The Natural Vet's Guide to Preventing and Treating Arthritis in Dogs and Cats
240
The Natural Vet's Guide to Preventing and Treating Arthritis in Dogs and Cats
240eBook
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Product Details
| ISBN-13: | 9781577319764 |
|---|---|
| Publisher: | New World Library |
| Publication date: | 04/27/2011 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 240 |
| File size: | 506 KB |
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The Natural Vet's Guide to Preventing and Treating Arthritis in Dogs and Cats
By Shawn Messonnier
New World Library
Copyright © 2011 Shawn Messonnier, DVMAll rights reserved.
ISBN: 978-1-57731-976-4
CHAPTER 1
UNDERSTANDING ARTHRITIS
Arthritis, or, more correctly, osteoarthritis or degenerative joint disease, is a common condition in older pets. Arthritis technically means "inflammation of the joint." So when we talk about arthritis, we are talking about an inflammatory disease. Inflammation is characterized by swelling, stiffness, and pain. When we treat pets with arthritis, our therapy must be designed to counteract these effects of inflammation. It would also be advantageous if the therapy could slow down the progression of the arthritis or, if possible, actually help the damaged joint to heal.
Most conventional therapies do a great job of treating inflammation and pain but rarely help the joint to heal. And in many cases, these anti-inflammatory therapies actually cause more cartilage damage (and with it, more arthritis) over time. Many natural therapies, conversely, not only relieve pain and inflammation but actually supply nutrients to help the cartilage heal and slow down the destructive forces of nature that act to destroy the injured joint.
GET A PROPER DIAGNOSIS
As I stated in the introduction, because lameness caused by osteoarthritis is commonly found in older pets, and because many doctors are uncomfortable treating geriatric pets, older pets are often ignored and improperly treated. Many veterinarians, instead of performing diagnostic testing to determine the cause and severity of the problem, and instead of searching for the least harmful treatment options, just try to make such a pet comfortable for whatever time the pet has left. These pets are often treated with corticosteroids or nonsteroidal anti-inflammatory medications without the benefit of a proper diagnosis. While nothing is wrong with making pets comfortable, assuming that a geriatric pet with osteoarthritis is on its last legs is unreasonable. Many older pets can look forward to months or years of good-quality living when doctors treat them as they would younger pets. There's also no reason for doctors to reach for corticosteroids or other potentially harmful medications, such as nonsteroidal medications, if more natural, safer alternatives are available.
While conventional therapy for osteoarthritis raises many concerns, perhaps the greatest is that many veterinarians prescribe without making a proper diagnosis. It may be that these doctors don't want owners to have to spend much money on diagnosing their pets' problems. Maybe the doctors simply assume that the pets have arthritis, which they figure is easy enough to treat with corticosteroids or other medications that relieve pain and inflammation, and they simply hope the pet doesn't experience serious side effects. These reasons, however, are poor excuses for failing to diagnose and treat the pet correctly. Arthritis is certainly the most common diagnosis in older lame pets, but other, more serious conditions can also cause lameness. Bone infections (bacterial or fungal), tumors, injuries, bone cysts, bone tumors, fractures, ligamentous injuries (cruciate injuries), and joint instability (hip dysplasia, shoulder dysplasia, elbow dysplasia, and osteochondritis) are among the more common causes. I discuss these in chapter 2.
WHERE ARTHRITIS STRIKES
As mentioned earlier, arthritis technically means "inflammation of the joint." In both pets and people, it is an inflammatory disease characterized by swelling, stiffness, and pain.
Joints commonly affected with arthritis include the knee, shoulder, ankle, elbow, and, most commonly in dogs, the hips. The joints between the vertebrae of the backbone (spine) also commonly develop arthritis. In most dogs, arthritis of the spine does not cause pain or discomfort. The same joints affected by arthritis in dogs are also affected in cats, although cats often develop arthritis of the smaller joints of the feet as well.
Arthritis results from erosion of the articular cartilage lining the joints. The lack of nerves in the articular cartilage is an important factor in the progression of arthritis. A great amount of damage to the cartilage can occur before the surrounding joint tissues (joint capsule, bones, and ligaments) become inflamed and cause lameness. Because of this, considerable cartilage damage is often present by the time the animal actually feels any pain and shows signs of lameness. Annual screening of the hips and spine, the most common joints affected with osteoarthritis, will allow for early diagnosis and treatment — before irreversible cartilage damage occurs.
THE JOINT AND CARTILAGE: A CLOSER LOOK
The components of the joint include the bones of the joint, ligaments from surrounding muscles that cross the joint space and attach to the bones, and the joint capsule, which encloses the joint. The joint capsule contains a thick protective outer layer, and a thin inner layer called the synovial membrane. The synovial membrane contains blood vessels and nerves and produces a special fluid in the joint called synovial fluid.
The end of each bone is covered with cartilage called articular cartilage, which acts as a shock absorber to protect the bone. The articular cartilage lacks blood vessels and nerves and depends on the diffusion of nutrients from synovial fluid. This fluid lines the joint space, nourishing the cartilage, and it acts as a lubricant and shock absorber.
With enough degradation of the cartilage, underlying bone may become damaged and the animal may refuse to use the affected limb. That's when the dog or cat begins to limp and its owner often seeks medical care. Some pets can still be helped with nutritional therapies to heal the joint, but others may have arthritis too advanced to actually allow for healing. The earlier the pet is diagnosed, the greater the chance for healing to occur using complementary therapies.
In addition to this general pathway for damage to the joint and its components, there are also specific causes of arthritis. For example, dogs with hip dysplasia have abnormal hip joints, which leads to instability. As the instability progresses, the body attempts to stabilize the joint by forming new bone around it. While this may sound like a good idea, unfortunately this new bone does not stabilize the joint but instead causes pain and inflammation.
THE ARTICULAR CARTILAGE: A CLOSER LOOK
The articular cartilage has a unique structure that allows it to handle the stressful loads placed on it as the animal walks and plays. The articular cartilage is made of both cartilage cells (the medical term is chondrocytes) and the tissue, called matrix, that surrounds these cells. The major components of this cartilage matrix are a type of protein (called collagen), water, and proteoglycans. The proteoglycan molecule is made of a central core of protein with numerous side chains of glycosaminoglycans (GAGs). There are several different proteoglycan molecules in the joint cartilage, including chondroitin sulfate (the predominant GAG in cartilage) and keratan sulfate. Glucosamine, a popular treatment for osteoarthritis, is a precursor chemical necessary for glycosaminoglycan synthesis. As I discuss nutritional treatments for arthritis, it will be important to remember the terms glycosaminoglycan, proteoglycan, and chondroitin sulfate, as some of the treatments attempt to furnish more of these molecules to help the cartilage heal.
As the animal walks and plays, a large amount of stress is placed on all the components of the joint. Biomechanical and biochemical alterations in the joints occur. With years of wear and tear on the joints, the cartilage breaks down and arthritis can develop. As wear and tear continues, the cartilage is disrupted and joint instability results. Chondrocytes, the cells that make up cartilage, are not able to synthesize enough of the proteoglycans to permit the cartilage to heal. As the chondrocytes become degraded, inflammatory chemicals are released, causing inflammation and further damaging the cartilage. The inflammatory chemicals also disrupt the proteoglycans. With enough degradation of the cartilage, underlying bone may become damaged, and the animal may refuse to use the affected limb. At this point, owners often seek medical care. Some pets can still be helped with nutritional therapies to heal the joint, but others may have arthritis too advanced to actually allow for true healing. The earlier the pet is diagnosed, the greater the chance for healing to occur using natural therapies.
This new bone and accompanying inflammation in and around it is called arthritis. Dogs with arthritis of the spine most likely develop this new bone and the inflammation as a result of degeneration of the intervertebral disks, the cartilage shock absorbers located between the vertebrae. Regardless of the cause, with time the joint instability and resulting inflammation occur. As the arthritis progresses, clinical signs begin to appear.
It is worthwhile to point out that some types of arthritis can be prevented. For example, hip dysplasia is a common cause of arthritis in older dogs and even cats. With this condition, the hips are unstable as a result of genetic factors, environmental factors, or both. Some puppies show signs of hip dysplasia before twelve months of age. These dogs have difficulty rising and their hindquarters sway when they walk. When the owners manipulate the dogs' legs, this may cause the dogs pain. Pets can be screened for this condition very early in life, and while many owners are familiar with the screening of breeding dogs at two years of age, others are surprised that puppies (and kittens) can be screened early in life. We routinely screen puppies and kittens brought in for spaying and neutering. Surprisingly, 40 to 50 percent of puppies we screen for hip dysplasia actually have the condition. Remember, these are "normal" puppies with no clinical history. They walk and play normally.
Under anesthesia, the puppies are radiographed for signs of hip dysplasia. Also, we attempt to physically "pop" the hips out of joint to check them for instability, which can indicate dysplasia. (I know this sounds graphic, but after we pop the hips out of joint, they go right back in at the end of our evaluation and the pet never feels any aftereffects.) The reason for early screening is that, if signs of hip dysplasia are discovered as a result of our radiography or orthopedic manipulations, surgery to repair or replace the joint is available. When the owner chooses to have the problem corrected early, it is rare for arthritis of the hips to develop later in life. This, then, is one arthritic condition that can actually be prevented early in life, either through surgery or careful screening of the parents before breeding.
It is enough to remember that osteoarthritis forms after months to years of wear and tear on the joints. With therapy, we not only relieve the pain and inflammation that accompany arthritis but also help heal the cartilage by supplying it with glycosaminoglycans. The therapies most commonly prescribed by doctors are conventional medications, which I'll discuss shortly.
CHAPTER SUMMARY
• Before beginning any treatment for your pet, be sure to get a proper diagnosis.
• The most common cause of lameness in dogs is osteoarthritis.
• A painful condition, arthritis is medically called osteoarthritis or degenerative joint disease.
• Osteoarthritis is inflammation of a joint, and in dogs and cats it is found most commonly in the joints of the hips and spine.
• The sooner the problem is diagnosed, the greater the number of treatment options available, the less the pet will have to rely mainly on conventional medications for relief, and the more successful the therapy.
CHAPTER 2NOT ARTHRITIS but SOMETHING ELSE
As I MENTIONED EARLIER, lameness in pets is often caused by osteoarthritis. The years of wear and tear on the joints lead to destruction of the articular (joint) cartilage and the resulting sign of lameness in the aging pet.
Other causes too, some even more serious than arthritis, lead to lameness. For this reason, let me stress again that a proper diagnosis should be obtained before embarking on chronic therapy for suspected arthritis. Administering nonsteroidal anti-inflammatory medications for seven to fourteen days to see if the pet improves is certainly not malpractice, and can be useful in healthy pets to determine if the pet experiences any relief from the cause of the lameness. But continuing to administer medication for a longer period without establishing the correct cause of the problem borders on negligence, if not outright malpractice. In the next chapter, I'll talk about what should happen during your veterinary visit to allow the doctor to accurately diagnose the cause of your pet's lameness. For now, I want to present other conditions that could cause your dog or cat to act lame, so that you can see the importance of a proper diagnosis (these conditions are also listed in the sidebar on pages 17–18).
The list that follows is not intended to substitute for a proper diagnosis. It is a tool for you to use to help your veterinarian determine exactly what is causing your dog's or cat's lameness, once arthritis has been ruled out, or once the treatment for arthritis has been determined not to be the complete solution to your pet's problem.
An unusual case of misdiagnosis presented itself when Angus, a seven-year-old neutered male Rottweiler, was referred to me for acupuncture for presumed hip dysplasia. I estimated Angus, at 149 pounds, to be approximately 30 to 40 pounds overweight. He had demonstrated difficulty moving around and lethargy, beginning two to three weeks before our visit. Within the previous week, according to his owner, Angus had "staggered as if he were drunk" when he stood up from a prone position.
One of two doctors who had already examined Angus had diagnosed hip dysplasia based on breed, age, physical examination, and a radiograph (X-ray). He had prescribed a nonsteroidal drug for Angus, but Angus's owner noticed no change in the dog after a two-week trial with the drug.
The medical history provided by the owner revealed recurrent staphylococcal pyoderma, a common bacterial skin infection in dogs, which was responsive to various antibiotics. His original veterinarian had mentioned the possibility of atopic dermatitis, a skin allergy, as a cause of Angus's constant itching and recurring skin infections, but had done no testing to determine whether the dog actually had the condition. Angus was fed a "premium obesity prevention diet" but did not lose weight while eating it.
The dog showed no sign of pain when I manipulated his limbs. Pelvic limb swaying, resembling a drunken stagger, was evident but no neurological deficits in either the front or rear limbs. Cranial nerve functioning was within normal limits, indicating no problems or diseases of the brain. He seemed to have mild but painless swelling of both front feet; fever was not detected. The dog had not been exposed to external parasites, according to the owner.
When I listened to Angus's chest, I noticed no abnormal heart or lung sounds; pulses were strong and regular. His abdomen and lymph nodes appeared to be normal, and his peripheral lymph nodes were not enlarged. Grade II periodontal disease was evident, based on the excessive tartar on his teeth.
His urine sample was normal. A review of Angus's pelvic radiographs, which the owner had brought in with him, showed that they were underexposed and offered only a frog leg–style view of the hip joints, because the films had been made without sedating the dog. The correct view — required to properly evaluate the hip joints — had not been obtained. Despite this shortcoming in his radiographs, it was apparent that hip dysplasia and secondary osteoarthritis were not the cause of Angus's clinical signs. As is typical with at least half the cases that come to me for complementary therapy for arthritis, the dog actually had perfectly normal hips that did not require treatment.
So what was causing Angus's problems? Based on his sudden onset of lethargy and a swaggering gait, I ordered a complete blood count and a biochemical blood profile. These tests revealed high cholesterol, anemia, and very low thyroid hormone levels. The diagnosis was easy to make: the dog suffered from a thyroid disease, hypothyroidism, which caused all his clinical signs and abnormal blood results.
(Continues...)
Excerpted from The Natural Vet's Guide to Preventing and Treating Arthritis in Dogs and Cats by Shawn Messonnier. Copyright © 2011 Shawn Messonnier, DVM. Excerpted by permission of New World Library.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Contents
Preface,About Natural Supplements,
A Note about Cats,
Introduction: Understanding the Holistic Approach to Treating Arthritis,
Chapter 1. Understanding Arthritis,
Chapter 2. Not Arthritis but Something Else,
Chapter 3. What Can I Expect at My Veterinary Visit?,
Chapter 4. Conventional Treatments for Arthritis,
Chapter 5. Natural Therapies for Arthritis: Nutritional and Chondroprotective Supplements,
Chapter 6. Additional Complementary Therapies,
Chapter 7. Diet and Arthritis,
Chapter 8. Exercise and Physical Therapy for Your Pet,
Chapter 9. Preventing Arthritis in Your Pet,
Chapter 10. Tying It All Together,
Acknowledgments,
Appendix 1: Results of a Clinical Trial Using Two Novel HA Supplements in Dogs,
Appendix 2: Natural Pet Foods,
Appendix 3: Some of Dr. Shawn's Favorite Joint Products,
Bibliography,
Index,
About the Author,