Osteoarthritis
Osteoarthritis (OA) is a slowly progressive and irreversible disease involving deterioration of the cartilage within joints. Arthritis is the medical term for inflammation of the joints, while osteoarthritis is the term referring to a form of chronic joint inflammation caused by deterioration of joint cartilage and underlying bone.
Osteoarthritis can range in severity from a mild, intermittent condition causing mild discomfort to an advanced clinical state characterized by constant pain and severe disability.
Causes include old age wear, trauma and congenital defects. Obesity, diabetes and excessive looseness of joints are risk factors for OA and hence ‘degenerative joint disease’ (DJD).
All species are affected, but our treatment options may vary due to species and individual patient safety factors
Treatment options
Diet & Weight Loss
Consider switching over to a formulated mobility diet. These contain additives including Omega 3 & 6 fatty acids, marine derivatives (like fish oils and green lipped mussel) and often glucosamine/ chondroitin. They are often also a lower calorie food which helps treat obesity and reduce added strain on joints. Obesity is a strong contributory factor, so weight reduction is essential to reduce stress on the joints.
Oral Supplements
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Omega 3/6 Fatty Acids are essential fatty acids not produced by the animal itself. This helps relieve pain due to their anti-inflammatory properties.
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PawOsteosupport capsules contain green lipped mussel as well as omega 3/6
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4Cyte is an oral liquid or granules containing a plant extract ‘Epitalis’ that is able to stimulate healthy cartilage regeneration and reduce inflammation.
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Antinol Rapid contains similar supplements as the above and also has an excellent reputation.
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Glucosamine, Chondroitin and RoseHip Vital all have good word of mouth but less research to support their use than the above.
Exercise
Light activities such as walking and swimming help strengthen muscles while keeping ligaments and tendons flexible. This also helps to prevent obesity and aids in circulating blood to stiff joints. 15-30 minutes regularly is a great start (5 days a week). Swimming is especially great for dogs with osteoarthritis because the water supports much of the body weight and inhibits sudden excessive movements. If you go to the beach, avoid breaking waves and heavy soft sand. You may need to carry your dog over the soft parts to the packed sand at the edges. Remember that walking or swimming in water are resistance exercises so your pet will work those joints a lot harder than simply walking in fresh air - keep it short and sweet.
Nonsteroidal Anti - inflammatory Drugs (NSAIDs)
Commonly used pain relieving and antiinflammatory medications. There are several very effective NSAIDs formulated for veterinary patients. Routine blood +/- urine testing to monitor organ function (liver and kidneys) are recommended for careful long-term usage and before commencing treatment. The safety margins are good but these medications should always be given with food and monitoring is recommended as if there is concurrent liver, kidney or GI tract damage then the dose should be adjusted or alternative medications pursued. Nonsteroidal antiinflammatories cannot be mixed together and cannot be mixed with corticosteroids. Frequency of use and safest choice of NSAID can be very species specific. Examples include Meloxicam, Carprofen, Firocoxib, & Phenylbutazone.
Chondro - protectives
Chondroprotective agents (polysulfated glyocosaminogycans) such as Cartrophen or Pentosan work to stimulate cartilage maintenance and slow ongoing damage. This is a course of injections commencing once weekly for 4 weeks, with booster injections every 1 to 3 months.
Add On Medications
We can add in other medications to help with arthritis pain, each works on a different pain pathway.
a) Gabapentin - Often our first additional medication. Good as an add on but not a strong pain relief on its own. Excellent safety parameters. Can cause drowsiness & can also help with anxiety.
b) NMDA receptor antagonists - Amantadine (caplets or compounded via a compounding chemist on prescription) or intermittent ultra-low dose ketamine injections (must be given at clinic as controlled drug).
c) Paracetamol - DEADLY FOR SOME SPECIES - ALWAYS CHECK WITH YOUR VET FIRST. If your dog has a healthy liver (regular blood tests are required as for NSAIDs) then your vet can give you a dose rate for plain human paracetamol.
d) CBD oil- this is different from hemp oil which does not contain active cannabidiols and is therefore basically just an expensive Omega 3 &6 supplement. CBD oil is legally available on prescription from the Oxford Pharmacy in Leederville. Pets with healthy livers (the same regular blood test will monitor this) can obtain additional pain relief from CBD
e) Opiods- As controlled substances, these are closely monitored & saved for end stage palliative care or short term use for very strong postoperative/ broken limb level pain management. Animals have all the same side effects and risks as humans on opiods, including drowsiness, slowed gut transit time, sometimes altered mentation and potential overdose when not used appropriately.
Physiotherapy
We have some great veterinary physiotherapists in Perth and locally including a specialist Rehabilitation vet (Dr Yoko Clinch). Please ask if you would like a referral.
Dr Yoko Clinch - Wellness Through Mobility
Gina Crawford- Perth Hills (20+) Facebook
Susan Yuen - Bibra Lake Animal Physiotherapy Perth | Dog Physio Perth | Physio for Pets
For other supportive therapies in horses, Dr Kylie uses our stables once a month among her other locations - (20+) Facebook
Other Injectables
Beransa/ Librella for dogs & Solensia for cats.
These are still very new to the veterinary market so all their side effects are not yet known. For some pets that cannot tolerate other medications (they get upset tummies or will not take them for you) or where all other options have been exhausted then we can consider these monthly injections.
Beransa and Solensia are absolutely not an option for patients with neurological symptoms (lack of feeling, history of seizures ect) as they can cause these disorders to progress rapidly.
The most common side effect in dogs is a dramatic increase in drinking and urinating (sometimes urinary incontinence). The most common side effect in cats seems to be itchiness, especially around the face.
These common side effects tend to wear off several weeks after stopping the injections, where some of the more uncommon but serious side effects are irreversible