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Arthritis and “Old Age”

Arthritis, or more properly, degenerative joint disease (djd), is one of my favourite educational topics with clients. Many people have the mistaken idea that dogs (and cats) become lame and less mobile with age. This is simply not so. When dogs seem a bit slow to get up, when they stop jumping up into the vehicle or the bed/couch, when they hesitate to climb the stairs, they are showing pain! They are not “getting old”. The pain is generally due to arthritis, although certainly back problems can be an issue at times. As a general rule our clients are completely unaware that their pet is in pain as they all expect the animal to be whining or crying when they are in pain. I remind my clients that dogs and cats do not exist in a world where they are aware of the existence of pain-killers. Pain to them is either bearable (in which case they suffer silently) or unbearable. It is only when the pain is becoming unbearable that owners will generally become aware of it. Of course by this point the arthritis has become quite severe.

My very favourite aspect of this disease is that we can do a great deal about it, especially during the earlier stages of the degeneration. This restores our patients to the happy, mobile, fun-loving critters that they were. There are many ways that we can make pets more comfortable with arthritis ranging from supplements to special foods to pain medications and anti-inflammatories and even chiropractic and physiotherapy modalities. Once we have made the diagnosis of degenerative joint disease in our patients we generally go through a series of “treatment steps” to help them.

The first step generally involves recommending a good quality glucosamine and chondroitin supplement, particularly ones with included Vitamin C, zinc and anti-inflammatory agents. There is a great deal of controversy presently concerning the method of action and the true value of these products. This is one of the few times where I lean on experiential knowledge. I have been using these products in my patients for decades, they always provide some level of relief and restore mobility to them. However they are only really effective during the early to middle phases of disease, by the later stages of arthritis there is so little cartilage left that their effect is minimal. Glucosamine and chondroitin are complex carbohydrate molecules (sugars basically) that are a part of the normal slippery surface of healthy cartilage. The concept behind these supplements is that when you take them orally these building blocks will become more prevalent in joint fluid, speeding up the repair mechanisms that are attempting to reduce the developing arthritis. In theory this slows the progress of the arthritis. The glucosamine also has some anti-inflammatory properties that make the joints less painful. Vitamin C is a free radical scavenger that reduces the amount of damaging chemicals being produced within the damaged joints. Zinc is an essential co-factor in repair enzymes that are trying to reverse the degeneration within the joint. Newer products that we have available have products called saponins within them that also reduce inflammation.

The next thing we recommend is the use of diets specifically formulated to provide high levels (and a very specific balance) of Omega-3 and Omega-6 fatty acids. In the appropriate balance these substances have been proven to significantly reduce inflammation in tissues. The one we prescribe most often (yes “prescribe”, these are literally prescription diets) is made by Hill’s and is called J/D. We also have other diets available, notably one called Joint Mobility made by Purina (also a prescription diet). At this point it seems that we get our best results with the J/D. When coupled with a good glucosamine and chondroitin supplement this diet has almost instantaneous effects that can be quite a pleasant surprise to owners.

The final step we have for controlling our patients’ discomfort is the most obvious one of all; pain killers and anti-inflammatory drugs. We generally leave these for last because we can often manage our patients for years on the previous therapies before they become uncomfortable enough t o warrant the use of pain-killers. We will perform blood profiles on our patients before putting them on these drugs and commonly repeat them a month after they have started on them. The purpose of this is to ensure that the patient is tolerating the drug well and we are seeing no ill-effects on their kidneys or liver.

An often neglected method of dealing with these problems is the use of physiotherapy. Physiotherapy can have dramatic results on humans and animals when it comes to managing and compensating for chronic pain. Anyone who has had a bad back can attest to the effectiveness of having that back restored to normal positioning by a chiropractor or a physiotherapist. It is truly amazing how many seemingly unrelated painful problems can all come back to a bad back, hip or knee and the way you have been walking abnormally as you compensate for the problem. Many people have specialized training in this area including Edith Trussler

So, please, don’t dismiss your pets’ lack of mobility as old age. Visit your vet and have a discussion about arthritis and all of the things that can be done to increase the quality of your their lives.

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