Ask the Vet: Arthritis by Stefanie Wong, DVM

Why is my pet limping?

Does your pet limp after chasing the ball in the park or going for a long hike? Does he or she have trouble getting up, especially in the mornings or after lying down for a long time? Do you now notice that he/she has difficulty doing things that previously were easy, such as jumping or going up and down stairs? If you said yes to any of the above, this article is for you. There are many different causes for limping in dogs and cats. This month, I will be focusing on one of the more common reasons we see, as well as the number one cause of chronic pain in dogs and cats - arthritis.
 

Arthritis is typically the result of:

1)  An abnormal formation of the joint, which your pet was born with (i.e. hip dysplasia or elbow dysplasia)

2)  Rupture of the cranial cruciate ligament in their knee (also known as the ACL in humans)

3)  Historical trauma to the joint
 

Image from: www.webmd.com/rheumatoid-arthritis/healthy-joint-vs-damaged-joint

Regardless of the cause, when there is abnormal weight bearing, excessive wear and tear, or trauma to the joint, over time the joint starts to undergo changes.  Normal joint cartilage is essential to a healthy joint – it acts as a shock absorber and allows the joint to move freely without any grinding or friction. Once arthritis and inflammation sets in, the joint no longer performs as it used to. The joint cartilage breaks down, exposing the bone underneath. This causes bone-on-bone grinding, which in turn causes pain. The joint fluid becomes thinner and is less able to lubricate the joint, and the joint capsule will thicken with scar tissue, which causes stiffness and decreased mobility.
 

Once this cycle is started, there is nothing we can do to stop it. However, there are a variety of different treatments that we can use to slow the progression of the disease.
 

What can we do to treat it?

• Weight loss: the less weight these joints have to bear the better! A study showed that Labrador puppies fed 25% less food had a significantly less clinical (pain related to) hip dysplasia when compared to their littermates! In some cases, getting them to an ideal weight can be enough to keep them pain free.

• Targeted exercise: With the loss of their joint cartilage, pets affected by arthritis no longer have shock absorbers in place. Therefore, from here on out, we should be limiting activities that can traumatize the joint further (i.e. uncontrolled running and jumping). Swimming and controlled leash walks are great alternatives.

• Glucosamine/chondroitin: Cosequin and Dasuquin are supplements that act by providing the building blocks necessary for re-building new joint cartilage and also act to prevent cartilage breakdown. They are given on a daily basis. It is important to note that you may have to give these for several weeks to months before seeing their peak effect.

• Adequan: Adequan is polysulfated glycosaminoglycan, which provides chondroitin sulfate (a building block for new joint cartilage). It is also thought to help inhibit cartilage breakdown, help create new joint fluid and facilitate joint repair. It is given as a series of injections (initially twice a week). 

• Pain medications: Often with arthritis, we reach for drugs called Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). These are great for treating musculoskeletal and joint pain. However, before starting your pet on a long course of this medication, we often will recommend bloodwork, to make sure there are no pre-existing kidney or liver issues. With chronic use, it is a good idea to check bloodwork every six months to one year. If your pet already has liver or kidney disease, there are other drugs that we have available to us.

  • It is important to note: please do not give your pet human pain medications! Tylenol, Ibuprofen/Advil and even aspirin can be toxic to them and at high doses, fatal.

  • Arthritis is rarely diagnosed in cats. However, there is a new medication that recently came out that is specifically labeled to treat pain in our feline friends. This medication is called Onsior. It is a Non-Steroidal Anti-Inflammatory Drug (NSAID) for cats. It helps to control pain by decreasing inflammation. The only drawbacks are 1) it's a pill, so hopefully your cat either tolerates pilling without a problem or you are a skilled cat piller, 2) it only is labeled for three days (three pill packs, each pill lasts 24 hours). 

• Acupuncture: We offer this at Bishop Ranch Veterinary Center & Urgent Care! Many of our canine and feline patients who have tried all of the above have gained additional mobility and comfort from acupuncture. Click here to read more about acupuncture.
   

Dr. Wong is a graduate of the Veterinary School at Cornell University in Ithaca, NY. Prior to veterinary school she completed her undergrad at UCLA and graduated magna cum laude with a B.S in Ecology, Behavior, and Evolution. She spent time in the rainforests of Nicaragua studying the poison dart frog and also spent three months living and working in rural villages in Tanzania with the non-profit Support for International Change. Dr. Wong completed a rotating internship at VCA West LA in Los Angeles and her special interests include soft tissue and orthopedic surgery as well as emergency medicine and dentistry. She is a San Ramon native and loves to spend time outdoors running, surfing, snowboarding, hiking, and kayaking.

Tags: arthritis, limping, acupuncture, joints