|
|
Degenerative Joint Disease and Your Pet
Degenerative joint disease (DJD), also known as arthritis or osteoarthritis, is a progressive deterioration of joint cartilage resulting in inflammation and irreversible changes in the joints. DJD can affect both cats and dogs, males or females of any age or any breed. Two broad classes of DJD are primary and secondary. Primary DJD is believed to be a result of long-term exercise combined with aging and has no known predisposing cause. Secondary DJD is much more common and is the result of some initiating cause such as joint instability, trauma, bone or cartilage defects, or poor joint conformation. Working dogs, athletic dogs, and obese animals are at increased risk for developing DJD because of the increased stress placed on the joints.
DIAGNOSIS
The diagnosis of DJD is usually made based on clinical signs found in the history and physical examination. Pets suffering from DJD often show intermittent lameness that slowly becomes more severe and frequent over time. The clinical signs are often worse after exercise, prolonged periods of recumbency, and weather changes. Some pets will walk with a stiff gait, rather than exhibiting obvious lameness. On physical examination pets with DJD may show stiffness in their gait, reduced range of motion in the affected joint(s), crepitus, joint swelling, pain, and joint instability. Often radiographs will be taken to assess the degree of change in the affected joint(s), to assess changes over a period of time, or to look for fractures, bone infections, or tumors. Often the severity of the changes seen on radiographs does not correlate with a pet’s clinical signs. Additionally, other diagnostic tools may be employed to better define the problem in a specific animal. Joint fluid may be collected for analysis. Blood work may be needed to look for underlying metabolic problems, infections, or to check the health of the liver and kidneys in preparation for using various anti-inflammatory drugs.
TREATMENT OPTIONS
There are a variety of treatment options available for pets suffering from DJD. They can be generally classified as drugs to decrease inflammation (anti-inflammatory drugs), drugs to protect the joints (chondroprotective agents), surgery, weight loss, and lifestyle changes.
1.) Anti-inflammatory Drugs: These drugs, which fall into two broad categories, decrease inflammation by disrupting the chemical pathways that produce pain and inflammatory compounds.
a.) NSAIDs: Non-Steroidal Anti-Inflammatory Drugs include such over the counter medications as aspirin, ibuprofen, and acetaminophen and such prescription medications as Rimadyl (carprofen), EtoGesic (etodolac), Deramaxx (deracoxib), and Metacam (meloxicam). Over the counter medications are generally less expensive, but may not be as effective as prescription medications. The primary side effects of these medications are gastrointestinal problems, including vomiting, diarrhea, and loss of appetite, which may progress to more severe problems such as stomach or small intestinal ulceration. Some of these medications are not recommended for pets with documented bleeding disorders or liver or kidney problems. Also, there has been some research that indicates that aspirin may actually damage cartilage over time. These medications are typically started at an initial recommended dose. The dose is then decreased to the lowest effective level.
b.) Steroids: The most common steroid used to treat DJD is prednisone or prednisolone. Steroids are more potent anti-inflammatory drugs than NSAIDs, but they also can have significant side effects. Most animals on steroids will experience increased drinking and urination, and increased appetite. As a result some animals may have urine or stool accidents in the house. In addition, dogs treated with steroids often pant more than usual and may cause changes in behavior. Steroids can also slow the healing process and can suppress the body’s immune system making infections a potential problem. Pets are typically started on an initial dose of steroids to control the inflammation. As with the NSAIDs the dose is then decreased to the lowest level that will keep the pet comfortable.
NOTE: NSAIDs and steroids should NEVER be given together as severe gastrointestinal upset and/or ulceration may occur. Please let us know if your pet is already taking either type of medication.
2.) Chondroprotective Agents: These agents are intended to maintain and restore the mechanisms that protect cartilage by encouraging growth of cartilage cells and joint fluid, minimizing inflammation, and preventing or removing blood clots in nearby blood vessels. The most commonly used agents are glucosamine and chondroitin sulfate. They can be administered orally or by injection. There are no significant side effects associated with these agents. Typically, pets are maintained on a consistent dose for long periods of time, often for the life of the pet. It may take six to eight weeks before clinical improvement is seen when using these agents. These agents are not prescription products and therefore are not tightly regulated by the FDA. Consequently, the consistency and quality of ingredients can vary widely between products. Check with our clinic or your pharmacist for recommended brands.
3.) Diet: Recently, Hills has introduced a new prescription diet for dogs called Canine j/d, intended to help manage canine arthritis. Beneficial nutritional components include: 1.) high levels of Eicosapentaenoic Acid (EPA) which works to turn off the gene that causes cartilage damage, 2.) high levels of Omega-3 fatty acids to help reduce mediators that cause inflammation, 3.) glucosamine and chondroitin to provide building blocks for cartilage repair, and 4.) L-carnitine to help maintain optimum body weight in dogs.
4.) Surgery: Some pets with DJD can benefit from surgery to support, repair, or replace damaged joints. These orthopedic procedures can be expensive, but can dramatically decrease pain and thereby improve the comfort level of many pets.
5.) Weight Loss:
Reducing the weight of overweight pets is one of the most important aspects of
effectively treating DJD because it reduces the amount of stress placed on
particular joints. For most animals weight loss involves dietary management
(adjusting the amount or type of food that is fed) and exercise. Often
prescription diets that are high in fiber and low in calories are recommended to
maximize weight loss. Most treats should be eliminated. Some low calorie
treats, either store bought or homemade, may be permissible. Many dogs enjoy
fruits and vegetables and these can be used as treats without adding significant
amounts of calories or fat to the pet‘s diet. Some overweight dogs suffer from
low thyroid levels (hypothyroidism). These dogs will need to have their thyroid
levels medically supplemented in order to increase their metabolism and
encourage weight loss. 6.) Lifestyle Changes: Light to moderate exercise is generally recommended for most animals with DJD in an effort to control weight and to maintain muscle mass and muscle tone. However, severely affected animals may need a period of enforced rest. Running, jumping, quick turns, and stairs should be avoided due to the increased stress these activities place on the joints.
With proper management many pets with DJD can be made significantly more comfortable and their quality of life can be improved. The type of treatment to be used will depend on the individual pet and will be decided between the pet owner and the veterinarian.
If you ever have any questions regarding any of the above information, please do not hesitate to contact us. Visit us online at www.WhiteBearAnimalHospital.com.
WHITE BEAR ANIMAL HOSPITAL OTTER LAKE ANIMAL CARE CENTER1909 East County Road E 6848 Otter Lake RoadWhite Bear Lake, MN 55110 Hugo, MN 55038 (651) 777-1393 (651) 426-8871 |