Knee ostoearthritis in a dog due to a ruptured cranial cruciate ligament (cruciate disease}
(aka ‘Arthritis’, ‘Rheumatism’, DJD)
What is osteoarthritis?
Arthritis means ‘inflammation of a joint’. Inflammation is a basic way the body reacts to infection, irritation or trauma and we generally see redness, swelling, warmth and pain. So ‘arthritis’ is actually not a very specific term and there are a number of quite different problems that will cause inflammation of a joint. However, the most common form of arthritis in dogs is called osteoarthritis (“OA”). This is sometimes called rheumatism, osteoarthrosis or degenerative joint disease (DJD).
What happens in osteoarthritis?
In osteoarthritis there is gradual deterioration and loss of the smooth cartilage surface of the joints. The soft tissues around the joint can become inflamed and the joint gets thicker and stiffer. This form of arthritis in dogs often develops slowly and can be well advanced before the joint becomes sore.
What causes osteoarthritis?
There are then a number of potential TRIGGER factors for osteoarthritis but once triggered, osteoarthritis appears to be a SELF-PERPETUATING PROCESS that generally progresses at a variable rate. So once a patient has it, they have it! Osteoarthritis in dogs is usually triggered by another joint problem such a Hip Dysplasia, Elbow Dysplasia and Osteochodrosis or by trauma to the joint.
Osteoarthritis is the form of arthritis typically associated with getting older and with wear and tear. However, if a growing dog has a developmental problem such as Elbow Dysplasia or Hip Dysplasia then osteoarthritis will develop in a joint at a very young age. What’s also interesting is that many older people and dogs will show little or no sign of arthritis, even if they have been very active and their joints have worked hard. So it is not just an inevitable consequence of aging; There are other factors at work.
What are the signs?
Stiffness after rest is a characteristic feature of osteoarthritis and these usually starts quite subtly. In some patients, quite marked lameness can come on suddenly, usually after particularly vigorous or unfamiliar types of exercise. These signs can be caused by other conditions that may require completely different treatment and so the diagnosis can’t be made on symptoms and signs alone. You may find your dog spend more time in their basket and maybe starts to struggle getting in and out of the car.
How is it diagnosed?
Osteoarthritis is usually diagnosed from the typical symptoms and signs exhibited by the patient. X-rays will be taken to confirm the characteristic bony changes around the affected joint(s). Your dog will be sedated or anaesthetised for xrays and this is a very convenient time to take a sample of joint (synovial) fluid for laboratory analysis. This can help to rule out other forms of arthritis such as rheumatoid arthritis or a bacterial infection in the joint. In some patients a camera may be used for direct visual examination of the inside of the affected joint. This is called arthroscopy and it is a type of key-hole surgery.
How is it treated?
There are three steps in treating osteoarthritis in dogs. Firstly we should look at any lifestyle modifications that could help. By focusing on some relatively simple steps, you can have a dramatic effect on your pet’s mobility and quality of life.
In the early stages it is likely that the patient will receive little specific medical treatment and in the early stages we should focus on preventing the condition worsening and avoiding things that may aggravate the joint and make it more painful.
In general, exercising on flat even ground is going to be kinder to all the joints. Exercise within the capability of your pet. This will be trial and error as osteoarthritis is a very variable condition and what is OK for one patient may not be suitable for another. Don’t exercise your pet to a level that aggravates signs and symptoms. It is essential that your pet gets down to an appropriate body weight. I can’t emphasise this enough. In people, it is not proven that being overweight will cause osteoarthritis – it may be one factor that could contribute in some patients. However, being overweight will definitely make your symptoms worse and increase your dependency on medications to control joint discomfort.
Secondly, a course of anti-inflammatories may be required to ‘settle’ the joint. Some patients require long-term medication with these drugs and they can cause some unpleasant and potentially very serious side effects. We discuss these in more detail in the Arthritis HELP videos which you can access free of charge from this page). Using a nutritional supplement such as glucosamine and chondroitin sulphate may be beneficial and some patients will be helped by a course of Cartrophen injections.
Thirdly, surgery may be required in some patinets. The main role of surgery is in the management of established osteoarthritis to replace a worn-out, chronically painful ‘end stage’ joint. None of us wants are pet to undergo surgery anymore than we want it ourselves but appropriate surgery at the right time can be life changing for dogs with severe, painful osteoarthritis. The main types of surgery performed are joint replacement, arthrodesis and excisional arthroplasty. We discuss these in more detail in the Arthritis Video Series. It is free so click here and take a look at these when you have time.