November 2017 - Pawsitively Intrepid

With the passing of every day, we all get older. Sometimes it feels that if you blink too quickly, your new puppy will start to develop silvery gray hairs along his muzzle. For those of us who hike frequently with our dogs, one of the first signs of old age is a dog who is slowing down on the trail. Or perhaps he runs hard all weekend, only to end up stiff and limping after a night of sleep. These are early indicators of arthritis and degenerative joint disease in our hiking companions. Arthritis is commonly diagnosed in dogs as they age - it has been estimated that one in five dogs will be diagnosed with arthritis in their lifetime. (This article is focused on dogs, but in cats the statistic can be even higher- as high as 40 to 92% of cats). What is arthritis? Osteoarthritis is defined as a degenerative and progressive disease affecting synovial joints. It is characterized by loss of cartilage, inflammation, and remodeling of the bone around the joint/cartilage. This results in pain and loss of normal range of motion. What are the early warning signs of arthritis in dogs? Many of us notice when our pets slow down on walks, limp during or afterwards, can't go as far, or have trouble jumping up or off of things. However, we should also be looking for the more subtle, early warning signs. These can include restlessness/trouble settling, frequently changing position when resting, shifting weight while standing, and little hitches in normal movement. With early recognition, symptoms can be treated sooner. This can help slow the progression of arthritis. Ideally, we want to prevent arthritis entirely. But when that is not feasible, we want to keep dogs in stage one (a growing or young adult dog with intermittent signs) as long as possible. By stage four (when older dogs lose the ability to walk) quality of life can be significantly affected. In case you were wondering: Stage 2 = young adult dogs with intermittent signs lasting a few hours. Stage 3 = adult dogs with exercise intolerance and difficulties performing activities of daily living. The Best Treatment is Prevention Even though arthritis is often diagnosed as our companion animals age, the foundation for the disease can begin when pets are young. Some arthritis is secondary to genetic developmental orthopedic diseases or acute injuries that were not preventable. However, there are many ways that you can help prevent arthritis from developing. 1. Early nutrition practices + growth rate All puppies should be fed food formulated for growth. However, it is also important that they do not grow too fast. Especially in large breed puppies, over-nutrition can lead to developmental orthopedic diseases. Free choice or overfeeding (especially with high energy foods) alone can be an issue, but specifically excessive calcium intake and an imbalance of vitamin D metabolites can impact joint development. Read more about nutritional influence on joint disease in puppies at dvm360. Or for more information about starting your puppy off right, check out my New Puppy Checklist. 2. Over exercising This is also especially important in puppies. As the joints are growing, they are extra susceptible to trauma from over-use. For example, a 6-month old retriever should not be running multiple miles on hard pavement. Stick to short episodes of exercise on soft surfaces - similar to the natural exercise that a puppy would get from play. Once the joints are done developing, then start slowly building their tolerance up. And remember to avoid the "weekend warrior" syndrome. Just like people, dogs who don't exercise during the week, but then are expected to run hard on the weekend, are prone to aches and joint pains afterwards. Slowly training the body to accept harder exercise helps protect the body from injuries. 3. Help your pet maintain an ideal body weight Extra weight means extra strain on joints. Just think about how much easier it is to sprain or strain an ankle when hiking with a 20# backpack. And every injury causes inflammation in the joint which can pave the way for development of arthritis. If reduction in arthritis isn't a great enough reason to help your pooch lose weight, check out the Purina Life Span Study. But once arthritis is diagnosed, how do we help our dogs get as many good hiking years as possible? There are several ways to treat arthritis. And the best approaches are multi-modal, meaning that they incorporate several different treatment modalities. 1. Exercise Just as it is important not to over exercise, it is also important to keep dogs with arthritis moving. Early stages of arthritis need moderate exercise daily. Later stages need short sessions of moderate exercise a few times each day. Swimming, underwater treadmills, and specific rehabiliation programs can be beneficial, especially in later stages. 2. NSAIDs (non-steroidal anti-inflammatories) This is the most commonly used (and most effective) category of pain medication for arthritis. For humans, these medications include aspirin, ibuprofen, and acetaminophen. Dogs are much more sensitive to this category of medication and typically shouldn't take the above over-the-counter medications. Dogs require specific NSAIDs that are less likely to result in kidney damage or stomach ulcers. Aspirin is an occasional exception, but should only be used under the direction of a veterinarian. The commonly used NSAIDs for dogs are carprofen, meloxicam, firocoxib, deracoxib, and the new gapiprant. Check out veterinary partner's article on medications for arthritis for more information on NSAIDs (as well as information on other medications/supplements). 3. Other pain medications In dogs with more chronic or severe pain, adding in a second pain medication can be helpful. Since NSAIDs cannot be combined with each other, oftentimes dogs will be prescribed a medication like gabapentin or tramadol. 4. Supplements Supplements can easily be combined with any type of pain medication. Or, if your dog doesn't have much pain yet, but you are attempting to slow down the progression of joint disease, anti-inflammatory and chondroprotectant (cratilage protecting) supplements can be used alone. The most common type of supplement used for dogs with arthritis is glucosamine +/- chondrotin sulfate. These are both chondroprotectants The clinic I work at uses the joint supplement brand Dasuquin. This is a chew that includes glucosamine, chondrotin sulfate, and avocado/soybean unsaponifiables. The avacodo/soybean unsaponifiables provide anti-inflammatory effects. There are many brands available, just make sure the one you choose has done some research into making sure they meet the recommended dose to provide the appropriate chondroprotectant and anti-inflammatory effect. Omega -3 fatty acids (often found in fish oils) are another commonly used supplement to support joint health. This supplement reduces inflammation in joints. Again, there are many brands available. Just make sure you are using the correct dose. I like to refer to the fish oil dosing chart provided by Colorado Veterinary Teaching Hospital. There are many more options out there, but glucosamine/chondrotin sulfate and omega -3 fatty acids are normally the two types that I recommend starting with. 5. Alternative treatments A final category of treatment for arthritis, includes the many alternative treatments. For example, have you considered acupuncture or laser therapy for your dog? Nerve stimulation, cryotherapy, and other physical therapy/rehabilitation procedures can have a significant impact in reducing pain and building up muscle tone in dogs affected with arthritis. In my local area, I have heard some good things about Twin Cities Animal Rehab and Sports Medicine. They offer many of the services listed above. Incorporating this information into your hiking plan. Now that you have read the information above, what does all this mean for you and your hiking dog? Don't take your puppy for long hikes until they are done growing. Don't be a "weekend warrior." Most dogs love hiking and won't stop or slow down when you suddenly take them on an 8 mile hike. Make sure your dog has good muscle tone (created via daily exercise) and is comfortable on shorter walks first. Once your dog is appropriately conditioned, then you can spend a whole weekend hiking on strenuous terrain. If your dog is limping after hikes (even if just for short periods of time), talk to your veterinarian. It may be time to start your dog on joint supplements and/or pain medications. Honestly, it is probably never to early to start on joint supplements. But check your dog food first. For example, my dog Glia's food already contains omega-3 fatty acids. Other foods (especially senior foods) may also contain glucosamine or other supplements. Once your dog has developed arthritis, don't stop hiking. Just take it slower and reduce the strain. Flatter terrain, frequent breaks, and swimming are great ideas. Okay, now get outside and explore with your own furry hiking companion! For some fun trails in La Crosse, WI, read about the 5 Best Dog-Friendly Hiking Trails in La Crosse, WI. Or check out one of the dog friendly National Parks. Inspiration for this post was partially a result of living with a lovely Labrador who developed arthritis in her later years. When I recently read an article (Mobility Matters by Boehringer Ingelheim), I hoped a blog post about arthritis would be helpful for some of my readers. Let me know your thoughts below.