Canine Arthritis Management How You Can Support Owners & Their Dogs
By Harmony Coriddi, LVT, CMT, CAMadvocate Level 1
A stiff gait, awkward sit and slowness to stand—these are signs which are often synonymous with elderly dogs. But are changes in mobility aging-related or pain-related? Mobility issues are common as dogs age—expected, in fact—but frequently go undiagnosed and therefore untreated, meaning that far too many dogs suffer with chronic pain in their twilight years.
As mainstays of millions of dogs’ lives around the country, boarding and daycare facilities have a direct impact on each individual dog’s wellbeing while they are under their care, with the ability to improve, maintain or even worsen the dog’s condition during their stay. As the owners and staff of these facilities, you are an integral part of your boarders’ multidisciplinary care team. This article aims to highlight the ways in which you can positively impact these dogs’ quality of life and, potentially, increase their lifespan.
Canine osteoarthritis (OA) is a massively under-diagnosed disease. Studies have shown that 80% of dogs over the age of eight years suffer from OA, while at least 20% of dogs of all ages have degenerative joint changes associated with arthritis. Recent estimates place that number even higher at 35%, bringing to the forefront the reality of this being a disease not just of the elderly dog, but of all dogs, regardless of age.
So why is osteoarthritis such a worrying problem? It is an incredibly complex disease. OA not only affects the joint, but, over time, it also causes changes throughout the rest of the body. As the joint degrades, causing inflammation and pain, the soft tissues surrounding the joint try to compensate, resulting in altered posture and/or gait. Chronic pain develops, bringing with it its own set of debilitating effects.
If a chronic pain state such as that resulting from OA continues unchecked, the nerves of the spinal cord become overly sensitive—a phenomenon called central sensitization, resulting in an exaggerated pain response (hyperalgesia). Eventually, progression of this central sensitization can lead to even normal sensations, such as being stroked or petted, being perceived by the dog as painful, a medical phenomenon known as allodynia.
The above explanation of the disease process of arthritis is highly simplified. But it brings across the main point; arthritis is a debilitating disease, and not something which should be dismissed as just being part of “getting old,” which is sadly so often the case. Osteoarthritis is one of the leading causes of elective euthanasia and was recently classed as one of the top three welfare concerns in dogs by the Royal Veterinary College in the UK, alongside obesity and dental disease.
Unfortunately, as previously stated, arthritis is frequently either ignored or dismissed. Oftentimes, this is due to either the misconception that “slowing down” is a normal part of aging, or because the signs of arthritis can be quite subtle so are not identified as being pain-related. That is why you must fulfill your pivotal role in helping to not only identify signs of arthritis in the dogs under your care, but also support their owners and become key players in the management of this long-term condition by working together with veterinary teams and other paraprofessionals.
Each stay at your facility for a dog suffering from OA can potentially improve, maintain or worsen their condition. If a dog comes in for daycare every day, Monday-Friday, they may be under your care for 10 hours out of 24 each of those days. Clearly, your influence on disease progression and control is massive. Take this opportunity to ensure you are doing everything in your power to improve or at least maintain these dogs’ conditions and wellbeing.
The first step is to consider the kennel environment. Adaptations to environment and lifestyle are particularly important in the management of OA, and this crosses over into boarding and daycare facilities too, not just in the home.
Slippery flooring can cause further harm to the joints and surrounding soft tissues through trips, slips and falls. For an arthritic dog, asking them to walk, run or play on a slippery floor is akin to asking an elderly person to walk across a newly-varnished floor in socks—it is more than likely going to end in a painful injury.
Some arthritis-friendly adjustments for the kennel environment include putting down non-slip matting/flooring, using raised food/water bowls (should preferably be between the dog’s elbow and shoulder height), providing a comfortable bed that supports the joints and provides adequate cushioning, and eliminating or providing a safe alternative (i.e., a ramp) to any steps or stairs the dog may have to navigate.
Activities for arthritic dogs should also be altered. Instead of high-impact games such as ball-throwing, switch to low-impact activities like interactive feeders (e.g., snuffle mats and lickimats) and games involving the dog using their sense of smell to find a toy, or, alternatively, some of their kibble (using a portion of their daily allowance as weight management is critical, not only for OA, but also for general wellbeing.)
Keeping arthritic dogs active is highly important, as disuse will cause further muscle atrophy and weakening of soft tissues, leading to greater laxity of the joint and resultant additional degeneration, producing a vicious cycle of pain. The key is to find low-impact activities that will challenge the mind while providing gentle exercise for the body.
Dogs suffering from OA should also be closely monitored on walks. If the dog is slowing down or seeming tired during the walk, they likely are overexerting themselves and causing further injury. Thus, provide shorter, more frequent walks allowing plenty of time for sniffing rather than longer walks only once or twice daily.
Dogs often begin coming to boarding and daycare facilities as puppies or young adults and may continue to attend the same facility for their entire lives, giving you a unique opportunity to play a central role in recognizing changes over their lifetime which may be pain-related. Identification of pain is key.
Chronic pain associated with OA can manifest in a wide variety, from alterations in behavior and posture to muscular and gait or capability changes. Dogs are incredibly skilled at coping with pain and discomfort, and therefore frequently do not show overt signs such as lameness or vocalization until the disease is quite progressed. Signs can range from weakness of the hind limbs, depression and licking their joints to muscle wasting, reluctance to walk or play, and sleeping more than usual. Behavioral changes such as unusual aggression are also frequent indicators of pain.
As highly-valued members of dogs’ care teams, you have a unique opportunity to influence and support owners. If indications of chronic pain become apparent, staff can immediately notify owners as well as pass their observations on to the dog’s veterinarian for a full investigation with diagnostics, as warranted. Note all observed changes in the dog’s file so progression of the disease can be tracked over time, which will allow you to communicate any worsening of the dog’s signs to the owner and veterinarian, indicating that a change in management is warranted.
Many dogs suffering from OA either require pain medications or will eventually need pain control as the disease progresses. Objective monitoring is another way in which you can support owners of arthritic dogs and be an integral part of the multidisciplinary dream team. Finding three to five objective measures unique to the individual dog that indicate they are having either a good day or a bad day is extremely useful in managing a long-term, complex condition like OA. Crucially, having objective measures in place provides a way of monitoring not only efficacy of interventions (e.g., medication(s) or complementary therapies), but also progression of the disease.
Make it standard protocol to ask owners of arthritic dogs for the objective measures they use daily to monitor their dog so that you can track the monitors throughout the dog’s stay at your facility and provide additional peace of mind for your clients. Through incorporating objective monitoring into your daily care routine for these dogs, you will allow better management of the disease through communication of any worsening or improvement directly to the owner and the veterinarian in charge of the pet’s care.
As previously mentioned, management of osteoarthritis frequently requires the utilization of long-term medications, often with two or three drugs being given concurrently to adequately control the pain in more progressed cases. The long-term usage of medication—NSAIDs (non-steroidal anti-inflammatory drugs) in particular—is often given an unwarranted bad rap, with rampant fear among owners that the drugs may have an adverse effect on their dog. In fact, the most common adverse effect of NSAIDs is mild, transient gastrointestinal upset; other adverse events of NSAIDs listed include vomiting, diarrhea, anorexia (loss of appetite), lethargy and, rarely, death. However, please note: in comparison to the large-scale daily use of NSAIDs in veterinary medicine, the occurrence of these side effects is incredibly rare. These more serious adverse events are commonly associated with inappropriate use, the dog having a comorbidity (a concurrent disease process; e.g., kidney disease) or suffering a drug reaction.
Understanding the appropriate use of the drug(s) a dog is prescribed is essential for avoidance of any potential adverse effects. Ensure that all medications a dog is taking come into the facility with clear instructions for use and are clearly labeled and kept separate (especially if the dog is on multiple medications with varying administration schedules) with strict record-keeping in place to ensure the dog’s medication schedule is followed precisely.
Even within the NSAID drug family, there are differences in recommended dosing times; for example, carprofen, a frequently utilized anti-inflammatory, is to be given with food, while grapiprant, a newer NSAID targeted for OA pain, is absorbed better on an empty stomach but can be given either with or without food dependent on the individual dog. All staff should be aware of potential side effects of the various medications and be able to promptly identify them if any should occur. A plan of action, including emergency veterinary contacts, should be put in place in case any adverse effects occur during the pet’s stay at your facility.
This article has only scratched the surface of proper multimodal management of canine osteoarthritis. But hopefully it has provided a glimpse of how you can play your critical role of not only increasing awareness of OA, but also aiding owners and their pets’ veterinary and complementary therapy teams in managing the disease. Through working together to raise awareness and promote proper management of OA, the veterinary and pet care fields can ensure owners have their dogs for more years. Make it your priority to provide the gold standard of care for dogs under your care suffering from OA—you have the ability to change, and even save, lives!
Harmony Coriddi, LVT, CMT, CAMadvocate Level 1, is the CAM Education Coordinator at Canine Arthritis Management (CAM), a self-funded, veterinary-led organization committed to providing evidence-based education and resources for both the public and canine professionals. Founded in 2016 by Dr. Hannah Capon, award-winning CAM now encompasses a website (www.caninearthritis.co.uk), owner support forums, a large social media presence, and a growing education platform for both canine professionals and owners (www.cameducation.co.uk). CAM has recently launched CAMadvocate Level 1, a course for canine professionals aiming to improve awareness, identification, and understanding of OA and how to successfully manage arthritis cases long term.