Arthritis

ARTHRITIS

Geneva Coats, R.N.

Originally published in the Pomeranian Review

The term “arthritis” means inflammation of the joints. Any joint can be affected by arthritis, including hips, knees, elbows, shoulders, even toes and the spine. Arthritis has a devastating effect on the quality of life, making simple motions such as walking, jumping, and climbing painful or even impossible.

The ends of bones are covered with cartilage, a form of connective tissue. Cartilage acts as a “shock absorber” between the bones. These areas rub together with movement and can literally wear away. As cartilage wears away, calcium deposits can be laid down, which causes further pain and restricts movement.

Special thick fluid lubricates the joint space for ease of motion, and helps prevent cartilage from wearing away as a result of friction. However, as the body ages it may lose the ability to replenish joint fluid or maintain the cartilaginous surfaces on the ends of the bones. Cartilage repairs itself very slowly, due to poor nutrient supply and the fact that joints are seldom resting.

WHAT CAUSES ARTHRITIS?

A common cause of arthritis is degeneration associated with aging. Arthritis can also be the result of a traumatic injury, or it can be due to a deformity like hip dysplasia or patellar luxation. Autoimmune diseases like lupus and rheumatoid arthritis are characterized by joint surface destruction and inflammation caused by a malfunctioning immune system. Arthritis may sometimes result from a systemic bacterial infection or from diseases acquired from tick bites. Gout is another form of arthritis caused by mineral or crystal deposits in the joints.

SYMPTOMS

Arthritis usually develops gradually over time. Cartilage does not contain blood vessels or nerves, so once the joint becomes painful, significant damage has already been done. Symptoms of arthritis can include pain, limping, stiffness, resistance to touch or reluctance to participate in activities that the dog formerly enjoyed. Sometimes a dog may be regarded as “lazy” when in reality he simply prefers to move around as little as possible to avoid pain. A radiograph can confirm arthritic changes in the joints.

PREVENTION

There are several things we as owners can do to help prevent and treat arthritis in our dogs. Throughout your dog’s life, keep him in lean, fit condition. Joint movement stimulates the production of beneficial lubricating joint fluids, so moderate low-impact exercise such as walking or swimming is recommended to maintain joint health. Being overweight stresses the joints, and exercise helps to prevent obesity. However, do not overdo physical activity because this can lead to fatigue and injuries. Also, too much stress to muscles or bones of a young developing body can cause deformity or damage, which may eventually result in arthritis. For this reason aggressive physical workouts are generally not recommended, particularly for the immature dog.

TREATMENT

Most treatments for arthritis center on resting the joint and reducing pain and inflammation. Providing your dog with a supplemental heat source can provide great relief. A heating pad or infrared heat lamp can be used for 15-20 minutes several times daily. Cold flooring should be avoided, and of course your arthritic dog would appreciate a nice soft bed. Many people buy or build ramps for their dog when navigating stairs or getting in and out of the car becomes difficult.

Consult your veterinarian for advice about the use of anti-inflammatory medications. Corticosteroids such as prednisone or dexamethasone may be prescribed in severe cases. Steroids provide quick relief to the inflammation and pain from arthritis, but they also have serious side effects such as GI upset, weight gain, elevated blood sugar level. With prolonged use, steroids cause loss of muscle mass, weakening of bones and depression of the immune system. Use of steroids can also make the problem worse by causing damage to cartilage. Their use is generally reserved for short-term treatment in cases of severe pain and immobility.

Nonsteroidal anti-inflammatory medications (NSAIDs) are frequently recommended. If your veterinarian agrees, aspirin can be tried, using a dosage of 5-10 mg per pound. Do NOT use Tylenol (acetaminophen) or Motrin (ibuprofen).

Other NSAIDS used for the treatment of canine arthritis include:

� Rimadyl or Novox (carprofen)

� Etogesic (etodolac)

� Deramaxx (deracoxib)

� Metacam (meloxicam)

� Zubrin (tepoxalin) and

� Previcox (firocoxib).

These NSAIDs are very effective for relief of pain and inflammation, but there is also a high risk of adverse reactions. Side effects of NSAIDs may range from loss of appetite to ulcers, gastrointestinal bleeding, liver disease, kidney problems and in some cases even death. These medications should only be used under careful supervision of your veterinarian.

Your dog should not take more than one type of NSAID at a time, and a NSAID should only be combined with a steroid very cautiously. Another important point to consider is that steroids and NSAIDs may temporarily relieve symptoms, but they do not improve the condition of the joint structure, and can actually cause further damage to the joint tissues. A holistic approach to arthritis is founded on nutritional joint support.

SOME DIETARY GUIDELINES FOR ARTHRITIS

There are some diet modifications that may be helpful to control arthritis. Grains and other starchy carbohydrates should be avoided because they may aggravate inflammation. Overprocessed foods with added sugar, salt, artificial colors and flavors and artificial preservatives such as ethoxyquin and BHA/BHT should be eliminated. Fruits and berries can be added to the diet; the bioflavonoids that they contain are powerful antioxidants that help reduce the pain and inflammation of arthritis. Beneficial vegetables include celery, carrots, parsley, asparagus, broccoli, cilantro, and garlic. Members of the nightshade family of vegetables should be avoided because they contain irritating solanine alkaloids. This includes peppers, onions, white potatoes, tomatoes and eggplant. Liver should be limited to no more than 5% of the diet.

DIETARY SUPPLEMENTS FOR ARTHRITIS

Nutraceutical supplements help to improve the actual problem, not just relieve the symptoms. Dietary supplements can be taken along with anti-inflammatory medications and can be continued on a long-term basis without any serious adverse side effects. They are generally regarded as harmless. There are many combination products marketed specifically for arthritis. We will cover some of the more commonly recommended supplements here.

Cartilage has two key structural components: collagen fibers (made of protein) and a reinforced gel composed of proteoglycans (GAGs like chondroitin and hyaluronan) which attract and hold water. Supplements provide the body with the building materials needed to maintain healthy cartilage.

Glucosamine is a natural substance that is found in normal joint tissue. Glucosamine stimulates the production of glucosaminoglycans (GAGs) which are important joint proteins. Two examples of GAGs are chondroitin and hyaluronan. When taken as a dietary supplement, glucosamine helps rebuild cartilage and restore synovial (joint) fluid. It also has been found to reduce pain and discomfort.

The tissues that depend on glucoasmine to remain healthy include tendons and ligaments, cartilage, synovial fluid, mucous membranes, several structures in the eye, blood vessels, and heart valves.

Glucosamine has been used for a variety of problems including: breakdown and inflammation of the synovial fluids, damage to the tissues, ligaments and muscles, inflamed sciatic nerve, inflamed joints associated with aging, tracheal weakness and loss of elasticity in the intervertebral discs.

Chondroitin is a major component of cartilage structure. Supplemental chondroitin is believed to promote water retention and elasticity in the joints. Chondroitin enhances the effectiveness of glucosamine when taken together. Also, chondroitin inhibits the enzymes that break down cartilage. Natural chondroitin production declines with age and is disrupted by stress or injury. NSAIDs and corticosteroid drugs that are often prescribed for arthritis also contribute to joint damage.

When taking glucosamine and chondroitin for arthritis, start at a high dose and taper down when you notice improvement. Use at least 20 mg glucosamine per pound of body weight. Allow at least four weeks before expecting to see improvement, although often you will notice pain relief and improved movement after just a few days.

Most glucosamine and chondroitin supplements are produced from the chitinous shells of ocean crustaceans, or from animal cartilage such as bovine trachea. Consumerlab.com has tested various brands of glucosamine supplements marketed for pets, and found that many contained far less chondroitin that they claimed, and some were contaminated with lead. One reliable source recommended Cosequin and Dr Foster and Smith brand.

Hyaluronan, also known as hyaluronic acid, is another substance in the same family as chondroitin. Hyaluronan is the main component of joint fluid. Natural hyaluronan is a thick gel in the joint that cushions and lubricates the joint cartilage surfaces. Hyaluronan is available as a nutritional supplement and has been shown to enter joints and improve condition. Some commercially formulated hyaluronan supplements include Trixsyn and Lubrisyn.

Manganese is included with many glucosamine/chondroitin supplements as it is believed to improve absorption.

Adequan is a purified injectable form of GAG. This injection is given twice weekly for four weeks. Adequan relieves joint pain, stimulates cartilage regeneration, reduces inflammation and stimulates the production of healthy joint fluid.

MSM is a natural sulfur-containing compound derived from kelp. Sulfur is needed for production of collagen, glucosamine and chondroitin

Perna Mussel or green-lipped mussel is a shellfish found in New Zealand. It is high in protein, and contains significant levels of glucosamine and GAGs. Some dog foods (Blue Buffalo and Ziwipeak) include perna mussel in their formulas.

OTHER NATURAL ANTI-INFLAMMATORIES

Fish oil or salmon oil is helpful to soothe arthritic joints. Recent studies in dogs and reported by the Journal of the American Veterinary Medical Association confirmed the benefits of fish oil for arthritis. Compared to placebo groups, the dogs receiving omega-3 fatty acids had a significantly improved ability to rise from a resting position and play by six weeks after beginning supplementation, and improved ability to walk by 12 weeks.

Fish oil contains beneficial Omega-3 fatty acids. Try one capsule of fish oil per ten pounds of body weight. Make sure to use plain fish or salmon oil, and not fish liver oil.

Vitamin E is depleted quickly with the use of fish oil, so supplemental E is a must. Vitamin E also has potent pain relieving and anti-inflammatory qualities. Use 100 IU of vitamin E per ten pounds of body weight at least three times a week.

Vitamin C is essential to maintain collagen, a major component of cartilage. Vitamin C can be taken in doses of 10 mg per pound of body weight, up to 30 mg per pound daily. Ester C is less irritating than ascorbic acid. While dogs do produce their own vitamin C, in cases of arthritis a supplement may be particularly helpful.

Bromelain is an enzyme. It should be given on an empty stomach.

Quercitin and other bioflavonoids naturally occur in fruits and are also available in some supplements. These have antioxidant and anti-inflammatory properties.

Boswellia is an herb that demonstrated significant clinical improvement in joint pain in dogs in a study done in 2004.

Yucca is a root that has a long history of use for arthritis. It contains saponins that may stimulate the body’s natural steroid production.

Avocado/Soybean Unsaponifiables (ASUs) are an extract of avocado and soybean. They have anti-inflammatory properties and enhance the action of glucosamine and chondroitin. Dasuquin is a product combining Cosequin with ASUs.

SAM-E is believed to have anti-inflammatory and pain-relieveing properties. It should be taken on an empty stomach.

Duralactin is a patented product derived from milk of grass-fed cows. It may help reduce inflammation in some cases.

Velvet Antler is a powdered deer antler preparation that is not recommended because of the possibility of transmitting prion chronic wasting disease.

Curcumin or Turmeric is an herb in the ginger family that is reputed to have anti-inflammatory and anti-cancer properties. It is also known as Indian Saffron.

With a little TLC and nutritional support, your arthritic dog can remain active and comfotable well into his senior years!

(This information is presented for informational purposes only; please consult with your veterinarian for advice regarding treatment of your dog’s arthritis.)