Chicagoland Tails, August/September 2003
Easing the Ache
top treatments for pet arthritis
Does your Lab limp? Is your Shepherd suddenly slow? If Sparky isn't feeling too spunky these days, the culprit may be arthritis. It's estimated that one if five adult dogs, along with many cats, suffer from this very painful and crippling disease. The good news is that today, there are more ways to combat this illness than ever before.
Knowing the Enemy
One of the most common ailments in small animal medicine, osteoarthritis, is a chronic, slowly progressing disease caused by the breakdown and loss of cartilage and destruction of its cells. Without protective cartilage, bone begins to rub against bone, resulting in inflammation and joint pain. Rheumatoid arthritis, on the other hand, is a condition in which the immune system mistakenly attacks the joints, causing inflammation and pain while oftentimes leading to their destruction.
While arthritis can occur in any breed and at any age, it is most prevalent in older pets. Large breed dogs such as Labrador Retrievers are prone to problems with elbows and hips, while small breeds such as Toy Poodles may experience arthritis in the kneecaps. Cats tend to be particularly susceptible to trouble in shoulder and elbow joints. Arthritis can also occur in the back, neck, and other areas of the body, and it may affect more than one area at a time.
Fortunately, there are effective treatments for all stages of the disease; however, early detection is key in minimizing your pet's discomfort and maximizing his chance for responding favorably. Keep in mind that warning signals can be very subtle -- especially in a cat. Your pet may not necessarily "cry" or show obvious signs of pain, so keep a close eye on her and alert your veterinarian immediately if you notice any of the following symptoms:
- Difficulty getting up after sleeping
- Stiffness after sleeping or exercise
- Limping or favoring of legs
- Repeated licking of joints
- Reluctance to climb stairs or hop into cars
- Unpredictable, aggressive, or "grumpy" behavior
- Worsening of symptoms during cold or rainy weather
- Loss of appetite
- Falling behind on walks
While arthritis is pets has traditionally been treated with surgery and/or pharmaceuticals, many of today's afflicted animals are finding long-term relief with holistic therapies and treatments. TOPS Veterinary Rehab in Grayslake, Illinois, is among the best facilities in America that are battling this disease. While the practice sees mostly dogs, about 2% of its patients are cats. Founder Dr. Laurie McCauley has witnessed much success with holistic therapies. "We recently treated an older dog who was only able to walk half a block before going completely lame for the next 12 hours," she says. "Twelve weeks later, after going through our therapy, the same dog is walking three miles every day."
According to Dr. McCauley, arthritis patients are most often treated with a combination of therapies in conjunction with nutritional supplements to provide the most relief, rebuilding, and strengthening possible. (See page 13 for more info on recommended supplements.) For example, she says, "We may start a pet out with acupuncture and Hako-Med treatments to get the pain under control, then progress to PST treatment a couple of weeks later to repair damage. After that, we may begin working in the hydro-treadmill to strengthen muscles and joints and to increase flexibility, then move on to specialty designed exercises to maintain that level of functioning." Meanwhile, patients may be given supplements to further promote rehabilitation of the cartilage, and in many cases they're slowly weaned off any prescription medications they were previously on. "It depends upon the individual pet," Dr. McCauley says. "Some pets are so severe that they must stay on the meds, but we try to keep them off if at all possible. You can't just go cold turkey, though; if your pet is able to come off the meds, it should be done slowly and under the supervision of a veterinarian."
As do many rehab clinics nationwide, TOPS treats both osteoarthritis and rheumatoid arthritis using the following therapies -- although cats refrain from the water involved treatments!
Used in animal medicine for more than 3,000 years, acupuncture was first brought to the United States in the 1970s. Fine needles are inserted at specific points in the body, creating physiological changes that help to relieve pain and muscle spasms and to increase regeneration of the nerves.
Dr. Patricia Cahill, of Northbrook Animal Hospital, has been certified in veterinary acupuncture since 2000. "What you're doing [with acupuncture] is treating the symptoms of pain and inflammation while you're hopefully slowing the progression of the disease with supplements. You will never be able to fully cure the disease, but the goal is to manage the symptoms and to keep the joints and tissues as healthy as possible.
Pulsed Signal Therapy
Non-surgical and pain free with no known side effects, PST has become a top choice for arthritis treatment. How it works: Electrical signals are repeated rhythmically at certain intervals. This "activates" cells to increase production of proteoglycans and collagen to promote regeneration of cartilage. The therapy has proven highly effective in reducing pain and swelling, and Dr. McCauley has witnessed continued improvement in patients for up to 12 weeks after treatment. While PST is new to the United States, it has been used to effectively treat human arthritis and tendon/ligament injuries in Europe for more than 20 years. As it is still undergoing FDA evaluation in the U.S., it is available exclusively for animal therapy at this time. According to Dr. McCauley, TOPS has used PST in more than 150 cases with "very good results."
The use of an underwater treadmill allows strengthening and rebuilding of leg muscles in canine patients, with virtually no pressure on the joints. A warm-water environment also promotes flexibility, mobility, and circulation.
Cryo & Heat Therapy
This type of treatment uses cold (a moldable cool pack or bag of cold peas) and/or heat (a moldable heat pack or warm, moist towels) over afflicted areas to decrease pain and inflammation and to speed healing.
Hako-Med (Electrical Horizontal Therapy)
According to Dr. McCauley, this new therapy is thought to be the "cutting edge" in pain management. The therapy is administered by a machine called the Hako-Med. Like PST, it involves running electrical signals over the body, but the signals are varied in a different way. Hako-Med can be used in conjunction with a whirlpool for generalized "all-over" conditions, or it can be used alone for more localized pain.
Dr. Barb Royal, of Family Pet Hospital in Chicago, is an advocate of "pets doing some sort of slow, low-impact exercise. I really recommend that if your dog can swim, take him out to the pool or water somewhere and let him work out a little at a time. It's probably the best exercise there is.
She believes, "If your pet isn't actively moving, he's going to deteriorate much faster. Pets that are doing some swimming or other exercise are going to build up strength and increase mobility and are just going to be able to get around much better."
Keeping pets comfortable is the goal. "Basically, I'll try anything if I think it will help the pet with his pain and inflammation," Dr. Cahill says. "It can't hurt, and most times even if it doesn't completely work, it is still an improvement."
Although many people prefer to stick to more holistic treatments for their pets, there are cases when "big guns" may be needed to help control severe pain and debilitation. NSAIDs (nonsteroidal anti-inflammatory drugs), steroids, and other types of prescription medications can be miracle workers at relieving pain and inflammation, but they also carry the risk of potentially dangerous side effects. Always watch for symptoms of adverse reaction when your pet is on any prescribed drug, and never give your pet over-the-counter human pain relievers without first consulting with your veterinarian.
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
One NSAID developed especially for dogs, Rimadyl (Carprofen), is highly effective at reducing pain and inflammation, as is Etogesic (Etodolac). While your pet may feel and act like a new dog, it is important to realize that these types of drugs do not treat the disease or rehabilitate cartilage. Also, as with any NSAID, side effects such as vomiting, diarrhea, intestinal upset, abnormal bleeding, and kidney and liver problems have been reported in some dogs. Labrador Retrievers in particular have experienced serious liver problems related to these medications, and death has occurred in a small number of cases as well.
DMOADs (Disease-Modifying Osteoarthritis Drugs)
Adequan (Polysulfated Glycosaminoglycan) is a part of a unique class of drugs which fight osteoarthritis by relieving pain and repairing damage. This veterinarian-administered injection stimulates cartilage repair and suppresses the enzymes that destroy joints. In addition, it reduces inflammation and improves joint lubrication, which in turn relieves pain and makes movement easier. Possible side effects may include soreness at the injection site, vomiting, diarrhea, depression, and abnormal bleeding, although reported side effects are infrequent and usually mild.
Steroid medications such as Prednisone are extremely potent anti-inflammatory drugs which are usually used in more severe cases when NSAIDs or other treatments are not able to fully control swelling and pain. Prolonged use, however, may cause side effects such as gastric glycemia, and insulin resistance, and it may actually speed up cartilage destruction rather than help slow it down.
The Surgical Option
Although surgery is not a welcome idea to most pet guardians, it may be the last resort in some cases of severe advanced arthritis. Pets who have not previously responded favorably to medications and/or therapy may find the greatest relief by way of hip replacement surgery, joint fusion, joint removal, or any number of other procedures. Talk to your veterinarian about your pet's specific options, their chances of success, and any risks involved.
For more information: