Painful conditions can develop in any joint at any age. There are many causes of joint disease but "arthritis" is the most common. Technically, we try to avoid the word "arthritis", which means "joint inflammation" because it is not always an accurate term for what is happening in joints. Instead, we use "osteoarthritis" or "osteoarthrosis" or the satisfyingly all encompassing "degenerative joint disease" or "DJD".
DJD occurs because of an inability of joint cartilage either to maintain a healthy state or to repair normally after damage. This fault in joint cartilage may occur because of abnormal physical force on a normal joint or because of normal force on an abnormal joint. It may also occur for seemingly no known reason.
Regardless of its cause, the diagnosis and treatment of all forms of DJD in any joint is similar. The first sign of DJD, and indeed of most other joint disorders in pets is a reduced ability to physically do things a pet previously used to be able to do. A pet may not be as agile when exercising or may not bound up stairs. You can see your cat thinking longer about jumping on the sofa or bed, Your dog may step into a car rather than leap into it. The first signs of DJD are subtle.
Eventually DJD causes overt stiffness or lameness after robust or prolonged physical activity. With time, stiffness or lameness appear after shorter periods of activity. Eventually there is stiffness or lameness after inactivity, resting for example. A pet's lying location or position may change. At this stage the stiffness upon arising can be "worked out" by a little physical activity. Eventually, stiffness or lameness upon arising cannot be worked out. A pet is permanently lame. Lameness is apparent when DJD is more severe in joints on one side of the body than on the other. If there is the more common symmetrical DJD you might not see limping but only stiffness and a reduced abililty to perform previous tasks or manoeuvres.
Diagnosis and treatment
We will flex, extend and rotate joints to assess their range of motion, the level of any pain and any sign of "crepitus", a dry, grating sound or feeling from within the joint. X-rays may show a narrowing of the joint space, new bone formation, calcification or other pathological changes. The degree of change gives us a good idea of how advanced DJD is. Arthroscopy or analysis of joint fluid may be undertaken in large dogs.
Regardless of cause there is a universal treatment for DJD.
- Control weight. If a pet is overweight, we will give you diet advice to bring weight back to within the normal range. If your pet's weight is "normal", we will discuss with you whether there is any value in reducing weight a little down to "lean".
- Control exercise. Rest is vital but so too is controlled, sensible exercise to maintain good muscle tone. Avoid running and retrieve games with dogs. Avoid jumping for toys games with cats. These put the greatest pressure on joints. Swimming is the best exercise for dogs because it tones muscles while relieving pressure on the joints. Exercise in hydrotherapy pools is ideal.
- Control pain. Non steroid anti-inflammatory drugs (NSAIDs) are excellent and safe for chronic use in most pets with DJD. Meloxicam, carprofen and firocoxib are our veterinary licenced NSAIDs of choice. The availability of these and other advanced NSAIDs has dramatically enhanced pain control for DJD.
Problems Treating DJD
- Weight and exercise control
- This sounds simple but most of us either give in to mournful eyes or strident meows pleading hunger or to toe-tapping demands for robust activity. Don't! If you can't stop giving treats, drop the calories in the meals. Forget about your dog going with you on the five mile jog you take on Sundays. Take your dog for a good short to moderate walk several times a day, every day.
- Control pain
- NSAIDs are magnificent but can be associated with gastrointestinal and other problems. If an NSAID is the only way to control pain but it causes stomach irritation, we will use medications to project the stomach lining and prevent ulcers. Pets on long-term NSAIDs will have periodic blood tests for liver function.