Last Updated on 2022-07-10 by Admin
Osteoarthritis is a disease where the cartilage in joints is weakened or damaged. That reduces or totally removes the cushioning properties of the cartilage between the bones that make up the joint.
As the condition deteriorates, it eventually causes the bones to rub against one another. This rubbing action destroys the smooth outer surface of the bone, and the bones become rough on the areas where they rub. This rubbing also causes inflammation and pain.
Because joints get used all the time, the condition generally worsens over time. Unfortunately, there is no cure for Osteoarthritis. However, many treatment options exist to manage the disease as it progresses. Later I will cover the typically prescribed treatment and some alternative treatment methods.
To appreciate the disease’s prevalence, impact and risk, You might want to look at a study out of the UK. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5884849/
Why a Dog Owner View Matters
Before going into the various treatment options available, I want to ensure you understand we have first-hand experience with Osteoarthritis and have invested much time investigating treatment options. Even though Annie had knee surgery, she still has Osteoarthritis, partially do to the fact that we tried the conservative treatment options for almost a year. Allowing the bones to rub for longer than needed. But now it is her other leg that is affected much worse with Osteoarthritis.
One reason for writing this article is to add something I find missing in much of the information on Osteoarthritis.
Specifically, what I want to address is the following:
- Provide aspects of the disease that need to be considered and balanced
- Take an analytical and critical look at treatment options
- Centralize treatment options, conventional and alternative ones, in one place
- Encourage, enable and inform dog owners on how to support a dog with Osteoarthritis regardless of income
I’m a dog owner, not a veterinarian. I see my dog in pain and how debilitating this disease can be for a dog. And I want to help Annie have as good a life as possible.
Treatment Considerations that Need to be Balanced
From a clinical perspective, we need to find a way to manage pain, inflammation, bone and soft-tissue degradation.
While it is essential to have a clinical perspective, we should not lose sight of the fact that our pet is a living being that depends on us and trusts us fully. That means it is my responsibility to make sure Annie, my Boxer girl gets treatment that is suitable for her. The following considerations are what I use to make treatment decisions.
What To Consider Before Starting Treatment
- Dogs’ overall quality and duration of life
- Treatment that is gentle and does not cause damage\strain
- Manage pain and inflammation and slow down the progression of the decease
The points listed below are my own, but they also are of interest to others. Because they help address the disease over the dog’s life. The various aspects also guide me on what treatment is suitable for Annie now and in the future. For an older dog, the treatment consideration might be different than for a Young dog. Let us take a deeper look at these considerations mentioned earlier.
Dog’s Overall Quality and Duration of Life
When considering a dog’s overall quality and duration of life, we must make all kinds of decisions. For example, if a dog is 14 years old, we might allow for a treatment that is unacceptable for a 4-year-old dog. I find this often overlooked, and we go along with a subscribed treatment option.
Understand the difference Between Conventional and Holistic Vet
One must remember that a conventional veterinarian treats a disease. The holistic veterinarian treats a dog. When dealing with a degenerative disease that affects the quality and duration of life, it becomes vital to be aware of the distinction. This awareness helps me choose the type of vet and treatment that fits Annie’s current stage of Osteoarthritis.
Considering a dog’s overall quality and duration of life, One must also be open to reviewing and changing one’s outlook over time as the disease progresses. However, the dog owner’s assessment of the quality and duration of life might be very different from that of a veterinarian.
How We View A Dog Influences Treatment
A good example is my experience with my Vet; Every time I visit him, the word cancer comes up, and I also hear things like; she is getting up in age. My vet looks at Annie, my almost 6-year-old Boxer girl, very different than I do. My vet sees Boxer, Cancer, short life span. Probably based on some experience with Boxers.
On the other hand, I see an amazing Boxer with some health issues in the prime of her life. I have not set an expiry date on Annie, although I’m highly aware of the cancer risk of Boxers and their overall life expectancy.
Considering my vet’s and my views regarding Annie’s quality and duration of life, it is clear there is a high degree of divergence. That tells me that my vet will think short therm and I think long-term. However, as a dog owner, I choose the best treatment for the dog based on my assessment. After all, I spend 24 hours a day with my dog. My veterinarian sees Annie only for 15 to 20 minutes at a time.
Treatment Should be is Gentle and Not Cause other Damage\Strain
Now that we considered the quality and duration of a dog’s life. We can look for treatments that fit our assessment.
I like to start with an example: If a dog is 14 years old, it might have a more severe case of Osteoarthritis and potentially other health issues. Because of age and health, viable treatment options might be few. However, the chosen treatment should not put extra strain on an older dog.
A younger dog, which is more resilient and healthy, will have more treatment options available. But at the same time, we want to ensure any potential treatment is not causing damage over time.
Now that I have dealt with two of the three considerations mentioned earlier. I might not have a 100% clear view of the treatment options. However, I know what to look for in treatment for Annie. I also know what treatment I don’t want for my Boxer girl.
Manage Pain and Inflammation Plus Slow Down the Progression of the Disease
Pain and inflammation are nasty, and they can reduce a happy, active dog to a dog that appears lazy and lethargic with little interest in anything. Seeing Annie in a state like that worries me.
Between pain and inflammation, inflammation appears to be easier to deal with as a dog owner. There are things a dog owner can do to reduce inflammation. But for pain, it’s different. We don’t have many options to address it.
Pain is a natural way to tell the body something is damaged and stop using it. What pain killers do is manage the pain signal, giving the body the impression things are OK. But dogs being dogs, will run, play and jump when not in pain. This, in turn, causes the condition to deteriorate without us or the dog’s awareness. Anti-inflammatory medicine reduces inflammation but has similar side effects as pain killers.
With the long-term use of pain killers and Non-Steroidal Anti-Inflammatory medicine, there is an increased risk of gastrointestinal, liver and kidney problems down the road.
Many diseases require pharmaceutical pain killers to manage pain. For some disorders, there is no other option. But with Osteoarthritis, there are other options besides pharma pain killers. As for inflammation, we have options gentler on the body than None Steroidal Anti-Inflammatory medication.
Treatment Options for Osteoarthritis in Dogs
The sequence of the treatment options listed reflects the disease progression in Annie my Boxer girl. From talking to other dog owners dealing with joint issues in dogs, my experience seems to follow theirs.
Joint Supplements
Joint supplements are used in the early stages and will most likely continue throughout the progression of the disease. The point of joint supplements is to provide as much help to the joints to reduce the speed of degradation. Most supplements also contain some anti-inflammatory substances and ingredients that speed up the absorption of the ingredients.
There is an excellent variety of joint supplements; some are formulated for more advanced conditions and can address mild pain.
However, one must be cautious regarding ingredients and interactions with potential medications. My advice would be don’t count on Your veterinarian to know all the interactions. In many cases, they will be unaware that the dog owner is giving a specific supplement.
My experience has been reasonably good with joint supplements, but it might take a while to find one that works, is tolerated and is liked by the dog. With my Boxer girl Annie, this was a challenge. So be prepared to try different products if the first one does not work.
What supplements can do is provide some general support. The right supplement can make a big difference to a dog’s quality of life and comfort in the early stages of arthritis and Osteoarthritis.
Non-Steroidal Anti-inflammatory and Pain killers
Probably the very first thing that a Veterinarian will prescribe is some NSAID (Non-Steroidal Anti-Inflammatory medication). NSAIDs work well. However, they are hard on the gut, liver and kidneys. For that reason, they generally are prescribed for shorter duration’s. Sometimes giving a dog NSAIDs for a couple of weeks and reducing activity can make a big difference.
In more advanced cases, a veterinarian will prescribe NSAIDs and pain medication. And both are given for the long term. And Your dog will see significant improvements, and the dog might be able to run again. Veterinarians may still state that Your dog suffers from a mild form of Osteoarthritis. The important thing to remember is that this disease is a degenerative disease, meaning it will worsen over time. The question that needs to be asked at this point is; How will we treat this disease long-term? What is the impact of this treatment?
Let’s Analyze what we do with this treatment
1. We keep inflammation under control with NSAID
2. We mask the pain with pain killers.
3. The most common potential side effects are: gut issues, liver and kidney problems
The medication used for treatment is very effective, making it appear the dog has no joint issues anymore. But this feeling well causes the quickening of the damage to the joints. The bones still rub against one another.
What do we do after the condition has deteriorated so far that pain killers are not all that effective? Have you discussed this with Your Veterinarian? What about the potential liver and kidney damage from the medication? Chances are, there is no mention of these things. And anyone that owns a dog breed that is known to have gastrointestinal knows how hard it can be to deal with it.
To be fair, no matter the chosen treatment, it must address inflammation and pain. And as long as a dog walks or runs, bones will be rubbing against one another. But there are considerable differences in how to address this.
I can not see Non-Steroidal Anti-inflammatory and Pain killers as a suitable long-term solution for my almost 6-year-old Boxer girl. There are other, more appropriate options.
Resources:
Here is an article from a veterinarian that looks at the age and stage of the disease as part of treatment. https://www.veterinarypracticenews.com/osteoarthritis-june-2020/
Here is the latest research I found related to many different pharmaceutical treatments for Osteoarthritis. https://onlinelibrary.wiley.com/doi/10.1111/jsap.13495
This study out of the UK looks at dog owners’ and veterinarians’ attitudes toward NSAIDs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001196/
Alternative Treatment Options
While there are many alternative treatment options, there is no panacea. Dealing with Osteoarthritis more gently than the conventional method requires multiple alternative treatments. That can range from things a dog owner can do to treatments that are not readily available and are often only performed by Holistic veterinarians or specialists.
It becomes very likely that a dog owner might be dealing with a conventional veterinarian and a holistic vet. That can lead to some uncomfortable situations. However, it’s worth remembering that it’s about the dog, not the veterinarian. If things get ugly, look for a veterinarian that is more open-minded.
I grouped the alternative treatments into categories\philosophies instead of individual items because one needs to find a clinic that offers a suitable range of treatment options.
Last but not least, lets also look at what a dog owner can do to help a dog with Osteoarthritis. And I share with You the treatment Annie currently is getting. It is based on things a dog owner can do.
Injections into the joint
Several treatments require the injection of a substance into the joint. These injections seem to have in common that they try to make joints work better with less friction and reduce inflammation. They also try to stimulate the healing\rebuilding of soft tissue.
After such injections, a dog will need to have its movement restricted for weeks so the injected solution can do its work. Something to consider before treatment, so getting informed about pre and post-treatment care is vital. Also, look at side effects and risks. As mentioned earlier, there is no panacea.
Platelet-Rich Plasma (PRP) Injections
PRP uses the patient’s blood and is put in a centrifuge to separate the red blood cells from the white. The clear plasma gets injected into the joint.
While a novel idea, effectiveness research is mostly scant. Many high-performance athletes have been given PRP treatments and seem to do well after.
Many holistic veterinarians and conventional veterinary hospitals are providing PRP injections. When I researched the topic just a few years ago, I could find hardly anyone offering PRP. So it appears to become more mainstream. Because now, it can be found without much effort.
Resources:
Platelet-rich plasma therapy in dogs with bilateral hip osteoarthritis https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-021-02913-x
wikipedia.org https://en.wikipedia.org/wiki/Platelet-rich_plasma
Hyaluronic acid injections
As part of my research on how to help Annie, I contacted Dr. James Cook, the inventor of the TightRope surgery. He is an expert on orthopedic research at the School of Medicine at the University of Missouri. He provided several things one can do, most of which I included in various sections of this article. What was new to me was the use of Hyaluronic acid injections to lubricate the joint and promote healing.
Hyaluronic acid is a substance that already exists in the body and gets added to many joint supplements, but scientific research is contradictory. Some studies claim it reduces cancer. In other studies, it shows it helps cancer cells grow faster.
As a joint injection, it is supposed to promote the regrowth\healing of damaged cartilage and lubricate the joint. Another aspect of Hyaluronic acid is that it becomes gel-like when it gets in contact with water. Which explains why it used in cosmetics for younger appearance.
One of the latest studies I came across combined Hyaluronic acid and Platelet-Rich Plasma (PRP) to see if the combination is effective in treating Osteoarthritis in Dogs. The research used twelve beagles to evaluate the effectiveness. That is a tiny amount of dogs and just one dog breed. However, it is worth reading.
Resources:
A placebo-controlled study comparing the efficacy of intra-articular injections of hyaluronic acid and a novel hyaluronic acid-platelet-rich plasma conjugate in a canine model of osteoarthritis https://pubmed.ncbi.nlm.nih.gov/31533754/
Intra-Articular Hyaluronic Acid Compared to Traditional Conservative Treatment in Dogs with Osteoarthritis Associated with Hip Dysplasia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101385/
wikipedia.org https://en.wikipedia.org/wiki/Hyaluronic_acid
Cartrophen Injections
I first heard about Cartrophen from the surgeon, Dr. Gillick, who performed the TightRope surgery on Annie’s knee almost a year ago. I had asked him to look at all the x-rays my veterinarian took of Annie’s joints. He provided a comprehensive plan of action and other things to explore.
Most of the research I came across is old regarding Cartrophen. Cartrophen is an NSAID medication with the same side effects as other NSAIDs. Cartrophen is used for acute pain relief, amongst other things and might be suitable in some cases. The result will last a few months from what I read.
Resources:
wikipedia.org https://en.wikipedia.org/wiki/Carprofen
Drugs.com https://www.drugs.com/vet/cartrophen-vet-can.html
TCM – Traditional Chinese Medicine
Under TCM are herbal formulas, diets and Acupuncture, among many other techniques. TCM is something most holistic veterinarians utilize.
Herbal formulas can treat a great many things. And while a conventional veterinarian might scoff at their use them. Many of these formulas have been in use for hundreds of years with a good record of success. For some formulas, there are even scientific studies.
Herbs, just like other medicine, can have undesirable side effects.
Acupuncture is a treatment that most likely requires many sessions. The effectiveness of the treatment depends on how the dog responds to acupuncture and the practitioner’s skill. Acupuncture has an excellent reputation for dealing with pain, muscle discomfort, and many other things. It is the type of treatment that can work for older dogs. As well as dogs that cant take regular medication for what ever reason.
While TCM is a more natural way to address illness, it is still medicine. Even acupuncture comes with instructions on what to do before and after treatment.
Western Herbal Medicine
The Western herbal medicine approach is more common in Europe. I don’t know of any Veterinarian that uses Western Herbal Medicine here in Canada. If there is one in Your area, it might be worth visiting.
Books like “Veterinary Herbal Medicine y Susan G Wynn and Barbara J. Fougere” are great resources on individual herbs and what they can treat. At the same time, I have seen the book downloadable for free online. The online version starts from Chapter 20. Drug interactions, dosage etc., are contained in the front section of the book, and you might have to purchase the book to get all the vital information. Having said that, this book will be overkill for most. There are books more appropriate for dog owners.
Although herbs are a naturally occurring product, it is still medicine. That means cross interactions (when blending herbs or when mixing herbs with pharma medicine), dosing and pharma drug interactions are of genuine concern.
A few herbs used to treat Osteoarthritis
Aswagandha – Used for Osteoarthritis and to help build up muscles and fight inflammation
Boswellia – Boswellia is a resin from a tree. It is very potent and is used to reduce inflammation. And based on my own experience, it works very well. Boswellia comes in many forms and concentrations. Here is some research on it. https://pubmed.ncbi.nlm.nih.gov/14994484/
Corydalis – used for pain relief
Devils claw – This plant shows up on several joint support formulas as it works for arthritic conditions.
Ginger – helps with circulation and is often used in joint support formulas because it has anti-inflammatory properties. Although much less so than Boswellia. It also helps with digestion.
Turmeric – Probably one of the best-known plants on this list, is part of many joint formulas. One supplement that worked well contained Tumeric, Devils Claw, Bromelain and other ingredients. Dog owners might have hear about GoldenPaste, which is paste one can make and supposed to help with arthritis and other health conditions. I tried a number recipes out there and have to say they did not for Annie’s arthritis. Also, prolonged use of it changes the dogs body odor.
Yucca – is a plant that grows in many places, including here in Canada. While it has many uses, it also is used to treat Osteoarthritis. However, it is less researched than most other herbs on this list.
A study that looked at a number o herbs for treating Osteoarthritis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682793/ For the study, the herbs were supplied by a company in Europe that sells herb-based pet formulas.
List of Items a Dog Owner can Do
Not everybody will have the time, resources or money to do all the items listed. But picking a few that fit the schedule can make a difference.
Reduce the Dog’s Weight if Overweight
Less weight means less force on the joints as they move. Probably has the single most impact on the dogs over all health and osteoarthritis. Simple to do, saves money and is good for the dogs health.
Replace Rice and Potatoes with Cooked Barley
Replace rice and potatoes with cooked Barley, increase the amount of vegetables and reduce the amount of meat. Add legumes like lentils or other types of canned beans for a source f protein.
The use of Barley to address arthritis goes back a long way. The indigenous people of America used the broth from cooked Barley to help manage arthritis pain. In Europe, it also was used for arthritis long ago. Most of this information I found in old or out-of-print books. However, Traditional Chinese medicine uses it for the same purpose.
Give High-Quality Omega-3 Supplement
Use a high-quality Omega-3 supplement. Or feed grass-fed meats and none farmed fish. Both contain way more omega-3 fatty acids than regularly raised meat and fish. However, not everybody can afford to feed grass-fed meats. My post on Omega 3 might help if you are looking for a good omega-3 supplement. But using omega-3 alone to address the pain and inflammation of Osteoarthritis is probably not realistic.
Add Collagen To Food
Make gelatin from veal bones. After cooking the bones, remove the cartilage from the cooked bones and feed it to the dog. My none scientific observation is that Annie seems to do better when I add homemade gelatin to her food.
If making homemade gelatin is too time-consuming, look into Hydrolyzed gelatin\Collagen. https://pubmed.ncbi.nlm.nih.gov/11071580/
Walk The Dog
Make sure the dog gets to walk and be outside. You might not be able to go for a long walk, but the movement is vital to keep the muscles and joints in good condition. The challenge is finding the right balance between walking that is good and overdoing it. Without exercise, dogs will lose muscle mass quickly, which we want to prevent. No movement can also cause joints to seize.
Leg stretching and Bending exercises
Leg stretching and bending exercises are an excellent form of physiotherapy that a dog owner can do at home to keep joints with Osteoarthritis flexible. When I started stretching with Annie, only the first two repetitions were tolerated. Any more than that, Annie began to pull her leg back. At that point, I stop. But after doing the exercise for a few weeks, I can do four or five repetitions, and Annie is fine with it.
Massage and Acupressure to Manage Discomfort and Muscle Stiffness
Massage and acupressure can relieve discomfort without much effort.
Massages, give the pet a massage on the limbs. Annie loves getting her legs and back massaged. It helps to loosen up stiff muscles.
Acupressure works well for many dogs to manage mild pain and general discomfort. However, it requires learning or the purchase of a book to guide You. Annie responds very well to acupressure, and I can tell she feels better after the treatment.
Cold and Hot Packs
When the joints feel hot to the touch, apply alternating cold and hot packs. These packs are best wrapped in a towel before applying them. However, you find that a dog prefers one over the other. Using heat and cold works better than just cold, so it is important to find a balance.
When the joints are sore but not hot to the touch. Warm packs or other warm item placed over the affected joints are comforting and reduces stiffness and pain—something to remember for the cold season.
Annie’s Current Treatment
Annie’s current treatment started with Boswellia as an NSAID replacement and worked amazingly well. However, Annie would still sit down a lot after walks. So more research and adjustments got introduced along the way to where we are now. In the last 3 to 4 weeks, I made no changes.
Medication\Supplements
To address Inflammation, Annie is getting a homemade herbal blend. A commercially available herbal formula is very close to what I give Annie. I don’t use it because some of the same ingredients are in Annie’s NuPro joint and immunity supplement. The NuPro supplement has such an overall positive impact on Annie that I don’t want to remove it.
Another supplement added to Annie’s food is a high-quality Omega-3.
Food
My wife cooks food for Annie based on a recipe for arthritis from the book “Veterinarians Guide’ to Natural Remedies for Dogs” The recipe is on page 99. The recipe contains very little meat but has lots of Barley, brown rice and vegetables.
Annie gets dense gelatin by simmering veal bones for 6 to 7 hours. Once the stock is drained, and the bones are cold, the meat and cartilage are removed, taking great care that no bone or bone splinters are in it. Some of the gelatin is heated and added to each meal. The cartilage and meat retrieved from the bones are added to the food or used as treats.
Massage\Acupressure and Stretching
Roughly twice a day, I give Annie acupressure treatment combined with massage. Acupressure helps with pain and stiff muscles. I do leg stretches while Annie sits or lays in the grass and relaxes after eating. She got so good at it that when I say stretchy, she will stretch the leg most of the way on her own while I support her leg with my hands. All I have to do is extend to leg a little more and praise her.
Effectiveness of the Treatment
This regiment has produced a change I could not think possible a few weeks ago. The way I can describe how well it works is the word remarkable.
Annie is now interested in running again and wants to play and be active. We can go for a one-hour walk before she sits down to rest, when she is up for it. Setbacks are getting less and recovery time from them is quicker. I still see improvements in mobility in the right hind leg when Annie runs.
When Annie is overdoing things, she sits down frequently. Hardly ever does she limp, and when she does, just slightly.
Most of the time, Annie is pain free. And when she starts to sit down, it means she has discomfort. Which is an indicator for me to gauge how much activity she can take without sitting down. So, now, the pain signal\discomfort is used constructively. The home made herbal formula contains a mild pain killer.
Annie’s current treatment addresses all my considerations mentioned at the beginning of this article.
If Annie keeps improving, I might remove the herbal formula and see how it goes without it.
Cost-Effectiveness
This treatment does take some effort, no doubt. But what is impressive is it does not cost much. The low cost makes it a treatment option for anyone who might not be able to afford another type of treatment. It saves us a lot of money, yet helps Annie. That makes it very rare combination.
Future Treatments, if and When Needed
Should the current treatment no longer work, I will consider the following options.
1. Acupuncture and other TCM
2. Platelet-Rich Plasma (PRP) Injections
3. Pain killers but instead of NSAID, I give the full amount of Boswellia based on body weight. Boswellia has shown to be incredibly effective for inflammation. In my opinion, it is just as good as NSAIDs, based on the experience I have with Annie. Without the side effects.
Conclusion
While there are many alternative treatment options, I have not heard my vet mention them. When I said PRP and Hyaluronic injections to my vet, it was simply ignored. As I mentioned, Holistic Veterinarians might have more to offer when it comes to managing Osteoarthritis. Bottom line, don’t expect a vet to offer you services they don’t provide, even if those treatments would benefit your dog. In the end, it’s not about the vet. It’s about my dog.
Whatever treatment is selected should be based on what is best for the dog based on more than just the clinical aspect. Some veterinarians get very defensive when a dog owner solicits a second or third opinion. I get this regularly with my veterinarian. My last encounter was when I asked my vet to send the X-rays to the surgeon that did the TightRope procedure on Annie. Tough luck.
Veterinary care is costly, and many dog owners will financially struggle to care for an animal with Osteoarthritis. It is not just the medication and treatment costs alone. There are also the x-rays and other forms of investigations that make a dent in a budget.
Special Thanks
Through this journey dealing with Annie’s Osteoarthritis, I have to give a big thanks to Dr. Gillick, who has put up with my many questions and provided a third opinion regarding Annie’s current state. He also brought forward other things to investigate and provided new treatment options to consider.
I also thank Dr. James Cook, who provided a concise action plan for potential treatment. He stressed that beside a good supplement weight reduction and activity are vital.
Resources:
Natural Treatments for Managing Arthritis in Dogs https://www.petmd.com/dog/conditions/natural-treatments-managing-arthritis-dogs