Crunchy Doggos - Managing Osteoarthritis

Getting old is no fun! Although, dogs of any age can develop Osteoarthritis, especially if they've had an injury such as Cranial Cruciate Ligament Rupture (CCL/ACL), a congenital issue like Hip Dysplasia, or participated in Canine Sports. Included below are some tips, tricks, warnings, and other info to help you keep your pup mobile and comfortable. Should you have any questions on any of this information or would like more details, feel free to ask the CROC team. We are here to support you and your best friend!

Weight Management

Keeping your dog at a lean body weight is the most important aspect of managing this condition.

Fortunately, it’s also one of the easiest! Sometimes, it’s as simple as adjusting their meal portions. Other times, a complete switch to a new food is necessary. These days, there are a wide variety of AAFCO formulated Weight Management or Weight Loss diets readily available for purchase. Some are even specifically formulated for Senior Pets or for those needing extra Joint Support. Be sure to look for diets that are high in Essential Fatty Acids.

Generally speaking, your goal Body Condition Score for an arthritic dog is a 4 out of 9, a little on the skinny side.

If you'd like more information about managing your dog's weight, including tips on diet changes and safe exercise, be sure to read through our article Body Condition Score & Canine Weight Loss.

Supplements

We'll briefly cover our favorite supplements here, but to learn more about supplements, such as how to pick a quality product, visit our article Pain Meds & Supplements.

Dasuquin Advanced with MSM is an excellent daily joint supplement that many of our team members choose to use for their own pets. It includes Chondroitin, Glucosamine, and other ingredients to support joint health and it comes in a tasty, chewy treat, making it an easy addition to your daily routine.

Fish Oil added to your pet’s meals is another easy addition to help keep joints happy (and it helps their coat too!). Start with 500-600mg per day, then increase to 1000-1200mg per day. It is important to start slow with this as some pets may be sensitive and have GI symptoms if started too quickly.

Myos Canine Muscle Formula is a supplement containing Fortetropin, a natural bioactive supplement made from fertilized egg yolk. Myos has been credited with improving muscle health, helping to reduce muscle loss (atrophy) and helping regain muscle after surgery or with other disease processes. It has also been shown to help skin, coat, cognitive, and bone health.

Medications

Adequan (Polysulfated glycosaminoglycan) is a series of injections that stimulates cartilage healing, slows the progression of osteoarthritis, and decreases pain and inflammation. It begins with an initial series of 8 injections with one injection given every 3-4 days. Once that is complete, many pets can drop down to a maintenance schedule of one injection every 1-6 months. For larger dogs, this can be a costly investment to get started, but we have seen significant improvement for many dogs using this medication. If you have concerns about giving your dog injections, be sure to speak to your veterinarian for options like an in-person demo or having their staff perform the injections for you. You can also speak to the CROC team.

Common NSAIDS - Rimadyl (carprofen), Metacam (meloxicam), Deramaxx (deracoxib), and their Generics are Non-Steroidal Anti-inflammatory medications that can be extremely helpful for managing pain and inflammation and since many generics exist, it can be easier to find one that fits your budget. They can have long term side effects to the liver and kidneys so regular bloodwork is strongly recommended to catch any change in organ function early. They must also be given with food! Some pets don’t tolerate these medications well and can have serious GI side effects like stomach ulcers and gastrointestinal bleeding. It is important to monitor your dog for any signs of vomiting, diarrhea, or dark stools while on these medications. Some pets REALLY like the taste of the flavored tablets so store these medications with caution, securely out of reach of your pet.

Galliprant (grapiprant) is a newer type of Non-Steroidal Anti-inflammatory that has less side effects than the more widely known NSAIDS listed above. It is reported to have less effects on liver, kidneys, and GI tract and can be safely used alongside a wider selection of other medications. Because it is newer and a more specific medication, it is generally more costly than the above listed NSAIDS that have been around longer.

Neurontin (gabapentin) is a medication primarily used to treat nerve pain, though it can also help with anxiety. Many pets experience some level of drowsiness when they first start this medication, but they usually become accustomed to it and return to their normal energy level after some time. Besides sedation, other side effects are extremely rare. This medication is a good option for pets that cannot tolerate NSAIDS and it can also be used alongside NSAIDS and many other medications.

Tramadol is a synthetic opioid that has been commonly used to treat moderate to severe pain in dogs. Newer studies on this medication show that it may be less effective than previously thought, with only a small fraction of dogs getting any pain relief from it. Side effects from Tramadol include sedation, vomiting, diarrhea, constipation, and loss of appetite

A Quick Note About Librela

Librela (bedinvetmab) is the newest OA treatment in the US; a once monthly injectable medication only for use in dogs. It must be administered by your veterinarian and may take up to 6 weeks for observable results. Librela is a monoclonal antibody (a protein that has been engineered to bind to a single target) that targets Nerve Growth Factor which helps reduce pain caused by osteoarthritis. It can be extremely effective for the right patient, allowing dogs to return to their favorite activities while potentially reducing the need for daily medications. However, the adverse effects reported with this new medication are highly concerning and side effects are still being discovered.

Due to potentially severe side-effects, we recommend that your pet be thoroughly evaluated before starting Librela. This should include bloodwork and radiographs at a minimum and may require evaluation with a neurological or orthopedic specialist. To learn more, visit out our article A Look at Librela.

Dogs with neurological conditions, auto-immune conditions, breeding dogs, or dogs that are skeletally immature should not be given Librela.

Librela does not cure OA. Dogs on Librela sometimes feel so good (since they can’t feel the pain) that they overdo it and cause further injury to themselves. It is best to introduce Librela alongside a structured exercise plan to avoid injury and only after thorough diagnostic screening to rule out auto-immune and neurological conditions.

Other Options

If the above options aren’t working well with your dog, be sure to speak to your regular veterinarian about other medication options for pain relief. We discuss pain medications in greater detail in our upcoming article Pain Meds & Supplements. While CROC does not prescribe medication, we do help you improve your dog's pain management plan as needed as part of their prescribed treatment plan at CROC. There are new medications coming out frequently that might be a better fit for your pet. Stem Cell Treatments are now available for pets and may be something that could potentially help your pet. There are also other, non-medication treatments which we will discuss below that might help reduce your pet’s pain

Exercising at Home

As part of your Consultation with us, you will have been provided with Veterinarian Prescribed Rehab Exercises (your Homework). These exercises will help keep your dog limber and improve their strength and stamina while maintaining their range of motion. Regular walks, tailored to your pet’s abilities are an important part of keeping those arthritic joints moving, reducing stiffness. Make sure to do shorter, more frequent walks instead of one long walk every day. Our article Motion is the Lotion discusses the importance of frequent but controlled exercise to maintain the joints' range of motion and musculature.

There should never be sudden changes between inactivity and exercise. Always have your pet warm up before exercise and cool down after exercise.

Avoid becoming the “Weekend Warrior” as over-exercising and acrobatic activities such as ball and Frisbee chasing are recipes for pain and stiffness later. Unfortunately, this also applies to rough play with housemates and other animal friends. Your dog may have once been the rough and tumble, go-go-go type, but it’s important to think of an OA dog as an antique luxury car. They’re still wonderful and should be taken out to enjoy the world, but great care should be applied when doing so. Regular maintenance and preparation will make all the difference for your dog’s experience.

Osteoarthritis flare-ups are common and can even be caused by changes in the weather. It can be tempting to call off therapy sessions when your dog is having an OA flare up, but more often than not, that's actually when they need Rehab the most! Don't forget that their treatment plan is geared towards treating the pain and inflammation associated with their osteoarthritis in addition to building muscle to better support the joints. Let us know when you see changes in your pet's symptoms and our Medical Team will adjust their therapy session to best address your pet's condition so they can go home feeling better than when they came in.

Swimming is frequently thought of as a low impact and helpful exercise for OA dogs, however it commonly causes significant abuse to the elbows, shoulders, and hip joints leading to inflammatory flare-ups. Opt instead for walking in warm water at your dog’s armpit level. Do this at very slow intervals to decrease the repetitive grinding of any arthritic joints.

Swimming exercises typically do not help pets become better or stronger at walking outside of the water.

To learn more about hydrotherapy, such as when swimming is appropriate and medical conditions that would make swimming unsafe, visit our article The Deep Dive into Swimming.

Physical Rehabilitation

Participating in Physical Rehabilitation Therapy at CROC allows your dog to get exactly the exercises and pain relief that they need on a regular basis to keep them comfortable and mobile, while also slowing the progression of their arthritis and atrophy. Our team closely monitors your pet’s abilities and adjusts their sessions as needed while also keeping you updated as your pet progresses.

Therapy Sessions at CROC include multiple pain relief modalities like Thermotherapy, Cryotherapy, Laser Therapy, Therapeutic Ultrasound, PEMF, E-Stim, and Massage Therapy to be used as appropriate for your pet’s condition. Veterinary Medical Acupuncture is another option CROC offers to provide pain relief and increase circulation.

Daily participation in at-home exercises wearing you down? Let us do some of that work for you and take your pet home feeling better than when you dropped them off!

Regarding Chiropractics...

We know this is a soft spot and that many people enjoy chiropractic for themselves. Human Chiropractic has been practiced since the late 19th Century but is still in contention regarding its efficacy today. In Veterinary Medicine, Chiropractic is a very controversial and divisive topic. We do not want to shame anyone for previous choices made with the intention of helping their pet. We do feel compelled as thoroughly educated Veterinary Medical Professionals to share our perspective. At CROC, we have treated multiple patients that were receiving chiropractic care and were in significant pain when they came to us, which resolved when chiropractic sessions stopped while proper Physical Rehabilitation Therapy continued.

A good percentage of CROC patients arrive here after being referred by their veterinarian. Because of this, we have developed very close relationships with the local Neurological and Orthopedic Veterinary Specialists.

CROC does not offer Chiropractic services because not a single one of these Board-Certified Specialists will support or recommend Chiropractic therapy for IVDD patients. 

Even when consulting with Boarded Neurologists outside of Orange County, we have yet to find one that would approve of their spinal patients undergoing Chiropractic treatments.

At this time, there are no Peer-Reviewed studies to substantiate claims that Chiropractic is an appropriate (or even safe) treatment for Veterinary patients.

In addition, the American Veterinary Medical Association, America’s leader in advancing the science and practice of veterinary medicine to improve animal and human health, has not published any policies supporting Chiropractic. Reviewing Chiropractic on a basic level - Chiropractic treatment involves applying jarring and intense force on the body, which is also one of the worst things for a patient that has spinal instability or just had spinal surgery.

The spine is particularly fragile under the forces of Chiropractic and there is a risk for severe pain and neurological injury.

This is the normal healthy spine of a young dog. Notice that the vertebrae and the spaces between them are very well defined.

This is a senior dog with severe Spondylosis Deformans (spinal osteoarthritis).

As intervertebral disks degrade, the spine starts to move abnormally and osteophytes (bone spurs) will form in an attempt to stabilize each joint. Eventually, osteophytes can become so severe that they bridge between each vertebrae. At this point, we have a spine that is poorly cushioned by degraded intervertebral disks and surrounded by extra bone.

Bone rubbing on bone and nerve impingement become chronic sources of pain and stiffness. Pain and stiffness are common reasons that pet owners will pursue Chiropractic for their pet.

Could you imagine applying jarring and intense force on a spine like this?!?! OUCH!!!

If your dog is experiencing enough pain that you are exploring other treatments like Chiropractic, please check in with us or your regular veterinarian first. There are certainly better and safer options for pain relief available.

Environmental Modifications

Use a good quality dog bed! Memory foam is an ideal material. Your dog’s bed should be at least 1 1⁄2 times as long as your dog and at least 1-2 inches of thickness for every 40lbs of body weight. Encourage your dog to change position frequently, such as switching which side of their body they lay on. Laying in one position for extended periods of time will lead to significant stiffness and pain once they go to get up.

Slippery, hard floors are tough on OA dogs. Rugs, yoga mats, and the like are extremely beneficial to help keep your dog on their feet and avoid slips and falls.

Doggie Doors need to be large enough for your dog to walk through without having to stoop or crouch. The bottom lip must also be low enough for your dog to easily step over.

Minimize how often your dog has to climb stairs, especially if they are shallow and tall. If you live in a home with multiple levels, you may need to carry your dog up and down the stairs. If you are unable to carry your dog, it may be necessary to contain your dog to one level of your home.

Don’t allow your pet to jump on and off furniture or in and out of your car. Especially jumping down, these types of movements put extreme stress on the body and are a very common cause for injury. Use ramps whenever possible.

Change the location of certain resources. Some dogs need to have their food, water, and bed close together to avoid over-exerting themselves to reach basic necessities. Others need these resources placed farther apart to encourage more movement during the day. Be sure to ask what would best suit your pet’s needs.

Engage in activities that require more mental participation from your dog. Whether it’s toys that have treat tucked inside or playing a game of hide and seek, mind games help keep your dog bright, engaged, and active even when their body may need a bit of a rest.

Ask the CROC Team

There are so many options to manage your dog's Osteoarthritis, it can be difficult to know which are the right options for your pet. The CROC team is always available to discuss your pet's case specifically and to help you find a management plan that fits your lifestyle and your dog's needs. Our arthritic pups got that way from a lifetime spent at our side, so it's only fair that we return their dedication by treating their aches and pains to the best of our ability.