Osteoarthritis
PhysioMy.Dog - Holistic Animal/Veterinary Physiotherapy & Other Hands on Therapies for your Dog
Osteoarthritis is the most common condition I treat.
The purpose of this page, is to provide owners with more information on the condition and how it can be managed.
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What is Osteoarthritis?
Osteoarthritis (OA) – sometimes referred to as degenerative joint disease (DJD) or spondylosis if in the spine - is a disease of any joint.
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Primary causes include age, normal wear and tear and some breeds are predisposed to the condition.
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More common causes are secondary such as joint trauma or surgery, or when a joint has not developed correctly.
Research shows (Rvc.ac.uk, 2019), osteoarthritis was the most common musculoskeletal disorder recorded by vets in the UK from September '09 to March '13.
Data (CAM 2019) states 1 in 5 dogs are affected with Osteoarthritis because the chances increase dogs age, it's therefore very likely your dog has or will get osteoarthritis. Golden Retriever and Labrador breeds are most prevalent. (Anderson KL, O'Neill DG, Brodbelt DC, et al) followed by Rottweiler, German Shepherd. See image for other affected breeds.
Breed Prevalent to OA (Anderson KL, O'Neill DG, Brodbelt DC, et al)
Royal Veterinary College Most Common Musculoskeletal
Disorder List
RVC, Vet Compass
“Osteoarthritis is a joint disease characterized by a progressive cascade of mechanical and biochemical events leading to cartilage destruction, subchondral bone sclerosis, synovial membrane inflammation and the formation of periarticular osteophytes.” (Bockstahler et al 2019)
What Osteoarthritis Looks Like
Osteoarthritis Progression Summary
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Degeneration of normal joint structure
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Reduced use of joint/limb due to pain
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Surrounding muscles, ligaments & tendons weaken
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Body compensates elsewhere causing further pain
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Brain becomes more aware of constant pain and magnifies it.
Progression of OA in Human Knee (Bioventus, 2017)
Spondylosis in the Spine
(PhysioMyDog)
Osteoarthritis in the Joints
The word “dysplasia” means “abnormality of development”
Elbow Dysplasia
The elbow is a complex synovial joint involving the articulation of three bones - humerus, ulna and radius. When bones meet and articulate (move against each other) they have to work in harmony to provide stability, reduce shock and friction.
Synovial joints tend to move the most so have a greater potential for instability resulting in a higher risk of developing OA.
If these bones don’t fit together correctly, it results in abnormal force on a specific region of the joint. This results in osteoarthritis, but also “in discrete pathological entities like fractures within the joint that may need to be managed separately and alongside the osteoarthritis.” (Fitzpatrick Referrals, 2019)
Elbow Dysplasia tends to be the umbrella term for several elbow diseases including
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Fragmented Medial Coronoid Process (FCP) – most common
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Ununited Anconeal Process (UAP)
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Osteochondrosis - OCD
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Medial Compartment Syndrome (MDC)
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Radioulnar Incongruity (RUI)
It’s usual for both elbow joints to be affected, but usually one is worse than the other.
Hip Dysplasia
Hip Dysplasia is the commonest orthopaedic condition in dogs and is usually the reason why dogs have hind limb lameness. As with elbow dysplasia, the vast majority of affected dogs have dysplasia of both hips.
The hip joint is where the thigh bone, or femur, meets the pelvis. This joint is shaped like a ball and socket. The soft tissues that normally stabilise the hip joint become loose, which leads to the joint not forming correctly. The ball becomes flattened and deformed and the socket becomes more saucer-shaped.
Because the joint isn’t formed correctly, it will cause pain – “initially by repetitive strain injuries to the lax hip stabilisers, and microfracturing of the bone and cartilage surfaces that are rubbing past one another. As cartilage erosion progresses, pain is the result of the global joint disease known as osteoarthritis.” (Fitzpatrick Referrals, 2019)
Despite the varying progression of these disorders, they all lead to osteoarthritis development.
Fragmented Medial Coronoid Process (Fitzpatrick Referrals)
Normal Hips (CARE)
Hip Dysplasia (CARE)
How Osteoarthritis is Diagnosed
The owner will likely notice behaviour changes such as
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Panting or pacing, not able to get comfortable
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Changes in posture and physique
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Mood changes
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Sleeping more than before
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Lameness worsening with activity
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Stiffness after rest period or activity
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Not wanting to play, or go out for walks
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Licking joints
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Reluctant to jump in or out of the car, furniture, negotiate steps etc.
Diagnosis is confirmed by a vet after clinical examination and often radiographs. If further clarification is required, an arthroscopy or computed tomography (CT scan) maybe necessary which can be done by the local vet or referred to a specialist.
Clinical signs vary but include
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Decreased range of motion and possible crepitus
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Joint pain
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Variable degrees of inflammation
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Joint effusion and joint capsule thickening
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Lameness
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Paddling gait is common if bilateral, or head nod lameness if one elbow is more affected
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Front paw(s) rotates outwards when in stand or sit
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Muscular atrophy around elbow and shoulders
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Pain on palpation, extension and rotation of elbow
CT Scan of Elbow (Fitzpatrick Referrals)
“It is a consuming, both emotionally and physically, debilitating disease for owner and dog” Hannah Capon, Canine Arthritis Management
How Osteoarthritis Is Treated
Arthritic pain in dogs means less activity and movement which has a huge knock on effect. Moving less can lead to weight gain if not correctly managed, decreased muscle mass, stamina and strength, increased joint stiffness and loss of overall fitness.
There is no known cure for OA, but whatever the underlying cause, it can be treated with either surgery or conservative management depending on variables such as severity, owner expectations, ability and budget, age and overall health.
With surgery or conservative management, it’s usual for the dog to be referred for therapy such as physiotherapy or hydrotherapy.
A behaviourist/trainer may also be involved if the dog has any behaviour challenges (often relating to pain). In conjunction with the vets, a multimodal Management Plan is developed which will include:-
Lifestyle Adaptations & Joint Protection
A successful plan will involve professionals such as vets, physiotherapists, hydrotherapists, behaviourist/trainer, dog walkers etc all working together with the owner.
The biggest impact and influence of managing the condition will come from the owner due to the amount of time the dog spends with them, so it’s essential owners are educated on the condition and adapt their dog’s lifestyle to accommodate their physical and emotional needs.
Complementary Therapies & Rehabilitation
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Manual Techniques - massage, joint mobilisation, trigger/stress point therapy
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Exercise Prescription & Rehabilitation - strengthening, stretches, balance, proprioception exercises
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Physio Therapeutic Equipment - such as phototherapy, ultrasound, pulse magnetic field therapy.
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Personalised Therapeutic Plan - for owners to perform in between sessions at home such as rehabilitation exercises, ice/heat therapy, massage and stretches
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Other Therapies often used include acupuncture, osteopathy & hydrotherapy.
For More information go to Physiotherapy Page
Read How Physiotherapy Has Helped Dogs with Osteoarthritis Here
Would you like to discuss how physiotherapy could help your dog?
Can you feel your dog's ribs?
Weight Management
There is plenty of evidence to demonstrate the negative impact being overweight can have on an arthritic dog. Obesity itself creates more pain due to mechanical forces and inflammatory mediators produced by adipose tissue – fat. (Marshall W, et al 2009)
According to a study looking at the amount Labradors ate over their lifetime, “Results suggest that 25% restriction in food intake increased median life span and delayed the onset of signs of chronic disease in these dogs.” (Kealy, et al 2002)
Confirmed by another study which limited the amount of food fed over 4 year period which minimised Osteoarthritis in the hip joints. (Kealy RD et al 1997) And “Radiographic evidence of osteoarthritis that affected multiple joints was significantly more common in the control-fed group than in the limit-fed group”. (Lawler DF, et al 2000)
Having your dog at the correct weight is one of the most important things you can do. And it's FREE!
A useful way to judge the correct weight for a dog is by using the WSAVA guidelines, aiming for a grade of 4 to 5.
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Viewing dog from the top, you should be able to see a visible waistline from looking down.
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Viewing from the side, you should be able to see a tuck
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Feeling your dog's rib, cage, should feel like rubbing your hands against your knuckles. Without pushing down to feel the ribs.
Home Environment Management
Restricting hazards around the home can help prevent repetitive trauma on already weaker and painful limbs. Adaptions include
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non slip mats on slippery flooring - providing grip which helps with mobility.
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minimising access to stairs - to avoid impact on joints
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comfortable and correct sized beds (so the dog can stretch out and supports their backs) in suitable location (ie avoiding drafts)
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ramp for access in and out of car/garden, buggies when out walking to increase stimulation whilst not over exercising
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raising feeding and water bowls to avoid weight bearing down onto painful joints.
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grooming - ensuring your dog's nails & fur inbetween pads are regularly trimmed.
More help on the fabulous Canine Arthritis Management website.
Evidence has shown playing classical music to dogs can help manage stress levels. (A. Bowman et al)
You can download playlists made for dogs from Spotify.
Supplements/Nutraceuticals
The canine supplement industry continues to grow with a huge variety of products available with varying amounts of clinical research to validate their effect. Much of the research discusses the benefits seen in human studies, but the number of clinical research for dogs only is fairly limited.
There is evidence that medication and some nutraceuticals do have a beneficial effect. But it is essential to be objective, monitor an individual dog's response and consider the placebo effect when introducing anything new. “In a published study, owners and vets were unknowingly given a placebo anti-inflammatory medication for their dogs. Fifty-five per cent of owners felt that their dogs improved, and 40 per cent of vets believed the dogs improved. When tested objectively there had been no change in the dog’s mobility.” (CAM, 2019)
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Omega 3 Fatty Acids
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Glucosamine and Chondroitin
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Green lipped mussels
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Turmeric
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Boswellia
Learn more about supplements here.
Want more guidance on which to choose? Click through for the ACCLAIM criteria
Pain Management & Scoring
It is essential a dog in pain isn't ignored.
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How do I know if my dog is in pain? More information on chronic pain here.
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Look out for some typical signs and behaviour. More information on what they are here.
There are different pain scoring scales used to assess the amount of pain a dog is in. The most effective tend to be multidimensional and include input from the owners.
New scoring system called COAST (Canine Osteoarthritis Staging Tool), has been published (Cachon T, et al 2018), enabling owners and vets to work together in staging Osteoarthritis
Further information on COAST Here.
“Close evaluation of behavioural and emotional indicators of pain gives us the means to measure the effect of the pain of arthritis on our dogs and allows us to monitor our treatments.” Matt Gurney - Joint Head of Anaesthesia, Anderson Moores
You can read more on Pain Management on Matt's excellent website Zero Pain Philosophy &
the equally great Canine Arthritis Resources & Education website
Medication
Medication is frequently used to control pain. Non-Steroidal Anti-inflammatory Medication (NSAID) tends to be the foundation of medical treatment for osteoarthritis. These drugs inhibit the enzyme cyclooxygenase (COX) which reduces inflammatory mediators and reduces osteoarthritis’ associated pain.
It is worth noting that dogs do respond differently to NSAIDs, so multiple trials are sometimes necessary to find the most appropriate, as there are some side effects including gastrointestinal issues experienced by some dogs.
Other drugs which can be used include
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Paracetamol – with or without codeine
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Amantadine (when combined with NSAIDs has shown to improve physical activities in dogs with OA when sole use of NSAIDs have been ineffective) (Lascelles BDX et al 2008)
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Gabapentin – often combined with NSAID to reduce neuropathic and chronic pain
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Grapiprant – which works differently to other NSAIDs with less side affects.
Learn more about Medication on the fabulous Canine Arthritis Management Website.
What Can Be Done to Help My Dog with Osteoarthritis?
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Lots of things! More information here.
How Quickly Should Owners Expect Improvement in their dog who has Osteoarthritis?
Where Else Can I Learn More about Osteoarthritis?