Did you know that, just like people, older pets can suffer with painful arthritis? In fact, this is very common, with almost half of all dogs and cats affected, and the percentage being even higher when you consider senior pets alone – it is estimated that 80% of dogs over 8 years old are affected, and up to 90% of cats over the age of 12. It is also documented in smaller pets, with it being particularly common in older rabbits.

What is arthritis?

Arthritis refers to the inflammation of a joint. There are actually several different forms of arthritis, depending on their cause, but when we talk about arthritis in senior pets, we are usually referring to osteoarthritis, sometimes also known as degenerative joint disease. This condition actually affects multiple parts of the joint – it is characterised by wearing away of the smooth cartilage that lines the joint, changes to the bone around the joint that make it less able to absorb force, new bone forming around the edges of the joint, changes to the joint fluid that normally lubricates the joint and thickening and inflammation of the capsule around the joint. All of these changes lead to pain signals being passed along the nervous system to the brain – arthritic pets aren’t just “stiff” or “slow” – they are in pain!

What causes arthritis?

There are a lot of factors involved in the development of osteoarthritis, not all of which are well understood. However, we do know that it is often related to abnormal forces acting through the joint. Significant factors in the development of arthritis are things like obesity – excessive body weight means excessive joints through the joint – and the dog’s conformation (body shape). Many dog owners have heard of issues like hip and elbow dysplasia, where abnormal joint conformation can contribute to degeneration of the joints, but there are many other conditions that can also contribute. In some cases, we have inadvertantly selected for abnormal joint conformation when we have bred pets to look a certain way – this tends to be most obvious in small breed dogs with short legs, though Scottish Fold cats are severely affected by arthritis at a very young age due to the same gene that causes their distinctive folded ears.

How do I recognise signs of arthritis?

Recognising signs of chronic arthritis pain in our pets can be challenging, as they can’t tell us how they are feeling! It often relies on owner and vet acting as a team to put the whole picture together. Often owners will feel that their pets aren’t in pain as they aren’t whimpering or crying out – but if you think about the last time you were in pain with a sprain or a strain, you probably weren’t screaming out loud! Signs of chronic arthritis pain are often much more subtle, and may include things such as:

• limping on one limb – but this may not be obvious if multiple limbs are affected
• generalised stiffness, especially when getting up after rest
• slowing down on walks, being less keen to go for a walk, or not coping with as long a walk.
• hesitation before jumping up or down, or going downstairs. Cats will often simply avoid climbing altogether and spend much less time than they used to at height.
• difficulty posturing to toilet – dogs will often “walk” while passing faeces
• sleeping more, or alternatively difficulty in settling and resting comfortably
• changes in temperament – they may be more fearful, more “grumpy” or less tolerant of handling, or become reactive towards people, other dogs or even noise
• panting
• reduced grooming or matted coat in cats
• overgrown nails – again, particularly in cats as they will be reluctant to use a scratching post if their joints are sore.

It’s important to remember that both dogs and cats will often carry out an action that is uncomfortable to them if the reward is great enough – that might be food, a comfy spot on the sofa or in some cases just their owner’s approval!

How is arthritis treated?

Unfortunately, there is no cure for arthritis. However, with careful management progress can be slowed and the impact on your pet’s life be minimised. A treatment plan should always be multimodal, and pharmaceutical treatments are only part of the picture, but they are very useful.

As an owner, you can help your arthritic dog in a variety of ways including:

• Use of appropriate pain medications at the right time.
  • Sometimes owners worry about starting medication too early, feeling that it will “stop working” or the dog may be more likely to suffer side effects, but there is no evidence of this occurring. What we do know is that using analgesia (pain relief) pro-actively can help your pet to use affected limbs more normally, reducing the stress placed on other joints by altered weight bearing, and preventing the loss of muscle which is really important to maintain joint stability – even more critical in a joint affected by arthritis.
  • There are a variety of pain medications available to manage arthritis pain, your vet will be able to advise you which options may be the most appropriate for your pet.
  • Remember, you should NEVER give your pet a human pain medication – even an over-the-counter one – unless it has been specifically prescribed by your vet for that pet. Some medications that are very safe for us can be extremely dangerous or even deadly for pets.
• Ensuring they are staying active, but that their exercise regime is appropriate
  • Maintaining activity helps to maintain muscle mass, maintain cartilage health for as long as possible, maintain range of motion in affected joints and maintain balance and proprioception.
  • However, certain high-intensity exercises, especially twisting motions, can be painful or even accelerate joint deterioration. Remember, dogs will continue an activity even if it is painful if they enjoy it, so exercises such as ball throwing should be modified in intensity or even stopped altogether. Replacing them with mentally stimulating exercises such as scent games or seeking out a hidden toy.
  • Don’t forget about the walk back to the car – your pet won’t save their energy for the trip back! And be aware that rough or slippy terrain may be much more challenging for an arthritic pet.
  • A supported exercise regime developed with the assistance of a physiotherapist can really help maintain mobility and correct gait.
  • Don’t forget about cats! Encouraging play can help to keep a stiff cat active.
• Keeping them to a lean, healthy weight and body condition score.
  • Excessive body fat means extra force through joints and can significantly worsen arthritis. In addition, fat is a metabolically active tissue and releases a variety of inflammatory chemicals that can make pain worse.
• Consider adding in complementary therapies, but be sure they have a good evidence base.
  • There are a variety of “joint supplements” on the market, with various levels of evidence behind them. Traditionally, glucosamine and chondroitin were advised for dogs and cats, as for people, but it is now considered that these may not be very effective. We currently have the most evidence to support omega oil supplementation (mainly increasing the omega-3 content), particularly through marine sources such as green lipped mussel. This can be in the form of a supplement or by switching to an appropriately enriched and formulated diet. Other natural remedies that may be helpful include undenatured collagen and curcumin (one of the ingredients in turmeric). However, the amounts that are given and the form they are given in are important, so a properly formulated supplement is the best way to provide these. Your vet or veterinary nurse will be able to advise some brands they feel are well formulated.
• Look into physiotherapy or hydrotherapy with an appropriately qualified individual
  • Maintaining your dog’s mobility with appropriate physical therapies can be really helpful. Physiotherapy can help identify subtle changes in weight bearing and provide you with exercises to carry out at home to keep your pet fit and flexible. Hydrotherapy in a pool or water treadmill can soothe painful joints and allow an arthritic pet to exercise while the water takes their weight. Massage can help to ease tight muscles and promote flexibility.
  • Did you know that, unlike in people, “physiotherapist” in veterinary medicine is not a protected title – anyone can use it, regardless of their qualification level. We always recommend that you consult a physiotherapist registered with the organisation ACPAT – we can provide contact information for local ACPAT physiotherapists.
• Making adjustments at home
  • Your pet’s home environment can become increasingly difficult for them to negotiate as they become more arthritic. One of the biggest problems are slippery tile, stone or wooden floors which require a constant balancing act for them to negotiate – and even tiny slips can be painful for an already inflamed joint. Try putting down non-slip surfaces such as rugs, or rubber or foam matting to make their lives easier. This can be especially helpful in areas where they have to stand still – for example to eat or drink – as well as routes between access points like the door into or out of the back garden.
  • Speaking of eating and drinking, it can be uncomfortable for arthritic pets to lower their head all the way to floor level. Try raising their food and water bowls – you can buy a special stand or improvise using a box or even things like a stack of books – maybe that big hardback cookbook you never use?
  • A comfortable supportive bed can be really helpful for older pets. Materials such as memory foam can help to cradle stiff joints and keep pets away from chilly draughts. Some may still like to curl up in a high sided bed (though make sure the entrance is low enough for them to get in easily) while some might start to prefer to stretch out on a mattress style.
  • Getting up to higher places can be really challenging for older, arthritic pets, whether that’s to snuggle next to you on the sofa, up to your bed to sleep (if they are allowed to!) or getting in or out of the car for a trip to their favourite walking spot. Training them to use a step or a ramp to manage this more easily can be really helpful.

Can surgery help my arthritic pet?

There are some cases where arthritis is considered to be more likely to develop due to an abnormally formed joint (for example, hip dysplasia) or a joint where the supporting structures have been injured and the joint is less stable than it should be (for example, cruciate ligament rupture). In these cases, surgery to correct the underlying abnormality may help your pet to feel more comfortable, and may reduce or slow the development of arthritic changes later in life. If your pet is suspected of having one of these conditions, your vet may suggest investigations such as x-rays to confirm, and speak to you in more detail about possible surgical options. Joint replacement surgeries are still fairly rarely carried out in dogs and cats, and are mainly confined to hip replacement surgery.

Remember, arthritis is a chronic, progressive condition, and what is appropriate at one stage may need to be adjusted later on, or additional treatments and therapies may need to be added. We are here to help and are always happy to review your pet’s pain management plan and discuss new or different treatment options, and anything else we may be able to do to help.

There are a lot of valuable resources available online to support owners of pets affected by arthritis. One of the best ones available for dogs is Canine Arthritis Management, while for cats International Cat Care has some very useful information.