Q: My older dog is having difficulty going up the stairs and he is slow to get up from lying down. While he walks awkwardly at times, he’s not limping, and he doesn’t yelp but could he be in pain? I don’t want him to be on medication for arthritis because I’m worried he’ll act sedated or groggy. What can I do that’s not medication?
A: Yes, it sounds like he is likely suffering from arthritis pain. Dogs typically don’t complain much about slow onset or chronic pain, like experienced with arthritis. It’s likely something he has been aware of for some time. When they gradually adapt like this, they typically don’t yelp, don’t go off their food, and generally act like things are normal. When it looks like your dog is struggling or slow to move around, you can bet he’s in pain. Getting him assessed by your veterinarian will be very helpful as there are a number of things that can be done to ease his pain and help him move around more easily and enjoy being active. Arthritis isn’t the only thing that can interfere with normal activity or cause pain (pinched nerves, bone tumors, collapsed disk spaces, autoimmune disease and pain from the abdomen are other common issues to rule in or out with chronic pain). Your veterinarian will perform a thorough history and physical examination, and may in some cases advise further workup. If generalized osteoarthritis is assessed as the problem, there are numerous approaches to successful therapy. What tends to work best is using a multi-modal approach, meaning that several methods combined yield better results than any single therapy. Here are some common things to consider:
- Is he at a healthy lean body weight? A dog at a healthy weight: a) has a clearly defined waistline when viewed from above (a taper just in front of the hips) and from the side (the belly tucks up just before the hips), and b) has ribs that are easily felt just below the skin. Talk with your veterinary team about whether your dog could stand to lose a few pounds. Numerous studies have shown that reducing weight leads to significant improvement in quality of life for dogs. An arthritic dog that is carrying around extra weight is putting undue stress and wear on already compromised joints. Measuring out and reducing portions is critical to reaching and maintaining a healthy weight. Talk to your veterinarian – there are medical conditions that can interfere with weight loss, and prescription diets that can be extremely helpful for some dogs that have had long term struggles with being overweight. Reaching a healthy weight early in the progression of arthritis, or preferably long before its onset, is probably the single most helpful step you can take for your dog.
- Is he active enough? Initially, at least, it is often very difficult for dogs with significant arthritis to be active. Controlled exercise, when introduced gradually and with other supportive measures taken, can be very helpful. Building muscle strength can help to support ailing joints. Initially an exercise program should avoid overloading the joints. Controlled leash walking, walking in water, jogging, swimming, and going up and down ramp inclines are excellent low impact exercise. I know many clients who provide activity to their older pets during our cold, slippery winters by teaching them to walk on a treadmill. Exercise needs to be monitored so there is no increased pain after the activity. If there is pain after an activity, the length of activity should be decreased by half.
- Try slow acting supportive measures – i.e. nutriceuticals. There is reasonably strong evidence that, when given daily specific ratios of omega-3 fatty acids (sourced from fish oils) can be helpful at reducing inflammation and pain in arthritic joints. These free radical scavengers must be given daily. Note that although shown as an ingredient in some dog foods, omega-3’s are seldom available in adequate enough quantities to address joint inflammation unless administered as a direct supplement. Talk to your veterinarian about which products are reputable, and what dose is indicated for your dog. Glucosamine is another much promoted material, but one that unfortunately has limited evidence of efficacy when subjected to stringent trials. Another joint building and supporting therapy (Cartrophen or Adequan) containing synovial fluid building blocks can be beneficial when administered as an injection.
- Are there modifications that should be made to his environment? Keep him in a warm dry environment (i.e. away from cold and damp). Use a soft, well-padded bed. Provide good footing to avoid slips and falls, e.g.: carpet runners for hardwood floors. Reduce stair climbing by using ramps if you can.
- What about acupuncture? Many animals appear to benefit from the ancient Chinese practice of acupuncture, particularly when it comes to treatment for chronic pain. Our clinic likes to use it combined with the benefits of western medicine.
All of the above measures are expected to take weeks to months to begin to provide relief to a dog with ailing joints. In the meantime, your dog really is in pain – what can be done?
- Arthritis meds do NOT make dogs act groggy or sedated. This seems to be a common misnomer. The modern long term meds we use long term to assist dogs with chronic pain lead normal active lives, do not interfere with day to day functioning, and do not make dogs act sleepy. Arthritis meds also come in several families, and what they have in common is that compared to other measures they DO act quickly to relieve pain. Some commonly used meds include non-steroidal anti-inflammatories (NSAIDs), gabapentin (to relieve neuropathic or nerve origin pain), and sometimes other synergistic measures. An aging dog may have medical conditions that affect the management of osteoarthritis and the use of these drugs. A complete history, physical examination and blood work with periodic monitoring are thus recommended as determined by your veterinarian.
Dr. Lisa Collis, BSc, MSc, DVM practices at the Delton Veterinary Hospital in Edmonton. She serves as Adjunct Clinical Instructor to veterinary students in the University of Calgary’s Distributed Veterinary Teaching Hospital program.