Management of Arthritis in Dogs

 Arthritis in dogs is most commonly osteoarthritis - inflammation of joints most commonly seen as dogs get older, influenced by genetics, body condition throughout life and presently and previous joint injuries and conditions.

Dogs are often stoic and do their best for as long as they can.  The signs of arthritis are subtle, such as being slower getting up, slower when going for walks and more deliberate negotiating stairs or getting into vehicles.  As the arthritis gets worse dogs that previously could, are not able to jump into higher vehicles without help.

(See previous blog on chronic pain and arthritis in dogs).

The factor that has the most influence on the effect of arthritis is body condition.  For those dogs that are overweight, weight loss is going to make the biggest difference.  Weight loss is not an overnight sensation and is not as simple as taking daily medication.  The best case scenario is awareness of the health benefits of a lean body condition and keeping dogs lean throughout their life.  (See previous blog 'What is a Healthy Weight for a Dog?')

Many older dogs are overweight.  Weight loss can be approached by reducing the daily amount fed including treats and other morsels.  There are also some useful diet foods available, some such as Hills joint and metabolic diet aid joint health as well as aiding weight loss.  Vets and vet nurses can help with weight loss, including explaining what a healthy and ideal weight is, recommending daily portions sizes and monitoring.

NSAIDs (non steroidal anti-imflammatory drugs) are the most common treatment for more advanced arthritis in dogs.  Examples of common active ingredients include meloxican (Metacam) and carprofen (Rimadyl).  These medications reduce inflammation and pain in a broad sense and increase comfort and willingness to exercise.

Physiotherapy, hydrotherapy with trained professionals and exercises that can be done at home are beneficial for dogs with arthritis.  Appropriate exercise for the degree of arthritis helps maintain mobility and muscle strength.

Nutriceuticals are oral medications which are intended to aid joint health.  Common ingredients include glucosamine, chondroitin, green-lipped mussel, Epiitalis™ and omega 3 and 6 EFAs (essential fatty acids).  

It is challenging to assess the effectiveness of medications for arthritis because arthritis in dogs is assessed subjectively and it is a condition that gets worse over time.  A realistic expectation is that the medication slows down the rate at which the arthritis progresses, which is difficult to assess.

In the earlier stages of arthritis nutraceuticals may help especially when combined with other management approaches.  As arthritis becomes more advances nutriceuticals are unlikely to provide sufficient pain relief on their own.

Other veterinary medications include pentosan polysulphate with or without acetyl glucosamine.  This is given as a subcutaneous injection, initially once weekly for 4 doses and then every 1-3 months.  This medication improves joint health and is useful for dogs with mild to moderate arthritis and in combination with some other medications.

Bedinvetmab (Beransa) is an injection which is focused on reducing the activity of an inflammatory protein called nerve growth factor which is commonly increased in dogs with arthritis and plays a lead role in the development of pain in dogs.  The injection reduces pain and consequently improves the willingness to move and quality of life of dogs. This is generally well tolerated although side effects can occur (1-10 out of 10,000 dogs).  Bedinvetmab is more often reserved for more advanced arthritis in association with consideration of the risk of side effects vs the benefit of improved quality of life in what is often the twilight years for the dog.

The comfort of dogs with arthritis can often be improved.  The first step is recognising the often subtle signs and understanding that medication can help reduce pain, improve mobility and function and quality of life.  Help with managing and easing arthritis in older dogs is something that home visits work well for.  Larger dogs are not so easy to get in and out of vehicles when they are unable to jump in themselves and most dogs are more comfortable at home.