(7/2021) Dogs and cats get arthritis too just like humans. There are two types. Primary results from wear and tear on joints related to aging. Secondary is the result of trauma or a congenital defect like hip dysplasia or elbow dysplasia where the joint doesn’t form correctly, which leads to joint damage. Arthritis, osteoarthritis (OA), and degenerative joint disease (DJD) all mean the same thing. There is degeneration of the joints, which leads to swelling, thickened joints, excess fluid in the joint and pain. There is decreased range of motion and muscle weakness and atrophy (loss of muscle mass), which can be seen and felt. The disease can be managed but not cured.

Symptoms

Dogs show more obvious signs. Commonly, lameness or stiffness are seen especially after laying down or sleeping.

Cats are very good at hiding signs. There may be subtle signs such as being less playful, laying down more, and not jumping up on things. They may take the stairs more slowly and deliberately by bunny hopping up or pulling themselves up with the front limbs or going down stairs sideways one step at a time and often taking breaks along the way.

Arthritis causes pain and effects a cat’s emotional state as well as physical well-being. Things to be aware of are a cat’s energy level, comfort level, and how happy they seem to be. Note any personality or sociability changes. Observe litter box habits. Reluctance to go into the box, difficulty getting in, and having accidents outside of it can warrant cutting down the entrance for easier access.

Zoetis Petcare has a Cat Osteoarthritis Pain Checklist to fill-out which you can then share with your veterinarian.

OA can effect dogs and cats of any age. It has been documented in greater than 60% of cats 6 years of age and older. One study showed that 90% of cats over 12 years old had signs on radiographs of OA. About 25% of dogs are diagnosed with OA in their lifetimes, and 60% of dogs have evidence of it on x-rays.

Diagnosis

This is based on the history, physical exam findings, imaging (like xrays) and medication trial response.

Physical Exam Findings in Dogs

Lameness, favoring at least one limb, is most common. It may be seen once in awhile, get progressively worse, or persist. After rest, there is more stiffness. With use and warm up of the joint, it may improve in function. It can also get worse with over-exertion.

Physical Exam Findings in Cats

Lameness is not so obvious. You can see decreased activity, behavior change such as being irritable (i.e. not allowing brushing of the coat anymore), decreased self-grooming with unkempt hair, and difficulty maneuvering in and out of the litter box.

So your pet has been diagnosed with arthritis. Now what can you do about it? This disease cannot be cured, but rather we concentrate on the prevention of progression.

There are 5 main principles for management of this disease. A multi-modal approach is required encompassing these categories: 1 - Weight management, 2 - Use of nutritional supplements, 3 – Medications, 4 - Physical Rehabilitation, 5 – Exercise.

Getting pets down to their ideal weight is the most important thing to do to prevent or treat osteoarthritis. This will decrease forces on joints, cartilage, bones, and soft tissues. It slows degeneration and reduces pain. Weight loss relieves lameness and pain.

Weight management begins with knowing your dog or cat’s Body Condition Score (BCS) and target weight. Your veterinarian can help to determine these values and setting up a plan to reach the goal of the ideal weight.

Keep this is mind. Nestlé Purina Lab found that dogs fed low calorie diets lived an average of almost 2 years longer than the dogs eating 25% more food per day. Also the dogs eating fewer calories had a lower rate and later onset of chronic disease (such as osteoarthritis). Osteoarthritis is more likely in dogs given more food and developed earlier in life. It was also more severe and more medications were needed to treat the pain from osteoarthritis.

The total daily allowance of calories needs to include all sources of food: meals, snacks, table food. Ideally, table food should be limited to none. Healthier snacks would include raw (cleaned) or steamed vegetables such as green beans, peas, baby carrots, broccoli, and cauliflower. Also, ice cubes and rice cakes are acceptable. Avoid starchy foods such as potatoes, rice, bread or baked goods.

Nutritional Supplements and Medications

Once again check with your veterinarian before starting supplements and medications. Some can be used together and some should not be. It is not advisable to do-it-yourself.

Nutritional supplements are considered slow-acting with mild effects. It can take weeks to build up their levels in the body. These products are not well-regulated and companies do not have to prove their efficacy. They are only required to show safety. Good quality control is not required either.

• Glucosamine-acts as anti-inflammatory, limits joint destruction and pain, helps cartilage healing
• Chondroitin-controls water within cartilage
• Glucosamine and Chondroitin are commonly used together. They can reduce the need for Non-Steroidal Anti-Inflammatory Drugs (NSAID)
• Methyl sulfonyl methane (MSM) - this provides building blocks for cartilage repair, has anti-inflammatory properties and may act as an anti-oxidant
• Omega 3 Fatty Acids-take about 1 month to show effects. Fish oils are better because they have more bioavailability than flax seed oil for pets.
• ASU-Avocado Soybean Unsaponifiables-provide cartilage repair and inhibit inflammation associated cartilage degradation. Gives DASUquin its name.
• Green-Lipped Mussel Extract-this can provide mild pain relief. It can take weeks to see positive effects.
• Anti-oxidants and free radical scavengers- examples are Vitamin C, Vitamin E, S-Adenosyl methionine (SaMe), Super Oxide Dismutase (SOD)

Anti-Inflammatory medications (NSAIDs)-fast acting, prescription-only medications

Use only one of these at a time. They can be used with other classes of products (i.e. Nutraceuticals/nutritional supplements above). These medications work by blocking the activity of cyclooxygenase (COX) enzymes which produce "bad" prostaglandins which control pain and inflammation. The problem is that "good" prostaglandins are affected too. These maintain kidney and stomach health. The goal is to inhibit the bad prostaglandins while sparing the good ones. Some examples are carprofen (Rimadyl) and Meloxicam

There is a newer class of NSAID called Piprants which work differently from the other medications in this class. The first in this class is Grapiprant called Galliprant and it is now available.

Human over-the-counter NSAIDs suppress good and bad prostaglandins. They are not good for dogs and are very bad for cats. This is because cats have a very sensitive liver, which processes the medication very slowly so they can build up toxic levels. There is a low number of products approved for short term use in cats. There are no approved NSAIDs for long-term use in cats in the USA.

Straight Pain Relievers

These medications can be added to an NSAID. They work on pain pathways without any anti-inflammatory properties; hence they do not alter the disease process (unlike NSAIDs). Gabapentin is used especially for neurologic/spinal pain. It can cause drowsiness. Tramadol-can be used in cats, but does not taste good. Has been found not to be very effective in dogs.

Consult with your veterinarian for information on these products and where to find them. Often you can get them directly from your vet’s office.