of canines prone to joint inflammation. I feel it’s more appropriate for owners to recognize that the size and lifestyle of their pets generally has a greater correlation with developing arthritis as compared to breed. Dogs having a medium, large, or giant body size more commonly develop arthritis regardless of age than their smaller counterparts. Small dogs and puppies are also prone to OA but their clinical signs are generally less-pronounced and owners may not be aware a problem exists until the condition has significantly advanced. Cats can also develop OA, but like small dogs they tend to hide their condition until it advances and causes observable clinical signs. Pure-breed cats like the Maine Coon, Ragdoll and mixed breeds that attain a larger body size are more known to develop OA than smaller pure-breed felines and their mixes.
What are the Clinical Signs of Arthritis in Cats and Dogs?
Clinical signs of arthritis may be mild or severe and sometimes only become evident when the disease has significantly advanced. Therefore, it’s crucial that owners pay close attention to their pet’s movement, demeanor, and day-to-day habits and immediately address any concerns with their veterinarian. Common clinical signs of arthritis include: Limping Limping (or the more medical term lameness) is one of the more obvious signs of arthritis. You may see your pet having:
Reduced weight-bearing on the affected limb while walking, running, or standing
Inability to use a limb (non-weight bearing lameness)
Head bobbing while walking or running
Tendency to place the foot to the ground then immediately lifting it back up
Struggling to stand, sit, or lie down The process of standing, sitting, or lying down can be challenging for arthritis-afflicted pets. Struggling to stand from a sitting or lying-down position is a common observation and can be exacerbated on slippery surfaces. Less-subtle signs include repeatedly circling before sitting or lying down, remaining standing or walking for extended time periods, or appearing restless while lying down. Difficulty going up onto or down from elevated surfaces or stairs Difficulty while moving up onto or down from elevated surfaces (bed, couch, etc.), traversing stairs, or getting in or out of the car are common clinical signs seen in dogs having OA. Cats may be more reluctant to jump up onto counters or navigate stairs and have challenge getting in and out of the litter box. Sitting or lying down with the arthritis-affected side facing up If arthritis pain is one sided, then an arthritic pet is more likely to lay with the comfortable side down and the affected side up. This way, less pressure is put on to the affected side in an attempt to reduce painful sensations. Altered patterns of elimination Arthritis-affected pets can find more challenge posturing to urinate or defecate. Your dog could walk while urinating or defecating instead of holding a normal eliminating position. Cat owners may find urine or feces outside of the litter box, often in close proximity to the box or on soft surfaces (carpet, bed, laundry basket, etc.). Licking or chewing at affected body parts Pets may lick or chew at and sore areas in attempt to self-soothe their arthritis pain. Owners can see moistened skin or hair, light hair that has turned pink (from porphyrins found in saliva), redness or crusting on the skin surface, or hair loss as a result of chronic licking or chewing. Behavior changes OA is one of the most common reasons pets, especially seniors, will show behavior changes. Aggression, attempting to bite when moved, withdrawal from interaction with people or other pets all can occur. Vocalization Arthritis-affected pets may vocalize when a painful body part supports weight or is touched by a person or other pet. Owners may hear barking, groaning, whimpering, whining and other altered vocal patterns. Exhibiting pain when touched Besides vocalizing, pets suffering from arthritis can show discomfort when a human or another animal touches a sore body part by withdrawing an affected limb or moving away from the painful stimulus. Exercise intolerance Exercising requires a comfortable body, so OA-affected pets commonly show reduced ability to perform while exercising. Your dog could sit down while out on a walk, seem slow while traversing a hiking trail, not be able to keep up with other canine companions while running, or even sink during otherwise routine swims. If you observe your dog exhibiting any of the above clinical signs, schedule an examination with your veterinarian or emergency veterinary hospital.
How is Arthritis Diagnosed in Canines and Felines?
The observations of a pet owner are a great place to start when diagnosing arthritis in pets. In addition to taking a history from the owner and performing a thorough physical exam a veterinarian may recommend diagnostic tests like x-rays, which are essential in attaining a diagnosis of OA. Sometimes more advanced testing like Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and Nuclear Scintigraphy may be used for cases where x-rays don’t yield the needed information. Pain mimicking arthritis can be caused by intervertebral disc disease (IVDD), cancer, thromboembolic disease (blood clotting abnormality), and other conditions, so knowing exactly what’s going on beneath the surface via diagnostic imaging is crucial in determining prognosis (expected course of a disease). Additional diagnostics like blood, urine, and fecal testing are often required to determine a pet’s overall health status and ensure that pain-relieving medications can be safely prescribed.
What Arthritis Treatment and Prevention Options Are Available for Canines and Felines?
OA is an inflammation-based condition, so using prescription non-steroidal anti-inflammatory medications (NSAIDs) is commonly the first line of treatment we veterinarians prescribe. Although effective at reducing joint inflammation, NSAIDs should not be the sole means of providing pain relief as there can be mild to severe side effects associated with their use. Damage to the digestive tract, kidneys, liver, red blood cells, platelets, and nerves can occur if any such systems are already compromised or if larger-than-recommended doses of NSAIDs are administered or inadvertently consumed. Besides NSAIDs, drugs having a more pain-numbing effect like opiates (Tramadol, Buprenorphine, etc.) and GABA-analoges (Gabapentin) can help arthritis patients. Yet, these drugs can also have undesirable side effects like sedation, appetite reduction, digestive tract movement, etc. Owners should take a multimodal approach in managing their dog’s arthritis, which means that more than one type of treatment modality is used to better address pain. Multimodal pain management aims to improve whole-body health so smaller or less- frequent doses of drugs potentially having side effects are needed to maintain a comfortable quality of life. Besides veterinary prescription medications, the multi-modal approach to pain management includes: Joint supporting nutraceuticals Nutraceuticals are food-derived substances having a medicinal effect. Nutraceuticals that promote joint health are termed chondroprotectants (i.e. cartilage protectors). Chondroprotectant nutraceuticals commonly include glucosamine, chondroitin, MSM, vitamins (C, E, etc.), minerals (Calcium, Manganese, etc.), antioxidants (Selenium, Alpha Lipoic Acid, etc.), anti-inflammatory substances derived from plants (turmeric, phycocyanin, etc.) or animals (omega fatty acids from fish oil, etc.) and more. Cartilage rebuilding medications Besides nutraceuticals, there are injectable medications that benefit joint health and rebuild cartilage, including Polysulfated Glycosaminoglycan (PSGAG, like Adequan) and Sodium Pentosyn Sulfate (Cartrophen), and others. Such products bypass the digestive tract, travel via the bloodstream from the injection site to multiple joints, and are more ideal for a pet having digestive tract problems than oral chondroprotectant nutraceuticals. Home environment and lifestyle modification Modifying a pet’s home environment and lifestyle are crucial ways to put less stress on affected joints and reduce the potential for injury. Lowering the height of a bed or couch and using a step, stairs, or ramp next to elevated surfaces can help provide safer passage. Carpeting, runner rugs, and yoga mats can provide improved traction on slippery floors. Foot and nail covers (Pawz, ToeGrips, etc.) also provide additional grip on slick surfaces and can aid in proprioception (awareness of where the foot is in space). Gates installed at access points to stairs can prevent a dog from slipping, falling, and injuring himself while attempting to ascend or descend. Ramps can provide safer access to the backseat or hatchback of cars. Dogs engaging in high-impact activities (running, ball playing, etc.) must transition to low-impact exercise, such as combinations of walking, hiking, swimming, and physical rehabilitation. Although dogs are generally in more need of environmental and lifestyle modification we also have to make efforts to help our feline friends. Cats’ access to counters should be restricted and the height of the litter box edges must be lowered. Weight management Overweight pets are prone to suffering from arthritis pain and obesity-related ailments during all years of life. Although many owners show their pets love by providing food treats, the better way to do so would be through praise and physical connection (petting, playing, etc.). According to the 2007 Imperial College of London Study Dogs Lived 1.8 Years Longer On Low Calorie Diet: Gut Flora May Explain It, there are health benefits to consuming fewer calories. The canines involved in the study ate 25% less calories than their non-calorically restricted counterparts, lived 1.8 years longer, were less prone to developing OA (and diabetes), and had an older median age for onset of late-life diseases (like OA). I recommend owners always restrict their pet’s daily calories and maintain a slim body condition score (BCS) on a lifelong basis. As part of a routine wellness examination, owners should request their veterinarian calculate a pet’s daily caloric requirement and recommend an appropriate volume of commercially-available or home-prepared diets to safely promote weight management. Transition your pet off kibble or moist pet diets onto one of The Honest Kitchen‘s canine or feline formulas. Discontinue pet treats containing feed-grade ingredients (some of which even contain known toxins and carcinogens) and provide appropriate amounts of The Honest Kitchen’s line of healthy pet treats. Some pets are overweight due to underlying glandular problems (hypothyroidism, hyperadrenocorticism , diabetes, etc.) which can be diagnosed via diagnostic testing (blood, urine, etc.) as part of a consultation with a veterinarian.
Complementary and Alternative Medicine (CAM)
Complementary and alternative medicine (CAM) includes a variety of treatments for arthritis, including:
Acupuncture - Insertion of needles into acupuncture points to promote the release of the body's own pain-relieving and anti-inflammatory hormones. Manual pressure (acupressure), heat (moxibustion), electricity (electrostimulation), injection of liquids (aquapuncture), or laser can also be used to stimulate acupuncture points.
Herbs - There are a variety of plant-derived products that help promote blood flow and reduce inflammation in body tissues. I always recommend veterinary-prescribed, U.S.-made products like those made by Xie’s Jing Tang Herbal, Standard Process, and others.
Laser - Low power (“cold”) lasers can be used to safely and painlessly promote tissue repair, blood flow, oxygen and nutrient delivery, and the removal of metabolic wastes. I commonly use a MultiRadiance MR4 Activet4 Laser on my patients painful spots and acupuncture points.
Pulsed Electromagnetic Frequency (PEMF) - PEMF is a non-invasive method of modulating OA pain. I’ve treated patients with the Assisi Loop, which is simple to lay over or around affected joints.
Physical Rehabilitation - Veterinarians and human physical therapists can pursue specialty training to provide physical rehabilitation to animal patients. Besides the aforementioned modalities, pets can swim in a pool (yes, cats too), walk on an above-ground or underwater treadmill, have their bodies stretched and massaged, receive passive range of motion (ROM) therapy, and more. I strive to get owners involved in the rehab process by learning techniques that can be performed at home so less-frequent trips to a physical rehabilitation are needed.
The great news for pets is that multimodal pain management can be started early instead of waiting for clinical signs of arthritis to emerge. After all, it’s better to prevent the problem so our beloved canine or feline companions never suffer from arthritis pain. Prevention via calorie restriction and lifestyle modification is also a more-convenient and cost-effective practice than pursuing diagnostics, medications, nutraceuticals, and other treatments.
Interested in seeing the impact of diet on pets with arthritis? Read through our True Storieshere.
Dr. Patrick Mahaney
Dr. Patrick Mahaney VMD, CVA, CVJ is a veterinarian and certified veterinary acupuncturist providing services to Los Angeles-based clients both on a house call and in-clinic basis. Dr. Mahaney’s unique approach integrating eastern and western medical perspectives has evolved into a concierge house call practice, California Pet Acupuncture and Wellness (CPAW), Inc. Additionally, Dr. Mahaney offers holistic treatment for canine and feline cancer patients at the Veterinary Cancer Group (Culver City, CA).