Canine arthritis

I often reply to questions on social media when dogs have suspected or confirmed arthitis – after writing up the same things once again, I thought I’ll add a page to save me from typing this up again!

Please note: I’m not a professional, so I will reference evidence where relevant – this is based on our experiences.

For any dog with arthritis, I would highly recommend taking them to a physiotherapist to be checked. We did this with Nell, and the combination of physio + hydrotherapy pretty much completely rehabilitated her after receiving a diagnosis of “minor arthitis in the wrist” aged 7. This was after our vet said there’s nothing else I can do but give Flexadin which “may or may not work” and then later on we just give pain medication.

I thought that can’t be right so I started researching. Fast forward one month of weekly treatments, we unexpectedly saw big behavioural changes: we had a dog who seemed much happier and also younger than 7, almost puppylike. We did six weeks of weekly treatments, then every other week etc. and eventually spaced them out to every 6 weeks. We had a prescription of Rimadyl (basic painkiller) just in case which we gave as needed – probably tablets/month just in case she was in pain after making poor choices (ie jump down from logs).

Front legs and especially wrists take the most impact when a dog jumps over things and runs downhill, so consider that Nell did all those thing every day at full speed, without slowing down until the end of her life aged 10…

Complementary therapies

Here’s the CAM page for complementary therapies:

  • Physiotherapy uses physical means to restore movement and function following injury or during the treatment of chronic conditions such as arthritis. It can help to relieve pain, improve physical activity and reduce the risk of future injury. A holistic approach is taken, which means that as well as attending appointments, you are often taught exercises to complete at home with your dog between sessions. These exercises aim to strengthen specific parts of the body. The body is considered as a whole, much like in human physiotherapy.
  • Hydrotherapy is a popular choice for rehabilitation following injury or surgery, or for dogs with chronic conditions such as hip dysplasia, elbow dysplasia or arthritis. It is a water-based therapy that uses key properties of water to support the dog’s weight, which in turn reduces pressure on  joints and encourages an increased range of movement.
  • Chiropractic is a manual therapy concerned with the treatment and prevention of mechanical disorders of bones, muscles and joints. Chiropractors tend to focus on the spine and feel that establishing good function through the spine will improve bio-mechanical and general health. The manual therapies involved are considered dynamic and high velocity to re-establish good function. There is good evidence in human medicine that it is effective in relieving persistent lower back pain.

Supplements

I also gave her a high Omega-3 diet (which has the strongest evidence of helping dogs with arthritis), and Type 2 collagen. Here’s the evidence on supplements from Canine Arthitis Management:

SupplementEvidence CAM says
GlucosamineWeak evidenceThis is the household name of an arthritis supplement for both humans and animals. It has been shown to potentially help repair joints as it is a building block of articular cartilage. However, there is much debate as to what concentration will actually reach the joint.
The well-respected GAIT study in 2006 suggested that glucosamine alone or with chondroitin sulphate did not perform better than placebo, whereas the Mayo Clinic suggests there is moderately strong evidence of its beneficial effect. The NHS will no longer prescribe it following a study that looked at evidence in a number of clinical trials.
There are some trials to show positive effects in dogs, however not enough to recommend it as a clinically effective anti-inflammatory, pain-relieving, joint-disease modifier. There are also unanswered questions of how much would actually reach the joint to have the effects suggested.
If used, you should wait for a minimum  of 2-3 months before judging its effect.
ChondroitinWeak evidenceChondroitin sulphate is extracted from mammalian cartilage, normally bovine tracheas. It is believed to provide structural components for helping to repair the articular cartilage, however there is only weak evidence of its effectiveness both structurally and in improving clinical condition of arthritis in dogs.
Omega-3Substantial scientific evidence of helping to reduce inflammation in joints (plus it has other health benefits)Omega-3 and omega-6 fatty acids are both classified essential fatty acids. Omega-6 are pro-inflammatory, whereas omega-3 are not. Supplementing with increased levels of omega-3 encourages them to replace omega-6 in cell walls. Therefore there is less omega-6 available for creating more inflammation in and around the joint. This will slow the progression of arthritis and reduce the clinical signs of pain and reduced joint function. The omega-3 fatty acids found to be effective in this role are eicosapentaenoic acid EPA and docosahexaenoic acid (DHA) which are from marine-based sources. There is substantial scientific evidence to support the above and recent studies have shown statistically significant mild improvement in owner perception of comfort and mobility.
There are only guidelines as to dosing (50-220mg/kg EPA and DHA, with suggestion of higher dosing for arthritis) and it is not known duration of treatment until effect, but one study showed owner assessed improvement 4 months after starting the supplement.
Green Lipped MusselStrong evidence for mild/moderate effeectGreen lipped mussel contains both glycosaminoglycans which are structural within cartilage, and also high levels of omega-3s. It is clear from initial studies that the way the extract is produced is critical for its effectiveness. There is strong evidence of it having a mild to moderate positive effect on mobility and pain in dogs with osteoarthritis, but the number of suitable trials are still considered limited. There is evidence that a high daily dose is needed and that it can take 2-3 months to have effect.
Collagen hydrolysateEvidence in humans, not yet in dogsThis is also known as gelatin and is made from collagenous structures of mammals such as bovine tendons. It is believed to supply proteins to help cartilage repair. It has been found to reduce joint pain and improve mobility in some trials in humans, but there have not been similar trials in dogs.

The products I used in the Netherlands:

  • With fish oil, you need to watch for the concentration and quality – look for very high concentration of Omega-3: Icelandpets
  • GLM also includes Omega-3, so I gave that too: BARF GLM powder
  • Collagen hydrolysate product I still give (recommended by our physiotherapist): Primeval Gelatinaat

This is the combination I eventually settled into with Nell, but since then I’ve discovered a Polish product that is much less hassle since it has all this (minus fish oil) and more: Game Dog AniFlexi HA

More links:

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