Aging and Aching
In veterinary medicine, we commonly like to say, “age is not a disease”. While this is inherently true, it is also true that as a pet ages, each pet will likely face a multitude of health problems. Geriatric pets should be able to grow old in comfort. To do this, we need to try to discover conditions earlier and be more proactive rather than reactive. Many times, we can be unaware of the presence of discomfort in out senior pets, so it is very important to have these pets examined every 6 to 12 months.
One of the most common problems we see as our pets age is arthritis. Osteoarthritis is the most common form of arthritis and effects approximately 1 in 5 dogs in the United States. It is a chronic, degenerative disease that may affect any joint in the body. In dogs and cats, then joints we are primarily concerned with the hip, elbow, shoulder, stifle(knee), carpus(wrist), hock(ankle) or intervertebral joints (along the spine). Most commonly, we associate arthritis with the hips, shoulders and elbows, but we can find it in any of these joints. Osteoarthritis occurs when articular cartilage in a joint is damaged or destroyed. This type of cartilage is found at the ends of bones where they meet within a joint. It reduces the impact on the bones, thereby decreasing any stress on that joint (kind of like a shock absorber). When this cartilage is damaged, inflammatory changes occur, which can lead to the destruction of the cartilage. When there is less cartilage, the bones are not as well protected and can become damages as well. Cartilage does not contain any nerves, so when the cartilage of one bone touches the cartilage of another bone, there is no pain. Bone, however, does contain nerves. If the cartilage is damaged or wears away, and the underlying bone is exposed and touching another bone, can cause pain and inflammation.
In dogs, osteoarthritis can occur due to several factors and is most prevalent in senior dogs, large breeds, overweight dogs, dogs with abnormal joint development, as well as athletic and working dogs. It is most commonly triggered secondary to another joint problem such as hip dysplasia, elbow dysplasia or trauma to the joint, but we can also see arthritis due to normal, long term “wear and tear”. Puppies who suffer from abnormal development (such as elbow or hip dysplasia) can also develop osteoarthritis, even at a young age. Once the disease process begins, any movement within the joint can cause the disease to progress and become more painful, so early diagnosis and intervention is important.
Symptoms of osteoarthritis in dogs can vary depending on the severity of the disease but usually include a combination of symptoms. Owners may notice stiffness (which may disappear once the pet begins moving), limping, reduced mobility, reluctance to go on walks, or restlessness. You may also find that your dog is having a hard time jumping in or out of the car, showing difficulty getting up from a resting position, or difficulty climbing stairs, onto the bed, or a sofa. Sometimes arthritis pain can also show as soreness when touched, whimpering or yelping in pain, acting withdrawn, or even signs of aggression when touched.
We would recommend bringing in senior pets for a thorough physical exam every 6 months. At this time, we can discuss any changes noticed at home and check for signs of muscle atrophy as well as signs of discomfort when the joints are manipulated. Radiographs (x-rays) are very helpful for identifying osteoarthritis and may be recommended at this time, as well as different options for treatment. We may also discuss further testing, depending on the age and overall health of your pet.
Treatment options range from oral medications to food or exercise. Slow acting chondroprotectants help to slow the progression of the disease and help keep the joints lubricated and cushioned; these include glucosamine/chondroitin supplements and Adequan injections. Prescription anti-inflammatory medications (NSAIDs, such as Carprofen/Rimadyl or Metacam) help to decrease the inflammation associated with arthritis and reduce pain. Over the counter pain relievers/NSAIDs are very dangerous for pets and are not recommended. We recommend discussing medication options during a senior exam to find the safest choice for your pet. Veterinary diets, such as Hill’s j/d may also be recommended. This diet contains glucosamine/chondroitin and EPA/DHA which help by including these chondroprotectants without a need to add a supplement. Weight loss, acupuncture and therapeutic exercise are also very helpful to decrease the progression of this disease and aid in discomfort, as are environmental changes such as carpets, toe grips or traction pads.
If pain medication is prescribed for your pet, we will most likely discuss blood work as well. Although very safe, NSAIDs can potentially cause kidney, liver, or gastrointestinal conditions over time. Routine blood tests can assess your pet’s ability to metabolize these drugs and ensure it is safe for us to prescribe them.
Osteoarthritis is also extremely common in cats; although they are much more stoic and much better at hiding any signs of pain. Just as with dogs, there are many causes for arthritis in cats, and the frequency of occurrence increases with age. One study showed that 90% of cats over 12 years of age had evidence of arthritis, but only 33% of those cats had clinical signs. Limping is not commonly a sign of arthritis in cats, which is one reason why it can sometimes be overlooked. Symptoms tend to come on very slowly and can include a combination of signs, just as in dogs. One of the most common arthritis associated problems is inappropriate elimination (not using the litter box). We also see cats grooming themselves less, showing a reluctance to be brushed or to jump, sleeping more or moving less. Cats may also act withdrawn from their owner or begin to hide. Cats, in general, are much less cooperative in the exam room so it can be tougher for us to fully assess joint discomfort and gait while they are in our office. We often rely on an owner’s observation at home, combined with radiographs(x-rays) and potentially blood work to rule out any other underlying medical issues. Treatment options for cats are like the options for dogs. Pain medication and joint supplements be recommended, as well as weight loss or environmental changes. There are multiple ways to alter your cat’s environment to help reduce pain associated with arthritis. This can include cutting a lower opening into the litter box, which can help reduce the need to jump.
We recommend ensuring that your pet has a physical exam once a year until they are considered seniors, at which time we would recommend bringing them in every 6 months. For dogs, this is recommended at 7 years of age, and for cats at 9 years of age. Please call us to schedule your senior pet’s appointment today, and we can discuss any potential discomfort and help to find the best treatment option.