I personally use the WET (weight, exercise, treatment) approach.
Weight: Excess pressure puts a huge strain on joints and when looking at a pain scale (i.e. 10/10 for pain), the pain score drop most significantly in obese animals who lose weight.
The advice is simple if you pet is overweight: cut out any treats or replace them with low calorie treats (such as Educ treats) and if your pet already does not get any extra food, reduce the food intake overall by 20% or failing that, switch to a prescription eight loss diet.
Here at Glasslyn, we are always happy to perform free of charge weight clinics – you can call us to book in for those!
Exercise: Ideally, every arthritic dog would get a physio- or hydrotherapy referral to target specific problem joints.
But in general, low impact exercise in the water (minimum of 10 minutes twice weekly) and little and often is best.
5K walks should not be your priority anymore as prolonged forces will put abnormal pressure on the joints and will worsen arthritis in time.
Treatment:
In the acute phase of arthritis, we should focus on acute pain management.
Our first line treatment is usual non-steroidal anti inflammatories (i.e. carprofen/ meloxicam), as it also deals with soft tissue swellings.
Sometimes we add in gabapentin or other pain killers that belong to the opioid group.
Recently, new products have come out on the market: Librela for dogs and Solensia for cats. This is a mononuclear antibody injection that mops up the messenger that signals arthritic pain. This provides superior pain relief, is however quite costly and is usually reserved for more advanced cases.
Personally, I also like putting a lot of emphasis on improving joint quality.
By improving the joint quality, we do not only eventually get a pain killing effect so that we can use less pain killers in the longer term but we also might slow the progression of arthritis down.
I quite like Cartrophen injections for dogs, which is pentosane sulphate and this injection is given weekly for 4 weeks. After the 3rd injection, 75% of clients see a vast improvement (usually after the 4th injection 99% of clients see a big improvement in the dog’s gait and pain level). The course of injections is repeated every 6-9 months (depending on the severity of the arthritis) .
Cartrophen not only improves the joint fluid quality but also prevent nasty enzymes gnawing away at the cartilage – thus it has the potential to slow down the progression of arthritis.
In addition, essential fatty acids (EFAs) reduce inflammation overall and should also be used. These are usually combined with glucosamines and chondroitin, which are proteins that we do find in joints – but it was discovered that there is no glucosamine transporter in the intestines, which means glucosamines need to be built down and up again as they are not directly absorbed.
Other supplements, such as boswelia or turmeric may also be used.
In any case, a multimodal approach is needed to manage arthritis.