If you're one of the 50 million Americans who have arthritis, you know the symptoms. It hurts to stand, sit, jump, run, climb, or turn your head. You're more sedentary, and inactivity can lead to weight gain. You might limp, and because everything hurts, you feel grumpy. We aren't alone, for our dogs share these symptoms. Arthritis affects one in five adult dogs, and a full 80 percent of dogs who are 8 years old or older!
Conventional medicine considers arthritis a chronic disease that progresses and has no cure but which can be managed with symptom-suppressing drugs and other therapies. Holistic veterinarians manage arthritis with diet, nutritional supplements, medicinal herbs, and a variety of noninvasive treatments, many of which dog lovers can provide at home.
Whatever the type of arthritis or its complications, early diagnosis helps keep symptoms from progressing, and understanding the disease may help you slow or prevent its development in your dog.
TYPES OF ARTHRITIS
There are a number of types of arthritis that affect dogs:
Primary osteoarthritis results from inherited anatomical problems that put excessive stress on joints. Most dogs develop secondary osteoarthritis, which is caused by damage from vigorous exercise, injuries, excessive jumping, torn ligaments, and other accidents.
Osteoarthritis is also known as "wear and tear" arthritis or degenerative joint disease (DJD). It develops gradually over months or years, and its symptoms can wax and wane. The cause is a loss of cartilage, the slippery material that covers the ends of bones. Cartilage is the body's shock absorber, and without its protective cushion, bone-on-bone movement creates serious discomfort.
The main symptoms of osteoarthritis are a deep, aching pain; difficulty climbing stairs; morning stiffness; pain while walking; and stiffness after resting. Joints may be warm to the touch, swollen, and restricted in their range of motion.
* RHEUMATOID ARTHRITIS (RA)
RA is an autoimmune disease, meaning that the body's immune system attacks joints and other body parts, leading to inflammation that can cause severe damage. It's unusual in dogs, occuring mainly in small and toy breeds between two and six years of age. Nova Scotia Duck Tolling Retrievers may also have a genetic predisposition to developing RA.
RA affects multiple joints, including wrists, elbows, shoulders, knees, ankles, feet, and even the jaw and neck. Stiffness that begins in the morning can last for hours or the rest of the day. Other symptoms include fatigue and a loss of appetite.
* SEPTIC OR INFECTIVE ARTHRITIS
This type of arthritis is caused by infections that enter joints through the bloodstream. An insect or tick bite, road accident, cut, abrasion, puncture wound, or similar injury can allow infective organisms to cause inflammation and discomfort.
* SPINAL STENOSIS, SPONDYLITIS, AND SPONDYLOSIS
All three of these disorders are degenerative spine conditions that often accompany arthritis.
Spinal stenosis, which can be caused by osteoarthritis of the spine, describes the narrowing of the spinal canal. Symptoms can include changes in bowel and bladder function, leading to incontinence, as well as poor mobility, increased fatigue, reluctance to go on walks or play, and obvious pain when touched on the hind legs, back, or tail. The most common symptom of lumbosacral stenosis in dogs is difficulty standing after lying down, which can worsen as muscles in the hind legs atrophy.
Spondylitis can cause an overgrowth of bones leading to their abnormal joining, called "bony fusion." Fusion that affects bones of the neck, back, or hips may impair movement. Calcium deposits can create a bony spur or bridge between vertebrae.
Spondylosis develops in older dogs as the spine's soft tissues degenerate and wear away, leading to pain. Herniated discs, degenerative disc disease, and spinal stenosis can develop as a result. Spondylosis typically occurs with no outward symptoms, and the condition is often discovered through X-rays taken for unrelated conditions.
DOES YOUR DOG HAVE ARTHRITIS?
Your veterinarian can tell for sure, but here are some common symptoms.
* Intermittent lameness or a limp
* A three-legged or "hopping" four-legged gait
* Stiffness after rest or after vigorous exercise
* An unusual or abnormal stance when walking
* Exaggerated hind leg movement
* Dragging the back feet
* Reluctance to rise or move
* Swollen joints, which can be warm to the touch and tender
* Joints that hurt when touched, moved, or palpated
* Visible joint deformities
* A lack of interest in play or physical activity
* An inability to jump onto familiar beds, sofas, car seats, or the back of an SUV
* Increased inactivity or sleep
* Weight gain from inactivity or weight loss from lack of appetite
* Depression or lack of interest
* Snapping or growling when joints are touched
Some dogs get arthritis and others don't, and there's no way to predict whether a puppy will eventually develop the disease. At the same time, understanding risk factors can help caregivers anticipate, recognize, document, and treat arthritis symptoms before they become incapacitating.
[check] SIZE. Larger dogs are more likely to develop joint problems. This includes large breeds and dogs that are overweight.
[check] AGE. The risk of arthritis increases with age.
[check] GENETICS. Any breed can develop arthritis, but some are well known for the illness, including those mentioned earlier, Labrador Retrievers, Golden Retrievers, and German Shepherd Dogs, along with breeds associated with joint abnormalities.
[check] JOINT ABNORMALITIES. Hip and elbow dysplasia stress the joints, as do injuries that interfere with proper alignment.
[check] STRESS AND TRAUMA. In addition to injuries and illnesses that damage ligaments, tissues, or bones, repeated stress on joints can make high-activity or working dogs susceptible to arthritis.
[check] INFLAMMATORY DIET. Food is an important factor because some common foods trigger arthritis flare-ups in humans and canines.
[check] TICK BITES. These arachnids sometimes carry bacteria that can infect joints with Lyme disease, Rocky Mountain spotted fever, or Ehrlichiosis, all of which can cause arthritis.
[check] DIABETES. Dogs with diabetes are more likely to develop arthritis than those with normal blood sugar.
[check] VITAMIN D DEFICIENCY. Dogs with arthritis tend to have low D levels, and when their levels improve, so does their range of motion. (See "D is for Dogs," a review of vitamin D supplementation, in the July 2016 issue of WDJ, for more information.)
WHAT TO DO
In addition to discussing options with your veterinarian, look for strategies you can use to help your dog avoid arthritis or improve its symptoms. One is helping your overweight dog lose weight, since excess weight on arthritic joints can trigger or worsen the condition.
Diet is an obvious first step, not only for weight control but also because many widely used foods have an inflammatory effect on dogs. Individual responses vary, so a food that causes acute discomfort in one dog may have no effect on another, and vice versa. Experimenting with your pet's diet can make a difference.
For example, polyunsaturated fatty acids (PUFAs) from soybean, corn, sunflower, and other vegetable oils, along with shortening and margarine, can trigger inflammation. Although cayenne (a member of the nightshade family) is often used to relieve joint pain in dogs and humans, nightshade plants (tomato, pepper, eggplant, tobacco, and potato, among others) may trigger inflammation in some individuals. Several grain-free foods contain potato, which might be a problem for your dog.
Compare pet food labels, whose ingredients are listed in order of quantity. Look for foods that contain high-quality, named animal protein sources in the first few positions on the ingredients list. Corn gluten meal and meat by-products from unnamed species indicate that the food has been made with low-quality protein sources.
Raw diets are increasingly popular, and many veterinarians and some pet owners report improved canine health as a result of adopting a balanced raw diet. Raw diets are almost all high in fat, however, which can lead to weight gain that makes arthritis worse. High-fat diets are inappropriate for inactive dogs who eat less than normal for their size.
If you feed a commercial diet, check WDJ's annual reviews of dry and canned foods for help. Feeding a home-prepared diet makes it easier to avoid any ingredients to which your dog may be sensitive. See "You Can Make It" by Mary Straus (WDJ July 2012) for guidelines. If feeding a commercially prepared raw diet, see "Cold, Raw Truth" by Karen Becker, DVM; Steve Brown; and Mary Straus (WDJ, September 2015). See also "Counting Calories" by Mary Straus (WDJ, September 2009) for how best to help your dog lose weight.
Dehydration complicates joint problems, so it's important to provide fresh, good-quality water in clean bowls at all times. To encourage a dog to drink more water, add small amounts of bone broth or other flavorings.
The most widely prescribed supplements for dogs with arthritis are glycosaminoglycans or GAGs. Also known as mucopolysaccharides, these nutraceutical supplements include glucosamine sulfate, glucosamine HCl, chondroitin sulfate; sometimes, the unprocessed sources of these GAG supplements, such as beef cartilage and green-lipped mussels, are used.
As Mary Straus reported in "Joint Decisions," WDJ March 2007, "GAGs are important because they actually protect the joint rather than just reduce symptoms, by helping to rebuild cartilage and restore synovial (joint) fluid. GAGs may also have some preventive effect on arthritis, though this is speculative."
GAG supplements may be most effective given between meals, though they can be fed with food if needed. "Always start with high doses, so you will be able to tell whether or not your dog responds," Straus says. "If you see improvement, reduce the dosage to see if the improvement can be maintained at a lower dose. If you don't see any change within three to four weeks, try another supplement."
Straus listed Arthroplex from Thorne Veterinary, SynFlex from Synflex America, Synovi G3 from DVM Pharmaceuticals, and K9 Glucosamine from Liquid Health. Products labeled for human use that contain glucosamine, chondroitin sulfate, and green-lipped mussel can be used as well, and manganese in the supplement may improve absorption.
GAGs work by decreasing the production of harmful inflammatory compounds that adversely affect the cartilage matrix. In addition to reducing pain and inflammation, GAGs stimulate cartilage synthesis, support new joint cartilage, and increase the synthesis of proteoglycans, the joint lubricant hyaluronic acid, and collagen, all of which are needed for proper joint structure and function.
Individual responses vary, and GAGs are not effective in all animals. A dog may have to take a GAG supplement for one to two months before noticing improvement.
Oral supplements are affordable, convenient, and often effective, but injectable GAGs can be used in addition for faster results. Injectable GAGs include Adequan and Cartrophen Vet, which are administered by veterinarians.
Treatment with Adequan (Polysulfated Glycosaminoglycan) involves twice-weekly intramuscular injections for a month, during which it prevents the breakdown of cartilage and may promote the development of new cartilage.
Cartrophen Vet, given in weekly subcutaneous injections, reduces pain and lameness in 80 percent of pets. The series of four injections is given once a year for mild cases and up to three times per year for severe cases. Cartrophen Vet is said to prevent destructive enzymes from breaking down collagen, stimulate the body's production of cartilage and joint lubricant, clear blood-vessel blockages to deliver nutrition to joints and bones, and stimulate the production of anti-oxidants.
S-adenosylmethionine (SAMe, pronounced SAM-ee) is manufactured by the body when the essential amino acid methionine reacts with adenosine triphosphate, a molecule that carries energy. SAMe is used to treat a variety of conditions, including osteoarthritis.
Products containing 200 mg SAM-e are appropriate for most dogs weighing more than 15 pounds.
Methyl-sulfonyl-methane (MSM) is a naturally occurring form of sulfur produced by ocean planktons and that can also be found in cow's milk, meat, sea vegetables, fruits, nuts, and vegetables. Low concentrations of MSM in the body may result in physical and psychological stress, organ and tissue malfunction, and fatigue. Sulfur deficiencies result in canine skin and coat problems, poor GI and immune systems, joint pain, and arthritis.
MSM supplements are sold as powders and capsules with a recommended dose for dogs of 50 to 100 mg per 10 pounds of body weight. MSM powder can be mixed with food.
DL-Phenylalanine (DLPA) is an essential amino acid used to treat both depression and chronic pain. It works by intensifying and prolonging the body's natural painkilling response. Studies have shown that the D-form inhibits several enzymes that are responsible for the destruction of endorphins, the body's endogenously produced pain-killing hormones.
The suggested human dose, which can be adjusted for your dog's weight, is 750 mg three times a day, taken 15 to 30 minutes before each meal. Most patients respond within one to two weeks. Rather than dosing continuously, DLPA can be given for one week per month to maintain results. Do not combine DLPA with MAOI drugs like Anipryl, used to treat Cushing's Disease and canine cognitive dysfunction, or amitraz, an ingredient in tick collars.
Hyaluronic acid, a naturally occurring polyanionic, polysaccharide consisting of N-acetyl-d-glucosamine and beta-glucoronic acid, is a constituent of joint fluid. It acts as a protective structure stabilizer and shock absorber. Use a product labeled for pet use, such as ActiPet Hyaluronic Acid for Dogs, which contains 20 mg per tablet, or adjust a human product for your dog's weight.
Cetyl myristoleate or cis-9-cetyl myristoleate is a fatty acid derivative discovered in 1972. It has been shown to help with several health conditions, including chronic back pain, osteoarthritis, and rheumatoid arthritis, and is usually taken as a supplement but can be applied externally. Popular products for dogs include Cetyl M from Response Products (which contains Cetyl myristoleate, marine-source glucosamine HCl, garlic, bromelain, and ginger root) and Myristin Hip and joint Formula from EHP Products, Inc., (which contains Cetyl myristoleate, glucosamine sulfate, MSM, bromelain, curcumin, vitamin C, manganese citrate, lipase, and lecithin).
THE RIGHT FATS
Polyunsaturated vegetable oils like soy and corn oil contain linoleic acid, an omega-6 fatty acid that is essential in the diet. Note, though, that too much can trigger inflammation, especially if the ratio of omega-6 to the omega-3 fatty acids found in fish and fish oil is too high. Never add vegetable oils to a commercial diet, and add only the amount needed to a homemade diet.
Coconut oil, which has become a popular pet supplement, contains saturated fats. No one has tested its effect on dogs in clinical trials, but reports published on Internet forums and Dr. Bruce Fife's book Coconut Therapy for Pets (Picadilly Books, 2014) document how adding coconut oil to food has helped overweight dogs and dogs with arthritis grow leaner, stronger, and more lively. The recommended dose is 1 teaspoon per 10 pounds of body weight daily, but start with less, as too much too fast can produce diarrhea. Inactive dogs should receive less in order to avoid weight gain, as each teaspoon of oil adds 40 calories. (See "Crazy about Coconut Oil," October 2005, and "Even More Favorite Remedies," November 2013, for more information.)
Salmon and other fish oils are rich sources of omega-3 fatty acids that reduce inflammation, in contrast to the omega-6 fatty acids in polyunsaturated vegetable oils. Fish oils contain EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), which block inflammatory cytokines and prostaglandins. They are converted by the body into powerful anti-inflammatory chemicals called resolvins.
Omega-3 supplements with 300 mg combined EPA and DHA are widely prescribed for dogs. Give up to 1 gelcap per 10 pounds of body weight daily, or if using a product containing 500 mg EPA/ DHA, give 1 gelcap per 15-20 pounds of body weight daily. Adjust liquid fish oil dosages to 300 mg combined EPA/DHA per 10 pounds of body weight. Higher doses can interfere with platelets and increase bleeding as well as increase rather than reduce inflammation.
Unless they are fermented products, refrigerate liquid fish oils to prevent rancidity.
One ounce of canned sardines, jack mackerel, or pink salmon with bones provides about 300 mg combined EPA and DHA. Krill oil and whole fish contain EPA and DHA that may provide similar benefits in smaller doses.
As Mary Straus explains, "You must supplement with vitamin E whenever you are giving PUFAs such as fish oils, otherwise the body will be depleted of this vitamin. Give up to 3 to 7 IUs per pound of body weight daily, with small dogs getting more per pound than large dogs. You can also give equivalent amounts less often. For example, a dog weighing 100 pounds might get as much as 400 IUs daily, while a 10-pound dog could be given 200 IUs every three or four days."
GELATIN AND COLLAGEN
Gelatin, a protein made from animal products, is familiar as a fruit-flavored dessert, but by itself, gelatin soothes the digestive tract and helps improve the assimilation of nutrients. Gelatin contains collagen, one of the materials that make up bone and cartilage, and Type II collagen supplements are derived from cartilage.
Extensive research in the early 20th century showed gelatin to be an important inflammation fighter, and its benefits are being rediscovered. In "Role of collagen hydrolysate in bone and joint disease" (Seminars in Arthritis and Rheumatism, October 2000), Dr. Roland Moskowitz published a literature review on collagen hydrolysate in the treatment of arthritis in humans, concluding, "Clinical studies suggest that the ingestion of 10 grams PCH [pharmaceutical grade collagen hydrolysate] daily reduces pain in patients with osteoarthritis of the knee or hip, and blood concentration of hydroxyproline is increased."
A double-blind, placebo-controlled, randomized clinical study of the effectiveness of collagen peptide (linked amino acids) on osteoarthritis published in the March 2015 Journal of the Science of Food and Agriculture concluded, "The study demonstrated that collagen peptides are potential therapeutic agents as nutritional supplements for the management of osteoarthritis and maintenance of joint health."
The Weston A. Price Foundation (westonaprice.org), which advocates traditional diets for humans and pets, promotes the use of bone broth, which is rich in collagen, as a daily digestive aid.
The recipe couldn't be simpler: just fill a stock or crock pot with bones (chicken, beef, lamb, etc.), cover them with water, add 2 tablespoons cider vinegar and wait for an hour to increase the broth's mineral content, then cover and cook on low heat for 12, 24, or 36 hours. Strain or remove the bones and store the broth in glass jars. Bone broth thickens when refrigerated and can be added to any dog's dinner for improved digestion, nutrient assimilation, and joint health. Add approximately 1 heaping tablespoon per 20 pounds of body weight per day.
Alternatively, mix a powdered gelatin or collagen hydrolysate with water before adding it to food. Start with 1 teaspoon for a 50-pound dog and gradually increase to 2 or 3 teaspoons. Adjust for smaller or larger dogs. Look for products made from grass-fed animals.
DIGESTIVE AND SYSTEMIC ORAL ENZYMES
Pancreatin, bromelain, papain, amylase, protease, lipase, and other enzymes are familiar digestive aids. They can be added to your dog's dinner to improve the assimilation of nutrients.
Clinical trials and anecdotal reports support the use of digestive enzymes with food, digestive enzymes without food between meals, and enteric-coated enzymes between meals for the treatment of arthritis.
Prozyme Enzyme Supplement, manufactured by Lambert Kay, contains lactose, Aspergillus oryzae, Aspergillus niger, and pineapple stem and fruit. Begin with a small quantity and gradually increase to the recommended dose of 1/4 teaspoon for every cup of food given. Double the dose for dogs age 8 and older.
NZymes Anti-Oxidant Treats for Pets, manufactured by Nzymes.com, contain dried ground soybean sprouts, heat-stabilized rice bran, vitamin A, ascorbic acid, vitamin E, selenium yeast, defatted liver natural beef flavor, stearic acid, cellulose, silicon dioxide, and magnesium stearate. Give one treat daily per 50 pounds of body weight.
Systemic oral enzyme therapy uses digestive enzymes but encases them in an enteric coating, which prevents the tablets from breaking down in the stomach. Instead, they release their contents in the small intestine, allowing the enzymes to circulate in the blood to all parts of the body, including inflamed joints.
Wobenzym contains pancreatin, bromelain, papain, trypsin, chymotrypsin, and rutin. Flavenzym, Medizym, and Medizym Fido have similar formulas. Because enzymes have a blood-thinning effect, they should not be given between meals to dogs with bleeding disorders and should be used with caution in combination with blood-thinning medications or immediately before surgery. (See "Favorite Remedies, Continued," WDJ October 2013, for more information about these products.)
All of the products mentioned here are sold online and in pet supply stores.
In the next issue, well look at traditional and modern plant-based treatments that use medicinal herbs and essential oils to help your best friend enjoy an active life despite arthritis.
CJ Puotinen is the author of The Encyclopedia of Natural Pet Care and other books. She and her husband live in Montana with a 13-year-old Labrador Retriever and 12-year-old Cairn Terrier.
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|Publication:||Whole Dog Journal|
|Date:||Oct 1, 2016|
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