So…arthritis? What now?

So your pet has been diagnosed with arthritis. What now?

What is it?

Otherwise known as “Wear-and-Tear Arthritis” or “Degenerative Joint Disease” (DJD), this is a painful, inflammatory and degenerative process, affecting one or several joints. There are many, many causes; not least ageing! The end poinsevere-hip-arthritis-with-new-bone-laid-down-arrowst of the disease is loss of articular cartilage, causing excruciating rubbing of bone on bone.

Can we cure it?

Modern medicine can do great things, but we cannot yet reverse established arthritic changes, nor regenerate lost cartilage (despite some internet claims for stem cell therapy). So: “No, we cannot cure it”.

Does that mean it is hopeless?

merlin

Click for ISFM discussion on arthritis in cats

No! We can now do amazing things to help with all the negative quality of life issues arthritis causes. We can definitely help with:

  • joint pain
  • joint swelling
  • muscle loss
  • decreased range of movement
  • reluctance to exercise
  • improved enjoyment of life.

Age is not a barrier to successful intervention. No animal should be left to suffer in silence – we must treat where we know there is a problem.

Standard of Care – the basics of treatment for all patients

Perfect Body Conditioning

We recommend all dogs and cats, but especially those with joint disease, have a body condition of between 4/9 and 6/9. Our team of vet nurses are all available to advise on diet so we can optimise this important factor. Weight Clinic appointments are free of charge: why not make an appointment now?

Exercise moderation

We aim to get your pet back to a good level of activity: it is important however to moderate the exercise especially in the early stages of treatment. We will advise on what is sensible on a case-by-case basis.puppy party 11 june16

Environmental Changes

pawz

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Simple things like providing a nice, warm, flat bed without high edges, can make sleep much more comfy. Slippy floors can exacerbate pain for older larger dogs – many people resort to rugs everywhere! We can supply rubber boots which stop slipping really well, or if you prefer, on line there are rubber nails which can be affixed over the dogs’ own nails to increase grip. Underfloor heat is a very helpful addition if that is possible. Perhaps purchasing a heated under-bed mat might be worth considering – we can advise/supply. Providing a ramp to aid entry and exit from house/car can be immensely helpful also. Cats with a back issue or arthritis may prefer a new low-profile litter tray, and may need water and food provided at ground level. Most modifications are common sense, but we have experience of them all – so do ask.

Pain relief

Arthritis is painful – pets can hide discomfort, and struggle on uncomplaining: that does not mean they don’t hurt just like we do. Many, many owners may mistake “slowing down” as a sign of ageing: it may be of course, but more commonly it is a sign that they have back or joint pain. Showing restricted movement and appearing stiff on rising after rest is a classic arthritis symptom. We mustn’t ignore this useful clue, nor dismiss it as a minor problem. If we can observe the signs of pain, then pain is there!

We use several medications for pain: each has its’ own advantages and disadvantages.

 

Non-steroidal anti-inflammatory drugs (NSAIDs):  These are often the core of any pain-management regime. In the main, they are safe and effective. Each requires metabolisation and elimination from the body: thus we insist that for safety sake we check liver and renal function at least every six months. They can also on occasion cause ulceration in the bowel, so we may prescribe tummy protectors alongside these great drugs to reduce the likelihood of any problems in that regard.

nutraquin

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Boswellia combined with Glucosamine and Chondritin sulphate (Nutraquin+): this supplement is of proven quality and is utterly free of adverse side effects. It both reduces pain, and offers some degree of long term protection to further joint degradation. In our opinion ALL our joint patients should be on this combination.

 

 

 

vetenox

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EPA/DHA: These highly anti-inflammatory components of fish oil are available in Vetenox, a stable oral liquid concentrate. Again, we believe ALL our joint patients will benefit from long-term administration of this product, as it too has no known side-effects. Most of the staff at Cedarmount Vets (of a certain age, LOL!) take the human version (Paradox), for their own joints: need we say more?

Tramadol: This opioid drug is remarkably safe in dogs and cats, although in actual fact its’ real efficacy has yet to be proven in our species. It does not cause delirium or constipation – common side effects in humans on tramadol.

Paracetamol and codeine: there is a licensed and tested version of this combination for dogs: NOT CATS (it kills cats!). We frequently prescribe it alongside a more potent drug to improve pain management.

Gabapentin, Amantadine, Amitriptyline: these are non-licensed drugs we occasionally resort to in very difficult cases.

Cartrophen injection course: sometimes, particular patients benefit from a four week course of this drug. Effects are variable, but side effects are few. It has earned its’ place in our armoury against this disease.

Additional Modalities we recommend

Veterinary Physiotherapy including acupuncture, ultrasound and K Laser therapy

We are very fortunate to have Josie, a fully qualified veterinary physiotherapist in the clinic. She oversees the more difficult cases and offers loads of compassionate care to these dogs and cats in pain. She selects appropriate treatment – perhaps involving physiotherapy, traditional needle acupuncture, electro-acupuncture, ultrasound, and now can prescribe a course of K laser too.

K Laser: This new treatment is a powerful additional tool. Made famous by sports starts like Rafa Nadal using it, it has now become main-stream and used widely in the National Health (for

K Laser

K Laser

human patients of course). We are proud to be the first vet clinic in NI to have taken delivery of the fantastic piece of equipment and our patients are benefiting daily from its’ use.

 

 

 

pawsclaire

Click to visit Claires’s website

Hydrotherapy: We are delighted to have teamed up with Clare at PawsForASplash in East Belfast. We can refer cases for assistance in a professionally controlled swim or walk on a hydro-treadmill. This facility is exceptionally well run, and Clare does a great job whilst keeping fully abreast of all the latest thinking on rehabilitation. We highly recommend her.

Our clients qualify for a discount withPawsForASplash. Ask us for details

 

 

 

 

Regenerative Medicine

Blood Spinning

This novel treatment again hit the headlines through professional sportsmen and women using it. We now offer this for dogs, more properly called V PET, or enhanced platelet therapy, available on a one-sedation only basis. We can discuss the merits on a case-by-case basis.

Stem cell therapy

This therapy promises great things, and some of these great things are now available to our patients. Adipose-derived stem cell therapy  is now available at Cedarmount. Please talk to us about this two anaesthetic procedure treatment – it may be the very best thing ever for your dog!

Salvage procedures

Surgery

Cheyenne

Cheyenne had a salvage procedure for her damaged hip. What a cutie!

When all else fails, we can offer various surgical solutions from joint replacement to a salvage surgery. If you feel the treatment we have tried is not providing adequate quality of life for your loved one, then talk to us about a salvage surgical option. Some joints can safely be fused and thereby become pain-free, and some can be replaced, just like in humans eg. total hip replacement.

 

Monitoring

Monitoring of these patients is a vital to maintain the best quality of life possible in each case. The level of pain or stiffness will vary from day to day and week to week, and every pet responds to medication differently. Regular check ups, every few weeks or months depending on the case allows us to see how well the treatment or diet etc. is working and, more importantly, change things if the current regimen isn’t having the benefits we expect. Regular monitoring also allows us to keep an eye on any potential problems with the medication and perform the necessary tests to make sure everything is OK.

The take-home message is: there are many different options to assist return to pain-free active happy lives for these pets. Do talk to us – we really can help.