Joint Health in Dogs

Joint disease leading to osteoarthritis is the scourge of many big dog owners, and for good reason too. It is a major factor that decreases quality of life in senior dogs, and many younger large breed dogs require orthopedic surgery to alleviate the effects of joint disease. While we can't do much about the root cause of joint disease, the increased forces that large breed dogs bear on their joint surfaces, it is one of the chronic conditions that responds well to dietary management.


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There are several factors that influence the development of joint disease in dogs:

  1. Size - larger dogs are much more prone to developing osteoarthritis due to their growth rates and the amount of stress placed on their joints from day to day activities.

  2. Genetics - some breeds are predisposed to developing joint disease, and often in the same joints within the breed. For example, this is why hip scoring using methods like PennHip are so important when determining if a dog from a risky breed is suitable for breeding. Similar methods are used for evaluating elbow joints, another common problem area. Furthermore, dogs bred for more extreme conformational traits, as well as inbred dogs, are more likely to develop joint disease.

  3. Exercise - dogs that participate in high impact exercise like agility are more likely to develop joint disease than low impact exercise, like swimming.

  4. Body condition - overweight dogs place more strain on their joints than appropriately conditioned dogs as they carry more weight on the same surface area.

  5. Age - while younger dogs, especially those with a predisposition for developing joint disease, do develop osteoarthritis, the clinical signs tend to worsen as they age, as osteoarthritis is a degenerative condition.

  6. Diet - nutraceuticals and supplements can be beneficial in helping to reduce the impact of symptoms, as well as encourage cartilage preservation, but it is important to remember that diet is only part of a multimodal plan for managing osteoarthritis.


There are several things that dog owners can do to help reduce the severity and delay the age of onset of osteoarthritis, and many of these things can be started long before the expected start of symptoms. While there are many supplements out there that tout joint benefits, remember to read and evaluate the ingredient list to ensure that the beneficial ingredients are included in a large enough dose to be effective.


Dietary Supplements



There are several nutraceuticals that can help reduce joint inflammation, support cartilage regeneration, and joint health. These can be found in supplements formulated for dogs, as well as diets formulated for joint health. Many large breed diets will contain some nutraceuticals for joint support. Remember that supplements are not a replacement for medication and other methods of management, and these work best as part of a multimodal management plan.


Omega-3 Fatty Acids

Omega-3 fatty acids are a type of healthy, unsaturated fat that has good evidence for reducing systemic inflammation, which helps reduce discomfort and swelling from arthritis. Sources of omega-3 fatty acids include fish oil and other fish products, greenlipped mussel, flaxseed, hempseed, and wild kangaroo. Omega-3 fatty acids are easy to add to the diets of pets with osteoarthritis, with both vegetable and animal sources available, and they are often palatable and well-liked. These are also commonly included in diets formulated for large breeds, and for joint support; however, it is not harmful to add in additional omega-3s on top of a diet already containing them.


Curcumin

Curcumin is a component of turmeric, a spice used in traditional Ayurvedic medicine. Curcumin has evidence as an anti-inflammatory, and for reducing symptoms of arthritis. While turmeric is often used as a supplement, using curcumin instead is likely to be more effective and reduces the risk of gastrointestinal side effects from consuming large amounts of turmeric. As turmeric also produces a strong yellow-orange stain, avoiding gastrointestinal distress also reduces the risk of staining surfaces! Apart from that, risks of other side effects are minimal.


Glucosamine and Chondroitin

Often used together, glucosamine and chondroitin are normally found in cartilage, and help to support cartilage-producing cells called chondrocytes. They may also help to reduce cartilage degeneration. As these are naturally-occurring compounds in cartilage, they are found in lots of sources, including meat meal, fish products, and in a purified form from animal or vegetable sources.

Some treats that are fish-based can be a great source of glucosamine and chondroitin, especially when they contain connective tissue like cartilage, skin, and soft bones.


Glycosaminoglycans

Glycosaminoglycans (GAGs) are a group of carbohydrate molecules, and for arthritis, the most important is hyaluronic acid. Hyaluronic acid is a major component of joint fluid and lubrication. It also is a component of wound healing and tissue regeneration. With those functions, it is no wonder that hyaluronic acid is a great supplement for arthritis. However, it is most effective when given via injection. That being said, there are oral forms now that have higher bioavailability. As it can be quite a sensitive molecule, they are usually in standalone supplements.


Catechins

Catechins are a type of flavonoid, a plant metabolite that has antioxidant properties, and may have anti-inflammatory effects. These are usually extracted from green tea, but there are lots of different types of flavonoids from various plants. While these compounds are still being studied, there is some evidence that they can help reduce the discomfort from osteoarthritis.


Rosehip

Rosehip contains a variety of antioxidants, including vitamins C and E, and may reduce the production of enzymes that break down cartilage. It may also help reduce generalized pain and discomfort. As the antioxidants in rosehip are sensitive to oxygen, temperature, and light, it is not commonly added into food, but as a standalone supplement.


Methylsulfonylmethane (MSM)

This curious sulfur-based compound is an organic molecule that is present in small amounts in plants. While we are unsure of its mechanism of action, there is good evidence that supplementation with MSM reduces inflammation in the body, as well as discomfort from osteoarthritis. It also has shown potential to be an antioxidant, protecting against cell damage and oxidative stress.


Joint support diets



Many of the supplements above are used in diets that are formulated to provide nutritional support to dogs with joint issues. These diets do multiple things that help dogs with arthritis, including added joint supplements, weight control, and antioxidants. A good example of a joint support diet is Hills Science Diet Healthy Mobility, which comes in sizes for large, medium, and small breed dogs.

It is important to go with a reputable brand when choosing a joint support diet, as some lower quality brands may only add enough ingredients for joint support to allow them to advertise as such on the label, making the food less effective. Other examples of reputable brands include Royal Canin and Purina Pro Plan.

There are also prescription joint support diets, which focus even more on joint health. However, as these diets are so specificially formulated, they may not be suitable for all dogs, and so a veterinarian must be consulted prior to starting your dog on one of these foods. Examples of prescription joint support diets include Hills Prescription Diet j/d, Royal Canin C2P+, and Purina Pro Plan JM.


Home management



There are also several things you can do on a day to day basis to help an arthritic dog. Many of these things are adjustments to their living area to make it easier for them to go about their daily business in a way that is comfortable for them, but also supports joint health and muscle mass.


Warmth

It is common for arthritic dogs to get worse in the colder months and better in the warmer months. Heated or insulated beds are a great option, and it is also worthwhile keeping the heater on for your dog during the colder days. Microwavable heat packs like the Snuggle Safe also are long lasting, but need to be used with a cover to prevent burns as they can get quite hot.


Gentle exercise

Arthritis can make it difficult for dogs to stay active, but it is important for them to do regular, non-concussive exercise to keep their muscle mass, and also to maintain a lean body condition. Swimming is the perfect exercise for dogs with arthritis as it doesn't place any strain on joints. Avoid exercises that involve impact, such as jumping, hard running, and ball catching.


Non-slip flooring

Slippery flooring like wood, tiles, or laminate can be very challenging for dogs with arthritis, and slips can further aggravate inflamed joints, ligaments, and tendons. Cover slippery areas of your house with rugs or mats, and ensure that it is easy for your dog to access food, water, beds, and go to the toilet. Some dogs find it difficult to cross doorways as well, and anti-slip tape can be added for more traction.


Ramps instead of stairs

Arthritic dogs struggle with stairs, but may still choose to climb them to reach resources or be with their person. When possible, adding ramps to stairs can be very helpful, or teaching your dog to wait for someone to carry or help them up. If these aren't feasible, avoiding the stairs completely is a good option. Ensure that your dog has everything they need on ground level, and place a baby gate at the stairs to prevent access. Ramps can also be useful for furniture access.


Veterinary care



Finally, remember that you and your vet are a team working together to achieve optimal health for your pet. Because arthritis is so common, there are lots of medications out there that are useful for managing arthritis. However, all medications can have side effects, and your vet is the best person to help you figure out the best medical options for your pet, so ensure that you always follow your vet's advice. Your vet may discuss diagnostic testing such as blood/urine tests or x-rays to ensure that you're on the right track, or that medications are suitable for your pet. There are some common medications that your vet may discuss with you.


Pentosan polysulfate

This is an interesting medication that doesn't have many side effects, and works by supporting cartilage regeneration in the joints. It also has a modest anti-inflammatory effect. However, the response to this medication varies from individual to individual, so it can be difficult to know how effective it is until the course is started. It is also available as injection only, and the usual regime is one injection once a week for 4 weeks, then monthly ongoing. The weekly course of 4 may be repeated. Many owners choose to bring their pets to the clinic for a nurse to administer the course, or your vet can teach you to administer them at home


Non-steroidal anti-inflammatories (NSAIDs)

This class of medications are a type of pain relief that works by reducing inflammation. These include common human medications like ibuprofen, paracetamol, and naproxen. Do not give any human medications to your pet unless advised by your veterinarian. Common animal NSAIDs that are prescribed include meloxicam, carprofen, firocoxib, and piroxicam. There are newer NSAIDs now like gapiprant that have been designed for reduced side effects.

NSAIDs are effective for pain, but can also have side effects and must be used carefully. Always follow the instructions on the label when giving your pet an NSAID, and do not exceed recommended dosage and frequency. NSAIDs also cannot be given with other NSAIDs or steroids, so ensure that you stick with the medication plan given to you by your vet.


Gabapentin

Gabapentin is a type of neuropathic pain medication that reduces pain by inhibiting nerve signalling sending pain signals to the brain. That means that it doesn't actually do much for the source of pain itself, but stops the brain from receiving pain signals. While this medication is quite mild in terms of side effects, the most common being sedation, the efficacy can differ from individual to individual, and it has to be given regularly for maximal effect.


Corticosteroids

Corticosteroids are powerful anti-inflammatory medications with lots of uses, including immune suppression for autoimmune disease. While they are very effective for inflammation, they also have several side effects, some of which can be serious. These include gastrointestinal bleeding, excessive drinking and urination, weight gain, and muscle weakening. This is why they are not used as commonly as they were, as we have better options available now.




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