Osteoarthritis (OA) is a disease that affects 20% of all dogs, and 80% of dogs over the age of 8 with these statistics thought to be underestimated. It is a debilitating, progressive disease but noticed early enough, can be successfully managed with a multimodal approach in order to slow the progression down. Owners are a vital part of the management plan, and play an important role in recognising the first signs of its presence.
Most dogs presented to a veterinary practice have secondary OA, meaning it develops following injury, microtrauma or because of abnormal anatomy. Breed and confirmation play a part here, with many breeds having dysplastic or abnormal joints due to genetics. In agility and sporting dogs, concussive forces and injury are commonplace and thus awareness that these dogs may be more pre-disposed to secondary OA is vital.
Lameness of course is one sign of underlying issues, but OA is much more than a disease of the joint and looking at the bigger picture can give clues to potential early recognition, when lameness may not be evident. An understanding that OA is an on-going, chronic pain as opposed to a sudden, acute pain where a dog my cry or yelp, helps owners to realise that the dog maybe affected by pain in many differentways. Pain from OA is not restrictedto the joint alone, compensatory painfrom a change in use of the rest of thebody and neuropathic (nerve) painassociated with long-term pain arejust two other aspects that need to betaken into account, making OA a muchmore complicated disease than weperhaps sometimes think. Coping withpain every day has a negative effect onboth the physical and mental health ofthe dog, who will be exhibiting signsreflecting this on a daily basis.
There is no cookie cutter solution for treating arthritis. Your vet may prescribe pain relieving medications for your dog. These will not be discussed in this article, but are often the cornerstone for the treatment of arthritis. Your vet may also discuss surgery like hip replacements, or some of the more recent advances in regenerative medicine. CAM believes that a multimodal management plan is imperative for coping with arthritis, and a combination of medications, weight management, home environment and lifestyle adaptations plus additional therapies such as physiotherapy, massage, hydrotherapy, acupuncture or laser give you and your dog the best chance at slowing down the inevitable progression of the disease.
Canine Arthritis Management (CAM) say that dogs can be showing signs of chronic pain in the following ways:
Examples of behavioural changes is an exhaustive list, but is generally recognised as a behaviour that the dog previously used to exhibit but has stopped, or a new type of behaviour. Suggestions may be differences in the way a dog socialises with other dogs or with humans such as aggression and intolerance, removing themselves from social situations or becoming more clingy or needy. Licking feet or joints, circling before laying down, suddenly not getting on the sofa, a reduced tail wag, less enthusiasm for their work or a hobby sport could all be potential red flags.
Whilst sometimes tricky to appreciate, dogs with chronic pain will usually display gait changes that allow them to compensate for the affected joint. Examples may be “whisking” of the back feet, flicking of the forepaws, scuffing of feet, hopping, a hip sway, a pacing gait or a preference to trot instead of a steady walk. For sporting dogs, differences in how the animal copes with its work could also be clues. Any abnormal or unusual change during movement can be significant if noted on more than one occasion.
The way a dog stands can provide clues to underlying pain. Again, compensation is common and a dog will shift its weight into other areas of the body, or stand differently to avoid using a joint, loading more into one limb than another. Examples could be; straighter stifles, paws, stifles and elbows turned inwards or outwards, a tilted pelvis, low head or tail carriage or standing with a wider or more narrow base.
Muscle mass changes again are good indications that a dog is not using an area of its body appropriately. Muscle wastage can be subtle to begin with, and comparisons with the opposite limb can be useful to detect any change. On the flip side, a dog that is over-using a muscle or group of muscles to compensate for pain elsewhere will begin to look built up and over-worked, which can often be mistaken for fitness. The prime example of this is the dog that has hip pain, and throws its weight forwards into it’s forequarters; pulling itself forwards rather than propelling with the back end. The consequence is a “torpedo” shaped appearance, with large shoulders and a solid neck, sometimes the appearance of a mane like a lion, yet with diminishing hind limb and gluteal musculature. Others can be less obvious, with lumbar muscles on each side of the spine becoming tense when a dog adopts a bottom sway-type walk to avoid using its hips or stifles in the usual way.
If you notice some of these differences in your dog, he could well be coping with chronic pain. If you can tick off one or more from every section, you are highly likely to be dealing with a dog in chronic pain. With all of this in mind, it is important to obtain a correct diagnosis from your vet. Whilst all of these things can signify pain, compensatory change and the presence of arthritis, your vet needs to be able to rule out other diseases and conditions that can also present in similar ways.
Traditionally owners have believed “slowing down” is simple ageing when in fact it is highly likely pain from osteoarthritis. This is a welfare issue that has been identified as one of the top three welfare concerns affecting companion animals, and one CAM is determined to change. If we catch this disease earlier and employ a multimodal approach including simple, accessible, low cost interventions, we can see substantial results. CAM believes that by changing owner, vet and public perception of how to diagnose and treat chronic pain, we will improve the lives of the animals and their owners, for longer.
For further information on the multi-modal management of OA, please see our website: www.caninearthritis.co.uk, and our Facebook page Canine Arthritis Management for help, support and advice in how to manage your dog.