Arthritis , Pain & Joint Problems

Two major categories of joint problems are:

  • Degenerative

  • Developmental

  • Developmental – Where joint does not develop correct

  • Causes problems like hip or elbow dysplasia

  • Degenerative- most common cause is cruciate ligament problems, where ligament degenerates over time and causes instability and secondary osteoarthritis and arthritis

 Causes: 
  • Dogs less active and have more difficulty with common activities

  • Dogs have problem getting up on couch, stairs, or elevated areas

  • Athletic dogs, have trouble running along side their owner or don’t want to play

  • Progresses to overt lameness – holding the limb up

Symptoms:
  • Larger dogs, or dogs that are overweight

  • No general breed or gender specific

  • Newfoundlands – highest prevalence of cruciate ligament disease of all breeds

  • Rottweilers – prone to knew and ankle problems

  • Bernese Mountain dogs – prone to elbow dysplasia

Breeds that are more prone:

Non- surgical: focuses on weight management and body condition

  • Manages weight of dog in order to decrease the stresses on the joints

  • Also decreases the inflammation because fat is a source of inflammation in the joints

Body Condition: focuses on building dog’ strength

  • Overall muscle mass and muscle function helps protect joints and overall function

Exercise: light to moderate helps keep stiff joints supple and mobile

  • Exercise varies depending on individual dog

  • 15-20 minutes of exercise twice a day is recommended

  • Swimming is ideal – known to be a low-impact activity that improves muscle mass without overstressing joints

Physical Rehabilitation: include underwater treadmills, ultrasound therapy, and electric stimulation

  • Application of cold and heat, massage, stretching and range-of-motion exercises to maintain joint health and muscle strength

  • Known to relieve pain and promote cartilage, tendon and ligament health

Acupuncture and Massage:

  • Although controlled clinical studies are lacking, there are many anecdotal reports

  • Claim to help relieve pain from hip dysplasia and degenerative joint disease in dogs

  • Gently massaging dog’s painful joints helps restore the blood flow

Transcutaneous Electrical Nerve Stimulation (TENS):

  • Used for pain management

  • Decreases pain and inflammation by providing a low level electrical current which disrupts the normal pain perception pathways

  • Pulse rate and width are controlled to deliver desired effect

  • Can also be used to stimulate acupuncture points in order to achieve a body-wide response

Therapeutic Ultrasound:

  • Used on tendon and muscle injuries, and conditions that result in decrease range of motion

  • This breaks down scar tissue, increases the elasticity of muscles, aids healing, increases circulation, and reduces pain and spasms

Pulsed Signal Therapy (PST):

  • New medical treatment to treat pain and injuries

  • Relieves severity of joint pain and swelling – can improve mobility

  • Signals mimic the normal healthy physiological signals, transmitted into the joint to promote the repair of damaged cells and to stimulate the repair and maintenance process

Bioelectric Whirlpool:

Form of treatment that combines the benefits of hydrotherapy with the pain management benefits of TENS

Medications, foods, and food additives can also be given – contain anti-inflammatories, analgesics, and pain relievers:

  • Foods are formulated for joint health – containing additives such as fish oils to help decrease inflammation, and glucosamine/chondroitin

  • However, important to note that no amount of consumed nutrients will correct the structural damage to a dog’s joints

  • Calcium deposits, scar tissue, cartilage tears and dissolution, or contour changes to the bones at the joint surfaces from long-term forces being applied

  • These abnormalities will remain present and will continue to affect the dog regardless of the nutritional intake

  • Supplements added to diet (Glucosamine and Chondrotin Sulfate, Omega Fatty Acids, Vitamin E, Selenium, and MSM) – all assist in decreasing inflammation and improving the body’s ability to repair and strengthen tissues

  • Important to note that there is no reverse structural changes in a joint

Common Treatments:

Non- Surgical Treatments are: Difficult to remodel the joint without surgical intervention – attempts are made to reduce inflammation and nerve endings

  • Allows dog to be more comfortable, even if range of motion is compromised – will not correct joints or reverse structural changes

Steroids: given to reduce swelling and inflammation to affected joints (Prednisone, Dexamethasone, and other corticosteroids)

Downside: use of steroids for a long period of time can actually contribute to additional joint damage and breakdown

NSAIDs: these are non-steroidal anti-inflammatory drugs (Aspirin, ibuprofen, Rimadyl, and Etogestic)

  • Can have noticeable beneficial effects

  • Downside: needs to be carefully regulated

  • Can cause bleeding disorders, gastric ulcers, as well as liver and kidney dysfunction

Nutraceuticals: substances consumed orally as an addition to normal diet

  • Known to be safer than conventional drugs – considered a form of food/nutrient

  • Toxicity is not a problem and have little to no side effects

  • Takes longer to see improvement than drugs

  • Most common form used are Glucosamine and Chondroitin Sulfate

Glucosamine: natural compound composed of sugar and an amino acid

  • Involved with the body’s production of joint lubricants and shock absorption necessary to maintain both cartilage and joint function

  • Manufactured in the body in the joint cartilage

  • One of the building blocks of articular cartilage that aids in rebuilding damaged cartilage

  • Beneficial to other body structures

  • Formation of nails

  • Tendons

  • Skin

  • Eyes

  • Synovial fluid

  • Bone

  • Ligaments

  • Heart Valves

  • Respiratory tracts

  • Unrinary Tracts

  • Created in the production of proteins associated with cellular growth and structure

  • Nutritional supplement is taken from crab, lobster or shrimp shells

  • When purchasing supplement – recommended to chose the sulfate form because it absorbed and utilized best

Chondroitin Sulfate:

  • Beneficial in prevent stress injuries to joints – helps in the repair of damaged connective tissue

  • Addresses the disease process itself, unlike pain killers (only help in dulling the pain)

  • Helps the body to repair damaged cartilage – restores joint integrity

  • Protects already existing cartilage from breaking down and keeps cartilage tissue hydrated

  • Also helps in cushioning impact stress

  • Studies suggest it reduces joint paint

  • Chondroitin production is known to decrease with age

  • Supplementation can be especially helpful for senior dogs

Non-Surgical Treatments:
  • Recommended if joints are severely damaged or the pain is great

  • Improves movement and overall function

  • Most procedures involve making small incisions through which surgeon can clean cartilage debris from the joint

  • Other surgeries involve and focuses on repairing bone deformity, fusing joints, or rebuilding part of a joint

Arthroscopy: known to be the list invasive (very minimal) arthritis joint surgery currently available

  • Can help resolve damage in shoulders, elbows, and the knee joint in the rear legs as well as the ankle bones

  • Procedure involves small cuts over joint where camera is inserted

  • Instruments uses are small to assess joint damage and plan joint repair

  • Some cases – surgery cannot be performed due to swelling and/or leakage from joint

  • Open surgery is needed in these cases to asses or repair the joint

Joint Replacement: Elbow and Hip

  • Intensive and expensive surgeries that require a long recovery time (1-2months)

  • However, 90% of dogs are successful in resolving joint and arthritic problems

Joint Fusion

  • Procedure uses metal implants to fix damaged joints

  • Recovery time is usually between 1-2 months

  • Can be risks involvedone:

Surgical Treatments:

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