Old Age Is Not A Disease: Living with Arthritis

“My dog is limping!” This is one of the most common complaints we hear from the guardians of elderly dogs. Yet other canines come into the clinic lame and sore and their owners dismiss the problem as “just old age.” What causes lameness in dogs, and what can we do about it?
Osteoarthritis, which means “inflammation of the joint,” is the most common culprit, usually affecting knees, shoulders, ankles, elbows and, of course, hips. Also known as “degenerative joint disease,” or “DJD,” arthritis appears as swelling, stiffness and pain. (Sound familiar?) At Morningstar, we work to counteract the inflammation and also to slow the degenerative progress or (ideally) help the joint to heal by supplying key nutrients, without producing unwanted side effects. Arthritis is progressive, and often pets suffer in silence, learning to adjust to their growing disability; the dog who is slower getting up because of arthritis in his hindquarters learns to rely on his front legs, but often the stress will bring on shoulder arthritis until he “doesn’t have a good leg left to stand on...” If you have a stoic dog, she may never let out a whimper, so it’s important to be a good observer.
Though osteoarthritis is the leading cause of lameness in canines, especially among our older patients, we need to rule out other possibilities: trauma from a fall or blow; disk disease, most common in Dachshunds and other small breeds; autoimmune disorders including lupus and rheumatoid arthritis (very painful but fortunately not common in dogs.); hypothyroidism; bone cancer, especially osteosarcoma, which most commonly strikes the limbs of larger breeds; inherited conditions including hip and elbow dysplasia (especially common in big dogs) and dislocation of the shoulder and knee (which we see often in poodles); Lyme disease, (fortunately, rare in Colorado); and osteochondrosis, where abnormal cartilage growth causes pain and lameness, and panosteitis, where new bone grows in the marrow cavity of a leg bone, both occuring most commonly in large-breed puppies.
Often we see overweight or obese dogs limp into the clinic. Carrying all that extra baggage may not be the cause of your pet’s problem, but it’s certainly not helping the situation. If your pet falls into this category, the most cost-effective (though not necessarily the easiest) way you can help alleviate the problem is by implementing a sensible weight-loss program. Does your dog eat too freely if he’s fed free choice? Are you dumping too much food in her bowl twice daily, or offering too many high-cal snacks? What about exercise? Swimming is great, though not always convenient throughout the year.... Walking benefits most pets with arthritis, and it probably won’t hurt you either. “A simple, brisk walk twice daily is enough to shift your pet’s metabolism into higher gear,” Dr. Hooley says, “and help to start shedding those extra pounds.”
*** Also known as “degenerative joint disease,” or “DJD,” arthritis appears as swelling, stiffness and pain.

Regardless of the cause of lameness, it’s hard to watch your dog limp or struggle to get up (especially knowing how it feels when our own bodies ache....) Some patients grow sore after exercise, while others improve. One thing is certain—the sooner the problem is diagnosed, the better. A thorough physical exam, blood tests, and radiographs (X-rays) may be needed to determine the best course of treatment. Often the vet will need to sedate or anesthetize patients for radiographs, as the positions that provide the best diagnosis are often uncomfortable-- and most dogs just won’t hold still!

Once your veterinarian figures out why your dog is limping, he or she can suggest an appropriate therapy. At Morningstar, we provide a holistic approach, enhancing and maintaining your pet’s health rather than treating a single symptom without considering the effect on the overall well-being of the animal. Supplements may contain enzymes, fatty acids, antioxidants, green-lipped perna mussels (Glyco-Flex), sea cucumber (Sea Jerky), shark cartilage, and/or glucosamine and chondroitin sulfate (Cosequin) which can help to heal damaged cartilage in pets and people. Acupuncture can reduce the pain associated with arthritis and helps to correct imbalances within the patient. Chiropractic evaluation and adjustment can diagnose and treat lameness in dogs, restoring normal motion to affected joints. Often our clients will followup with massage at home.
Non-steroidal anti-inflammatory medications (NSAIDS) like Rimadyl, Etogesic, and Deramaxx can be quite effective in controlling pain and stiffness in joints and muscles, but these products require careful monitoring, especially with older pets (who are usually the ones that need them most.) Sometimes steroids can be used (especially on cats, whose metabolism doesn’t tolerate NSAIDS) on a short-term basis to relieve pain and inflammation in severe cases; however, they suppress the immune system and long-term use can contribute to the destruction of arthritic joints. Many dogs tolerate aspirin, but it can irritate the stomach and cause vomiting or dark, tarry stools in some pets, so often other forms of anti-inflammatory medication are preferable. (As you probably know, Tylenol and Advil are considered toxic to pets.)
In extreme cases, a veterinary surgeon may perform special procedures like stabilizing kneecaps, repairing knee joints after tears of the CCL (a ligament in the knee), and even joint fusions to relieve the pain of arthritis, especially after ligament tears and joint fractures.
Lameness may not be a simple problem, but it’s important to make our companions’ lives as full and happy as possible. Remember, old age is not a disease—it’s just part of the cycle.

*** Complementary therapies often provide the desired relief without unpleasant or potentially dangerous side effects.

What about CATS? Twenty years ago, your veterinarian would probably have told you that cats don’t suffer from arthritis. Now we know otherwise. Radiographs of slow-moving, older cats do show arthritic changes. At home, you may notice your cat just seems quieter; the feline that used to leap onto the back of the couch may use her front legs to haul herself up, or simply stay on the ground. Don’t think she’s finally learned manners after all these years! Few anti-inflammatory drugs are safe for cats. (NEVER give aspirin unless directed to do so by a veterinarian.) Comfort is one supplement that works well for many cats. A combination of particular vitamins, minerals, anti-oxidants and bovine liver extract, the geriatric formula can help with pain relief and actually stimulate new growth in damaged cartilage. You can also purchase a glucosamine/chondroitin formula called Cosequin for Cats that is flavored with chicken and tuna. New complementary products are becoming available all the time; contact your vet if your companion refuses or doesn’t do well on one form of medication.

Sidebar to arthritis article

The Latest on NSAIDS
Arthritis and old age: sometimes it seems the two are inevitably linked, especially with the larger-breed dogs. But research is uncovering new treatments all the time. Several supplements and drugs have recently become available and show great promise in controlling both the pain of osteoarthritis and damage to the joints themselves. We can always hope for the “magic bullet,” a product that will make suffering a thing of the past. Yet as holistic practitioners, we are always concerned about the possible side effects of these “miracle drugs.”
We often field questions from clients who have seen ads on TV or in magazines touting the amazing healing properties of various forms of non-steroidal anti-inflammatory drugs, commonly grouped together and referred to as NSAIDS, which include Rimadyl, Etogesic, and Deramaxx, the latest pharmaceutical offering. Studies and our own experiences show that NSAIDS can reinstate a quality of life for many lame dogs—but are they safe?
It depends. The majority of dogs tolerate these medications well if used on a short-term basis for an acute problem. Chronic cases can be different. Most of our arthritic patients are elderly, and age often brings liver insufficiency as well as kidney problems. That’s why we require blood chemistry panels for these dogs if the drug is prescribed for a lengthy period. Even when the liver and kidneys are functioning well, side effects can include loss of appetite, lethargy, increased appetite, diarrhea (often bloody), weakness, confusion, seizure, itching, anemia, and convulsions.

We will often recommend a complimentary therapy or something as basic as weight loss first. But if your dog has been diagnosed with arthritis (perhaps after x-rays) and you want to try NSAIDS, always give the medication with food. Realize that your pet needs to be monitored—both through examination and laboratory testing, don’t add new drugs without consulting your veterinarian, and be on the lookout for adverse reactions. For the otherwise healthy animal with arthritis, NSAIDS can truly seem like a miracle.
*** Studies and our own experiences show that NSAIDS can reinstate a quality of life for many lame dogs—but are they safe?

Troubled Times

Do animals have emotions? Aristotle, the famous philosopher of ancient Greece, believed that although humans may be more complex, animals are capable of feelings. During the thirteenth century, St. Thomas Aquinas agreed with Aristotle, and his view became formal Church doctrine. (Not long after, things grew more complicated, since some theologians worried that Heaven might get too crowded...) Darwin, who studied species as diverse as porcupines, birds, kangaroos and apes, believed animal emotions span the entire spectrum: from love to terror, joy to grief, admiration to shame.

Those of us who work closely with animals (and many of you who live with them) are convinced that animals do feel. And in this society, that means stress must surely play a part in affecting your pet’s health and well-being. It doesn’t mean your feline needs “Kitty-Prozac,” but in certain situations, the essences of flowering plants can make all the difference.
In the 1930s, British physician Edward Bach gave up his lucrative practice to search for a natural method of treatment (for humans) that did not require “anything be destroyed or altered.” He developed 38 healing remedies from the essences of flowers, mostly those growing in the English countryside. Bach was convinced these remedies would work on animals, and soon they were used to treat various “emotional conditions”: jealousy over a new family member, fear of new places, grief over the loss of a companion.
At Morningstar Veterinary Clinic, we’ve taken to utilizing the spray form of “Rescue Remedy” (a special combination of five flowers) when a cat visits us for an appointment and “comes unglued.” Then we can move close enough to apply a few drops of the liquid version to the ears, safely examine the animal, and treat its physical problems. Also called “Calming Essence,” this remedy is great to have on hands for emergencies, helping your pet deal with stresses such as car travel, relocating to a new home, injury, or boarding at a kennel.
Bach Flower Remedies aren’t a substitute for veterinary care or TLC, but they can be a useful aid in troubled times.
*** Darwin... believed animal emotions span the entire spectrum: from love to terror, joy to grief, admiration to shame.

Hazardous To Their Hearts

Concern over West Nile virus has catapulted the tiny mosquito into the headlines. Apparently cats and dogs aren’t at risk from this disease, but mosquitoes still pose a serious health hazard to canines because they can transmit potentially fatal heartworms.
If you grew up in Colorado (and many other areas) and owned dogs all your life, you may be wondering what the fuss is about: Rover lived to be fifteen years old and no vet ever said anything about heartworms. Apparently dogs that served in the armed services in Korea, Japan and Vietnam transported these unseen parasites to America., but for many years heartworms were only a concern for folks and their dogs living in the southern U.S. and other warm, wet climates. Over thirty years ago, blood tests on dogs living in Grand Junction began to come up positive for heartworms. As more dogs infested with the parasites travel or relocate to the Delta-Montrose area, the risk of exposure increases.
Heartworm disease is caused by a worm called Dirofilaria immitis. As many as 30 species of mosquito can transmit heartworms by first biting an infected dog, then incubating the microfilariae for 10 to 30 days before spreading the parasite to another canine. The larvae enter the dog’s bloodstream and travel to the heart, where they mature in 2 or 3 months and begin reproducing.
Dogs seldom show signs of heartworm infestation for at least two years. Symptoms can include a chronic cough, shortness of breath, weakness, nervousness, listlessness and loss of stamina. Unfortunately, by the time these symptoms are noticeable, the disease is advanced, affecting the lungs and liver as well as the heart. A severely infested dog may faint or even die after exercise or excitement.

Testing for heartworms requires only a tiny blood draw and a ten-minute wait for results. The disease is treatable, especially if diagnosed early, while only the microfilariae are present, but it’s far preferable to protect your dog from infestation. In this area we get enough cold weather to eliminate mosquitoes during the winter, so many local folks use a once-a-month chewable preventative called Interceptor (most dogs love it!) from April or May to November. This formula also eliminates hookworms and whipworms (useful for dogs that head south). Canines that travel with their owners may need year-round protection against heartworm disease.
If you’re concerned about giving your canine a drug powerful enough to kill heartworms, protecting your pet from the mosquitoes themselves is an alternative. If possible, you can avoid letting your dog out during the evening when the risk is greatest, and use a natural, DEET-free repellant. Not comfortable with the products on the market, Morningstar’s veterinary technician Jennifer Omer has concocted an herbal preparation for dogs only, designed to repel mosquitoes, ticks, fleas and flies—appropriately named BUG OFF!
*** ...mosquitoes still pose a serious health hazard to canines because they can transmit potentially fatal heartworms.