Managing arthritis in dogs?

First - my old vet died and I’m currently vet-shopping and not happy with the fill-in one I’ve found. So ‘going to the vet’ will happen again in the near future. In the meantime…

Pirate is a bigger dog (lab mix I think) coming up on 10 years old and recently has started showing signs of being ‘ouchy’ - when I took him to the vet it was diagnosed as arthritis and he was prescribed Rimadyl as needed, but the vet was not particularly useful about other management information. (I generally found him to be not particularly useful period - he was one of those don’t-ask-questions-I-am-the-vet types and I do not do well with those. I want to know what’s going on with my critters! Anyway.)

Thus, COTH, any comments on the following questions?

  1. Supplements. Worth it, not worth it? Try it and see? I know in people there’s a lot of questions about if they even do anything.

  2. Exercise. I have arthritis myself (since I was 10, joy) and I know that gentle exercise does actually help manage the pain and stiffness, but too much can make things worse. Should I do anything different with walks, etc. to help him out on days when he seems worse? Just let him guide things? (He’s one of those super stoic types so I worry he could actually be in a lot of pain and not show it.)

  3. Medication. Anything interesting I should know about Rimadyl that the vet might not have told me because he doesn’t think clients need to know anything? Better to give it in the morning or evening or anything along those lines?

  4. How worried should I be that this isn’t actually arthritis? The vet’s exam was not as thorough as I would have liked, and I do agree that arthritis would not be at all surprising for a dog of his age and size, but there is a difference between saying ‘well, it’s most likely arthritis’ and ‘it must be arthritis because he’s an older dog, I’m not going to consider anything else.’ (I got Pirate when he was 5, so it is entirely possible that he had some injury before then which is making him more likely to develop arthritis or making it worse - one side does seem to be a little worse than the other.)

Adequan. Do the loading dose for a month. (I think it is one shot every 4 days for a month). Don’t waste your money doing one shot a week, or anything else. Dog should seem much better at the end of the month. Repeat dose in 6 mo-1 yr as needed.

Adequan will actually help the produce joint lubrication, which reduces pain. It doesn’t block pain, but helps remove the cause, and is very safe. Rimadyl and other NSAIDs all have potential side effects, and don’t truly help with the cause of the pain, other than reducing some imflammation. Your vet can show you how to give the shots.

If you do the Adequan, you may find that you don’t need the NSAIDs for a while.

Also give a flax or fish oil supplement (natural anti-imflammatory), as well as a glucosamine/chondroitin/MSM supplement.

Keep him on the lean side as opposed to carrying extra lbs.

Regular low impact exercise will help. Swimming is especially good, if you have a place for it. Doing 20 min of exercise daily is better than 1 hr 1 day a week.

Orthopedic dog beds can help.

you really have to do x-rays to confirm arthritis, so unless you don’t think the diagnosis is correct I can sort of see why one might assume it is arthritis and go from there.

management:

  1. keep the dog skinny. Every extra pound puts stress on those joints.
  2. feed the dog an anti-inflammatory diet high in omega-3 fatty acids. For example, Acana Pacifica looks like an ideal kibble for an arthritic dog- it’s salmon based, is low carb, has an anti-inflammatory type of carb (sweet potato), and uses actual salmon oil as its primary source of fats. Alternatively feed something with a low fat content such as EVO weight management and use added fish oils to bring the fat content back up to a normal fat level (around 20%). Ziwipeak is another food that looks useful for arthritic dogs- it has a very high green-lipped mussel content, and feeding green-lipped mussel has been shown clinically to reduce arthritic symptoms. You might have to do trial and error to see which diet your dog does best on.
  3. exercise. Swimming is the best, but anything to keep the dog moving is good.
  4. consider injections- adequan, pentosan.
  5. consider oral supplements- dogs absorb some of the oral supplements through their guts far better than horses do, so even if you scoff at feeding glucosamine to horses it may actually do something for your dog. Look for something with a “cocktail” of glucosamine, chondroitin, HA, and MSM. HA and MSM should give some immediate relief, but glucosamone and chondroitin can take weeks before having a visible effect on symptoms.
  6. consider other supplements like cetyl-M and duralactin. Some dogs respond dramatically to one or the other of these, some don’t.
  7. consider oral painkillers- rimadyl, previcox, metacam.

[QUOTE=wendy;6499772]
you really have to do x-rays to confirm arthritis, so unless you don’t think the diagnosis is correct I can sort of see why one might assume it is arthritis and go from there.[/QUOTE]

I’m reasonably confident it’s arthritis based on the way it manifests and my own experience with dealing with arthritis, but the vet was just pretty useless so I’m not sure how much I trust much of anything he said. (I mean, I know it’s likely it’s arthritis, but how about you actually look at the dog before you tell me that’s for sure what it is? Jeez. At least PRETEND so I feel like I’m paying you for doing something. Did not like that vet at all.)

Interesting that you mentioned Evo Weight Management, since that’s what they get now. By accident, actually, since they usually get regular Evo and someone grabbed the wrong bag, but it seems to be working just fine and Foxy does have weight issues so I was going to stick with it since they’ll eat it. (Foxy has seasonal allergies and when she needs steroids for them, keeping her weight down is a hassle and a half. So she’s pretty much constantly in a state of ‘weight management’ anyway. And Pirate isn’t overweight but it’s not going to hurt him to slim down a little, either. He could be at the lighter end of ‘normal’ instead of just ‘normal’. :slight_smile: )

Though I do need to get some good oil/fat supplement - Pirate has always seemed to do better on a higher healthy fat content anyway. Acana Pacifica sounds possible too. Maybe Evo for both but with added Acana Pacifica for Pirate.

I’ll make a note to ask about the injections for sure. I’m not entirely happy about just sticking him on NSAIDs indefinitely without exploring the other options.

Would multiple short walks be better for him over the course of a day than one or two longer ones? I can do either way. Swimming I’m not sure about - not sure where there is around here where I could take him swimming regularly.

As far as oral supplements go I prefer glyco flex III’s or dasaquin over most anything else. I have a lot of personal experience with those, and have seen plenty of good results.

I second the adequan as well. Works wonders as well.

There is also a herbal product called Body Sore that got my arthritic dog off of rimadyl, and has less side effects and risks to the organs.

Other options include a certified rehab vet, as well as acupuncture and possibly chiropractic. As I’m sure you know, the body will shift weight away fom the sore areas, causing secondary soreness and muscle changes. Rehab and hiropractic can help with these secondary problems and help relieve the pain and inflammation of the arthritis. Acupuncture and herbs can really help not only to improve the pain, but also to help older dogs feel more energized. They can also help support the organs like kidneys and liver that are having to process the NSAIDs.

Swimming is great for arthritis, both in dogs and people. Non pounding exercise is good,…walking on grass rather than pavement etc. Less is more with weight…the more you have to lug, the more it hurts. Vitamin C has some naturally anti inflamatory properties. Two 500mg tablets a day is a good start. Fish oil will also help. You do need to find a vet you trust for Adequan etc. There are many management tools available from prescription to rehab, but you need a professional you can trust to help you make the best choices for your dog.

[QUOTE=Horsegal984;6500094]
As far as oral supplements go I prefer glyco flex III’s or dasaquin over most anything else. I have a lot of personal experience with those, and have seen plenty of good results.

I second the adequan as well. Works wonders as well.[/QUOTE]

How common is adequan in dogs? I’ve only heard about it with regards to horses before - should a small animal city practice be familiar with it if I ask about it?

(Next stop on the local area vet tour is actually going to be the clinic associated with the shelter where I got Pirate. They did good work on him when they extracted his broken tooth, plus the clinic helps subsidize stuff like their spay/neuter program, so hey, vet bills going to a good cause!)

Good point. Maybe I will start driving him somewhere for his walks so we can do a dirt path and grass instead of sidewalks.

You do need to find a vet you trust for Adequan etc. There are many management tools available from prescription to rehab, but you need a professional you can trust to help you make the best choices for your dog.

Yeah. I was not at all happy with this guy. The primary reason for the appointment was to test for heartworm, which got done and the dogs got on their meds for it, so success there, but for an on-going relationship managing something like Pirate’s arthritis or Foxy’s allergies? No thanks. I didn’t even start any conversations with “I read online…” :stuck_out_tongue: :slight_smile:

Fish oil supplement…just the regular human version. It made a huge difference in my senior collie for several years. We were just getting ready to start Adequan when she died.

14 year old lab puppy

This is my 14 year old lab’s regimen:

breakfast: she gets totw lamb or salmon. her weight is good. 3/4 cup

one rimadel
one glucosamin/chrondroitin (from Costco-the same I take)
one fish oil (ditto)
one prilosec

dinner totw 3/4 cup
one rimadel
one glucosamin/chrondroitin (from Costco-the same I take)
one fish oil (ditto)
one DES as indicated (for her urinary incontinece)

the best thing we did for her was get a younger dog. We got him about 5 years ago and he insists that she play with him.

the rimadel was a miracle drug. she went from not being able to climb onto the floor of the car to jumping on the very high bed. this was a dog who could jump over my pickup tailgate when it was up when she was younger.

I will ask my vet about the adequan but I am very happy with the rimadel.

We have a 15 year old, very arthritic, Cattle Dog/JRT mix. She was never one to take it easy, 150% all the time…that plus age has done her in. Both elbows and lumbar spine (rads done, she’s a mess). I put MSM and fish oil in her dinner, give her Adequan shots every three weeks (that’s where we’ve found the “sweet spot”) and give her 1/2 a 227mg Previcox each day. She’s still lame, but the difference between “off the stuff” and “on the stuff” is noticeable.

I do the Adequan shots myself, at vet’s recommendation, to save money. I give them sub-q, which is off label, but the vet produced a study that found sub-q to be as effective as IM. I try to piggyback on someone ordering Adequan for a horse, and pay them to throw an extral vial or two in, as it saves me money. One 5ml horse vial will last my dog for several months, it’s the same, exact, drug, just labeled differently and the equine version is less expensive.

Exercise is slow walking, short distances (on leash, she won’t do it if we don’t make her) and swimming. Fortunately, we live on a lake and she can swim every day, she still loves fetching sticks out of the lake and she is much more enthusiastic about swimming than any other form of exercise.

We have a 14, almost 15, year old female lab. She was showing the normal signs of old age, but we had a full work up done about 3 years ago just to make sure we weren’t missing anything. Her EKG showed her heart was in the 97% range - great news. Xrays, however, showed pretty bad arthritis in her spine and hips. Even though she hadn’t really slowed down much, she could no longer jump up on the bed, furniture, etc. and was starting to lose a bit of control in her back legs.

Our vet, who has seen her since she was 6 weeks old, recommended Rimadel. It made her terribly sick to her stomach, even with anti-nausea meds. Then we switched her to Previcox. Started out with 1/2 tablet daily, now she gets 1/4 tablet daily. She acts like a dog half her age. There are side effects though. Because of her age, the Previcox affects organ function. We have a full blood workup/urinalysis done every 3 months to make sure that all levels are within proper ranges.

We keep her just slightly underweight to put the least amount of strain on her spine/hips. She gets Evo dog food and Nutramax Dasuquin (from the vet) - one tablet daily. The vet recommended the Dasuquin because of the levels - 900mg Glucosamine, 800mg MSM and 350mg Chondroitin. She can’t do very long walks, but we do take her swimming as much as possible and that seems to help (our neighbors are nice enough to let us use their pool). We limit swimming to on-leash only and don’t let her get much deeper than she could easily stand in (she also tends to have mild seizures, and we don’t want to take a risk of that happening while in the water).

With luck and proper management, we expect her to be around for a long time.

I would maybe get some recommendations and find a vet that you are more comfortable with. There is much that can be done to keep our best friends comfortable, but finding a vet you really trust and can work with is so important.

Good luck!

Personally, I’d find a vet I liked and have a full check-up done, then tackle the arthritis. It sounds like arthritis and it probably is, but I share your wariness of it being pretty easy to dismiss an older dog as arthritic and miss something else. That happened with my first dog - her tiredness was attributed to early arthritis, and they missed the cancer. That was a long time ago, but I’m sure it still happens.

I now have an older collie mix (60lbs) who has arthritis and I’ve found it very frustrating to figure out when she’s in pain, and how much to let her do. It’s difficult - there’s no crying out or limping. Mostly, it’s restlessness, being unable to settle down, panting, and - much the most obvious visually - real awkwardness in standing or lying down.

The NSAID issue is also frustrating. My dog was doing great on Deramaxx - and then the maker halted production for unrelated reasons. *%(&$@% Novartis. She switched over to Metacam, but that appeared to be having a side effect that indicated it was affecting her kidneys (massive amounts of urine) so we’re now on to Rimadyl. All the NSAIDs have roughly the same side effects, so read up on those and be alert to anything unusual in your dog’s behavior. Mine broke housebreaking in such dramatic fashion that it was obvious this was something weird.

I have no idea if supplements work - there was a study about a year ago that seemed to really say Chrondroiton (sp?) didn’t work in people. I still do the Dasuquin and fish oil caps, figuring it might work, won’t hurt, and she likes them (she has allergies, doesn’t get many treats).

Other stuff - putting food and water bowls up higher, raised feeders or just on top of a stool, helps taller dogs who might have mild pain in their necks, back, etc. Also, being hydrated is good for arthritis, so putting an extra water bowl down is probably helpful in getting them to drink more.

The absolute BEST thing you can do is keep your dog lean and fit.

Cosequin is the only suppliment with published research behind it, however there are others out there that likely give similar results. Really its personal preference. I support cosequin.

Adequan is hit and miss, I think its better in horses than dogs, however there are some owners that report their dogs do well with it

An NSAID such as rimadyl, previcox, metacam etc. is also going to help with pain and inflammation associated with OA.

You never stated “where” your dog was arthritic. Can you describe the symptoms? There could absoutley be something else going on, and unless a full physical is done you wont know for sure. We have had some dogs come through with RDVMs referring them for hip pain, and low and behold the dog has a giant liver tumor and is slow to rise because the liver mass is so big! In most cases though, vets should do a full abdominal palpation and joint palpation to narrow down where the pain is coming from. Radiographs will confirm arthritis, but not always necessary if your goal is general maintenance.

Joint injections can also be done with IA polyglycan for more extreme cases.

The severity of the symptoms varies. Sometimes it’s just he’s slow to get moving in the morning and looks a little ‘off’ in a stiff way until he’s been moving around for a bit, other times (generally when he’s been doing something that seems like it could exacerbate things, like running around a lot) he has a lot more trouble - difficulty getting up on slippery floors, trouble jumping up into the car, etc. (He has discovered that he can go ground to floor of car to car seat, though, and that seems to work for him all the time. It’s just the jump from ground to car seat that’s a problem.) Generally when he’s having more trouble he’s also just less enthusiastic about the world. So far, one Rimadyl when he’s that bad seems to help quite a lot - he seemed a bit sore last night (not as interested in his walk as usual) and extra stiff this morning so I gave him a Rimadyl and tonight he was quite unimpressed that we did not keep walking when he thought we should.

ETA: I’m probably skipping over symptoms and little things I notice, too - I’ve had arthritis myself since I was ~10 (bad genetics, bad!) and so I’m sure there’s little things here and there that he does that just look familiar to me, you know?

He also looks to me like he should have more muscle than he does in his back end - like it’s not like ‘omg, where did the muscle go!!!’ but more ‘… I’m sure he used to be a bit bulkier than he is now.’

Oh, and he has a distinct preference that’s developed recently for warm cushy spots to sleep. The other night we had a cold snap and he came and demanded a spot in the bed and to be covered up a bit with a blanket. But that could just be him discovering that I will totally spoil him a bit. (ETA the 2nd: Spoiling him is not actually new, but I adopted him as an adult and I think sometimes he’s still surprised by what he’s allowed to do with me, like be on the furniture.)

I saw an amazing difference in my older dog when I started using Arthrimaxx. It’s a liquid glucosamine/chondroitin supplement, and the difference really was dramatic.

I have also seen acupuncture make an amazing difference in older dogs. I did not get to that point with my girl, as the Arthrimaxx made such a difference, but it certainly would have been the next thing I did in addition to the Arthrimaxx.

Interesting that you mentioned Evo Weight Management, since that’s what they get now.

uh yeah, but I meant this is only useful for arthritic dogs because it has a low fat content plus a high protein content (= low carb content), and therefore you can add LOTS of extra fish oil to it without over-loading the dog with fat. It’s the fish oil that makes the difference, not the diet itself. If you can find it, Wysong Epigen 90 might be even better for arthritic dogs- it’s extremely low in carbs (VERY high in protein), and also very low in fat (12%), so you can add a theraupeutic amount of fish oil without creating a diet that is sky-high in fat.
Many of the other low-carb foods are already high in fat, and thus it’s hard to add sufficient extra fish oil to the diet without over-loading the diet with fat.
It makes intuitive sense to start with a low-carb fish-based diet instead, on the theory that such a kibble would come pre-loaded with omega-3 fatty acids, but notice that many of these diets use a non-fish-based oil as their fat base- they use chicken fat, or canola oil, or something else. Acana pacifica is one that stands out as actually using salmon oil as its base fat.

But it works out well if the Evo WM is a good food option because it will do for Foxy without much or any added fat, and will do for Pirate with added fish oil, and I happen to have both the Evo and fish oil (capsules for people) on hand already. So I can start him on that right away and see how it goes.

What do you find to be a reasonable amount of fish oil for supplementation? Google is turning up a few different numbers. (20mg EPA per lb of body weight? 1000mg of fish oil per 20lbs of body weight? 1000mg of fish oil per 10lbs?)

Now to remind my mom not to give him too many treats… Gotta try to get him to slim down a bit.

(I live at home atm because my mom has cancer so I’m helping out, but she likes to ‘treat’ the dogs with people food and I’m not hardline no people food, but I allow for only a little bit when I figure out how much dog food they get, and only certain stuff, and my mom is weak in the face of puppy dog eyes, so we have to revisit the topic now and then.) (I know some people are hardline no people food, but - my mom has cancer. Treating the dogs is a perk for her. If she can do it and keep it within reasonable limits in terms of the health of the dogs, even if it’s not ideal, then fine.)

Anyway, I want to thank everyone who has commented so far. I feel much better about the options available and what I can try in the short term while I’m vet shopping and what I should ask about with vets. So fingers crossed I can find a vet who understands that I want a management plan for his arthritis, not just to stuff an NSAID into him now and then.

Adequan

My parents have my 14 year old Wheaten terrier (they wouldn’t give him to me when I moved out after college!). I would come visit and it was upsetting to see how hard it was for him to get up and move around. My parents had talked to their vet and all he wanted to offer was pain meds for his worst of days (Previcox) and told them to put him on Cosequin.

After 8 months of watching Cosequin do nothing for him I stepped in. I had previously discussed him with my horse vet (an hour from my parents so not usable as their vet) and she had told me if I wanted to try giving him Adequan she would tell me the dosage and I could use my horse’s prescription. He’s been on it for a month now (5 shots) and he is a different dog. When I went over to give him his last shot of the loading dose he was jumping up and down on his back legs, something he hadn’t done in a very long time. Usually he would stand on his back legs carefully in front of me, and only because he was so excited to see me. He also always enjoyed jumping the 2 back steps in one bound and he is back to doing that.

I just wish I had forced my parents to let me do it sooner.

PS My vet did mention she had seen even more extreme result giving dogs polyglycon (sp?), but it is IV.

the dose I have been told repeatedly by several sources is 1000 mg fish oil per 10 lbs. dog per day. I’m not sure where that number came from. You can try it, or:

See studies below, they seem to suggest you should aim for approximately 3 to 4% of the diet to be fish oil.

So if you feed your dog 4 g of fish oil for every 96 g of kibble, you’d hit 4% (you will need a kitchen scale to see how much your kibble weighs). If you’re using EVO weight management as your kibble, at 15% fat, and you add that much fish oil, you’ll end up at a comfortable 18.5% fat in the diet. That will obviously increase the kcals your dog gets vs. kibble alone, so you’ll have to take that into account in your quest to keep the dog skinny, which is probably more important than feeding fish oil.

There are other studies I haven’t posted showed that if you decrease the amount of omega-6 fatty acids while simultaneously increasing the omega-3 fatty acids (adding fish oil) you get a better clinical effect- in kibble, simply avoiding kibbles with grains will reduce the omega-6 content dramatically.

J Am Vet Med Assoc. 2010 Jan 1;236(1):67-73.

Evaluation of the effects of dietary supplementation with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis.

Roush JK, Cross AR, Renberg WC, Dodd CE, Sixby KA, Fritsch DA, Allen TA, Jewell DE, Richardson DC, Leventhal PS, Hahn KA.

Source

Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.

Abstract

OBJECTIVE:

To evaluate the effects of a food supplemented with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis.

DESIGN:

Randomized, double-blinded, controlled clinical trial.

ANIMALS:

38 client-owned dogs with osteoarthritis examined at 2 university veterinary clinics.

PROCEDURES:

Dogs were randomly assigned to receive a typical commercial food (n = 16) or a test food (22) containing 3.5% fish oil omega-3 fatty acids. On day 0 (before the trial began) and days 45 and 90 after the trial began, investigators conducted orthopedic evaluations and force-plate analyses of the most severely affected limb of each dog, and owners completed questionnaires to characterize their dogs’ arthritis signs.

RESULTS:

The change in mean peak vertical force between days 90 and 0 was significant for the test-food group (5.6%) but not for the control-food group (0.4%). Improvement in peak vertical force values was evident in 82% of the dogs in the test-food group, compared with 38% of the dogs in the control-food group. In addition, according to investigators’ subjective evaluations, dogs fed the test food had significant improvements in lameness and weight bearing on day 90, compared with measurements obtained on day 0.

CONCLUSIONS AND CLINICAL RELEVANCE:

At least in the short term, dietary supplementation with fish oil omega-3 fatty acids resulted in an improvement in weight bearing in dogs with osteoarthritis.

PMID: 20043801 [PubMed - indexed for MEDLINE]

J Vet Intern Med. 2010 Sep-Oct;24(5):1020-6. doi: 10.1111/j.1939-1676.2010.0572.x. Epub 2010 Aug 12.

Dose-titration effects of fish oil in osteoarthritic dogs.

Fritsch D, Allen TA, Dodd CE, Jewell DE, Sixby KA, Leventhal PS, Hahn KA.

Source

Hill’s Pet Nutrition Inc, Topeka, KS 4Clinics, Paris, France. dale_fritsch@hills.pet.com

Erratum in
J Vet Intern Med. 2011 Jan-Feb;25(1):167.

Abstract

BACKGROUND:

Food supplemented with fish oil improves clinical signs and weight bearing in dogs with osteoarthritis (OA).

OBJECTIVE:

Determine whether increasing the amount of fish oil in food provides additional symptomatic improvements in OA.

ANIMALS:

One hundred and seventy-seven client-owned dogs with stable chronic OA of the hip or stifle.

METHODS:

Prospective, randomized clinical trial using pet dogs. Dogs were randomly assigned to receive the baseline therapeutic food (0.8% eicosopentanoic acid [EPA] + docosahexaenoic acid [DHA]) or experimental foods containing approximately 2- and 3-fold higher EPA+DHA concentrations. Both veterinarians and owners were blinded as to which food the dog received. On days 0, 21, 45, and 90, serum fatty acid concentrations were measured and veterinarians assessed the severity of 5 clinical signs of OA. At the end of the study (day 90), veterinarians scored overall arthritic condition and progression of arthritis based on their clinical signs and an owner interview.

RESULTS:

Serum concentrations of EPA and DHA rose in parallel with food concentrations. For 2 of 5 clinical signs (lameness and weight bearing) and for overall arthritic condition and progression of arthritis, there was a significant improvement between the baseline and 3X EPA+DHA foods (P=.04, .03, .001, .0008, respectively) but not between the baseline and the 2X EPA+DHA foods.

CONCLUSIONS AND CLINICAL IMPORTANCE:

Increasing the amount of fish oil beyond that in the baseline food results in dose-dependent increases in serum EPA and DHA concentrations and modest improvements in the clinical signs of OA in pet dogs.

Copyright © 2010 by the American College of Veterinary Internal Medicine.

PMID: 20707845 [PubMed - indexed for MEDLINE]