Osteoarthritis

Osteoarthritis

old gsdSynonyms:

OA

Arthritis

Degenerative joint disease

DJD

Overview of Arthritis:

Osteoarthritis affects 20 – 80% of all dogs, depending on age and size.

Osteoarthritis is a complex, progressive, degenerative process affecting synovial joints.  It is often seen secondary to joint instability, trauma, joint misalignment, and aging.  As OA progresses within a joint, it becomes a vicious cycle: small tears in cartilage release enzymes that cause inflammation, and inflammation leads to further cartilage damage.

Clinical Signs

Clinical signs of OA are similar regardless of cause: stiffness, loss of mobility, muscle atrophy, and varying degrees of pain and inflammation.  Owners often notice reluctance to jump or difficulty standing up from sitting.  Typically, the gait is worse after a period of rest.

Treatment

Because OA is multifactorial, the treatment approach should be multimodal.  Because the damage is irreversible, the goal is to keep your pet comfortable, slow the progression of OA, maintain or improve joint range of motion, and maintain or improve strength.

Weight Loss

In overweight pets, weight loss has been shown to affect mobility more than any other treatment modality.

Medications

Medications are often necessary to control pain and inflammation.

Non-Steroidal Anti-inflammatory Drugs (NSAIDs) are one of the most commonly prescribed medications in the treatment of OA.  They decrease inflammation and control pain.  They are known to have side effects, so it is important to have regular blood work as recommended by your veterinarian.

Other pain relievers, such as Tramadol or Gabapentin, are often important in the control of chronic pain and compensatory muscle pain.

Chondroprotective Agents

Oral products contain Glucosamine and Chondroitin to support the cartilage.  These should be started at the earliest sign of OA because they work by slowing progression of cartilage damage rather than by repairing cartilage.
Injectable products, such as Adequan, can be given weekly to monthly as OA progresses.

Rehabilitation

Joint mobilizations can help with pain management.  Along with passive range of motion, joint mobilizations help maintain or improve joint range of motion and also help lubricate and nourish the joint by distributing joint fluid.

Massage and Trigger Point Release help reduce pain and increase blood flow to sore muscles.  Dogs that have restricted movement in one part of their body often overuse their muscles in other parts of their body.

Therapeutic Exercise encourages active range of motion, promotes symmetrical weight bearing, improves proprioception, and improves core strength.

Laser helps decrease pain and inflammation in the joints.  It also relieves trigger points in muscles.

Hydrotherapy is ideal for low impact weight bearing exercise, strengthening, and endurance.  It can also promote active assisted hip extension, stifle flexion, and elbow flexion.

Lifestyle management: Mobility aids are available, such as booties to help with traction and to protect the toes, and harnesses that support weight for dogs that have difficulty rising.  Some dogs need ramps to help them navigate the stairs and get into the car.  Owners need to be sure that the footing in the house has good traction to decrease the likelihood of slips and falls.

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