Arthritis is a common condition that will affect many dogs at some point in their life. One large study (Anderson et al, 2018) found that approximately 2.5% of dogs in the UK are affected every year. This is 200,000 dogs! But is there a “cure”, or some treatment that can “fix” it?
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What is arthritis?
The most frequent type of arthritis in dogs is osteoarthritis or OA. Osteoarthritis is caused by degenerative changes to the cartilage within one or more joints. It leads to varying levels of pain and discomfort. Generally, osteoarthritis gradually worsens with time although the rate of progression differs between individuals. It is more common in older dogs but can also occur in young animals too. Osteoarthritis can be due to simple wear and tear of the cartilage over the years. It can also occur secondary to trauma to the joint or to developmental abnormalities such as hip or elbow dysplasia.
How will I know if my dog has arthritis?
There are some clues to look out for that might suggest that your pet is suffering from osteoarthritis. These include:
- General stiffness
- Limping
- Getting slower on walks
- Reluctance to jump/climb stairs
- Being slow to rise from rest
- Changes in behaviour including becoming more irritable
Often these signs can go unnoticed as they can develop very gradually and may be thought of as simply changes associated with old age. It is important to be aware of the possibility of osteoarthritis (especially when our pets get older) as there are now so many options available that can help improve comfort levels and quality of life. If you have any concerns, a visit to your vet would be advised. They will want to have a feel of the joints to check for pain and may advise further investigations such as x-rays to assess for signs of arthritic change.
What medical treatments are available for arthritis?
Luckily there are many different treatments that can help dogs diagnosed with osteoarthritis. Your vet may prescribe nonsteroidal anti-inflammatories which aim to reduce pain and inflammation within the affected joints. These may not be appropriate for all dogs and alternative pain relief medications can sometimes be needed. Joint supplements are also sometimes recommended by vets. Advances in medical treatment options are being made all the time and it is a good idea to have a discussion with your vet as to what is available.
Simple changes to your pet’s lifestyle can also be very beneficial. Avoiding being overweight significantly reduces the effect of arthritis and vets can usually help with diet programs for dogs that struggle to maintain a healthy weight.
Can surgery be used to treat arthritis?
Most dogs with osteoarthritis can live a very good quality of life with a combination of medications and lifestyle management. However, there are some cases where surgery can be a good option. This can be because conventional medical management is not providing sufficient levels of comfort or where medications are not well tolerated by patients.
Surgical options depend on the joint or joints affected. Surgery can be divided into three main types:
- joint replacement
- joint fusion (arthrodesis)
- surgical removal of part of a joint (excision arthroplasty)
These surgeries are considered salvage procedures. They do not return the joints to normal but can allow animals to live a happier and more active life than they are able to before surgery.
Joint replacement
Hip replacement is the most common joint replacement surgery. It is primarily used in dogs suffering from hip dysplasia. Hip dysplasia is a condition where there is increased laxity in the hip joint which leads to the development of varying degrees of osteoarthritis, potentially at a young age. In most cases the arthritis can be managed without surgery but where this is not possible, replacement of one (or in some cases both) hip joints can improve quality of life considerably.
Hip replacement surgery involves replacing the arthritic hip joint with a new artificial ‘ball and socket’. Hip replacements have been performed in dogs since the 1970’s. The procedure has developed significantly over the years and is now an option for both small and large breed dogs. It is an advanced surgery but is offered by many specialist centres throughout the country. Whilst good or very good outcomes can be expected in approximately 95% of cases (Henderson et al 2017), in a small number of cases complications can arise and it is important to have discussed this with your vet when considering hip replacement surgery.
In more recent times joint replacement surgery has also become available for the treatment of severe osteoarthritis of the elbow and the stifle (knee) joint. The complexity of these joints has made it more challenging to achieve good outcomes but again these surgeries are now available in many centres throughout the UK.
Joint fusion
Joint fusion (also known as arthrodesis) is a salvage procedure most often used in lower motion joints such as the carpus (wrist) and tarsus (hock) joints. Again, joint fusion procedures are likely to be recommended only when clinical signs of pain associated with arthritis cannot be controlled with medical management alone. They are sometimes also performed following traumatic fractures or dislocations that cannot be accurately repaired.
Joint fusion involves the surgical removal of the cartilage within the affected joint, placement of a bone graft and the use of metal implants (often a metal plate and screws) to hold the joint permanently in a normal standing position. The long-term outcome for pets who undergo joint fusion of the carpus or tarsus is good in most cases. Complications can occur and these can be discussed with your vet prior to surgery.
Excision arthroplasty
Excision arthroplasty is a surgery most relevant to the hip joint. Here it is also known as a femoral head and neck excision (FHNE). The head and neck of the femur (thigh bone) which forms the ball of the ‘ball and socket’ joint is removed surgically. This is not replaced but instead fibrous tissue forms within the gap resulting in the formation of a “false joint”. A femoral head and neck excision is more frequently performed in small rather than large breeds dogs. Following this surgery physiotherapy is often recommended to achieve a better long-term outcome.
Overview
Osteoarthritis is very common in pet dogs. The good news is that for most animals the signs of arthritis can be effectively controlled through lifestyle changes and medications such that they can continue to live very happy, active lives. For those dogs where this is not the case there are surgical options which can be considered.
References and further information
Anderson et al (2018). Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Scientific Reports vol 8:5641
Canine Hip registry: https://caninehipreplacement.org/home
Henderson et al (2017). Evaluation of variables influencing success and complication rates in canine total hip replacement: results from the British Veterinary Orthopaedic Association Canine Hip Registry (collation of data: 2010-2012). Veterinary Record vol 181(1) page 18
Discussion