Dogs are no different than people and have joints that will gradually deteriorate secondary to osteoarthritis, which can create significant discomfort. Almost 7 out of 10 people have at least one dog in their family. They can be of the working class, assisting with hunting or even protection, or in most cases, they are perceived as members of the family. It is interesting to see the status of the family dog change over the past two decades, which is a good thing, as they have moved up in ranks to more of a social companion for many, following us around with our every task and move. As we see the changing status and increasing level of meaning they have in our lives, it becomes even more important to provide for their health in the best ways possible. They often suffer in silence, trying to please us, but it is needless as there are options available to assist in maintaining not only their comfort, but their overall health. Joint health in our canine companions is a very important facet to their overall well-being. Let’s dig into options to assist them on a new level, above pain medications.
Joint conditions impact the dog just as much as they do us, as humans, but there is a high predominance of hereditary or genetic issues such as hip dysplasia or even subluxating patellas or knee-caps. Osteoarthritis in dogs is often a slowly progressing condition in which the joints degenerate due to stress on the joint due to body size, excessive overuse or even conformational flaws. Considering this, most joint conditions tend to become apparent later in life for dogs and often leaning towards involving larger breeds. The bigger they are, breed and size wise, the more stress that is placed on the joints and increased wear. In the smaller breeds, we tend to see true osteoarthritis more in the older dogs, but the younger ones can have genetic conditions such as patellar luxation, which creates moderate joint pain and discomfort. It is also common to see larger breed dogs, at a younger age, present with hip pain due to the genetic hip dysplasia condition.
Patellar or Kneecap Luxation in the Dog
In smaller breeds, patellar luxation is a genetic condition in which the kneecap or patella fails to stay in place. The reasons behind this are first, the groove in the distal Femur is too shallow which allows the patella to dislocate easily or pop out of place. The second contributing factor is often and genetic inward rotation of the lower limb (Tibia). This inward rotation of the tibia means that the associating patellar ligament will also be rotated, which creates an abnormal pull on the patella during movement, usually to the inside. Considering this, a high percentage of patellar luxations are medial or to the inside of the leg and can be of varying degrees, ranging from intermittent dislocation to permanently out of place.
Patellar luxation can create a wide range of symptoms and discomfort for the pets. In many cases, they are running around freely, then cry out in pain, holding one rear leg off of the ground. After a period of rest, the leg is often returned to normal function but relapses with over use again. In more severe cases, the pets are constantly in a state of discomfort, crying out and refusing to jump, run or even climb stairs. Again, most of these dogs are young when clinical problems first develop. This condition is diagnosed fairly easily just by palpation of the knee joint and manipulation of the patella. Often, x-rays are also taken to get a better picture of joint health, looking for deterioration or osteoarthritis that may also be present.
Hip Dysplasia in the Dog
In larger breed dogs, hip dysplasia is more common, dependent on the breed. In this condition, there is a genetic deformity of the hip joint, which consists essentially of a cup (acetabulum) and femoral head, which is a ball on the head of the femur. Under normal circumstances, the femoral head fits snuggly into the cup or acetabulum and held in place not only due to the depth of the cup but also by the ligament of the femoral head. In cases of hip dysplasia, this system is upset due to a variety of factors including a malformed femoral head and a shallowing of the cup or acetabulum. In both of these cases, one can hopefully appreciate the problem. As a result, the cup is too shallow and the femoral head is prone to dislocating over time. Usually, the first clinical signs are discomfort, crying out, refusal to jump, play or climb stairs which is all related to degeneration that is occuring within the hip joint as a result of the condition. Over time, the pain levels increase, joint degeneration worsens and often the hip simply pops out of place. Hip dysplasia is generally diagnosed by examination and evaluation of the hips and assessing gait movement. X-rays are also taken to assess the hip joints, evaluating changes that have taken place and overall severity of the problem. Most often, it is involving both hip joints, but may be worse in one over the other. For more information on Hip Pain in Dogs, check out this article.
Osteoarthritis and Cruciate Ligament Tears in the Dog
Aside from these two mentioned hereditary conditions, most pets succumb to normal joint deterioration, osteoarthritis, as a result of age and body size. The most common joints involved are the hips, lumbar vertebral joints, elbow, wrist region and even the shoulder. Breed does have a lot to do with speed of deterioration and age in which clinical problems develop, with larger breeds being more likely to have issues earlier. An overweight animal, small or large breed, is more prone to joint issues due to excessive load in which the joints are bearing. Osteoarthritis is generally diagnosed with a combination of a good physical evaluation, joint manipulation, clinical signs and x-rays to determine joint damage.
Another common condition affecting the knee or stifle joint of both large and small breeds is cruciate tears. The knee joint is very similar to ours and contains two crossing ligaments internally, the cranial (anterior) and caudal (posterior) cruciate ligaments, which attach the top part of the tibia to the lower part of the femur within the joint. A cruciate tear is a common sports injury in humans, generally as a result of a sudden stop in motion in the lower limb. In dogs, the cause of the condition is almost identical and a common scenario is a large breed dog that was running at the park, but suddenly came up limping or non-weight bearing on a rear limb. As a result of the sudden stop in the lower limb, the upper limb and body continue forward, which puts excessive strain on the cruciate ligament, usually the cranial ligament, creating anything from a partial to a complete tear of the ligament. Cruciate tears are diagnosed based on history, palpation and manipulation of the knee or stifle, and x-rays to determine concurrent joint damage if present.
Treatment & Prevention Options for Joint Pain in Dogs
In the case of genetic conditions, such as patellar luxation and even hip dysplasia, often the only solution is surgical intervention. That being said, there are stages in which these conditions present and the early stages can often be managed fairly successfully through a variety of means to improve patient comfort and even slow progression of the condition, potentially helping to postpone surgery.
The biggest factor that we have to consider in all of these scenarios is the role that inflammation plays. It is agreed that in cases of genetic conditions, there is a flaw in the makeup or integrity of the joint, which cannot be remedied without surgery. However, we have to take into consideration that inflammation is the main cause of joint deterioration, cartilage erosion and bone remodeling. In the cases where we have genetic flaws, the joints are then under increased physical stress which accelerates the degenerative process as a result of increased inflammation. This is no different than having a Golden Retriever that is 30 lbs. overweight and having that excess weight add physical stress to the hips or back, creating accelerate joint degeneration.
Inflammation is a cellular process that essentially starts from the moment we are born and they are puppies. This process is what causes us and them to age and with this, also contributes to many health conditions including joint disease. If a dog has a genetic condition or conformational flaw, then the inflammatory process is increased over a more normal patient. Even in the case of a cruciate tear in a dog, inflammation is present, which contributes to pain and discomfort, but also may actually contribute to prior weakening of the ligament and subsequent rupture.
This inflammatory process is further pushed along by the diet you choose to feed your dog, the environment in which they live, the level of exercise they receive daily and many other factors. So, you, as their owner, play a vital role in their health, whether if you realize this or not.
The other thing we must realize is that no matter the condition, the longer it is present, the higher the inflammation levels and thus the more likely there is to have secondary joint degenerative changes. This is what occurs in hip dysplasia patients, patellar luxation patients, cruciate patients and even those with normal osteoarthritis. The question comes as to how to best manage this process for overall patient comfort and improved quality of life? Often, even in cases of joint conditions, if we diagnose it early enough and manage the inflammatory response properly, we can return function and improve comfort quite readily in many patients, without the need for medications or even surgery.
The inflammatory process is so critical to health on many levels. As a veterinarian, I would often recommend to our new large breed puppy owners to start targeted supplementation on a routine basis beginning at the age of 6 months. The reason is that I know inflammation will play a role at some point for that pet, especially if they are a large breed. If we can manage it and improve their overall health earlier, then we reduce the risk of joint conditions and even possibly cruciate injuries earlier in the life of that pet.
We, as pet owners, can choose to be either proactive or reactive. By this, I mean we can either look at potentially preventing a condition or we can wait until an injury or problem develops. Usually, if we wait for the joints to develop problems, then they have already progressed and become harder to manage. Much better to nip it in the butt earlier than later!
How do we prevent and manage inflammation? Typical approaches include traditional joint supplements containing glucosamine, chondroitin sulfate or even MSM. In some instances, we as veterinarians even have access to injectable forms of those ingredients, which improves efficacy but also raises cost. These nutrients do have merit, based on research, but often requirer higher than labeled doses to achieve those results. Even in the best cases, usually it takes 6 months or more to see improvement in the patient.
Other options, which unfortunately are heavily used, are prescription pain medications called NSAIDs or non-steroidal anti-inflammatories. There are many of these medications on the market with different names, but the bottom line is that they do help to manage inflammation and pain, but it is on a restricted level. If we have to rely on them for the long term or use high doses, then we run the risk of stomach ulcers, kidney disease, or even liver failure. These medications are helpful and necessary in late stage conditions, but I believe we may be able to do better or at least have less of a dependence on these medications.
As a researcher and veterinarian, I know we can do better for our patients by seeking more potent nutraceuticals that may work at a higher level. As discussed, inflammation is a complex process, but in many cases, it originates at one point which is really an area of central cellular signaling. Through the use of some herbs including Curcumin and Boswellia, for instance, we can potentially impact this central cellular signaling, which then reduces the inflammatory process from a high level to a more normal level. Antioxidants, such as Vitamin C, are also important as they also not only help to control the inflammation, but Vitamin C is actually needed in the formation of collagen and maintaining healthy cartilage in the joints. When we look at health as a whole, we realize how much nutrition plays into the role of inflammation through cellular health. If we go one step further and provide herbs that are also nutritive in their ability, such as Alfalfa and Spirulina, then we are also providing nutrients for overall cellular health, which impacts the patient positively on many levels.
Looking back at my practice years and patients, we did a lot of surgical procedures in the dog for joints, repairing patellar problems, hips and torn cruciates. That being said, even though we had the ability to take our patients to surgery, it was not always my first line approach. More often, we would use herbal formulas (Cur-OST SA) to assist these patients with improving comfort and even helping to heal some soft tissue damage associated with the conditions. These formulas helped us to control and return the inflammatory response down to a more normal level and with that, improving quality of life and comfort for the pet. In many cases, if diagnosed early enough, we were able to stabilize the problem and avoid surgery, even for the long term with daily usage.
Our own personal pet, a 15 y.o female Doberman, had been on the Cur-OST SA since the age of 6. She had only three legs as a result of an injury many years ago, which puts excessive strain on her front legs. Even at this age, she was totally functional, running around like a puppy and felt great with no medications. Most Dobermans that we saw as patients were generally restricted to less than 10 years of age, and even with that, they were presented for euthanasia due to joint and health problems. Considering Angel’s age and current health status, it is a real testament to the potential impact that managing inflammation can have on health.
Angel has moved on, but in more recent times, we have adopted a Greyhound female that had a history of being on the racetrack. She was very timid and her body condition was less than ideal, being fed a generic dry kibble dog food. Upon coming into our house, her diet was changed to a home-cooked regimen, and the Cur-OST SA Total Support is a part of her daily routine. In the few months that we have been blessed with her presence in our house, her body condition has completely transformed, almost back into what would be called race-condition. Lean, tight, and very muscular. She moves well, but at times, her past injuries do come back to bother her, although for a very brief period.
The bottom line point is that there are options for promoting joint and overall health in your dog! We often overlook their needs but rarely do they overlook ours. If we just make some simple changes to our approaches, we can potentially make huge changes for them.
Here is an article to help you determine the best joint supplement for your dog?
All my best,
Tom Schell, D.V.M.
Nouvelle Research, Inc.