By Dr Lise Hansen

Dr Lise Hansen DVM MRCVS CertIAVH PCH is qualified as a veterinary surgeon and a homeopath. She has also undertaken training in acupuncture for animals.

A quick overview

Arthritis, also referred to as osteoarthritis, osteoarthrosis or degenerative joint disease (DJD) is one of the most common chronic complaints in dogs. It mostly affects the hip, elbow, lower back and knee joints.

What causes osteoarthritis?

Many different factors can lead to joint degeneration. It often develops as a consequence of dysplasia, an inbuilt tendency towards joint laxity. It can, however, also develop as an unavoidable sequela following traumatic injury such as a cruciate ligament rupture or other injuries due to falls or traffic accidents. Osteoarthritis may also be a result of overuse, as may be seen in some sporting dogs or in the very overweight. Finally, to some extent, it is a normal sign of ageing, as the wear and tear of a long life begin to show. In short, while there are risk factors for the development of arthritis in dogs that are well known (dysplasia, joint trauma, previous orthopaedic surgery, obesity and inappropriate exercise come in as the top five), some risk factors are still poorly understood. In recent years it has become clear that neutering significantly increases the risk of joint disease in dogs, particularly osteoarthritis of the hip and cruciate ligament disease of the knee. We do not yet understand what impact, if any, the age of neutering may have. There also appears to be breed differences. However, since it has become clear that neutering may play a large part in the development of these very common problems, everyone should think twice before proceeding with the routine neutering of dogs that in some countries have been standard recommended practice.

Treatment of osteoarthritis

Osteoarthritis is a progressive and incurable condition. It is, however, treatable, and there are many steps that can be taken to prevent pain and maintain mobility. This is an area of intensive research and development in recent years. Gone are the days when a dog diagnosed with arthritis would be treated solely with ongoing painkilling medication. Today, an array of treatment options are used to ensure maximum quality of life and minimum use of drugs (with the inherent risk of side effects after long-term use). Depending on the stage of the disease in each dog, these treatments can make a significant difference towards keeping the dog mobile and pain-free, often for many years.

Dogs that are known to be at risk of developing osteoarthritis, such as those that have undergone orthopaedic surgery, should be treated with the aim of protecting against osteoarthritis developing in the future. This is done primarily through nutraceuticals (food supplements) such as fish oils, glucosamine, chondroitin and green-lipped mussels. These supplements reduce inflammation of the joint and aid the ongoing repair of micro damage to joint structures. The supplements are added to food on a daily, long-term basis. Apart from supplements, the two most important steps are to ensure that the dog doesn´t become obese and to avoid exercise that is too strenuous or excessive. Ball or stick-throwing games are a bad idea for a dog at risk of arthritis. Swimming is an excellent form of low-impact exercise that strengthens muscles without straining joints. You could argue that while the above steps are highly recommended for dogs that are known to be of high risk of developing DJD, they are, in fact, appropriate for any middle-aged dog of a large breed, even those without a prior history of orthopaedic injury.

Dogs who have progressed to showing mild arthritic changes and symptoms, will, in addition to the steps described above (supplements, weight control and exercise caution) also need some kind of regular manipulative therapy. A veterinarian with postgraduate training in osteopathy can help your dog maintain an appropriate gait, which will reduce muscle tension and help prevent the vicious circle of tension leading to pain leading to more tension. Once the patient starts to favour one joint or limb, the whole gait is altered, and secondary strain and tension are unavoidable. Using some form of qualified manipulative therapy – be it massage, physiotherapy, chiropractic or osteopathy – is invaluable for these patients and can sometimes significantly postpone or reduce the need for painkilling medication. Your practitioner may be able to teach you exercises or massage techniques to use at home to strengthen muscles, reduce tension and support normal body movement.

Eventually, many arthritic animals will reach a stage, in which the disease has progressed to a point where they experience pain and have significantly reduced mobility. These dogs will naturally still benefit from supplements and manipulative therapies, but they also need pain relief to ensure an optimal quality of life and freedom from pain. Either acupuncture or gold implants will often effectively relieve the pain associated with osteoarthritis. Individually selected homeopathic remedies can also be very helpful in some patients.

Even when all of the above measures are used, many arthritic dogs will at some point need conventional painkilling medication. If you start with supplements, weight control and exercise restriction and, as the disease progresses, move on to manipulative therapies (such as physiotherapy and hydrotherapy), acupuncture, homeopathy and/or gold implants, you will be able to greatly postpone and reduce the need for painkilling medication. That doesn't mean that it will always be completely avoidable. No dog should ever be left in pain. If the first drug treatments are not effective or are poorly tolerated, rest assured that the right drug or drug combo will be found. There are a vast number of drugs available and no one-size-fits-all medication regimen. Together with your vet, you will determine what drug or combination of drugs has the best effect and is tolerated best by your dog. 

Be prepared to experiment. Your vet will recommend a blood test before and at regular intervals during treatment to check your dog's liver and kidney function and ensure that the drugs continue to be well tolerated. You may need a referral to an orthopaedic specialist to get it right. Remember, no one should suffer pain, and there will be a way to relieve pain for every arthritic patient– and please don't forget that there are many steps to take besides long-term medication.

To summarise the treatment options:

• Nutraceuticals (such as fish oil, glucosamines, chondroitin, green-lipped mussels)
• Weight restriction
• Controlled hydrotherapy and other suitable physical activity
• Manual therapies (Osteopathy, chiropractic, physiotherapy, massage)
• Acupuncture (possibly gold implants)
• Homeopathy
• Painkilling drugs

The role of diet

Diet has a very important role to play in the treatment of arthritis. A natural, raw diet will not only aid and support optimum health but will make it easier to keep your dog a good weight. It is especially helpful as it tends to contain high levels of natural glucosamine, which are present in cartilage and connective tissue in the raw meaty bones. Supplementation with oily fish can also be beneficial to increase omega 3 levels in the diet. A raw diet is also, by the way, an excellent way to help an overweight dog lose a few kilos without feeling hungry. Species appropriate feeding is, therefore, to be recommended in all but very complicated cases (such as where the dog may have had recent bowel surgery).

If you live in the UK, Honey’s Healthcare Team will be delighted to devise a special dietary plan for your dog. Feeding a natural diet couldn’t be easier and we can do all the hard work for you – working out exactly what your dog should eat each day (and how much, of course), explaining what to buy and how to prepare it. If you would prefer, and you will be under no obligation, we will be happy to supply the food you need and deliver it straight to your door.

Parts of this text are revised extracts from ‘The Complete Book of Cat and Dog Health’ (Hubble & Hattie 2019) by Dr Lise Hansen. www.hubbleandhattie.com

The advice and information contained in this fact sheet is for guidance only. The Honey’s Healthcare Team (vets, veterinary nurses and other experts) is here to help you in any way we can. However, nothing can replace a physical examination by a vet or other qualified professional.