Joint Disease

Chronic joint disease is common in older dogs and cats. Poorly formed joints (dysplasia), injury, or overuse may cause degenerative joint disease (osteoarthritis). Chronic joint disease may also occur secondary to previous infections with bacteria or the Lyme disease organism, or immune-mediated inflammation. Joint disease may cause muscle loss, limping, slowness on rising, reluctance to jump, climb stairs or play. Dogs rarely cry with chronic joint disease even if quite painful.

Diagnosis

Diagnosis of joint problems is based on a thorough history and examination. X-rays are often indicated and may require sedation. Special studies such as joint fluid analysis, bone scan, MRI or arthroscopy may be recommended.

Prevention

Puppies born with hip dysplasia who receive limited food have significantly better hips than similar puppies allowed to become overweight. Maintaining your pet at an optimum weight is important to avoid excessive stresses on the joints.

Regular exercise such as walking, jogging, and swimming helps maintain strength and flexibility. Excessive, infrequent exercise may cause fatigue and potentially damage muscles and joints. If your pet has been diagnosed with joint disease, avoid jumping, vigorous ball-playing and excessive stair climbing.

Some premium dog foods have included the nutritional supplements, glucosamine and chondroitin sulfate, to help preserve joint function. The amounts of these supplements are too low to treat active joint disease but may be useful to slow the progression of very minor joint problems.

Treatment

Weight loss is imperative for any obese animal. Gradual, consistent weight loss may be accomplished by feeding less of the regular food or switching to a controlled amount of a diet food, and eliminating high calorie treats.

Rest is prescribed for pets with sudden, painful joint problems to allow for recovery. Otherwise, consistent and controlled exercise is recommended (see prevention.)

Physical therapy may be demonstrated by your veterinarian and may include massage, passive range of motion exercises, and heat or cold therapy.

Surgery is indicated for certain joint problems and may be very effective at relieving pain and improving function.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce pain. Aspirin is useful in mild cases but causes stomach and intestine ulceration. Deramaxx and Metacam are prescription pain medications specifically formulated for the sensitive stomach and liver of dogs. These drugs are very effective and usually well-tolerated by dogs. Metacam may be used safely for cats. For chronic use of any NSAID, an initial and periodic blood testing is recommended to identify potential problems, such as underlying liver or kidney disease. All NSAIDs may have harmful side effects when combined with certain other drugs, especially corticosteroids. Do not use any pain medication not prescribed by your veterinarian. Most over-the-counter and human prescription pain medications are harmful and potentially deadly to dogs and cats.

Corticosteroids are used occasionally in dogs to reduce sudden inflammation and may be used chronically in cats.

Chondroprotective agents are nutritional supplements used to help preserve cartilage health and reduce pain and inflammation. These formulations are helpful in treating painful dogs and cats, and also in slowing cartilage damage due to injury, surgery, or abnormal joint formation (elbow and hip dysplasia.) Purified pharmacy grade glucosamine and chondroitin sulfate has been shown to be effective in treating osteoarthritis. Unfortunately, since these products are considered nutrients and not drugs, no claim to effectiveness, actual content, lack of contaminants, availability or even safety is required.

Adequan is the most effective chondroprotective agent. It is given by injection twice weekly for 1 month then once every month. Chondroflex is the best oral form available at this time. Other brands, although much less expensive, may use inferior or unavailable forms of the nutrients. It has been found that 70% of the products tested did not contain the amount of the nutrients stated on the label. Improvement due to chondroprotective agents may be noted after 2 to 6 weeks of the initial loading dose. If there is no improvement after the initial 6 weeks, this form of therapy will probably be ineffective. Gradually reduce the amount of supplement given every 4 to 6 weeks to the lowest effective dose and continue long term.

Nutritional supplements for joint health have been added to some higher quality dog foods. These foods have a much lower dose of the nutrients than is available in the capsules. The diets may be helpful to slow disease progression in dogs predisposed to joint conditions but not yet stiff or lame.

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