What is OA?
OA, sometimes referred to as degenerative joint disease (DJD), is the breakdown of articular cartilage and is a progressive condition that is a common problem in a high proportion of adult dogs. OA can be primary (overloading or overuse of a particular joint) or secondary (due to abnormalities in a joint, such as hip dysplasia). Some very active athletic dogs may get some primary OA but in the majority of cases, the disease has been caused by a malfunctioning joint.
The body will often lay down additional bone to stabilise an unstable or painful joint in an attempt to restrict the range of motion. The soft tissues surrounding the joint (muscles, tendons and ligaments) will also become tight and sore. Common joints affected are the elbows, hips, stifles (after cruciate rupture), and spine (spondylosis). Although OA can also be present in the wrists, toes, shoulders, and ankles.
Dogs and cats suffering with OA have limited activity, reduced athleticism, joint stiffness and reduced range of motion, pain and discomfort, muscles atrophy, loss of strength and an overall decreased quality of life.
Photo credit: The Veterinary Nurse
What are the treatment options?
Management of chronic OA is a lifelong commitment and can be hard work. It involves a multifaceted approach, combining anti-inflammatory and analgesic drugs with lifestyle changes, weight loss, and rehabilitation in the form of remedial exercise, manual therapy and electrotherapy.
Surgery is often considered an option for joint diseases (such as cruciate rupture) in order to prevent OA and further degeneration of these joints. However, in severe cases of OA, surgical management is also considered as a salvage treatment, where the disease is too advanced for conservative management. The types of surgery used in these cases can include total joint replacements and joint arthrodesis (fusion of a joint).
You will have to speak with your vet about what medication is most suitable for your pet and whether surgery is necessary.
What are the benefits of rehabilitation for OA?
The aims of using physiotherapy for patients with OA are to provide adequate pain relief in order to try and reduce the severity of the disease, allowing the patient to be active enough to undergo therapeutic exercise and weight loss, and overall improve the quality of life.
Veterinary physiotherapy employs the use of manual therapy techniques (such as massage and range of motion), electrotherapies (such as pulse mag) and other therapeutic modalities (such as cold and heat packs), along with a therapeutic exercise plan. Hydrotherapy is also a great way to keep an arthritic animal moving but at the same time reducing the amount of force being but put through their joints during the exercise.
These treatments are important to accomplish increased muscle strength and joint function, maintain an acceptable quality of life, control pain and discomfort, slow the progression of disease, and promote repair of damaged tissue in some cases.
Whilst rehabilitation can be hugely beneficial to help dogs with OA, what happens in between sessions is going to have the biggest impact. Therefore, it’s important to know what can be done at home to help your pet live a more comfortable life.
Keeping them healthy
If your pet is suffering from OA (or any condition for that matter), keeping their weight under control is a very important aspect of managing the disease. Obesity has a very strong association with the development and progression of OA, not only because with extra body weight there will be increased force going through a patient’s joints but also because the pro-inflammatory cytokines that fat cells produce can actually increase the symptoms, inflammatory process, and pain felt by the patient.
I’m sure a lot of us are guilty of putting on a bit of extra insulation when the weather gets colder and with that, the temptation for us to give our pets leftovers is going to be much greater but we must resist their puppy dog eyes! If your pet is on a diet, restricting the intake of your pet’s daily calories and eliminating treats are important changes to make to aid in weight loss. You can try weighing out their daily calories in the morning and give your pet portions of this as treats throughout the day, if necessary, giving them the remainder as their dinner. This way they are not consuming any extra calories but can still be rewarded for being a good boy/girl. Ask your vet about prescription diets that could help achieve and maintain the ideal weight for your pet. Some satiety diets can help your pet feel fuller whilst not increasing the number of calories they consume.
A healthy diet should also include enough digestible protein in order to aid in muscle building and maintenance. Sufficient muscle mass is essential for older and weaker patients as it aids in supporting their joints and improving their general willingness to move.
If you’ve been told to monitor your pet’s weight but don’t have any scales available, you can use the body condition scoring (BCS) system to estimate whether your pet is a healthy or unhealthy weight. For the ideal body condition score (4 or 5), you should be able to easily feel the ribs and your pet should have a “waist” when viewed from the side and from above.
Photo credit: Royal Canin
Joint supplements are a hot topic and there is some conflicting evidence out there, both in anecdotal and actual scientific evidence. OA is always going to involve a combination of lifestyle changes in order to achieve the desired outcomes and so, by adding in joint supplements without implementing any other changes, there is unlikely going to be a significant difference noted. However, supplements that contain joint-protective nutraceuticals (such as chondroitin and glucosamine), avocado-soybean unsaponifiables** (ASU) and omega-3 fatty acids, do have an evidence base for their use in older individuals with OA and when used in combination with the other aspects discussed here, can be of benefit to a patient. Although, some fish based diets can include a good source of omega-3’s too but this might not always be as high of a level as a supplement.
When talking calories in vs. calories out, diet is going to have the biggest impact. But exercise is also an important component of that and therefore, in keeping them healthy. However, there are right and wrong ways to exercise.
Find out how to keep them moving in a comfortable way in part 2!
All the best,
**Try saying that 3 times fast!