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The Clinical Signs of Osteoarthritis | Arthritis Awareness Week Day 2

Full Interview Transcript 

Eric Shannon:

Hell, everybody. Welcome to Day 2 of Arthritis Awareness Week. Thanks for joining us today. I am here with two experts. I'm here with Dr. Hannah Capon and Dr. Gwen Covey-Crump. Dr. Capon is the founder of Canine Arthritis Management, which is a group she started in the UK, and she devotes her entire life to helping dogs with arthritis. Dr. Gwen Covey-Crump is a veterinary specialist who runs a pain clinic who treats tons and tons of dogs with arthritis.

Eric Shannon:

So, I'm really happy that they're both here with us today for Arthritis Awareness Week. Now, just to recap what Arthritis Awareness Week is, we are doing five days of events this week. This is day two. If you'd like the recordings for the other sessions, there's a link with this Facebook Live. It's www.bigbarker.com/aaw. Big Barker is the primary sponsor of arthritis awareness week, and we're thrilled to be playing that role because we make product that helps dogs with arthritis and dogs that are likely to get arthritis. So, this is a subject that's near and dear to our heart. We have a co-sponsor, Outward Hound, who is another wonderful company who makes lots of products that are good for dogs with arthritis, such as interactive toys, puzzle games, et cetera. So, I encourage everybody to go to bigbarker.com/aaw to make sure you get all these recordings. But with that being said, I'm going to leave it to you, Dr. Capon, take it from here.

Dr. Hannah Capon:

Thank you. So, hi guys. Thanks for coming back. It was really great to see you yesterday, and I hope we answered all the questions that you had. I'm so excited to bring my dear friend Gwen here today, because she really is an inspiration and started my journey. So, I'm going to throw right in the deep end and ask her, what are the consistent and reliable signs associated with arthritis? Over to you, Gwen.

Dr. Gwen Covey-Crump:

That's a really interesting question because I would say the key, they're consistent and reliable. There aren't many, to be honest, to be consistent, but I think the main ones, in order of importance that you will see, I think like slowing down, lagging behind on walks perhaps, getting out of bed less, interacting less, and then difficulty with demanding tasks like climbing the stairs, getting on the bed. A lot of owners notice, that not being able to get on the bed when their beloved pooch normally does that.

Dr. Gwen Covey-Crump:

And then people might start to see, what we see as muscle wasting, but you see as body shape change, skinny bottoms, big beefy shoulders, and then stiffness, stiffness especially after long periods of rest, lying in bed for a long period of time or excessively heavy exercise perhaps. And, stiffness really relates to pain in dogs, and it's actually pain in the joint they're experiencing, and not just in the joint.

Dr. Gwen Covey-Crump:

I think you can even start to see changes in personality. They don't want to play so much. They don't want you to touch them or groom them. And, I think everyone thinks that... Go ahead.

Dr. Hannah Capon:

So, when people are waiting for their dog to limp, because that's what [inaudible 00:03:10] with joint pain, therefore the obvious sign must be that they must limp. Does that happen?

Dr. Gwen Covey-Crump:

Yeah. And I was about to say that. I think everyone thinks that the dog's going to limp if it's painful, but if that dog's got pain in both its front legs or both its back legs, it might not be limping. It might just be walking a bit strangely or running a bit strangely. And, sometimes dogs have arthritis in several joints, so they don't know which to limp on. And, I wouldn't say that was a reliable, consistent sign, to be honest. And then, when you get into the advanced stages, you start to see swelling. Sometimes you can see visible swelling in the joints and tenderness. They don't like having their feet touched anymore, as an example. So, I think those would be the main things.

Dr. Hannah Capon:

I think one thing that a lot of people will be able to relate to is the dog that develops the big main and the big front [inaudible 00:04:03]. And they have that, as you say, skinny backend. And if you look at your dog and took a photo now and compared it to when they were younger and look at those body shape changes, that can be really quite pronounced, can't they?

Dr. Gwen Covey-Crump:

Yeah, yeah, yeah. It's something I see a lot, but I don't think I used to notice it, even as a vet, but yeah, I really noticed it now. It's really obvious to me.

Dr. Hannah Capon:

Yeah. And I think, it isn't obvious to owners who see their dog every day, so they don't see changes. So, maybe getting a photo out and [crosstalk 00:04:36] years ago and having a cross compare and think, wait a minute, actually, there's a lot going on there. But I definitely think over my time learning, I've been surprised at how subtle the signs can, because when people [inaudible 00:04:51] pain, when they think pain, they think it's going to be waack, really painful, but it could be quite subtle the way that they show us.

Dr. Hannah Capon:

So, next question then, please. Yeah. Why are these signs are often overlooked, ignored, or not even acted upon?

Dr. Gwen Covey-Crump:

Yeah, well I think it's because it's gradual. It comes up gradually the pain builds gradually. We know this from the human experience of arthritis. It doesn't suddenly appear one day. And so, because it's gradual, you learn to adapt to it, and that's the same for animals. It's a disease that waxes and wanes. So, they're going to have good days and bad days. And I think, if you see a bad day and then the following day, they're much better, you tend to sort of disregard it and think, oh, it'll be okay.

Dr. Gwen Covey-Crump:

And, then I think also people assume that the dog's just slowing down. I hear people say this all the time, just slowing down. And it's because it's getting old, and it's normal, and they think that the dog's going to cry out if it's painful. And they think the dog's going to complain somehow, and dogs don't do that with chronic pain. Humans don't do that. If you've got arthritis, you don't spend all your time screaming in pain. You might complain to your partner, but you complain verbally. And actually your partner can notice some of these other signs that we were mentioning before, and that, a dog that's in that sort of pain will still go and chase the cat, and it will still go and chase the tennis ball. And so, the owner assumes it's really happy. It can't possibly be in pain because it will run across the field after squirrel or a rabbit. We know that actually physiology means that that's going to happen, even if you're in pain.

Dr. Hannah Capon:

I think definitely advising people to look at how their dog is in a calm, quiet environment, rather than looking at how they are in a park with lots of other dogs and a lot of exciting stuff, and lots of distraction, and a lot of smells, how are they behaving in a very calm, home, safe environment? Because that's more of a true indicator of how they feel.

Dr. Hannah Capon:

And I think, the ones that break my heart quite a lot is when people assume the dog's lazy. That one really gets to me. I'm not lazy. I really hurt. So, I'm walking slowly, or I'm not interested in going out. So, I don't want to jump in the car, or I'm not interested in getting on the sofa or off the sofa. It's because I'm quite sore. And then, you have people that say, oh, he's just lazy.

Dr. Hannah Capon:

And then, the other one that really upsets me is when they decide that they're grumpy, and then I always become a [inaudible 00:07:28] and you're sitting there thinking, no, no. He's really sore. It's really painful. And he's telling you to leave him alone because he doesn't know where what you do to him might actually hurt.

Dr. Gwen Covey-Crump:

Yeah. Yeah, I think, yeah. So, I think people often put human emotions onto their pets, and yet they don't actually think about the source of it, even though actually they themselves would be grumpy if they were feeling that kind of discomfort. I'm grumpy when I have that sort of discomfort.

Dr. Hannah Capon:

Well, I think you taught me a real lesson a few years back. And you said, it's about change, Hannah. It's about seeing a change. If it might be a change in physical appearance. It might be a change in behavior. It might be a change in exercise ability, how far they can go, how agile they are, but it's a change that you wouldn't expect. And, I think anybody that's seeing a change in a middle age, young dog, somebody that's really good old for their time, then that needs to be checked out. Would you agree?

Dr. Gwen Covey-Crump:

Yeah, definitely.

Dr. Hannah Capon:

Okay. Next question. Ooh, tricky. How can people be sure that the signs they think could be related to arthritis actually are?

Dr. Gwen Covey-Crump:

Well, the problem is a lot of these things that we see could also be due to something else. So, it's really important that you get a vet to examine the dog, because actually there are other diseases that can also manifest as these sort of behavior changes and slowing down, et cetera, and usually that can be treated, sometimes, more sinister stuff that actually you need to know is going wrong rather than just assuming it's arthritis.

Dr. Gwen Covey-Crump:

And, if you take your dog to the vet, you need to let them, or encourage them even, to do tests. So, they'll need to do x-rays and joint taps, for example, to properly diagnose arthritis, and they'll have to sedate the dog to do that. But the problem is a lot of people, if you're completely led by your vet, vet's are so used to people not wanting to go through tests and things like that. That a lot of vet's just assume that a provisional diagnosis of arthritis is okay.

Dr. Gwen Covey-Crump:

Still, the point is you get a clinical examination, but if you encourage your vet, actually I do really want answers. I want to make sure this is the problem. Really, the only way to efficiently, properly diagnose arthritis is to do x-rays and take samples of joint fluid and things like that.

Dr. Hannah Capon:

Definitely agree with that. We run a community group called Holly's Army, and a regular feature is an owner saying, I don't think my vet really was interested, or didn't do what I wanted them to do. But when you actually say to the owner, so did you go in with a clear plan of what you wanted? Did you tell them exactly what you saw, exactly what you were thinking, and to seek their support and guidance to get to the bottom of it? It's quite often, I know as a vet myself, I'm looking at your facial expressions. I'm looking at your body posture. I'm looking at the way that you talk to me, and I'm trying to make sure I treat your dog to the best of my ability, but I also treat you and what you wanted. And if you come in, and you've been quite closed and not given me the green light to get on with what I'm supposed to do, you're very held back then, I'm going to be assuming that you actually don't want me to investigate it further.

Dr. Hannah Capon:

And, I think there's a big problem there. I think it'd be wonderful if this could be clearer. And yesterday, we talked about a document called the Suspicion of Chronic Pain document, and it is in the link. And, it's just a PDF that you can print out, and you can fill in what you see has changed in your dog. It might be a behavior change, a posture change, a physical change, like muscle mass loss, muscle mass gain, or a lameness or a gate change. Fill in what you see, take it to your vet, and say, this is what I see. This is what I suspect. What do we do now? How can we get the answer that we need? Would you agree?

Dr. Gwen Covey-Crump:

I love that. I think that's brilliant. I didn't know you had that tool.

 

Dr. Gwen Covey-Crump:

That's fantastic. That's fantastic. You know vets love it. People think we don't, but vets love it when you come with a list, as long as it's well thought out. I have to see doctors because I've got chronic health problems, and I know that I'll get the most out of my appointment with the doctor if I go with a plan of what I'm going to say to him, and the questions I'm going to ask, the answers I want to get. And, we should be doing the same in the veterinary context, actually planning what we're going to ask in a consult so you can get... Yeah, they're quite often quite rushed, quite often the consults are a bit short, and so you want, if anything, the owner can be rushing the console, worrying about the vet's time. So yeah, explain what you want.

Dr. Hannah Capon:

Yeah, it's a very difficult situation, isn't it? Because as vets, we've both experienced really constricted time, a small room, a slippery floor, a stress [inaudible 00:13:08], a waiting room full of people that you know you still got to see. And, you're trying to actually talk about something that's quite subtle and is going to affect the dog for the rest of its life.

Dr. Hannah Capon:

So other tips that I could give you is, your clinic might actually have an arthritis clinic. So they might actually do a pain clinic or an arthritis clinic, like Gwen does at her referral center, but they also might have a nurse clinic that specializes in either arthritis or senior dog care. You might be able to ask for a double appointment so you have more time. You might be able to ask, when you're booking your appointment, if you can have the appointment at the end of the [inaudible 00:13:52] session, just in case you needed a bit more time. You could ask if you could email what you think before the consult, so the vet is prepared with what you're seeing so they can get straight on with it. Silly little things like that can make a massive difference, in my opinion. Do you agree?

Dr. Gwen Covey-Crump:

Absolutely, absolutely agree. It can make such a difference.

Dr. Hannah Capon:

So have we got some questions, Eric?

Eric Shannon:

Yes, actually. We have a lot of comments going on. Let me just get this thing off of our heads. That's better. So, okay. So, let me pop a couple of these comments on the screen. So, lots of positive comments. They really like the discussion that you guys are having. So like right here, we have Kat Higgins says, "I'm glad to catch this one. My 1 1/2 year old golden doodle has double hip dysplasia. It's good to learn more of the effects and arthritis."

Eric Shannon:

I have a question here for you guys from Theresa. Says her dog is 16 1/2 years. "How do I know if she's in pain? She walks like a bunny hop." She says in another comment that she is on Cosequin.

Dr. Gwen Covey-Crump:

Both of those questions actually [inaudible 00:15:01] very comment from me, the first one with the really young dog with two hips painful, and the second one that is bunny hopping. And that's what I've seen most, is if you've got hip dysplasia or lumbosacral disease, which could be the source of the bunny hopping, this is what you see this funny bunny hopping gate.

Dr. Gwen Covey-Crump:

And just the other day, I was teaching my students online because we're doing most of our teaching online at the moment, some of the signs of chronic pain. And, I showed them a picture of a German Shepherd bunny hopping along, being videoed for bunny hopping along. And my students said to me, I had no idea that dog wasn't walking normally.

Dr. Gwen Covey-Crump:

So, this is really important for you to know as a vet, that bunny hopping is absolute classic for bilateral hindquarter pain, and particularly lumbosacral pain, pain in the pelvis where the spine joins the pelvis, or both hip pain. And so, yeah, I think bunny hopping could well be something that needs to be looked into.

Dr. Hannah Capon:

Yeah, and I think the first thing would be to go to a vet and have that checked out, give them the time, give them the information before you get there. So, this is a perfect case where you can get [inaudible 00:16:11] chronic pain document. You can fill in what you see, see if there's other things. You might had a change body shape, change behavior, take it with you and say, this is what I'm seeing. I'm concerned it's pain. What do we do next? And then work with them.

Dr. Hannah Capon:

Another thing that I think, again I learn it from you, Gwen, was that some case [inaudible 00:16:33] to treat on the assumption of pain and see what unravels-

Dr. Gwen Covey-Crump:

The response.

Dr. Hannah Capon:

The response. And I think a lot of people are in fear of this, and they shouldn't be. This is part of the diagnostic workup of, we believe this is pain. We're going to treat it as pain, and we should expect to see an improvement. And you work with that.

Eric Shannon:

I have another question for you guys. This is from Linda, "Does hearing the movement in the joints, like sandpaper relate to arthritis?"

Dr. Gwen Covey-Crump:

Yeah. But, they talk about in people. They talk about one of the signs is the sort of gritty feeling in your joint and the grating sensation. And, the dog can't describe that to us, can it? But if you can actually hear it when the dog walks past you, yeah. That could be. Yeah, you've got [inaudible 00:17:26] in the joint.

Dr. Hannah Capon:

Yeah. That's one of [crosstalk 00:17:28] signs. Yeah. So if you want to be really clever, it's called crepitus. So, here's some crepitus in my dog's joints, and then [inaudible 00:17:38] a little long bow in their head that goes, oh, arthritis. Yeah, definitely.

Dr. Gwen Covey-Crump:

It'll also make the vet think you know what you're talking about if you say crepitus.

Eric Shannon:

I'm going to put one final comment up here. This isn't a question. This is the kind of comment that makes me think of my dog, Hank. And Hanna, it might make you think of Holly. I'm putting this up because it shows, in my opinion, this is the problem with arthritis, and this is what can eventually happen.

Eric Shannon:

So, Jennifer Jackson says, "We had a dog named Rascal, and he wanted to go for a walk, but he knew that he couldn't, and he would cry because he wanted to go, and he knew that he couldn't." And to me, that's the saddest thing about arthritis is like when Hank, he was still 100% the same dog in the head as he always was. He wanted to go because he wants to be interacting with you. He doesn't want to let you down. And that to me is the saddest thing about arthritis. So, thank you for sharing that.

Dr. Hannah Capon:

I totally agree. And I really believe if people hear that, they'll realize the importance of identifying this disease early, when you've got lots and lots of options and they have positive outcomes, whereas there's still this tendency to wait until it's a real problem when you've run out of options, and we've got to stop. We've got to stop this. We've got to identify this disease early to get those best results.

Eric Shannon:

Right. Well, thank you, Hannah. Thank you, Gwen, for your time today. This was a great discussion that we're going to play as much as we possibly can, because I think it's super useful for people who might not be aware of the signs that the dog is facing a problem. So, I really, really appreciate you guys being here today.

Eric Shannon:

For anybody watching, remember go to www.bigbarker.com/aaw, which stands for Arthritis Awareness Week, and we will email you the recording of not just this video, but the other four as well. Plus, the resource that Dr. Capon mentioned earlier with the PDF, we'll send you as well. So, thank you, everybody. I really appreciate it. Have a great day. 

Shannon Wells

Big Barker's Marketing Director

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