Ahh, the wonderful season of fall. The crisp cool air and crunchy leaves just beg for you to take your fluffy friend out on a long walk. Maybe even a jog for those ambitious health nuts among us. But what happens when you notice your companion taking longer than usual to greet you at the front door when you grab their leash? How do you cope and assist your pet when they are no longer as active as they once were in their younger years?
Most of us have experienced the sinking feeling of realizing our once active and rambunctious companion has slowed down bit by bit, seems less eager to jump in and out of the car, hesitant to come follow us upstairs for bedtime and unable to climb into our bed.
With an increasing life span thanks to medical advances, combined with an obesity epidemic, a significant number of dogs and cats develop some degree of osteoarthritis (OA) in their lifetime. It is estimated that at least 20% of the canine population is suffering from osteoarthritis. And this is not just a dog-specific disease. Despite their reputation for having a perfectly designed, highly flexible skeletal system, cats are also commonly afflicted by this degenerative process. A 2011 study using X-rays found that 61 percent of cats over the age of 6 had OA in at least one joint, while 48 percent had two or more affected joints. Cats older than 14 had an 82 percent chance of having arthritis. Because of the diverse range of presenting signs, OA is likely one of the most under diagnosed conditions in dogs and especially in cats.
What is Osteoarthritis (OA)?
There are multiple contributing factors to OA including genetics, age, body weight, obesity, gender, exercise and diet. OA is a chronic, progressive disease characterized by loss of articular cartilage that is covering and protecting the ends of bones where they meet each other to form a joint. In its healthy state the cartilage acts as a cushion between two bones. Without that cushion of cartilage for protection, the bone is essentially rubbing up against other bone in the joint space. When there is bone on bone, an abnormal process of new bone formation occurs around the joint (osteophytosis) as a response to increased instability and inflammation in the joint leading to pain. Signs of OA are often times non-specific and reported by owners as subtle changes. You might notice your pet has decreased activity, stiffness, occasional limping, inability to jump, or changes in gait such as “bunny-hopping”. Sometimes owners will report behavioral changes such as aggression or vocalization shown by their pet when asked to rise or move. It is often signs of pain observed by an owner that lead to an appointment at the vet’s office asking for help.
How do you diagnose OA?
Diagnosis of OA is usually made by a combination of physical exam and imaging such as X-rays. Initially I will watch a patient walk up and down the hallway of the clinic and perform a distance exam with a gait analysis that will help narrow down which specific joint(s) may be involved. Then I will palpate the limbs and joints to assess for painful response, thickening of joint capsule, accumulation of joint fluid (effusion) or sometimes osteophytes and muscle atrophy (wasting). Depending on the physical exam findings I will often recommend X-rays as an additional tool to help confirm my exam findings and rule out other causes for pain such as bone cancer or a fracture. On the x-ray I am looking for evidence of bony changes (osteophytosis) and assessing the severity of OA present.
What is the treatment for OA?
Treatment recommendations for OA are multimodal which means they include different approaches and can be either medical or surgical or a combination of both. Every patient is treated based on their unique case and all treatment decisions are made based on individual patients in discussion with the pet parent.
Dr. Little’s approach to treatment:
• Weight control. An overweight pet places additional force on joints causing more pronounced OA changes and can ultimately be more painful with limited mobility. See more information on how to prevent and/or reduce obesity in Dr. Jennifer Ramsey’s blog from October.
• Nonsteroidal anti-inflammatory drugs that are formulated specifically for canine and feline patients. Note: NEVER give over-the-counter NSAIDS as many can cause serious illness to pets. NEVER give any medication without consultation by your veterinarian and understanding of the potential risks
• Adjunctive pain medications are often prescribed if pain control cannot be achieved with NSAID use alone
• Joint supplements such as chondroitin sulfate, glucosamine, and omega-3 and 6-fatty-acid supplementation. These come in a variety of formulations such as prescription foods, liquids, chews, and treats.
• Chondroprotective injections (such as Aqequan®)
• Activity modification and physical therapy – I discuss with clients what type of exercise and PT techniques such as underwater treadmill work or laser therapy would benefit their pet. Although we do not have this equipment at our clinic we can refer to pet physical therapists or show you techniques you can practice at home
• Surgery is indicated in some specific cases depending on the cause and degree of OA
What is the prognosis for a pet diagnosed with OA?
Unfortunately OA is a progressive disease that will worsen with time. Despite there being no true “cure” for OA, I find this disease as one of the most rewarding to treat in practice. Often owners report feeling helpless or guilty for their pet’s pain and concerned about their quality of life. But because of the multimodal approach, there are so many tools for pain management and environmental changes that can improve your aging pet’s quality of life and mobility. Having a 14 year old cat and 8 year old large breed dog myself, I have a very big soft spot for the grey faces and geriatric pets I get to help make more comfortable every day at Great Plains SPCA’s Veterinary Care Center. For the month of November, senior pet exams are 50% off on Wednesdays. Call us at (913) 742-7310 to schedule your senior pet today.