Treating osteoarthritis in dogs and cats

Osteoarthritis, or degenerative joint disease (DJD), is a progressive disease of the joint characterized by loss of cartilage, bone spur formation called osteophytes and scarring of the joint.

Cats more commonly get primary DJD, which is associated with aging. Dogs more commonly get secondary DJD, which is a consequence of trauma, ligament injury or joint dysplasia.

Regardless of primary or secondary disease, DJD is progressive to affect the entire joint structure leading to pain, loss of function, muscle wasting and poor quality of life.

Cartilage is comprised of hyaluronic acids, glycosaminoglycans and water. As this cartilage structure is broken down, inflammation increases, elasticity decreases, and the joint becomes less shock-absorbent. Tiny bone spurs may form, contributing to pain and stiffness. Dogs and cats may exhibit changes in the way they walk, decreased willingness to go on walks, changes in the way they sit or curl up, decreased grooming activity, changes in appetite, loss of muscle mass and difficulty rising.

Cold or wet weather may worsen clinical signs. Unfortunately, there is no cure for DJD, only control of symptoms and progression. Diagnostics may include a full and thorough physical exam with joint manipulation and gait analysis, x-rays, blood work, joint fluid analysis, and/or CT/MRI. The goal of treatment is a multi-modal approach to relieve pain, increase function and slow progression of disease.

This approach includes weight management, environmental management, nutraceuticals, controlled exercise and medications.

Weight reduction, if indicated, is a major factor in slowing disease, as excessive weight creates a large amount of stress on an animal’s joint. Talk with your veterinarian to either start a commercially available weight reduction diet or tailor the current diet to reduce caloric intake.

Healthy snacks for dogs include apple slices, green beans, plain rice cakes, carrots, blueberries, bananas and cooked sweet potato. For most cats, reducing carbohydrate intake helps with weight loss.

Environmental management for an arthritic dog may include non-slip runners in the house, toe grips (Dr. Buzby’s toe grips or booties), keeping nails trimmed, raising food bowls to help with neck pain, stairs or a ramp to help access furniture, memory foam bedding or a harness to help with mobility (such as Help Me Up Harness).

Non-drug treatment modalities for arthritis can include a combination of any of the following treatments or supplements:

• Adequan (PSGAG): Given via injection either in the muscle or under the skin, Adequan provides faster and longer-lasting responses than oral forms. Adequan prevents cartilage breakdown, increases synovial fluid and blocks inflammatory mediators. Owners can be taught how to give this injection at home.
• Fish Oil: Long chain fatty acids provided by fish sources of EPA and DHA are preferred over short chain fatty acids from plant sources. The dose for arthritis is typically higher than other uses of fish oil, so stomach upset can occur.
• Laser therapy: A noninvasive and highly effective way to treat pain and inflammation, laser therapy provides targeted super pulsed laser light that stimulates cell regeneration. (multiradiance.com)
• Acupuncture: performed by a trained professional, acupuncture provides pain relief, increased mobility and increased blood flow
• Assisi loop: Targeted Pulsed Electromagnetic Field therapy delivers a micro-current to damaged tissue that is precisely tuned to trigger an animal’s own natural anti-inflammatory process. The electromagnetic signal, which is 1/1,000 the strength of a cell phone, stimulates cellular repair by upregulating the body’s own production of endogenous nitric oxide. (assisianimalhealth.com/technology)
• Joint supplements: Movoflex, Flexadin, Dasuquin Advance. In some cases, a therapeutic trial of nonsteroidal anti-inflammatory drugs (NSAIDs) may help confirm that pain is responsible for the patient’s clinical signs; however, a positive response alone does not provide a definitive diagnosis of DJD.

Examples of NSAIDs’ available for dogs and cats include carprofen, meloxicom, deracoxib, grapiprant (Galliprant) and robenacoxib (Onsior for cats). NSAIDs block COX-1 and COX-2 pathways, except Galliprant, which spares the COX pathway and is safer for use in dogs with kidney or liver issues.

All NSAIDs have the potential to cause stomach upset or organ damage. Do not give your dog or cat any human NSAID such as ibuprofen, aleve or aspirin. Especially avoid Tylenol in cats, as it can cause a severe blood disorder called methemoglobinemia and death.

Other pain modulating drugs which can be combined with NSAIDs include gabapentin, tramadol and Amantadine. Gabapentin specifically targets nerve pain, which in combination with inflammation can be significant in a pet with arthritis. Tramadol, a weak opiate, can also be given in combination to help with more severe pain. Amantadine is a N-methyl-D-aspartate (NMDA) antagonist that in combination with other medications helps relieve pain. It is not used as solo-therapy.

Solensia is the first FDA approved drug to control osteoarthritis pain in cats. A feline anti-nerve growth factor monoclonal antibody drug, Solensia is given via injection by a veterinarian once a month. A total 77% of cats showed an improvement in mobility after three monthly treatments. Read more about Solensia here at zoetispetcare.com/products/solensia.

Provided by Erika Pitkat DVM, HelloVet.