Osteoarthritis

Osteoarthritis is a chronic progressive disease that alters the articular cartilage, subchondral bone and synovial lining of the joint. The degenerative change begins long before clinical signs are apparent.

If the treatment(s) can be initiated prior to clinical signs long term control is more effective and will last longer.

There can be many contributing factors to this disease.

1. Breed – Some breeds seem to have a predisposition to developing arthritis. Labradors Retrievers, German Shepherds and Rottweilers are just some of these breeds.

2. Trauma – Previous injury that involves bones and joints may predispose to the development of arthritis later in life. Injuries such as HBC(hit by car), fractures and ligament injuries.

3. Weight – Being overweight increases the load that the bones and joints must carry. This will speed up the degeneration process of the cartilage and subchondral bone.

4. Joint Instability – Some breeds have inherited joint problems that predispose them to joint instability and development of arthritis. Example: CCL(cranial cruciate ligament rupture), hip dysplasia, medially luxating patellas and elbow dysplasia.

Some of these factors are within our control; the others we have to minimze the best way possible.

Medical management can produce pain free results but must embrace a multifactorial regimen. The factors that we must look at are:

1. Weight control

2. Proper nutrition

3. Exercise control

4. Physical therapy

5. NSAIDS

6. Osteoarthritis disease modifying agents

1. Weight Control – Obesity increases the load bones and joints must carry. Because of the increased load on the cartilage and subchondral bone an acceleration of loss is seen. As a result we see an increase in the level of pain and inflammation associated with osteoarthritis. Loss of excess weight will reduce the impact of everyday movement on these joints which will have a direct impact on reduction of discomfort. When your pet is overweight the pet is more uncomfortable and this leads to more inactivity which leads to more weight gain. Studies have shown that many pets become pain free just by losing excess weight. Keeping your pet at its optimal weight life-long can be a factor in avoiding osteoarthritis all together.

2. Proper Nutrition – Important in many ways for all life stages but especially in geriatrics. Proper diet choices will help control weight but also avoid other health concerns. Controlled salt intake, protein intake and the choice of high quality, highly digestible protein sources are important concerns. Essential fatty acids (EFA’s) should be included into the dietary regimen since they are effective prostaglandin inhibitors.

3. Exercise Control - Exercise brings multiple benefits to all geriatric programs. These benefits include movement of muscles and joints which maintains strength and tone of muscles, range of motion in joints and joint fluid stimulation. Other benefits are weight control, mental stimulation and a reduced need for analgesics. Types of exercise to use are low impact exercise. Swimming and walking are two excellent examples of low impact activities. Chasing the ball, frisbee or running around the yard should be discouraged due to strain on joints.

4. Physical Therapy – The physiology of bones and joints is very similar between humans and canines/felines. It has been well documented that physical therapy is important in surgical recovery, disease recovery and disease maintenance. Movement of muscles, bones and joints helps in maintaining strength and tone. Movement also helps joint fluid production and maintains range of motion.

Passive range of motion therapy, muscle massage, hot/cold packs, etc., may be very helpful in keeping an osteoarthritis patient comfortable and reducing the amount of medication necessary.

5. NSAIDS - Non steroidal antiflamatory drugs are common over-the-counter drugs. Examples of these drugs are aspirin, ibuprofen, ketoprofen etc. There are two categories of NSAIDS, selective and non-selective. Human and veterinary medicine prefer to use selective NSAIDS. These help reduce side effects because they have a narrower mode of action. However side effects may occur with any of these drugs. NSAIDS are effective because of their inhibition of prostaglandin cycles. They also can have a direct antipuretic analgesic effect. Please ask us about which of these NSAIDS are safest for your pet.

6. Osteoarthritis disease modifying agents - Products in this category are what are commonly called “neutra–ceuticals.” There are now some studies that have shown benefit in both veterinary and human medicine. These products are mostly effective if used in the early stages of osteoarthritis. They work by increasing the levels of glycosaminoglycans produced in the joint. GAG’s/glycosaminoglycans are produced in the matrix of the cartilage. If the joint’s cartilage is severely damaged or destroyed these will not be effective.

The most effective agent seems to be a combination of chondroitin sulfate and glucosamine hydrochloride. There is a huge discrepancy between available products as to their percent bioavailability. This means how much of each drug is present and how much can be absorbed and used by the body. Some of the products on the market have a bioavailablity of 10% or less. Since these products are expensive this can be a huge waste of money. Also EFA’s should be included in our supplement program. These are inexpensive products with no side effects and are very effective in blocking prostaglandin production. This helps reduce inflammation.

Our staff can help you and your pet begin an osteoarthritis program if you are interested. Please let us know if you have any questions or concerns we can address.