Archive for the ‘Arthritis’ Category

Arthritis Management

Monday, January 26th, 2015

ArthritisManagement-01Managing Osteoarthritis 

Osteoarthritis is common amongst both dogs and people—it’s one of the things about which we can commiserate with our furry companions. Put simply, “osteoarthritis” means “bony joint inflammation.” That’s an oversimplified representation of a complex degenerative process, but that’s the basic idea. Just like in people, arthritis is the result of bony changes within joints; once the cartilaginous “brake pads” have worn down, bone grinds on bone, resulting in microtrauma, inflammation, and pain. This, then, often leads to decreased use of limbs, muscle wasting, and immobility.

Perhaps because we can relate to the woes of arthritis, it is a common thing for vets to address at any given appointment. Unfortunately, there is no cure for it, nor one “silver bullet” treatment. Many factors play into this condition, and as such it requires a multifactorial treatment plan. If improperly managed, arthritis can lead to premature euthanasia due to extreme discomfort. Here are the basics for managing arthritis in your dog to help ensure a long, happy life.

HEALTHY WEIGHT. The most important factor in managing arthritis is weight management. That’s significant enough to say again, so let me repeat it: The most important factor in managing arthritis is weight management. More weight means more stress on arthritic joints. No other factor is as important in keeping your pet comfortable. Even with a slue of other aids, such as medications, supplements, even surgery, your pet will still be in pain if he or she is carrying extra pounds. One study showed that in arthritic dogs, healthy weight management increased the median life span by two years! In other words, dogs of a healthy weight were comfortable enough to delay euthanasia by an average of two years relative to their overweight cohorts.

It can be difficult to help your dog stay slim if he or she is already arthritic and slowing down. Do not give your dog “free choice” food, but feed him or her in measured meals two or three times a day. Use a measuring cup so you know exactly how much you’re feeding rather than guessing. If you’re already doing that, try replacing a quarter to half of a meal with green beans (fresh, frozen, or no-sodium canned), or feeding a favorite vegetable or fruit for treats instead of high-calorie processed ones at the store. If your dog has specific dietary limitations, talk to your vet about some options you might try.

CONSISTENT EXERCISE. In addition to helping shed pounds and keep them off, this is an important piece of osteoarthritis management. A moving joint is a healthy joint. If your dog never gets exercise, joints don’t move, weight builds up, and muscles waste away. If you and your dog are “weekend warriors,” and squeeze ALL your exercise into a couple days a week, that aggravates arthritis and causes more inflammation. The same thing happens with “spring fling” dogs that have been lazy all winter and hit the trails running in the springtime.

Instead, focus on small doses of daily exercise. Work within your dog’s physical abilities; if your dog can only make it around the block, then that is his or her limit. If he or she can play fetch for half an hour, make it a priority to spend that time with your dog. It is essential to helping your dog maintain his or her mobility.

REHAB. If you are having difficulties keeping your dog’s weight down or his activity level up, we can help with rehab. The underwater treadmill is an excellent tool to help reduce stress on painful joints while strengthening muscles to help maintain mobility. Modalities such as laser and ultrasound can relieve chronic pain, reducing the need for medications. Massage, acupuncture, chiropractic work, and joint range of motion are other tools that rehab has to offer. Even simply swimming for 10-15 minutes can loosen up tense muscles and provide excellent cardiovascular exercise. The exact exercises and modalities used in your dog’s treatment will be up to your rehab vet, but together, you can make a significant difference in keeping Fido healthy!

NON-STEROIDAL ANTI-INFLAMMATORIES (NSAID’s). Most clients are familiar with the dog-equivalent of ibuprofen, carprofen or Rimadyl. (Please note: never give a dog any human NSAID’s or acetaminophen, as they can quickly cause liver failure and death. Dog livers are different from human livers and cannot handle drugs made for people.) Anti-inflammatories alleviate pain whenever there is inflammation present in an arthritic joint, but they all come with adverse effects. Unfortunately, many veterinarians build a treatment plan centered around NSAID’s. They should be used sparingly due to side-effects; consider these a bonus of modern medicine to have during times of increased pain (due to cold weather, increased activity, or a slip or fall, for example) rather than a cornerstone of treatment.

SUPPLEMENTS. Arthritis supplements can be very useful, but I caution all my clients to do their own research first before purchasing any. By nature, supplements and other homeopathic remedies are not regulated by the Federal Drug Administration (FDA), so there is no one to ensure that the label matches the contents. For example, one study evaluated label claims for chondroitin sulfate; of 32 products tested, only 5 contained the actual ingredients and concentrations of chondroitin sulfate advertised on the label. There is a lack of scientific studies when it comes to supplements, as well, so it can be a tricky subject to approach. Having said that, innumerable people have seen a difference in their dog with several reputable supplements, and if used in conjunction with weight management and an active lifestyle, they can be very beneficial.

Glucosamine, chondroitin sulfate, and omega-3 fatty acids have been shown to be the most beneficial supplements available. They contain essential factors for maintaining healthy cartilage within joints, slowing the breakdown that occurs with normal wear and tear.

OTHER THERAPIES. Less commonly pursued and treatments include intra-articular injections (injecting a drug directly into the joint) and surgeries. Sticker shock usually accompanies these therapy options, but they can be useful if the other therapies used above are not adequate to keep your dog comfortable. Injections contain purified versions of important cartilage and joint components, such as hyaluronic acid and glycosaminoglycans. Surgeries can realign a joint, replace a joint, or eliminate bony chunks that have broken free and are floating within the joint. These options should be discussed carefully with your veterinarian before undertaking them due to their potential risks, especially in older animals.

For more information on managing your dog’s arthritis, or if you have questions not addressed in this article, please contact us at CRCG or your regular veterinarian. We are happy to help, and we look forward to being part of the team to keep your fluffy friend comfortable and going strong for as long as possible!

Meet Noah

Friday, January 16th, 2015

NoahMeet-01Noah is a 9 year old retriever mix who was brought in to see us because of such severe arthritis in his one of his carpi (wrists) that he was completely non-weight-bearing in that limb (he was holding it up when he walked).  He needed to be on two pain medications and was still uncomfortable in that wrist.  We started with gentle manual therapy to help increase the production and flow of joint fluid which lubricates the joint and improves its health and comfort.  We used laser therapy to decrease pain and inflammation, massage for his significant muscle tightness (which was secondary to his joint pain), and ended with cryotherapy (ice) to further decrease inflammation in the wrist.  We helped his owner with an exercise restriction plan and guided her through a safe and gradual return to more activity as he started feeling better.  One week after his first visit, he was bearing weight on that leg again.  We started exercising him in our underwater treadmill which allowed him to walk with less stress on his joints because the buoyancy of the water helped to support his body weight.  We also started strengthening exercises because a stronger leg means more stable joints.  Each week that followed, his limping lessened until it was completely gone 1 month later.  He’s now back to walking 2 miles a day, is comfortable, and off all pain medications.

Canine Arthritis

Monday, May 5th, 2014

yukon2

Arthritis. At one point in time, we have heard that word either for ourselves or for our four legged companions. This condition can be seen in any joint from head to tip of the tail. But what exactly does that word mean? In studying many definitions for arthritis, the consensus is that it is inflammation of a joint, loss of joint cartilage, and bony changes that result from the first two situations.

In simple terms, arthritis can occur for many reasons. Some arthritis originates from infections the companion has contracted. Some arthritis occurs because of an autoimmune situation. The most common form of arthritis noted in our 4 legged companions is osteoarthritis. This particular type of arthritis slowly occurs over time, and is related to instability in a joint whether from an injury, congenital situation (like hip dysplasia) or a repetitive motion on a joint.

So as guardians, what do we see with arthritis? A common story is that your companion is having trouble rising after lying down for a period of time, is slower to go up or down the stairs, cannot walk as far as before, and will whine, groan, or vocalize more often. Some guardians report an increase in panting- a sign of pain in companions. There is often a loss of muscle associated with arthritis. This complicates things because as stated before, arthritis occurs because of instability within a joint. Muscles, ligaments, and the joint capsule, along with gravity, are the main stabilizers of a joint. The more muscle loss, the more difficult it is for a companion’s body to keep a joint stable and the more stress on other tissues.

If a companion has arthritis, cannot walk as far as before, is having trouble moving and transitioning in everyday life, and appears to be losing muscles mass, what can be done to break that cycle? It is amazing what you can do with your companion to help make them more comfortable, more stable, and stronger.

First things first- you need to have your companion assessed. This involves a thorough physical examination, gait, joint and muscle evaluation, and possibly other diagnostics (like radiographs or blood work) if indicated. At this time, a pain assessment will be done. If your companion is painful, medications will be recommended to help with the inflammation and pain. It is important to know that if the inflammation and pain is not under control, you may increase their pain response in the long term. Pain is a tricky situation. If the pain becomes chronic, there are changes to nerves that occur not only at the site of the pain, but that can also occur in the brain. This can ultimately cause a companion to perceive more pain than is present or pain when there is no pain stimulation. Aggressive pain control and inflammatory control helps to prevent this from happening. Icing and heat therapy, when applied correctly, have been known to help with inflammation, swelling, joint effusion, and pain. Joint supplementation has been very controversial in human medicine, but increasing the joint fluid within a joint and its ability to provide nutrition to joint cartilage can be a benefit from supplementation. Ask your veterinarian or rehabilitation therapist about what may be right for your companion.

Next, we need to help the joints and the soft tissues move better. This can be done by gentle range of motion of an arthritic joint. This allows for increased movement of joint fluid- fluid that bathes the joint cartilage and provides nutritional support. This also gently stretches the capsule and ligaments around the joint. Massage of the affected muscles can also help to increase muscle activity and awareness as well as decrease tightness and pain. Gentle stretches are also able to help arthritic patients increase flexibility of the affected area. In some cases, short, frequent walks on surfaces that are compressive (dirt, grass) can help to activate the joint and it’s receptors (muscles/ligaments) that help support the joint, and increase brain and nervous activity. All of these things help to improve an arthritic companion.

Lifestyle modification is another way to help an arthritic companion. Ramps instead of stairs are less stressful on arthritic joints. Rugs can be placed in common pathways or areas that your companion resides to prevent slipping or make it easier for an arthritic companion to rise from the floor. A decrease in running, jumping, and rough play can help prevent painful situations where the companion has over exercised and inflamed the arthritic joint(s).

So how can this be fun for the whole family? Getting together to go on a walk can be fun. Massage, passive range of motion and stretching can be a very one-on-one bonding time with that companion and the family. Not to be left out, other non-arthritic companions can get a massage too! There are also trick classes, nose work classes, and some obedience classes that can be done by arthritic patients to help keep their mind engaged. All of these classes are ways the family can be involved together, and the arthritic companion does not get left at home by themselves, and instead continues to be an active and integral part of the family.

Although arthritis may change your life with your companion, there are many things that can help improve and maintain a good, engaging life and relationship for you and your companion.

Yukon’s Success Story

Tuesday, April 29th, 2014

Yukon

Yukon

yukon2

Yukon

Yukon, an 11-year-old husky, first came to CRCG in July of 2013 for elbow and shoulder osteoarthritis and hind limb weakness.  During his visits, he enjoys walking in the underwater treadmill, has laser therapy to decrease pain in his spine and hips, and targets strengthening his core and rear limbs through in-clinic exercises. Yukon’s 5-year-old energetic younger brother, Bandit, likes to join in on the treadmill next to him for conditioning and moral support.

Both Yukon and Bandit love their Saturday excursions to CRCG and are pleasantly tired after their appointments. Today, Yukon has strength and energy when running around at home on his family’s property. Yukon, you are an all-star!! And Bandit, you rock too!

Bandit

Bandit