Wednesday, March 22, 2017

Is Fido Slowing Down...this could be the reason!

What is Arthritis?
The word arthritis is a generic term referring to many different types of conditions in the joint. When the term arthritis is used it commonly refers to osteoarthritis (OA), which is also known as degenerative joint disease   (DJD). Osteoarthritis is the most common form of arthritis and studies indicate that it occurs in 20% of dogs over 1 year of age.

Understanding Canine Osteoarthritis
A healthy joint consists of cartilage that covers and protects the ends of the bones in a joint. The cartilage has no nerves and in a normal joint when cartilage rotates on the cartilage of another bone, the dog feels no pain.

However, arthritis causes the cartilage to wear away. This exposes the bones, which have many nerves. When two bones touch each other, your dog feels pain. This pain can greatly affect your dog’s quality of life, although dogs tend to be very quiet about displaying their pain.

Early treatment of Canine Osteoarthritis
Osteoarthritis can be managed much more successfully when it is diagnosed and treated early in the process. Some owners will proactively start joint supplements or joint support diets in working or active dogs.

The Risk Factors of Canine Osteoarthritis 
Dogs of any age or breed can develop osteoarthritis and there are certain risk factors you should be aware of including:
  1. Breed size - large or giant breeds have a higher incidence of arthritis
  2. Age - arthritis is more common in older dogs
  3. Weight - overweight dogs are more prone to arthritis
  4. Breed inherited traits and conformation - which can lead to arthritis because of hip dysplasia or elbow dysplasia changes in the joint
Overweight dogs: Studies have shown that weight loss alone can significantly improve comfort in dogs with OA. Joints that are already sore and stressed are made worse when they have to support extra weight. Ease of activities such as climbing stairs, jumping into a car or truck or getting up from a sitting position can improve dramatically with weight loss. If your dog has a Body Condition Score over 6/9 you should consider weight loss for your pet.
There are a number of very good weight loss diets available. Royal Canin Satiety Support is a low calorie diet that contains ingredients designed to help your pet feel full, maintain lean muscle mass, help with skin and coat and also contains Glucosamine/Chondroitin to help improve joint function. It comes in a dry and canned formula. We would be happy to develop a weight loss program to help achieve weight loss and ultimately improve the comfort of your pet. 
Other option for weight loss include: Hills Metabolic and Royal Canin Calorie Control diets. Hills also makes a combination weight loss and joint support food.

Just like in people exercise is vital for weight loss.  Exercise helps increase the resting metabolic rate and burns more calories while maintaining or improving muscle tone. The most successful weight loss programs are combined with good exercise programs.
Controlled exercise is invaluable in treatment for patients with osteoarthritis. This can help improve function and reduce pain, by using the “move it or lose” it principle. Please see our additional exercise sheet.

Joint Support Diets
Royal Canin Mobility is a veterinary diet that is specially formulated to help improve joint health and reduce joint pain in the canine patient. It contains green lipped muscle, omega fatty acids and glucosamine /chondroitin all ingredients that support joint health. It is also moderate in calories to help maintain weight.
Please see the diet brochure.
This is the diet that Bowmanville Veterinary Staff reach for with their older active dogs and many of us use it proactively as our pets become seniors.
Other options for joint support diets include Hills J/D and Hills Metabolic/Joint.  (See brochures)

Nutraceuticals are nutritional supplements and are believed to have a positive influence on the cartilage health in the joint. Many people will have heard of Glucosamine and Chondroitin which are products that have been available for humans for many years. Using products that contain these natural ingredients may help but we have found products that contain more than these two ingredients to be more valuable.
There are many products available as joint supplements.  At Bowmanville Veterinary Clinic we will only stock/sell products that have been proven by scientific studies. Some products on the market have anecdotal reports that they work, which is supportive great, but we want to know that the products we sell also have evidence based scientific studies to support them.. The other criteria that must be met before we consider bringing a nutraceutical to our shelves is some thing called the NN number. Unfortunately some nutraceuticals have inconsistent delivery of ingredients so you may not be getting what you pay for. Products that carry a NN number mean they have been certified to meet safety and quality criteria. When a product contains only approved ingredients which are safe or low risk they can be assigned a NN number. For you and your pet the NN on the package is proof that the manufacturer meets adequate standards for these types of products.
Flexadin Plus - our number one nutraceutical for joint support is Flexadin Plus.  It has scientific studies and is NN certified. This product contains Glucosamine, Chondroitin, Omega fatty acids and Devils Claw. Devils claw is a naturally occurring anti-inflammatory. Many of our canine patients have started with this product and owners have found a very positive improvement in their dogs comfort and mobility. Remember it is very important as your dog ages to encourage exercise to control weight and maintain flexibility. We need to keep them moving.
Results can often be seen within days. The same company that makes Flexadin Plus also manufactures Flexadin Advanced. This product uses UCII collagen a very advanced ingredient that is widely used in human medicine. This product works with the immune system to help maintain joint integrity. It can take up to three months to see the maximum benefits of this product. One big advantage of Flexadin Advanced is that you only need to feed one chew regardless of the size of your dog.
Flexadin Plus and Flexadin Advanced have a palpability guarantee so if your pet does not approve of the taste they are fully refundable. This company also offers a “buy six get one free” loyalty program. (See brochure)
We also carry Dasuquin by Nutramax another scientifically studied and NN certified product that has been widely used in the U.S for years. This is a good alternative to Flexadin if your pet does not like the taste of Flexadin.

The term NSAID refers to Non Steroidal Anti –inflammatory Drug a class of drugs that are used to treat the pain and inflammation caused by arthritis. One of most common NSAID’s used in people is ASA but since dogs are much more sensitive to NSAIDS than humans aspirin can cause unwanted side effects such as stomach upset or irritation to intestines and can lead to vomiting and diarrhea, stomach ulcers and possibly more serious side effects. NSAIDS specifically formulated for dogs were introduced in the 1990’s. These NSAIDS work more effectively for dogs than aspirin while minimizing side effects in the internal organs. These drugs have changed and provided improved quality of life for millions of dogs living with the chronic pain of osteoarthritis. NSAIDS do have side effects that we must consider. Kidney, liver  or gastrointestinal conditions must be assessed to make sure your dog is able to metabolize and excrete the medication A complete history, physical exam and blood work are necessary prior to initiating NSAIDS along with periodic follow-up blood work as recommended by our veterinarians
Metacam (Meloxicam) is our number one NSAID of choice. It comes in a flavoured liquid that can be given directly or mixed in to food. We also like this product because it can reduced to what we call a lowest effective dose i.e. the least amount of drug needed to still provide pain management and improved quality of life.  (See brochure)
There are a number of other NSAIDS available to us if Metacam is not giving the desired results.
For our very arthritic patients it may become necessary to prescribe drugs to use in conjunction with nutraceuticals and Nsaids. Drugs commonly used for pain management in humans are now approved in dogs. The most commonly used adjunct drugs are Tramadol and Gabapentin. These are sometimes used alone if a pet is not able to safely use an NSAID.

DMOAD-Disease Modifying Osteoarthritis Drugs
There are injections available that to retard the progression of arthritis by stimulating production of lubricant and cartilage in the joint. Examples are Cartrophen or Adequan.
The treatment starts with a series of four injections given a week apart. After the initial series the treatment usually consists of one injection per month. Injections are given at the veterinary clinic, along with treats to distract your dog. (See brochure)
Alternative therapies-there are many exciting opportunities in this area for additional resources such as physical therapy-is done here, acupuncture, massage, chiropractics, etc. Please ask for our list if interested.
As you can see, there are now many options to help prevent pain and improve the quality of life of dogs affected by Osteoarthritis. 

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