In this column veterinarian Dr Liesel van der
Merwe provides practical assistance for common
problems in companion animals. She is a specialist
physician at the Onderstepoort animal teaching
hospital and a senior lecturer in
the section of small animal
medicine. Send your questions to
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Dr Liesel van der Merwe
Osteoarthritis (OA) occurs due
to degradation of the joint
cartilage by enzymes which
are produced due to inflammation
within the joint. It can be broadly
divided into primary and secondary
arthritis depending on the causes.
Secondary arthritis is most common
in dogs and cats and arises from
traumatic joint disease (fractures or
ligament ruptures), abnormal joint
shape or conformation causing
abnormal pressures (hip or elbow
dysplasia), infection and immunemediated
joint disease.
With increasing joint incongruency
there is increased cartilage damage.
This causes inflammation. Joint
incongruency also stimulates the
development of bone deposits in
the joint capsule and ligaments
around the joint in an attempt to
stabilise the joint. Once established,
OA cannot be cured, only managed,
and progression is slowed down.
Because of the hereditary component
with dysplasia, OA is not only a
disease of older animals but can
occur in young animals. OA is more
common in dogs, but is present and
possibly underdiagnosed in cats.
The most common symptom of OA
is lameness, usually gradual in
onset, which worsens after exercise
or minor trauma. A period of stiffness
after rest is an important sign
of joint disease and is often present
in OA before the onset of lameness.
Stiffness is worsened by obesity,
long periods of exercise and cold,
damp conditions. Only in severe
cases will the stiffness persist and
the dog show behavioural symptoms
such as aggression and
depression, due to constant pain.
A good orthopaedic examination as
well as radiographs (X-rays) in
selected cases are necessary to
make the diagnosis. In some cases
surgery may be indicated (loose
bone chips or ligament ruptures),
but in the majority of cases medical
management is the way to go.
General supportive measures
include weight loss and exercise.
Many dogs become symptom free
when they reach their target weight
and are more easily managed with
medication. Many reducing diets are
available. Exercise moderately.
Inactivity leads to muscle weakness
and an accumulation of inflammatory
products in the joint due to poor
blood flow. Over-exercise, on the
other hand, can cause further cartilage
damage and inflammation.
Gradual initiation of low-impact
exercise is the way to go. There are
various facilities offering hydrotherapy
and physical therapy.
Medical treatment includes anti-inflammatories,
pain killers and
nutritional supplementation
(nutraceuticals). A combination of
therapies has the best results.
My aim is to try the nutraceutical
route first and only if this treatment
shows no results after a period of
about 30 days would I start routine
anti-inflammatory treatment.
Modern anti-inflammatory drugs are
safer and more specific, but can still
cause side-effects such as ulcers and
kidney damage. Nutraceutical supplementation
has come a long way.
Chondroitin sulphate and glucosamine
are basic components of
cartilage and can prevent or reverse
further degradation of joint cartilage
and also have an anti-inflammatory
effect. However, only use products
from reputable veterinary
companies.
Diets rich in essential fatty acids
reduce inflammation and pain.
There are veterinary diets with
increased levels of chondroitin and
glucosamine and essential fatty
acids, reaching up to therapeutic
levels in the advanced joint disease
diets.
My advice to those of you with stiff
arthritic dogs this winter is to get
them a warm place to sleep.
Insulate the ground under their baskets
or blankets using rubber matting
or cardboard boxes.
Get your dogs going in the morning
with a gentle walk around the garden
to loosen the joints. Gradually
start an exercise programme to
maintain muscle strength, which will
assist with joint function.
Put your dog on a diet to reach normal
body weight. Start feeding a
diet specific for joint disease, or
alternatively a good diet and add
joint supplements with chondroitin,
glucosamine and essential fatty
acids.
Don’t be afraid to use anti-inflammatories
as needed. A check-up at
your veterinarian may be required
to check kidney function in older
animals.
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