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The Definitive Guide to Canine Arthritis

Dr. Sarah Wooten

Veterinarian

Learn about Dr. Wooten

Table of Contents

What Is Canine Arthritis?

Every Joint is at Risk

Heavier Dogs Get Hit The Hardest

Danger Signs To Spot

Diagnosing Canine Arthritis

What to Expect at the Vet

A Simple “Home Test” For Arthritis

Is Your Best Friend Suffering In Silence?

Treatment Options

What Treatment Is Best For My Dog?

Weight Management

Why “Weight Creep” Can Shorten A Dog’s Life

How To Tell If Your Dog Needs To Trim Down

7 Tips and Tricks for Healthy Weight Loss

Support from Supplements

Start Supplementation Before The Pain Starts To Show

Pros and Cons Of Adequan® Injections

Can Hyaluronic Acid Injections Help?

 

Anti-inflammatory and Pain Medications

NSAIDs

Common Side Effects

Avoid Buffered Aspirin?

The Scandal Around Steroids

Tramadol and Gabapentin

What About Alternative Therapies That Don’t Involve Drugs?

Why Dog Owners Love Laser Therapy

Acupuncture

Massage Therapy Hits The Spot?

Therapeutic Ultrasound

Electrical Stimulation

Heat and Cold: A Trick From The World Of Sports

Physical Therapy Grows In Popularity

Impressive Results From Stem Cell Therapy

Platelet-Rich Plasma

When to Consider Surgery

Is Surgical Repair The Answer?

Cranial Cruciate Ligament Tear

 

Joint Dysplasia

Additional Surgical Procedures

What Can l Do To Help At Home?

High-Quality, Supportive Sleeping Surface

Nail and Foot Care

Sweaters and Jackets

Low-Impact Exercise, Shorter Sessions

Swimming

Almond Oil Massage 

The Most Difficult Decision Of All

Responsible Arthritis Prevention

Know Your Dog’s Genetic History

Work With A Reputable Breeder

Diet control

Delaying Spay/Neuter

FAQ Video Library

References

What is Canine Arthritis?

Canine arthritis is the most common musculoskeletal disease encountered in dogs. It’s caused by progressive deterioration of cartilage found in joints. 

Arthritis has several names. It can also be called “degenerative joint disease” and “osteoarthritis.” Whatever you call it, we can all agree on one thing: it’s painful. Arthritis is a debilitating disease that limits a dog’s ability to function and move normally. 

A normal joint is made up of cartilage, bone, ligaments, tendons, and a joint capsule that encases all the structures and bathes them in a lubricating fluid called synovial fluid. In arthritis, each of these structures is affected, the cartilage breaks down, synovial fluid decreases leading to loss of lubrication, bone spurs develop, and ligaments and the joint capsule thicken and lose their blood supply, leading to irreversible changes that increase stiffness, decreased range of motion, and cause pain. 

Take a peek at what all these different parts of a joint look like when the joint is healthy and when it’s arthritic:

Images courtesy of Bothell Pet Hospital

Every Joint is at Risk

Arthritis causes pain when the cartilage that coats the ends of bones in joints wears away, allowing the bones to rub and grind together. Arthritis is a progressive disease, which means it gets worse over time. Once damaged, cartilage is very difficult to heal because the blood supply to joint tissues is limited.

Image courtesy of Bothell Pet Hospital

Arthritis causes varying amounts of pain, swelling, and stiffness. All joints are at risk of developing arthritis, from spinal vertebrae, to hips, to elbows and toes. The difference between normal hip joints and arthritic hip joints:

Images courtesy of North Downs Specialist Referrals Veterinary Services

Heavier Dogs get hit the Hardest

Arthritis can result from developmental disorders such as hip and elbow dysplasia or osteochondritis, which is a problem with the cartilage lining the joints. These developmental disorders can be caused by a combination of genetics, i.e. passed down from mom or dad, and environment, i.e. imbalanced nutrition and excessive exercise at a young age. 

Looking for more information on hip and elbow dysplasia? Check out our Definitive Guide to Hip Dysplasia

While arthritis can also be caused by old-age wear and tear, it is usually a secondary disease with an underlying problem. If the underlying cause is not treated, arthritis develops slowly, and the symptoms get worse over time. 

For example, If your dog suffered an acute injury such as a torn cruciate ligament in his or her knee, you would notice your pet limping suddenly for a while, then get better, and then slowly get worse as degenerative changes and arthritis set in. In this case, the best chance at halting arthritis is treating the acute injury with surgical correction as soon as possible.

According to Vet Street, approximately 65% of dogs between the ages of seven and eleven years have some degree of arthritis, with a greater proportion occurring in larger, heavier dogs. 

Any dog that has ongoing lameness or stiffness may be suffering from arthritis, but large dogs (greater than 60 pounds), working dogs, canine athletes, and obese dogs are all at higher risk for arthritis because more stress is applied to their joints as they move. 

While arthritis is of concern to all dog owners, large-dog owners are particularly aware of this condition as their pets are more likely to suffer from the effects of arthritis at some point during their lives. The reason comes down to a simple matter of physics: more weight on the shocks and struts will cause them to break down more quickly. And soon, the dog has a hard time getting around. Because the animal is big, the problem becomes big. You can put an arthritic chihuahua in your purse and carry him around with relative ease; it is NOT the same story with a 150-pound Great Dane.

Danger Signs to Spot

Dogs do not develop arthritis overnight; the early signs can be subtle and varied, causing you to miss a critical time period where treatment might arrest the progression of this disease. 

Watch out for these signs: 

If your dog is showing any of these signs or a combination thereof, it is important to get him or her to a veterinarian ASAP. Arthritis can strike at any age, so don’t assume that a younger pet may not be experiencing an arthritic condition.

Diagnosing Canine Arthritis

What to Expect at the Vet

During your visit, your veterinarian will take a history from you and do a full examination of your dog. This will usually include you walking and trotting your dog around so the veterinarian can assess your dog’s gait. Your veterinarian will then feel all of your dog’s bones, muscles, and joints. They will test for pain by moving the joints through their range of motion while feeling the joint for any swelling or crepitus. Then your vet will most likely check neurological reflexes as well. When there is thickening, arthritis, or degenerative changes around a joint, your dog will show fairly predictable patterns with each joint. 

Your veterinarian will feel for muscle mass on your dog while he or she is standing and compare muscles on each side. Arthritis anywhere in a leg will cause loss of muscle mass over the entire leg, not just around the affected joint. Just because your pet has a bony hip does not automatically mean your pet has hip pain; instead, they may be experiencing knee or ankle pain. Also, loss of muscle mass can be secondary to spinal or nerve dysfunction; your veterinarian will determine whether the condition is musculoskeletal or neurological.

A Simple “Home Test” for Arthritis

You can do the same thing at home: Make sure your dog is standing as straight as possible with the legs in similar positions. Run your hands over the shoulders and hips and back legs, noting if one side feels bonier than the other side. 

 

One thing to be aware of: some dogs with arthritis can also have muscle gain. Dogs with long-standing arthritis in the hind legs will often have very muscular front limbs and chest and thinner muscles over the back legs. This is because the dog uses the front legs to haul himself up and shifts all weight onto the front legs when walking. Watching for muscle gain or loss is an easy and non-invasive way to monitor your pet, even during therapy.

Based on the physical exam, your vet may recommend diagnostic testing, including X-rays and possibly bloodwork to rule out other conditions or determine if your dog is able to safely metabolize pain medication. Additional diagnostics that may be recommended include joint fluid analysis, ultrasound, CT scan, MRI, arthroscopy, or bone scans.

Rest assured, if your dog is diagnosed with arthritis, there are many options available to help your best friend feel better. The trick is finding the right combination of therapies. Your veterinarian will be your best guide in finding this magic combination.

Is Your Best Friend Suffering in Silence?

One of the most difficult aspects of managing arthritis is that, just like with people, every dog is an individual, so each will respond to the disease differently. Like people, some dogs are very stoic and brave and won’t show any pain even with severe changes noted on an X-ray or in a physical exam. 

On the opposite end of the spectrum, some dogs act very painful or limp even when the radiographic (X-ray) signs are very mild. The goal of any treatment plan should be to eliminate the underlying cause (where possible) and minimize pain and loss of function caused by the disease. 

The basic goals of treatment are: 

Treatment Options

What Treatment is Best for my dog?

One of the terms you may hear your veterinarian say is “quality of life.” When your veterinarian says this, he or she is talking about minimizing pain and maximizing function and mobility, i.e. your dog’s ability to get around, not feel pain, and do the things he or she enjoys. 

There are many options available to help your dog have a better quality of life. This usually involves some combination of therapy, including decreasing the compression forces felt on the joints through exercise moderation and weight reduction (if needed), maintaining or increasing joint mobility with therapeutic range-of-motion exercises, maintaining muscle mass via good nutrition and weight-bearing exercises, and pharmaceutical options for pain control. 

Your veterinarian will work with you to determine the best combination of treatments to minimize pain and maintain mobility in your dog. The goal of any and all therapy should be to minimize pain and keep your pet as active as he or she wants to be—which, as we know, is different for all dogs. Activity in a two-year-old Border Collie agility champion is definitely different than that of a thirteen-year-old Labrador Retriever. Your veterinarian will likely want to restore full function, or as close to full function as possible, to your dog. However, it is important to clearly communicate your expectations to your veterinarian so you can work together as a team for the good of your dog. Make sure to tell your veterinarian about any financial or time limitations as well as your own physical limitations. Taking all of these factors into account will help your veterinarian design the best treatment plan for you and your dog.

Weight Management

One of the most important, effective, and least expensive things you can do to help relieve the pain and suffering associated with arthritis is to make sure your dog’s weight is on the lean side. 

Why “Weight Creep” can Shorten a Dog’s Life

Just like with people, our pets are what they eat. By and large, dogs in our society are very fortunate: they actually eat better-balanced diets than many people. Feeding your dog the correct amount of a high-quality diet can have excellent health benefits. Unfortunately, despite the advancements in pet nutrition, many dogs still experience dietary problems that cause obesity and exacerbate the signs of arthritis. These problems usually stem from too much dog food, people food, and treats (calories), and not enough exercise.

Just like in humans, the pounds can creep up on our dogs little by little over time. An overweight dog is not a healthy dog: He or she moves slower, tires more quickly, has a lowered immunity and is prone to joint disorders such as arthritis.

Being overweight is the primary factor in making the signs of arthritis worse AND in causing arthritis to progress faster.

Being overweight also increases the cost of medications and other treatments. A 2001 report completed a fifteen-year longevity study in Labrador Retrievers and their findings were eye-opening, to say the least. The dogs that were fed a low-calorie diet and were fed 25% less than the control group lived an average of twenty-two months longer and had a lower incidence and later onset of chronic diseases, including arthritis. 

American dogs are too fat, and unfortunately, the bigger fat cells get, the worse they misbehave.

Recent research has shown that fat also functions as an endocrine organ, in that it secretes hormones. The bigger fat cells get, the more of a bad hormone they give off, causing increased appetite, decreased metabolism, and the release of an enzyme into the joints causing the joints to become painful. There is good news, however: As the fat cells shrink, all of this joint-damage reverses. 

Watch Does a Little Extra Weight Put Your Dog at Risk? to learn more about canine weight management.  

How to Tell if Your Dog Needs to Trim Down 

To evaluate your dog’s weight, your veterinarian will use a body condition score (BCS). The score is evaluated on a scale of 1 to 9 (or 1 to 5 depending on the chart they utilize) to judge the amount of fat on a dog’s body. A BCS of 1 is a severely underweight dog, a BCS of 9 is a severely obese dog, and a BCS of 4-5 is just right. You can tell if your dog has a BCS of 4-5 at home by feeling their ribs when they are standing. If you can feel ribs but not see them, that is ideal.

Ask your veterinary team for assistance in determining your dog’s BCS and to formulate a plan to get him or her to a healthy weight if needed. If your dog is overweight, it is also a good idea to get your veterinarian involved before you start a weight-loss program in order to eliminate the possibility that your dog has concurrent problems. For example, hypothyroidism or Cushing’s syndrome are common hormonal conditions that can make it difficult, if not impossible, for your dog to lose weight without treatment. 

As the most qualified person on your dog’s care team, your veterinarian will assess your dog, determine a healthy goal weight, help you determine daily calorie counts, and help assess your dog’s progress. Monthly weigh-ins will help you determine if your weight loss program is effective. 

If your dog needs to lose weight, the safest approach is to control the number of calories he or she eats each day. To determine a goal, a general rule of thumb is to aim for a loss of 15% of body weight. For example, if your overweight dog weighs 75 pounds, then your goal weight is 64 pounds. 

Later on, you and your veterinarian can decide whether additional weight loss is necessary. If your pet is grossly overweight or just a couple of pudgy pounds over, and the 15% weight loss doesn’t fit your situation, ask your veterinarian for a goal weight. Your pet should be able to reach his or her goal weight within 3-6 months and lose 1-2% of body weight each week. 

Here are 7 tips for healthy and long-lasting canine weight loss. 

Support from Supplements

In theory, joint supplements produce anti-inflammatory effects or stimulate positive effects on cartilage metabolism. 

Research into the efficacy of these supplements is still growing, but the relatively low incidence of side effects, growing body of supportive research, and anecdotal success warrant their use in arthritis cases. The right supplements may help ease the pain of arthritis, protect cartilage, and reduce the need for anti-inflammatory medication. There’s an often confusing plethora of oral products to choose from, and sometimes it can be difficult to determine the quality and bioavailability (i.e., how much of the ingredients actually make it into your dog’s joints) of the products. Your veterinarian is an excellent resource in helping you choose the most effective supplement for your dog.

Look for supplements that include the following ingredients: 

Additional ingredients to consider:

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Start Supplementation Before The Pain Starts To Show

Joint supplements should be considered as a therapy for any dog suffering from arthritis, but new science suggests that we should begin prophylactic supplementation even before the symptoms and signs of arthritis appear. It is thought that this may protect healthy joint function for as long as possible by ensuring the tissues receive the nutrients they need. 

Many veterinarians are now recommending that owners of large or giant breed dogs start joint supplements around age 4 as a preventative measure. While there is no science that prohibits starting joint supplements in dogs younger than 4 years of age, it is recommended that you wait until your dog is fully grown (anywhere from 12 months to 2 years of age, depending on the size and breed) before giving any joint supplements.

Although the evidence supporting the efficacy of joint supplements remains somewhat contradictory, there does appear to be value in joint supplements and little risk to the health of the dog, other than the occasional report of an upset stomach. Unfortunately, these products are unregulated and do not have to provide any guarantee of efficacy. 

At this time, the government does not require testing and regulation of the nutraceutical industry. So be sure to do your homework and give your dog brands that have been tested for quality and content by an independent third-party laboratory. The FDA has posted a list of guidelines for choosing quality supplements on their website: http://www.fda.gov/Food/ DietarySupplements/

Joint supplements are also formulated into therapeutic diets (i.e. Hill’s J/D, Purina JM, Royal Canin Mobility Support). These diets can only be dispensed under a veterinarian’s supervision. 

Pros and Cons of Adequan Injections

Adequan® is a nutritional supplement that is injected intramuscularly or subcutaneously twice a week for eight doses. In theory, Adequan® strengthens cartilage to limit further damage and promotes healing in damaged cartilage. Recent studies have shown that Adequan® does decrease lameness in dogs and promote healing of cartilage, but other studies have been inconclusive.

Image courtesy of Adequan

Adequan® has been around for quite some time and does seem to ease pain and improve mobility in some dogs. Adequan® is more effective in cases where the cartilage is likely to heal, such as in fractures that involve the joint or acute cranial cruciate ligament ruptures. It is less effective in chronic arthritis cases where the cartilage is too damaged to heal. Adequan® doesn’t have any widely reported side effects. It does require trips to the veterinary hospital twice a week for four weeks unless the owner is willing to learn to give the injections at home, and it can be pricey. Adequan® limits blood clotting, but bleeding is rarely a problem unless Adequan® is administered in combination with other drugs that limit clotting, such as aspirin. Make sure to talk with your veterinarian about drug interactions.

Can Hyaluronic Acid Injections Help?

Hyaluronan is an important component of joint fluid and is found in cartilage. Hyaluronic acid is administered to promote healthy joint fluid and to reduce the pain caused by joint movement. In human medicine, the pain-relieving effect of hyaluronic acid may last longer than steroid injections. Other potential effects are also being investigated. 

There are a couple of drawbacks to hyaluronan injections. The hyaluronic acid preparations on the market in the United States are not approved for intra-articular (inside the joint) use in dogs. The scientific proof of the efficacy of hyaluronic acid is not strong in either veterinary or human medicine. However, as the risks associated with intra-articular medications are in general rather small, they may be worth trying in certain cases. According to the manufacturer, about half the dogs treated with hyaluronan injections will respond positively. The only way to tell if 

Hyaluronan injections are working is to observe your dog after treatment. Reported improvements are noted as early as 2 weeks, and effects can last up to 6 months.

Anti-inflammatory and Pain Medications

Anti-inflammatory drugs are often used to treat arthritis. In many cases, these drugs can do amazing things to improve your dog’s pain and mobility, but they can have negative side effects and require additional monitoring by your veterinarian.

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The main anti-inflammatory drugs available are NSAIDs and corticosteroids. 

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most prescribed medication for the treatment of arthritis in people and dogs. NSAIDs reduce pain, fever, and inflammation of many conditions. There are many NSAIDs that have been developed specifically for canine use. They are available only by prescription, and because of potential adverse effects (liver or kidney toxicity, GI upset, blood cell count abnormalities, and skin abnormalities), careful adherence to dosing is required, and periodic monitoring of blood work is usually needed. 

To choose an NSAID, work with your veterinarian. Just because one doesn’t provide pain relief or has negative side effects doesn’t mean another NSAID won’t work better. Dogs have individual responses to medications, just like humans.

NSAIDs are often started in conjunction with a joint supplement, weight loss, laser, or other treatment, and often the dosage can be decreased and sometimes eliminated as the other therapies begin to take effect.

Common Side Effects

Never give any NSAID at the same time as aspirin, corticosteroids, or other NSAIDs. Acetaminophen (Tylenol) and ibuprofen (Advil) have many potential adverse side effects and are not recommended for use in dogs. Even though they are more expensive, the brand name NSAIDs are recommended over the generic because brand names are required to formulate their tablets/capsules with more accurate dosing. 

For example: If you purchase brand name Rimadyl, you know that the amount of the active ingredient (carprofen) contained within the chewable tablet is accurate within 2% of the stated dosage. If you purchase generic carprofen, then dosing only has to be accurate within 20% of the stated dosage. 

If your dog requires the 100 mg dose, with carprofen you could be giving as much as 120 mg or as little as 80 mg, which has the potential to either not control pain or cause adverse side effects associated with too high of a dosage.

If your dog is taking Rimadyl, be sure to check out their Rewards Program. 

If your pet develops any side effects from NSAID usage, stop the medication, and talk with your veterinarian.

If you only use NSAIDs occasionally, consider giving your dog a dose of the medication before strenuous physical activity instead of waiting until your dog appears stiff or sore.

Avoid Buffered Aspirin

Buffered aspirin has been used as an anti-inflammatory and a pain killer in dogs. Aspirin (even buffered baby aspirin) can cause stomach upset, gastric ulceration, or bleeding disorders. There are better, safer products available, and aspirin is not routinely recommended for arthritis care in dogs.

The Scandal Around Steroids

The use of steroids (prednisone, triamcinolone, etc.) for the treatment of arthritis is controversial. Steroids do have potent anti-inflammatory effects, but there are many undesirable side effects, including increased appetite and water consumption, weight gain, muscle and bone loss, and increased susceptibility to infection. Steroids will make a dog feel better for a short period, but long-term administration of steroids actually makes arthritis worse due to endocrine changes and muscle weakness.

Currently, steroids are only recommended for arthritis due to immune-mediated diseases, such as idiopathic immune-mediated polyarthritis. These dogs present sick with lameness, fever, and enlarged lymph nodes.

For arthritis that is not immune-mediated, steroids should only be used only in pets where all other therapies have failed.

Tramadol and Gabapentin

If your dog’s arthritis is getting worse and the NSAID isn’t “cutting it” anymore, your veterinarian may add in Tramadol or gabapentin. 

Tramadol is a drug that provides pain relief in a manner similar to morphine, but unlike morphine, it is not a controlled drug. Tramadol is often used in patients with chronic pain. For severe arthritis cases, it works very well in conjunction with carprofen. As long as it is dosed appropriately, tramadol has a very low incidence of side effects, but pets can be difficult to pill because the medication has a bitter taste.

Gabapentin is a muscle relaxant. Like tramadol, gabapentin is not a standalone drug. It is unlikely to control arthritis pain in your dog when given alone; however, it might enhance the effectiveness of other pain-control medications. Results vary from individual to individual, and if other drugs begin to fail in controlling your dog’s pain, discuss adding gabapentin to therapy with your veterinarian.

What About Alternative Therapies that don’t Involve Drugs?

Complementary and alternative therapies are gaining in popularity with dog owners and veterinarians alike, which is likely due to the limitations, negative side effects, and disappointment associated with traditional therapies or aversion to surgical therapy.

There are a plethora of alternative therapies out there, so many that it may seem overwhelming for the pet owner to sort through them. In this guide, we will review only the therapies that we have seen to be the most effective and viable treatment options for surgical therapy.

Why dog owners love Laser Therapy

The advent of cold laser therapy has revolutionized the treatment of canine arthritis. In many cases, dog owners have been able to decrease and in some cases completely eliminate the use of NSAIDs.

Laser therapy eases pain and improves mobility without the use of surgery or drugs with harmful side effects. It provides geriatric dogs immediate relief of aches and pains associated with arthritis and allows for more freedom and improved quality of life without any dangerous side effects. Laser is quick, affordable, and non-invasive, and the dog owner can be present for treatment.

Read Dr. Wooten’s interview with Dr. Robert Riegel, a laser therapy expert.

Approved by the FDA, therapy lasers apply deep-penetrating light energy into tissues, allowing relief of pain through the release of endorphins, and stimulate injured cells to heal at a faster rate.

Talk with your veterinarian about laser treatment. Many veterinary offices sell laser treatments in packages of 6 or 10, which allows you to purchase more treatments at a discounted rate. If you pursue laser therapy for your arthritic dog, expect a lot of sessions at the beginning of treatment (for example, laser treatments every other day for two weeks), and then sessions spread out over time; the goal is to maintain pain control in most dogs with a laser treatment every 2 to 4 weeks. Many laser-treated dogs are able to dramatically reduce the use of pain medication and regain their youthful vigor.

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Acupuncture 

Acupuncture involves applying tiny needles to specific points of the body in an effort to stimulate nerves, change chemical messengers, and alter blood chi in the body. The practice of acupuncture has been around for over 4,000 years. It is likely that acupuncture helps with pain, but it is less likely to help with joint stiffness or muscle strength.

“Acupuncture stimulates the body to heal itself, that’s pretty much it in a nutshell” — Kevin May, DVM

Acupuncture sessions generally last 30 minutes. The more chronic the arthritis is, the more sessions it will take to treat the condition. The limitation with acupuncture is that the effects do not seem to be permanent—your dog will need to see an acupuncturist periodically to continue to benefit from the treatment. 

Veterinarians practicing acupuncture require a special license. If you wish to pursue acupuncture to treat your pet’s pain, the OneHealth SIM website has a search index to find practitioners certified in acupuncture.

Massage Therapy Hits The Spot

Massage can be a very useful alternative therapy for dogs with arthritis, especially in the hands of certified veterinary rehabilitation practitioners. These therapists can train owners to perform simple massage at home, but advanced techniques should only be performed by trained veterinary professionals.

Massage improves the function of muscles, bones, circulation, and the nervous system. It may help the body recover more quickly from injury and can relax an anxious dog recovering from surgery or other procedures.

Here’s a great at-home massage tutorial specifically designed for arthritis from Dr. Mark Smith, DVM.

Therapeutic Ultrasound

In arthritis, therapeutic ultrasound is typically used to increase blood flow, decrease pain and muscle spasms, and increase the range of motion of a joint.

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Electrical Stimulation

In the hands of an experienced practitioner, electrical stimulation can be a valuable tool. You may be familiar with this form of therapy as it is commonly administered in human rehab with a “TENS unit.” It is a great form of pain relief especially in new injuries or for post-surgical pain. It can also be used for muscle stimulation and muscle building. 

Electrical stimulation makes the muscle contract and gives the dog an actual “workout”; practitioners use it to try and wake up the muscles in animals with spinal cord injuries.

Heat and Cold: A Trick from the World of Sports

Just as in human sports medicine, applying heat or ice to an inflamed joint in a dog (under your direct supervision) can bring relief. 

Cold therapy (an ice pack, a bag of frozen peas, iced towels) reduces swelling, bleeding, and pain. Cold therapy is only useful in the acute phase of an injury, i.e., in the first 24-48 hours after an injury or surgical procedure. Always use a thin layer of material between your dog’s skin and the cold pack, and cover the cold pack with material to prevent loss of cold. 

Most dogs tolerate cold therapy for around 5 to 15 minutes, and it can be repeated every 6 hours. If your dog seems excessively uncomfortable with the ice pack, check the skin under the ice pack to make sure the skin is not too cold.

Heat therapy is used to stimulate blood flow, increase flexibility, loosen muscles, and decrease pain. Heat should only be applied after the signs of initial inflammation (redness, heat, swelling) are gone. Heat therapy can be used long-term for chronic inflammatory conditions such as arthritis. 

Heat can be applied for 20 minutes every 2 to 4 days. Make sure to inspect your dog’s skin every 5 minutes to prevent burns. Heat should not be applied to dogs that have lost feeling (spinal cord injuries), local infections, or cancer.

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Physical Therapy Grows in Popularity

Physical therapy in dogs is called “rehabilitation.” The goals of physical therapy for the arthritic pet are to maintain strength, range of motion, and endurance. This area of veterinary medicine is relatively new and is growing quickly. 

It is more widely known as sports medicine or canine rehabilitation for canine athletes, but the application for pets with arthritis or other chronic disease is quickly becoming mainstream.

Many of the treatments already described in this guide are tools used by veterinarians certified in canine rehabilitation. Rehabilitation veterinarians also utilize balance boards, elevated steps, exercise balls, pole jumps, and various other tools to help arthritic dogs get stronger and more flexible. 

Some rehabilitation vets have access to an underwater treadmill. There are many advantages to this therapy: the heated water warms up the joints before the workout, there is no compression on the joints, the hydrostatic pressure of the water decreases swelling, and the water resistance helps build muscle faster.

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Started my boy on some therapy at work. Cold laser + underwater treadmill to help those aching knees. || 💙🐾💪🏼

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Working with a canine rehabilitation veterinarian is a wonderful way to keep your dog mobile and pain free for longer. Deciding whether you need one or not should be based on your goals, and time and financial constraints. Working with a therapist can be very rewarding but does require a higher level of dedication than simply giving your pet a pain pill.

To find a veterinarian near you who has been certified by the Canine Rehabilitation Institute, visit their website.

Check out this awesome hydrotherapy set up!

 
 
 
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I will post this to give some context of why Behrang is doing hydrotherapy. Since many of you asked and got worried. Behrang does 15mins of controlled swimming to build front muscles and 15 mins of Hydro treadmill to build back muscles. Swimming is one of Behrang's favorite activities, as you may know, but he was a bit shy in his first session. We had a success this morning. He did really well and he was very happy when we got home. We are also trying to include a few exercises to his daily routines which are targeted to build muscles around his hips. We do this as a preventive measure to support his hip joints in addition to keeping him fit. Behrangy gained quiet a few pounds over the last two months since he has been less active due to summer heat and covid. He also ate more ice cream than he should have : / Shout-out to the amazing staff @worthstreetvet and @water4dogsnyc ❤️ #pyreneespooch#smilewithbehrang#greatpyreneesdogsofnyc#greatpyrenees#hydrotherapy#hydrotherapyfordogs#instagram#stayfit#swimming#water4dogs#manhattan#nyc

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Impressive Results From Stem Cell Therapy

The company, VetStem is promoting another unique angle of attack: regenerative medicine. Under anesthesia, your dog has some fatty tissue extracted. The sample is shipped to the company’s lab, where it is processed to extract stem cells, which are then returned to your veterinarian. With your dog once again under sedation, these stem cells are injected back into his or her arthritic joints. Over 500 dogs have received stem cell therapy in the past six years with more than 80% of owners reporting an improvement, according to the company’s website.

There are only two studies on stem cell therapy in dogs, both of which were sponsored by VetStem. The overall results were impressive: statistically significant improvements in lameness, less joint pain, and improved range of motion were reported. There are, however, a few points worth noting:

Stem cells hold lots of promise for the treatment of arthritis, but independent studies are needed.

Platelet-Rich Plasma

Injections of platelet-rich plasma (PRP) into joints affected with osteoarthritis is another emerging area in veterinary medicine. This treatment is less expensive than stem cell therapy, takes less time, and requires only mild sedation. It is relatively inexpensive, autologous, safe, and may mitigate inflammation and facilitate tissue healing. These attributes, coupled with promising results from the initial clinical studies performed, warrant the further characterization of the PRP products available and investigation of their efficacy for treatment of common orthopedic diseases and injuries. PRP has produced promising results in the treatment of cruciate ligament ruptures. 

In PRP treatment, blood is drawn from a dog and then spun down in a special centrifuge. The PRP is then injected back into the joint to reduce inflammation and facilitate healing. The main drawback to this therapy is that not all veterinarians have the equipment to perform this treatment, and some veterinarians may not be familiar with PRP.

When to Consider Surgery

Sometimes your dog’s condition may warrant surgery, either to treat arthritis or the underlying disease. There are many surgical options available for the treatment of arthritis in dogs. Some procedures can be performed by your regular veterinarian while others require special board certification and training. Orthopedic procedures can either repair a joint, replace a joint, or remove a joint. Surgery can be performed traditionally or with a scope (arthroscopy). 

Is Surgical Repair the Answer? 

When considering surgical therapy for your dog, ask your veterinarian the following questions:

1. What is the goal of treatment? (stop arthritis from happening, correct arthritic changes, etc.)
2. What are the risks?
3. What is the cost?
4. What is the follow-up care?
5. What is the success rate?
6. What is the alternative if you don’t have the surgery performed?

Let’s review two common conditions that cause arthritis in dogs—cranial cruciate tears and joint dysplasias—that are treated surgically and can have different outcomes.

Cranial Cruciate Ligament Tear

The most common ligament injury in dogs is stretching or tearing of the cranial cruciate ligament in the knee. This is an acutely painful condition, and without surgical correction almost always causes arthritis in the knee. Immediate repair is key to keeping arthritis from developing in the joint.

Surgical Repair: In smaller dogs, the knee can be stabilized by replacing the torn ligament with a strong suture or surgical wire. This type of repair often fails in dogs larger than 40 pounds, however, and a TPLO (tibial plateau leveling osteotomy) is usually recommended for larger dogs. In this procedure, the knee is stabilized when the lower bone of the hindlimb (tibia) is cut, rotated, and then repaired with a bone plate.

Note that obese dogs will have a harder time recovering, and the unaffected knee is at risk for overuse injury or rupture of the same ligament. Keeping your dog confined in the postoperative period is critical to healing. Expect 4 to 6 months for a full recovery.

Joint Dysplasia

Dysplasia is the medical term for abnormal growth. The two most commonly affected joints are elbow and hip. In joint dysplasia, a malformation develops in the joint as the puppy grows. Dysplasias can range from mild (you don’t even know your dog has it) to severe. Dysplasia is a genetic disease that can be made worse by over-feeding or over-exercising large breed puppies.

Veterinarians may recommend surgery for dogs with severe dysplasia. In elbow dysplasia, a piece of bone often breaks off in the elbow, which can be removed surgically. 

Surgical treatment for hip dysplasia is not as straightforward: there are less clear-cut answers and many factors must be considered. In young dogs, a TPO (triple pelvic osteotomy) can be performed to change the angle of the pelvis. In smaller dogs, an FHO (femoral head ostectomy) to remove the hip joint can be performed. In large dogs, a THR (total hip replacement) replaces the ball and socket with a plastic and metal joint. 

80% of patients with arthritis in both hips only require one side to be operated upon to return them to a satisfactory and comfortable life. The decision of which hip to replace is based on the owner’s observations, the physical examination findings, and the hip X-rays. Your knowledge of your pet’s disability is important in making this decision. The best way to decide on surgery is to talk to your veterinarian and a board-certified veterinary orthopedic surgeon and make the decision yourself.

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Additional Surgical Procedures

Arthrodesis fuses a joint and is only recommended in the most severe cases. It is relatively successful in the wrist (carpus) and ankle (hock) arthritis cases but not very successful in other joints. 

Arthroscopy uses a scope to explore a joint. It is successfully used to remove loose cartilage flaps, bone chips, and treat meniscal and ligament tears. 

Amputation is the complete removal of the leg. It is utilized commonly in dogs with bone cancer but rarely in arthritis cases.

What can l do to Help at Home?

High-Quality, Supportive Sleeping Surface

A comfortable and supportive sleeping surface is a must. A supportive sleeping surface is of critical importance; many pet owners can hardly believe how soundly their arthritic pet is able to sleep when the bed is supportive. Choose a bed that has thick orthopedic foam and is at least 6 inches longer than your pet measures at the shoulder.

See how Murphy’s arthritis symptoms changed after he got a Big Barker: https://bigbarker.com/pages/arthritis-case-study 

Nail and Foot Care

Arthritic pets can benefit from good nail and foot care. If they are not exercising or are spending a lot of time indoors, the toenails can grow too long. Nails that are too long are uncomfortable; they cause the toes to splay out in abnormal positions that place additional strain on the foot. You can either take your dog to the groomer or vet for nail care or trim them at home to keep them comfortable.

Sweaters and Jackets 

If winters are cold in your area and your pet has short hair, get your pet fitted for a sweater or jacket to wear during the cold months. Ruffwear has a solid winter collection and there are lots of options available at Chewy.

Low-Impact Exercise, Shorter Sessions

Dogs suffering from arthritis might do better if you break their daily exercise into several shorter sessions rather than one long session, as repeated motions on degenerated joints can tire a pup out. Try your dog on moderately hilly and uneven terrain—hills can help stretch out stiff joints and help your dog maintain body awareness. If hills are too much, then stick to flat ground.

Check Doggy Brain Games, our 3-part series that can help build muscles and keep older dogs mentally stimulated.

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Swimming

Swimming is a fantastic low-impact exercise. It strengthens muscles without the compressive forces of walking or running. Underwater walking is a good variation on this theme as well.

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Almond Oil Massage 

Dogs can be massaged gently and then put through stretching and range-of-motion exercises. Essential oils can be very soothing. Combine a total of 10 drops of lavender in 100 ml of sweet almond oil and massage a teaspoon of this blend onto the affected area daily for 5 days, then weekly. (This treatment is only for dogs; do not use in cats.) Never apply full-strength essential oils directly to the skin, and do not use on skin that is irritated or infected. Talk with your veterinarian or a canine rehabilitation specialist about massage and range-of-motion techniques that are appropriate for your pet’s condition.

Learn the basics of canine massage from Dr. Narda Robinson, DVM from the American Animal Hospital Association:

The Most Difficult Decision of All

There is no cure for arthritis. While pain and mobility can be managed with the treatments outlined in this guide, in some cases, arthritis can be so crippling that quality of life cannot be improved, even after exhausting all options. Humane euthanasia is not a wrong decision, especially after a long and happy life or in cases of young dogs that have such extensive joint disease that treatment will not help. Humane euthanasia can be considered in the case of extreme suffering when no other options are available. The difficult decision to euthanize should be based on your veterinarian’s assessment of your dog’s quality of life and your family’s situation.

Responsible Arthritis Prevention

It isn’t always possible to prevent arthritis, but there are steps you can take to help safeguard your dog from this debilitating disease.

Keep adult dogs at a lean body weight, start joint supplements early, secure your dog a supportive sleep surface, and treat underlying causes (cruciate ligament tears, fractures, etc.) as soon as possible.

Did you know that Big Barker beds are clinically proven to help dogs with arthritis? Check out the study results to learn more. 

Prospective dog owners who want a puppy that is less likely to develop joint disease should consult with a reputable breeder. Understanding some basic facts about joint disease and breeding can save dollars and heartache down the road. 

In order to reduce the risk that your new puppy is going to develop joint disease, adhere to the following guidelines: 

Know Your Dog’s Genetic History 

Research the common genetic problems in the breed you want to acquire. Veterinarians and animal-behavior specialists can provide basic information. The AKC (American Kennel Club) has information on breed-specific health issues at www.caninehealthinfo.org.

Work with a Reputable Breeder 

A reputable breeder is someone who is concerned with breeding healthy puppies that benefit the breed as a whole. Healthy, good-quality puppies have few genetic defects, good temperaments, and demonstrate their breed’s desired traits. A reputable breeder breeds animals that are older than 2 years of age, have hips and elbows certified by the Orthopedic Foundation for Animals, and are certified as being free of any other conditions that are documented as common to the breed. 

Reputable breeders may have a website, but they usually do not advertise in newspapers, consider it unethical to sell via pet stores, and even though they may post information about their kennel online, they would never sell a puppy without a personal interview. Always 

visit a kennel before purchasing a puppy — a reputable breeder has clean kennels, houses the dogs in a humane manner, and provides health care and loving interaction with the puppies before they are placed in homes. These breeders usually have more buyers than puppies, resulting in a waiting list. These puppies are worth the wait.

Diet control 

Although genetics, exercise, trauma, and other uncontrollable aspects of the environment impact the skeletal development of puppies, diet is the one factor that every owner can control. It is necessary to feed a puppy enough to allow for controlled growth, but it is equally important to avoid overfeeding. Many people believe that a round puppy is a happy, healthy puppy. However, maximal growth in large-breed puppies (or any puppy, for that matter) is not optimal growth. 

In addition to excessive energy intake, inappropriate amounts of calcium have also been shown to cause developmental bone disease (Hazewinkel, 1989). Many breeders and dog fanciers advocate calcium supplementation for growing pups, but excess calcium is potentially very detrimental to the development of a healthy skeleton. Calcium supplements should never be given to dogs eating commercially available diets designed for growth. 

Ideally, your large-breed puppy should be fed a large-breed growth diet that is AAFCO feeding- trial certified, or at the very least, formulated to AAFCO standards until the puppy reaches about 80% of the expected adult weight. Avoid additional supplementation until the dog is fully grown.

Delaying Spay/Neuter 

A study conducted at the University of California, Davis further supports a growing body of evidence that spaying or neutering, and the age at which the surgery is performed, may increase a dog’s risk of certain cancers and joint diseases.

The UC Davis study looked at the health records of 759 Golden Retrievers, one of the most popular breeds in the U.S. and Europe. The intent of the study was to investigate the effects of neutering on the risks of several diseases in a single breed of dog, distinguishing between males and females, and between dogs that had been neutered or spayed early (before one year), late (after one year), or not at all. The dogs ranged in age from 1 to 8 years and had been seen at UC Davis’ William R. Pritchard Veterinary Medical Teaching Hospital for one or more of the following problems: hip dysplasia (HD), cranial cruciate ligament (CCL) tear, and three types of cancer. 

The study revealed that for all five diseases, the rates were significantly higher in both males and females that were neutered or spayed (before or after one year of age) compared with intact dogs. The study results indicate that dog owners should carefully consider when to have their male or female dogs spayed or neutered. Many veterinarians are counseling clients to wait until their dog has finished growing (anywhere from 9 months to 2 years for giant breeds) before neutering to allow normal growth-plate closure. For more information on this, talk with your veterinarian.

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Have a question we didn’t cover? Check out our Canine Arthritis FAQ Library:

Can Canine Arthritis Be Cured?

Is CBD oil good for dogs with arthritis?

Can Arthritis Come on Suddenly in Dogs?

Do Supplements for Canine Arthritis Work?

Is Rimadyl an Effective Treatment for Arthritis?

Is Canine Arthritis Fatal?

Will Massage Help my Dog's Arthritis?

What's the Difference Between Canine Arthritis and Hip Dysplasia?

How to Prevent Arthritis in Dogs

Will Glucosamine Help a Dog's Arthritis?

Will a heating pad help with my dog's arthritis?

My dog is slowing down. Is that normal or something I should worry about?

Will Baby Aspirin Help my Dog's Arthritis?

What's the Difference Between Canine Arthritis and Degenerative Myelopathy?

Is Hydrotherapy good for a dog with arthritis?

What Does Arthritis Look Like in Dogs?

What can I do to help my dog with arthritis?

What Medications are Best for Canine Arthritis?

Is arthritis painful for dogs?

How to Treat Canine Arthritis

How to Treat Canine Arthritis at Home

Can Laser Treatments Help a Dog with Arthritis?

References

Nutrition and osteoarthritis in dogs: does it help? Vet Clin Small Anim. Budsberg SC and Bartges JW. 2006;36:1307-1323.

Evaluation of the effect of glucosamine on an experimental rat osteoarthritis model. Life Sciences. 

Naito K, Watari T, Furuhata A, et al. 2010;86:538-543.

Randomised double-blind, positive-controlled trial to assess the efficacy of glucosamine/chondroitin sulfate for the treatment of dogs with osteoarthritis. Vet J. McCarthy G, O’Donovan J, Jones B, et al. 2007;174:54-61.

Effects of glucosamine-chondroitin sulfate supplementation on serum fructosamine concentration in healthy dogs. 18.Lenox CE and Lunn KF JAVMA. 2010;236;183-186.J Bone Miner Metab. 2013 Jan;31(1):16-25. doi: 10.1007/s00774-012-0378-9. Epub 2012 Aug 10.

Assessment of safety and efficacy of methylsulfonylmethane on bone and knee joints in osteoarthritis animal model. Ezaki J1, Hashimoto M, Hosokawa Y, Ishimi Y. Can J Vet Res. 2013 Jan; 77(1): 66–74. PMCID: PMC3525174

Effect of a diet enriched with green-lipped mussel on pain behavior and functioning in dogs with clinical osteoarthritis. Pascale Rialland,1 Sylvain Bichot,1 Bertrand Lussier, Maxim Moreau, Francis Beaudry, Jérôme RE del Castillo,Dominique Gauvin, and Eric Troncy

Protective effects of total fraction of avocado/soybean unsaponifiables on the structural changes in experimental dog osteoarthritis: inhibition of nitric oxide synthase and matrix metalloproteinase-13. Christelle Boileau, Johanne Martel-Pelletier, Judith Caron, Philippe Msika, Georges B Guillou, Caroline Baudouin, Jean-Pierre Pelletier. Arthritis Res Ther. 2009; 11(2): R41. Published online 2009 March 16. doi: 10.1186/ar2649 PMCID: PMC2688188ArticlePubReaderPDF–4.5M

Management of Osteoarthritis with Avocado/Soybean Unsaponifiables. Blaine A. Christiansen, Simi Bhatti, Ramin Goudarzi, Shahin Emami Cartilage. Author manuscript; available in PMC 2015 January 23. Published in final edited form as: Cartilage. 2015 January; 6(1): 30–44. doi: 10.1177/1947603514554992 PMCID: PMC4303902

Expression of pro-inflammatory mediators is inhibited by an avocado/soybean unsaponifiables and epigallocatechin gallate combination. Stacy L Ownby, Lowella V Fortuno, Angela Y Au, Mark W Grzanna, Ann M Rashmir-Raven, Carmelita G Frondoza. J Inflamm (Lond) 2014; 11: 8. Published online 2014 March 28. doi: 10.1186/1476-9255-11-8 PMCID: PMC3983882 Arthritis Res Ther. 2009; 11(2): R41. Published online 2009 Mar 16. doi: 10.1186/ar2649 PMCID: PMC2688188

Perazzi A, Busetto R, Martinello T, et al. Description of a double centrifugation tube method for concentrating canine platelets. BMC Vet Res 2013;9:146.

Sundman EA, Cole BJ, Fortier LA. Growth factor and catabolic cytokine concentrations are influenced by the cellular composition of platelet-rich plasma. Am J Sports Med 2011;39:2135-2140.

Arnoczky SP, Shebani-Rad S. The basic science of platelet-rich plasma (PRP): what clinicians need to know. Sports medicine and arthroscopy review 2013;21:180-185.

Fahie MA, Ortolano GA, Guercio V, et al. A randomized controlled trial of the efficacy of autologous platelet therapy for the treatment of osteoarthritis in dogs. J Am Vet Med Assoc 2013;243:1291-1297.

Silva RF, Carmona JU, Rezende CM. Intra-articular injections of autologous platelet concentrates in dogs with surgical reparation of cranial cruciate ligament rupture: a pilot study. Vet Comp Orthop Traumatol 2013;26:285-290

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This is the original. Try it for a year. If you don't feel the same sense of pride that I do when you see your own dog resting peacefully on their new bed, let me know, and you won't pay a penny.

Author Eric Shannon, Founder of Big Barker, with Co-Founder Hank