Just a little reminder that osteoarthritis (OA), otherwise known as arthritis, degenerative joint disease (DJD), or osteroarthrosis is a progressive and irreversible degenerative condition of the joints.
How do we diagnose OA?
We suspect OA as a diagnosis based on age/breed, history, and our physical exam findings (lameness, painful joint, decreased range of motion). In order to confirm OA, this requires us taking X-rays. X-rays also lets us rule out other potential causes of lameness like bone cancer, fractures, dysplasias, conformation abnormalities, etc.
Radiographic signs of OA vary from patient to patient. I attached a radiograph of a dog with very obvious arthritis in his stifle. You can see how much smoother the joint is of the leg pulled forward compared to the leg that is pulled back. Signs we look for include:
- Subchondral sclerosis (increased density of bone),
- Narrowed joint space,
- Osteophytes (bony growths in the joint),
- Enthesophytes (bony growths in tendon/ligament attachments),
- Soft tissue calcification
- Bone remodelling
- Joint effusion
Other confirmatory tests may include: anthrocentesis (synovial fluid analysis), arthroscopy (camera in the joint), CT scan, MRI, nuclear scintigraphy
How do we treat OA?
Unfortunately, we cannot cure arthritis but we can slow the progression to limit disease and work towards alleviating your pets pain. There are surgical options to try to remove the lesions and stabilize the joint. Often, because of cost or wide spread arthritis surgical intervention is not an option. Medical and lifestyle management can involve a multi-modal approach to keep your pet comfortable.
Medical/Lifestyle management options:
1. Weight loss: excess weight significantly increases stress on the joints and muscles so daily, low impact activities in combination with a weight loss diet/plan can help your pet lose the pounds they need to.
2. Joint supplements (chondroprotective agens) and/or diets: these help support the cartilage to prevent breakdown and also have some anti-inflammatory effects. I will talk about these in the next post on OA when I discuss prevention.
3. NSAIDs (nonseroidal anti-inflammatories): this drug helps reduce the inflammation AND also helps combat pain. There are multiple different types of NSAIDs available for animals and sometimes certain kinds work better for particular individuals. Just remember… never give your pet any human anti-inflammatories. NSAIDs can have side effects and are not ideal to stay on long term unless absolutely necessary. It is best to run bloodwork prior to starting this medication.
4. Non-COX inhibiting prostaglandin receptor antagonists (i.e. galliprant): this is an anti-inflammatory that works more directly to reduce pain and inflammation associated with arthritis. This medication needs to be given daily but is much safer to be on long term.
5. Extra pain medication: if NSAID alone does not cover the pain.
6. Interarticular injection of PRP (platelet rich plasma)
7. Acupuncture, physical therapy, and/or rehabilitation therapy
8. Low impact activity is encouraged (leash walks, swimming): improves joint mobility, muscles mass, and exercise tolerance
As vets, we will work with you and your pet to develop the best approach to keep your pet comfortable and thriving. OA is not fixable but it can definitely be managed with a good quality of life!
Stay tuned for the next mini series that explains prevention of OA.