Arthritis  

Osteoarthritis is a total joint syndrome characterized by progressive deterioration of cartilage in movable (synovial) joints, and results in pain and disability. Osteoarthritis affects approximately one out of every five dogs, and is probably the most common skeletal disease encountered in dogs. Left untreated, arthritis can destroy the pet's quality of life.

Who is Affected?
Dogs and cats can both be affected, though it is more commonly seen in dogs. There are no breed predilections, but larger breed dogs between the ages of 8 and 13 years of age tend to be over represented. Young, immature animals can also be affected due to hereditary or developmental disorders.

Causes of Arthritis

1. Primary (idiopathic) - Is thought to be the results of long term use combined with aging. This form of arthritis can be associated with a known predisposing cause (primary genetic or metabolic cartilage disorder, inflammation or immune responses or the normal aging process).
   **Typically this type of arthritis is the consequence of normal stresses on abnormal cartilage.
    

2. Secondary - Much more common form of arthritis, results from an initiating cause such as joint instability, trauma, osteochondral defects, joint incongruity (luxation or subluxation), and congenital or developmental abnormalities.
   **Typically this type of arthritis exhibits a degradative cycle. Progression is inevitable due to the breakdown of articular cartilage.

Symptoms of Arthritis

Osteoarthritis most commonly presents as lameness or a stiff gait. The pet experiences pain either from inciting trauma or the disease process itself. Pain leads to inactivity or decreased exercise, which often leads to weight gain. Muscle loses its tone and weakens and shrinks (atrophies) from disuse. The combination of obesity or weight gain and loss of muscle structure increases in the stresses on already compromised join structures.

Common complaints or signs from owners include:

• Loss of normal performance (reluctance to jump, climb stairs or difficulty getting up from laying down).

• Lameness

• Licking of the joints

• Stiffness (after rest, in cold weather, of after exercise)

• Joint swelling or pain (which can lead to aggression problems)

• Depression

• Loss of appetite

• Trembling or shaking

Diagnosis of Arthritis

1. History and clinical signs - usually described by owner.

2. Physical exam - lameness, stiffness of gait, decreased range of motion, crepitis, joint swelling and pain, and joint instability (ligament tears or luxations).

3. Diagnostic imaging - radiographs (x-rays)

4. Lab tests - lyme disease titers and other tick borne disease titers, Coombs and ANA titers (for immune mediated diseases).

5. Arthrocentesis

6. Arthroscopy

7. Surgical exploration

Treatment of Arthritis

Medical Options - Usually the first treatment tried initially.

1. NSAIDS - Nonsteroidal anti-inflammatory agents used to inhibit inflammatory mediators. Examples include: Rimadyl, Metacam, Etogesic & Aspirin.

2. Chondroprotective Agents - Used to stimulate synovicytes and chondrocytes to produce synovial fluid and regenerate cartilage. Examples include: Cosequin and Synovicre.

Surgical Options - Depending on age, use or requirements of the dog (pet vs. police dog vs. hunting dog), financial situation of the owner and/or failure of previously tried medical options; surgical intervention may be available.

Nutritional Management - Because obesity is associated with progression of arthritis, weight reduction is usually recommended. Weight loss results in decreasing the odds of developing arthritis, less joint pain and decreased needs for medications. Many diets include glucosamine chondroitin supplements that act as disease-modifying agents by improving articular cartilage or synovial fluid health. Therapeutic diets can assist in achieving and maintaining ideal body weight, and help to reduce stress on already arthritic joints.

Exercise/Other - Low-impact, controlled exercise can improve joint function and reduce pain. Light walking and swimming allow for weight loss without overstressing or overloading joints. Acupuncture, special bedding (soft and padded vs. waterbed), circulating warm-water blanket, portable ramps for the car and providing good footing at home.