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.
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