By Amy Plankenhorn, DVM
Winter, with its cold and damp weather, can be tough on arthritis sufferers. But for animals with arthritis, any time of the year can bring pain and stiffness. While cats definitely can have arthritis, today we're going to focus on hip dysplasia and hip arthritis in dogs.
What exactly is arthritis?
By definition, arthritis means painful inflammation and stiffness of the joints. When we talk about "arthritis," we're usually thinking about osteoarthritis or degenerative joint disease, which occurs when there is a breakdown in the normal smooth cartilage in a joint. As the protective layer of cartilage goes away, bone rubs against bone causing pain, decreased mobility, and further joint damage. While osteoarthritis is a "wear and tear" type of arthritis, hip dysplasia is cause by abnormal formation of the hip joint during development, making it a disease of younger dogs. Genetics can play a large part in the development of hip dysplasia, but it's not the only cause.
How is arthritis diagnosed?
Physical examination and x-rays are the diagnostic tools for hip disorders. First, let's talk about hip dysplasia. The Orthopedic Foundation for Animals, also known as OFA, has a database of dog breeds that have the highest incidence of hip dysplasia. Responsible breeders will have their dogs screened with x-rays, and will receive a registration number from OFA indicating that their dogs do not show signs of hip dysplasia. Some cases of hip dysplasia are discovered during this screening process. Young dogs may present with symptoms such as stiffness when running or getting up, a "popping" feel in the hips, a "bunny hopping" gait, or a narrow stance in the rear legs.
Here is an x-ray of normal dog hips. The sockets are deep, completely covering the ball portion of the joint. The connection between the ball and the main part of the femur leg bone (called the femoral neck) is narrow.
Here is Jack, who was diagnosed with hip dysplasia when he was about a year old. You can see that the ball portion of the joint on the right side of the picture is nearly out of the socket altogether. Both femoral necks are thick, and the sockets are shallow.
Now, let’s talk about degenerative joint disease (DJD). We can see DJD in any age dog, since it can be caused by poor joint development, an injury to the joint, or progressive aging changes. Symptoms of DJD in the hips include stiffness when getting up, jumping up, or taking runs or longer walks. Some dogs may be slow to lie down, carefully lowering themselves part way then plopping down onto the floor. They may be reluctant to go on walks at all, or can only go short distances. Decreased muscle mass in one or both thighs or in the entire back end may be present.
Here is Summer at age 13. The hip on the right side of the picture looks fairly good. The socket is pretty deep, and the femoral neck is a little thick. The hip on the left side of the picture has DJD. The femoral neck is very thick, the socket is shallow, and there is extra bone present on the edges of the socket. Also, her thigh muscle is much skinnier on that side since she’s not using that leg as much.
What can we do about it?
There is no cure for hip dysplasia or osteoarthritis, but there are some things you can do to help your pet have as little pain as possible.
Weight management and diet: Obesity makes arthritis worse. Dogs who are even mildly overweight have more rapid progression of arthritis changes in their joints. The veterinarians and veterinary technicians at Animal Hospital of North Asheville can help determine an appropriate weight management strategy for your dog, and our website has many excellent resources to help. Some dogs benefit from glucosamine and chondroitin supplements; there are many on the market, including Dasuquin which we have in stock at AHNA. A diet or supplement high in Omega fatty acids derived from fish oil can also reduce inflammation Hill’s j/d is a prescription diet formulated to provide complete nutrition, high levels of Omega fatty acids, and reduced calories.
Exercise and physical therapy: Moderate exercise is important for dogs with arthritis. Exercise helps dogs maintain a healthy weight, keeps muscles strong, and reduces joint stiffness. Some dogs benefit from more targeted physical therapy. There are several physical rehabilitation facilities in the Asheville area.
K-Laser and acupuncture: Many dogs get pain relief from the use of “cold” laser therapy, which is a type of therapeutic laser that penetrates into the tissues to reduce inflammation and stimulate healing. AHNA offers K-Laser, with treatments performed in the office twice a week for three weeks, then as needed. We can refer you to several excellent veterinary acupuncture practitioners in the Asheville area if you are interested.
Adequan injections: Adequan is a polysulfated glycosaminoglycan, which is a product that inhibits the breakdown of cartilage and slows the progression of degenerative joint disease. It is given by injection twice a week for up to 4 weeks. It is especially helpful in the early stages of arthritis, but can be used at any time. Your veterinarian can help determine if Adequan is a good option for your dog.
Anti-inflammatory and other pain medications: The main class of drug used for dogs with osteoarthritis is non-steroidal anti-inflammatory drugs (NSAIDs). There are several veterinary NSAIDs including Deramaxx, Rimadyl (or generic carprofen), Metacam, Previcox, and Galliprant. All of these drugs target the body chemicals responsible for inflammation. Inflammation causes pain, but it also causes further joint damage, meaning NSAIDs not only give pain relief but they slow the progression of arthritis. DO NOT GIVE YOUR DOG HUMAN NSAIDS LIKE ASPIRIN, IBUPROFEN, OR ALEVE! Dog metabolize these drugs differently than people, and have a much higher risk of stomach ulceration or kidney damage from human NSAIDs. Some dogs benefit from the addition of other pain relieving drugs, which will be determined by your veterinarian.
Surgery: Surgery is usually a last resort for dogs with arthritis. Young dogs with hip dysplasia may benefit from a surgical procedure to alter the angle of the hip socket. Severe arthritis or dislocation of the hip joint can be painful enough that surgical removal of the ball of the femur relieves the pain of bone-on-bone joints. Total hip replacement is available at some veterinary teaching hospitals. Fortunately, most dogs can be managed with medical treatment alone.
A diagnosis of arthritis isn’t the end of your dog’s fun.
Stop the ache by following the ACHE:
Be Aware of signs of arthritis
Consult your veterinarian for a diagnosis and treatment plan
Help your dog with medication, weight management, and exercise
Enjoy every day!