Pets often hide pain. When we humans are in pain, we generally talk about it. Your pets can’t tell you where or how much it hurts but they suffer from pain just as we do. Animals have evolved to hide their pain as a protection against predators.  

Acute and Chronic Pain

• Acute or predictable pain from surgery or injury is usually short-term. Acute pain is obvious and troubling.
• Chronic pain, which is often progressive and long-term, can be subtle and difficult to recognize. It may be masked or dismissed as ‘aging’ or ‘slowing down’.

Recognizing Clues Indicating Pain

Paying attention to the little clues that indicate your pet is hurting is very important because unrecognized and untreated pain may lead to other health issues, which erode your pet’s quality of life, such as:

• Immune suppression
• Digestive troubles
• Insomnia

Signs of pain in dogs can include:

• Sad or anxious expression
• Unwilling to move or interact socially – not greeting you as usual
• Yelping, whimpering, or whining more
• Restlessness
• Limping, crouching or change in posture
• Changes in eating and drinking patterns
• Sleeping more
• Shaky legs or trembling
• Difficulty moving, rising or lying down
• Difficulty going up and down stairs or jumping
• Difficulty in urinating or defecating
• Self-mutilation – chewing
• Increased aggression – growling, pinning their ears back, and even biting
• Generally avoiding the things that they would normally like to do

Signs of pain in cats can include:

• Reduced activity or loss of curiosity
• Changes in litter box routine
• Hunching – sitting or walking in a hunched position
• Stiff posture
• Changes in behavior, such as sleeping more
• A decrease or loss of appetite
• Weight loss
• Not being able to jump up on a bed or couch
• Increased or decreased licking and grooming or not wanting to be groomed
• Changes in appearance – cat becoming greasy or scruffy
• Hiding – not wanting to interact with their family
• An aggressive reaction to touch, such as biting, hissing or spitting

Diagnosis and Treatment of Pain

If you suspect that your pet is suffering, contact you veterinarian for an evaluation. Besides a thorough examination, the veterinary health care team will use a variety of tools and inventories to diagnose the pain and its severity before starting an appropriate pain management protocol.

This protocol can include medications, individualized diet for healthy weight, and other therapies such as supplementation and massage. When a pet is in pain, comfort is crucial so recommendations will be made to increase comfort level, such as padded beds, raised food and water dishes or litter box with lowered sides and ramps for stair access. Once pain is relieved your pet can get back to activities and keep moving for a longer, healthier and happier life.

Aging Dogs are Vulnerable to Osteoarthritis

Just like humans, joint disorders are common degenerative diseases that are more likely to affect older dogs. Osteoarthritis (OA) is a common form of arthritis in older dogs and is a progressive disease; however, sometimes, it can be triggered by an injury to a joint, such as a knee injury that damages the cartilage. OA can affect one or more joints anywhere in the body but the most common joints affected in dogs are the hips, knees, shoulders and elbows.

In OA, the surface cartilage in the joints breaks down and wears away, allowing the bones to rub together. This causes pain, swelling, inflammation and loss of motion in the joint. The long-term deterioration of the cartilage is progressive and permanent. Untreated pain and loss of mobility may lead to other health complications, such as immune suppression, digestive troubles and insomnia.  

Recognition of Changes Important for Pain Management 

All dogs age differently but most dogs enter their senior years at about 7 years old (a little sooner for larger dogs) and begin to slow down and may gain weight more easily. An aging dog’s behavioral, mobility and temperamental changes will give you clues as to what he may need.

As changes happen through aging, your dog will need different care. To provide the best quality of life for your dog requires an understanding of the changes that are affecting him.

Signs of Joint Pain

Physical and behavioral changes may include:

• Slowing down and stiffness
• Reluctance to walk, run, climb stairs, jump, or play
• Change in temperament (e.g. withdrawn, more anxious or less tolerant)
• Becoming quiet, withdrawn, and inactive
• Increased licking of a painful/sensitive area
• Limping or stiffness, especially after lying down
• Lagging behind on walks
• Change in grooming habits
• Unexpected reaction when handled or touched
• Showing uncharacteristic aggressiveness when approached (an attempt to protect themselves from further pain)
• Whimpering

Strategies for Pain Management

Because of innovations in modern medicine and other therapies, there are many ways to help slow the progression of OA.  To relieve related suffering a multimodal approach is most beneficial.

Focus on Nutrition

Dogs with osteoarthritis are more prone to weight gain because they are less active. Extra weight puts further stress on joints resulting in increased pain. A nutritious diet has been shown to be beneficial and if necessary, a weight loss regimen should be implemented.

Your veterinarian will guide you concerning appropriate diet and weight and take into consideration factors, such as other medical conditions, size and predisposed breeds.

Provide a Comfortable Environment

Ensure that bedding is padded and away from cold or damp drafts. Provide a ramp for your pet to join you on the bed or couch. A ramp can also be helpful for access into the car. You can also use them on any stairs into or out of the house.

Muscle Massages

Massages stimulate blood flow to sore muscles. Warm compresses over sore joints can be soothing, but ensure that heat is not excessive.

Supplementation 

Veterinarians and owners have found that supplementation can be helpful. The anti-inflammatory effects of omega-3 fatty acids (EPA, DHA) have also shown to be of benefit in dogs with arthritis. Consult your veterinarian who will take into consideration factors, such as diet and genetics.

Maintaining Mobility

Exercise is vital no matter what the age of the dog. However, a younger dog with early signs of osteoarthritis should get more exercise than a senior dog with severe osteoarthritis. Swimming, a non-weight-bearing exercise, is an excellent form of exercise. Consult your veterinarian that swimming is not contraindicated because of other medical conditions.

Pharmaceuticals 

When joint pain sets in, a nonsteroidal anti-inflammatory drug (NSAID) prescribed by a veterinarian could be helpful. The objectives in managing osteoarthritis include minimizing joint pain by reducing the inflammation and slowing the progression of the cartilage damage, resulting in increased joint flexibility and ultimately improving quality of life.

Importance of Recognition and Treatment of Postsurgical Pain

NATURAL SURVIVAL INSTINCTS OF ANIMALS

Just like humans, it’s predictable that pets will experience pain following surgery. However, animals instinctively hide pain as a natural survival instinct because in the wild those that are vulnerable are most in danger of predators. Therefore, animals instinctively hide weakness and pain.

Since your pet cannot describe the pain or tell you where or how much it hurts, it’s important to recognize the signs of pain that a pet might show. Unrecognized and untreated pain can lead to further health complications.

NEGATIVE EFFECTS OF UNTREATED PAIN

Untreated pain can have many negative consequences on body systems. These detrimental effects include:

• Poor or delayed wound healing
• Increased tissue damage
• Impaired immune function
• Increased risk of sepsis (infection that triggers a chain reaction throughout the body)
• Cardiovascular stress
• Decreased gastrointestinal function
• Imbalance in body fluids
• Increased mortality

IDENTIFYING PHYSICAL AND EMOTIONAL PAIN FOLLOWING SURGERY

Surgery can be challenging for both pets and their owners.  The recovery process is usually simple, but the first few days and weeks after surgery require special care for your pet.  Recognizing the subtler signs of pain as well as the obvious signs is vital to treating pain successfully.

Pain associated with surgery has both physical and emotional components. The most common sign of pain is a change in behavior.

Changes in behavior due to post-operative pain may include:

• Vocalization – Often a normally vocal pet becomes quite subdued, while a normally quiet pet vocalizes more
• Reluctance to interact with other pets and owners
• Lameness
• Decreased interest in playing
• Spends more time in bed
• Display of aggression when approached or stroked
• Restlessness and anxiety
• Hiding and spending time alone

Other signs of pain that a pet might show after surgery may include:

• Not eating or drinking
• Panting, shaking or trembling
• Abnormal posture, such as crouching or hunching body
• Not wanting to walk or move
• Wanting to lick or chew at surgical site
• Decreased grooming
• Flinching or increased body tension when surgical site is gently touched
• Inappropriate eliminations (urinating or defecating in the house)

Signs not obvious to the owner but recognizable by the veterinary healthcare team may include:

• Tachycardia (fast heartbeat)
• Increased or shallow respiration
• Increased body temperature
• A feeling of warmth or heat at the affected site
• Changes in blood pressure

If these signs occur, your pet may be experiencing pain. Consult your veterinary healthcare team for advice on pain management. A team-oriented approach, including the veterinary healthcare team and the owner, is essential for maximizing the recognition, prevention, and treatment of pain in pets.

An essential part of veterinary medicine includes compassionate care by preventing and managing pain. Post-surgery pain relief reduces anxiety and discomfort, which improves overall recovery and quality of life.

Pain Management in Pets is Vital

ACUTE AND CHRONIC PAIN

Pain can occur as a result of various situations or conditions, for example, injury, surgery, arthritis and cancer. Pain management is vital since untreated pain may lead to other health issues, such as immune suppression, digestive troubles and insomnia.

Acute pain can be mild and lasts a short time, or it might be severe and last for weeks or months. Acute pain is often predictable as a result of surgery or injury and is usually short-term. Chronic pain is pain that is ongoing and usually lasts longer than six months. Acute pain is usually obvious and upsetting. Chronic pain, which is often progressive, can be subdued and sometimes be related to ‘slowing down’ in middle-aged and senior pets. Whether pain is acute or chronic there are many options to treat the causes of pain that range from pain medications to physical rehabilitation to dietary changes.

Studies have shown that acute pain relief may be able to speed the recovery process following surgery. Chronic pain relief may also help your pet live a longer and happier life because it reduces stress and increases a sense of well-being.

VETERINARY ADVANCES IN PAIN MANAGEMENT

There have been significant advances in veterinary medicine in understanding how pets feel pain. Veterinarians and their health care team are trained to recognize signs of a pet’s discomfort or fear. They work towards easing your pet’s discomfort and applying the best ways to manage pain. They continually monitor for pain and if necessary, adjust pain management protocols to make certain that your pet is comfortable.

With modern advances in pain management, untreated pain is something that no pet should experience. Veterinarians and their team work to pre-empt pain whether it be acute or chronic pain.

PRE-EMPTIVE PAIN MANAGEMENT FOR PREDICTABLE SURGICAL PAIN

If a procedure has the potential to cause pain in a dog or cat, the veterinary team will establish a protocol to prevent that pain from occurring. In surgeries, for example, the veterinarian may administer pain medication before, during, and immediately following surgery. This preventive action to stay ahead of the pain helps to keep pets from becoming unnecessarily stressed and will allow their bodies to direct energies towards healing and recuperating.

NUMEROUS TREATMENTS FOR PAIN RELIEF

There are numerous treatments and products available to manage pain in your pet. Following a thorough examination, your veterinarian will develop a personalised treatment plan for your pet.

Pain Recognition and Management Are Vital For Quality of Life

Pets Hide Pain

If you notice changes in your pet’s behavior or appearance, it could be because of pain. Pets usually hide their pain and cannot tell you where or how much it hurts. Untreated pain may affect the body’s functions and lead to other health complications, such as immune suppression, digestive troubles and insomnia.

Recognition of Physical and Emotional Signs of Pain

Signs that your dog may be experiencing pain include:

• Shaking or trembling
• Lack of appetite
• Displaying a sad or anxious expression
• Avoiding the use of a leg
• Avoiding stairs or movement
• Lethargic
• Not greeting you as usual
• Crouching
• Difficulty urinating or defecating
• Panting excessively

Indicators that your cat may be in pain:

• Hiding
• Grouchy behavior
• Flattening ears back
• Crouching
• Unable to jump up on a bed
• Difficulty using the litter box
• Not grooming or refusing to be groomed
• A decrease in appetite
• Aggressive behavior when touched

Types of Pain

Acute pain (usually short-term) is a predictable response to a stimulus (such as crushing or twisting) or tissue injury (such as wounds or cuts as a result of surgery).

Chronic pain (usually long-term) is associated with progressive disease, such as osteoarthritis (OA) or degenerative joint disease. OA is very common in aging pets, especially dogs, and is usually a result of the ongoing wear and tear and instability in the joints.

Pain Management and Comfort for Your Pet

NSAIDs for Pain Control

Veterinary medicine has made great progress in understanding how pets feel pain and the best ways to manage that pain. You can rest assured knowing that there are animal-specific medications that have been developed to safely and effectively deal with pain in both dogs and cats.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are approved veterinary analgesic medications designed to control pain and inflammation. NSAIDs have many uses, including providing pain relief for routine or emergency surgeries, for cases of injury, and for longer term use for treating pain associated with OA in dogs and cats.

They work quickly to decrease prostaglandins (hormone-like substances) that cause pain and inflammation, and this allows pets to get back to activities and keep moving.  Once pain is relieved, pets are able to exercise and systems, such as their hearts, lungs, and digestion can return to normal functioning.

When pain and discomfort can be effectively controlled and managed, pets with degenerating joints are able to exercise and muscle strength is maintained. This process helps hold their joints in better alignment, therefore, reducing pain and providing general well-being.

When pets are happy, you as the pet owner feels more at ease. If you are concerned about your pet’s pain, seek the advice of your veterinary healthcare team to develop a medical management routine suited to your pet’s needs and conditions.

Recognizing Signs of Pain in Pets

IDENTIFYING PAIN IS IMPORTANT

Paying attention to the little clues that indicate your pet is hurting is very important because unrecognized and untreated pain may lead to other health issues, such as immune suppression, digestive troubles and insomnia.

ACUTE OR CHRONIC PAIN

Pain can occur as a result of various situations or conditions, for example, injury, surgery, arthritis and cancer. Pain can either be acute or chronic. Acute pain can be mild and last a short time, or it might be severe and last for weeks or months. Chronic pain is pain that is ongoing and usually lasts longer than six months. Acute pain is usually obvious and upsetting. Chronic pain can be subdued and sometimes be related to the ‘slowing down’ of aging. Whether pain is acute or chronic there are many options to treat the causes of pain that range from pain medications to physical rehabilitation to dietary changes.

PETS OFTEN HIDE SIGNS OF PAIN

Pets don’t often express the fact that they may be in pain.  Your dog or cat can’t tell you where or how much it hurts and usually mask their pain. Animals have evolved to withdraw and hide the signs of pain because any display would put them at risk with predators.

CLUES INDICATING THAT YOUR PET IS IN PAIN

Whether the pain is predictable, as a result of surgery, injury, etc., or chronic, such as joint pain especially in older dogs, there will be physical and behavioral changes that can be identified.

Signs of pain in dogs can include:

• A sad or tense facial expression
• Yelping, whimpering or whining more
• Restlessness
• Limping or crouching
• Changes in eating and drinking patterns
• Sleeping more
• Changes in affection patterns – not greeting you as usual and interacting less
• Shaky legs or trembling
• Difficulty rising or lying down
• Difficulty in urinating or defecating
• Difficulty going up and down stairs or jumping
• Aggression – growling, pinning their ears back, and even biting
• Generally avoiding the things that they would normally like to do

Signs of pain in cats can include:

• Trouble using the litter box
• Hunching – sitting or walking in a hunched position
• Changes in behavior, such as sleeping more
• A decrease in appetite
• Not being able to jump up on a bed or couch
• Increased or decreased grooming or not wanting to be groomed
• Changes in appearance – cat becoming greasy or scruffy
• Hiding – not wanting to interact with their family
• An aggressive reaction to touch, such as biting
  
  

Don’t let your pet hide pain from you. It’s crucial to uncover aches and pains early before other complications arise.

If you recognize signs of pain, contact your Veterinary Healthcare Team right away for an evaluation. If necessary, a pain management protocol will be initiated so that your pet can get back to activities and keep moving for a healthier and happier life.

Differences Between Arthritis and Osteoarthritis

Arthritis

Arthritis is a general term for conditions that affect the joints and surrounding tissues. It often involves inflammation of the joint, which affects movement and also causes pain. Because the dog or cat suffering from arthritis is less mobile, there is weight gain and continued disuse of the affected joint results in further deterioration and increased loss of the joint’s mobility.

Arthritis in dogs is a common condition and it is a major cause of chronic pain in older dogs. The most commonly affected joints in dogs are the hips, knees, shoulders and elbows. In cats, the most commonly affected joints are the shoulders, elbows, hips and spine.

Osteoarthritis (OA)

Osteoarthritis (OA) or degenerative joint disease (DJD) is a common form of arthritis in dogs and cats. Osteoarthritis refers to a form of chronic joint inflammation that is a progressive and permanent disease of joints. The condition can cause long-term degeneration of joints and involves cartilage tissue, bone under the cartilage, joint capsule, fluid in the joint, pain and inflammation as well as immobility.

Osteoarthritis is a common condition in dogs and cats and it is estimated that around 30 % – 50% of dogs and cats will be affected by osteoarthritis at some point in their lives.

RISK FACTORS FOR OSTEOARTHRITIS IN PETS

This condition may manifest very early in animals due to certain underlying conditions, such as hip or elbow dysplasia, broken bones and joints that are more commonly affected by wear and tear. Pets can develop osteoarthritis, particularly as they age. But there are some factors that can predispose pets to this condition, such as:

• Obesity
• Age, particularly middle-age to senior dogs and cats
• Repetitive stress from activities
• Injuries such as fractures or ligament tears
• Diabetes and other hormone disorders can cause inflammation that leads to osteoarthritis
• Improper nutrition
• Poor conformation
• Genetics
• Larger dog breeds predisposed include German Shepherd Dogs, Labrador Retrievers and Golden Retrievers. Cats predisposed include Maine Coons, Persians and Scottish Folds.

PETS DON’T ALWAYS EXPRESS PAIN

It can be easy to miss symptoms of osteoarthritis in pets because they cannot easily tell us that they are in pain and signs may be subtle. There are many misunderstandings regarding pain in animals. For example, it is thought that a dog that is not moaning or yelping is pain free. This may not be the case. Most animals are not vocal about their pain. From a survival point of view, it was to an animal’s advantage, when still wild, to suffer silently and not attract a predator’s attention.

The key symptoms of osteoarthritis are lameness, stiffness, and pain. Lameness and stiffness are evident after a period of rest or if the animal was exposed to exercise previously.

CHANGES THAT MAY INDICATE PAIN

Changes vary from pet to pet and pain can manifest in physical or behavioral changes.

Cats Hide Their Pain

Cats are good at hiding their pain. Here are some indicators of pain:

• Aggressive behavior when touched
• Change in general attitude
• Inability to jump on and off objects
• Urination or defecation outside the litter box
• Poor grooming habits or not wanting to be groomed
• Decreased appetite
• Weight loss

Dogs Seldom Whine

Dogs will seldom whine or cry unless pain is severe. Here are some signs indicating that your dog may be experiencing pain:

• Avoiding the use of a leg
• Trembling
• Sad expression on face or lethargy
• Avoiding stairs and reluctant to go for walks or play
• Behavioral change, such as not greeting you as enthusiastically
• Crouching
• Decreased appetite
• Taking a long time to urinate or defecate
• Excessively panting

With time these signs may become more obvious since the deterioration progresses and the pain worsens. Osteoarthritis is not a condition that can be cured because of the permanent deterioration of affected joints. However, there is effective pain management to bring relief and comfort. Animal-specific medications have been developed to safely deal with chronic pain in pets.

DIAGNOSIS AND PAIN ASSESSMENT

Diagnosing this condition in dogs can be done by firstly manipulating the joint to check for any discomfort or pain then followed by radiographs which are the most common tool to use and also to rule out any other conditions. Other methods of diagnosing this condition include MRI scanning, CT scans and collection of fluid from the joint. Radiographs or X-ray tend to be the most cost-effective way of diagnosing osteoarthritis.

Pain in cats is more difficult to assess. There are various lameness scales and assessment tools used in feline pain studies. An example of an assessment tool used is a subjective questionnaire. Currently-used objective tools include:

• Force plate analysis (measures the amount of force a limb generates at one instant in time)
• Pressure-sensitive walkways (indirectly measure the amount of force generated at one moment in time)

PAIN MANAGEMENT OF OSTEOARTHRITIS

There are several things pet owners can do to help their pets maintain their mobility and improve their quality of life:

• It is important to control the weight of the animal as this could have a great impact on the condition. Weight management through a prescriptive diet will also aid in weight loss in the case where the animal is overweight. More weight on joints causes more localized inflammation and irritation to the joints and this in turn can speed up the progression of osteoarthritis.
• Exercising is also a very important part of disease management. An exercise regime tailored to the animal’s specific needs can keep the joints mobile, the muscles working well and slow down the degeneration of joints.
• Comfortable surroundings such as ensuring that your pet has a warm, comfortable place to sleep that is away from drafts can help ease pain. Provide plenty of soft bedding to help protect any painful joints. Rather than expecting your dog to negotiate stairs, provide assistance with a ramp. Help your cat to get onto the bed.
• Medications such as nonsteroidal anti-inflammatories (NSAIDs) may work to alleviate pain particularly in dogs, but it is also advisable for the pet owner to discuss with their veterinarian which ones will suit their pet the best.

Contact your veterinarian for more information on the best treatment options available to manage osteoarthritis and keep your pet pain-free.

Joint pain not only affects people of all ages but also strikes dogs. It is one of the most common sources of pain that veterinarians treat.

THE DIFFERENCE BETWEEN ARTHRITIS AND OSTEOARTHRITIS

• Arthritis is the medical term for inflammation (swelling) of the joints. The term arthritis doesn’t apply to only one disease. This term actually refers to many other conditions affecting joints.
• Osteoarthritis (OA) is the most common type of arthritis in dogs and it is also called degenerative joint disease (DJD). OA refers to chronic joint inflammation caused by progressive and permanent deterioration of cartilage surrounding the joints.

CAUSES OF OSTEOARTHRITIS

Cartilage acts as a cushion to allow a healthy joint to move smoothly through its full range of motion. In cases of OA, this cartilage cushion begins to break down because of various factors. When this protective cushion is damaged inflammation, pain, decreased motion, and the development of bone spurs result.

RISK FACTORS FOR OA INCLUDE:

• Age – middle-age to senior dogs – older dogs are at the highest risk
• Obesity or poor nutrition
• Genetic reasons
• Trauma or injury such as, fractures or ligament tear
• Excessive physical activity or repetitive stress, such as dock diving
• Larger breeds (for example, German Shepherd Dogs, Labrador Retrievers and Golden Retrievers) are more susceptible to different forms of skeletal disease than smaller dogs
• Inherited developmental abnormalities of the bones and joints
• Infections that affect the joints, such as Lyme Disease

HOW DOES OSTEOARTHRITIS AFFECT DOGS?

When dogs suffer from osteoarthritis, their joints become inflamed, swollen and painful. Any joint in the body can develop osteoarthritis. The hips, knees, elbows, shoulders and spine are the bones and joints which are most commonly affected.

Dogs with mild OA may have (and show) slight stiffness of the joints. When the disease is more severe, there is often limping and an abnormal stance (called lameness).

SIGNS OF OSTEOARTHRITIS IN DOGS

Since dogs cannot easily tell us that they are in pain and signs may be subtle, it’s difficult to identify pain. There are many misunderstandings regarding pain in animals. For example, it is thought that a dog that is not moaning or crying out is pain free. This may not be the case. Most animals are not vocal about their pain. From a survival point of view, it was to an animal’s advantage, when still wild, to suffer silently and not draw the attention of predators to themselves.

Here are a few behavioral and physical changes that could indicate pain:

• Change in normal eating habits
• Joint seems to hurt when touched
• Excessive licking of a joint or leg
• Stance changed / seems abnormal
• Limping and/or walking differently
• Disinterested in playing
• Lack of vocal expression or frequent yelping/whimpering
• Walking, running, jumping and/or climbing stairs seem more difficult
• Stiffness and/or slow to rise from resting position
• Behavioral change (for example, withdrawal, aggression)

If you notice changes in your dog’s physical appearance or behavior, talk to your veterinarian about your concerns.

CONSEQUENCES OF UNTREATED PAIN

If pain is left untreated, most dogs with OA experience loss of mobility (limitation of movement). Untreated pain may have many damaging system-wide consequences, such as immune suppression, digestive troubles, insomnia and anxiety. It is important for pet owners to learn to recognize possible signs of pain in their pets and consult a veterinarian.

IMPORTANCE OF REGULAR PHYSICAL EXAMINATION

Regular visits to your veterinarian can help ensure your dog maintains a healthy weight and active lifestyle. The veterinarian will perform a full physical examination, including palpating your dog’s joints and assessing their range of motion. X-rays can also help your veterinarian evaluate the degree of damage to the joint and can often catch signs of osteoarthritis early before the problem becomes serious.

TREATMENTS

Non-steroidal anti-inflammatory drugs (NSAIDs) are especially designed for animals to treat both acute and chronic pain. NSAIDs are very effective at reducing pain and stiffness and can improve the dog’s quality of life. It is important to use only pain relief medication that is prescribed by your veterinarian. 

Other treatment modalities can include physiotherapy, laser, and changes in diet. In severe cases, surgery may be recommended to remove damaged tissue from the joint or to replace the joint entirely.

Osteoarthritis (OA) in cats is now more frequently diagnosed

WHAT IS OSTEOARTHRITIS (OA)?

Advances in veterinary medicine have helped to extend the lives of our pets. Because of longer lives, chronic diseases such as osteoarthritis are more common. Osteoarthritis has been recognized as a disease in dogs; however, in recent years there is more awareness and diagnosis of this condition in cats resulting in better care and pain management.

OA is a chronic degenerative condition of the joints, in which:

• The normal cartilage cushion in the joint breaks down
• There are changes to the tissues that comprise a joint, such as cartilage, joint capsule, and surrounding bone
• Adjacent bones eventually rub against each other, causing pain, decreased joint movement, and sometimes the formation of bone spurs

Although OA is a progressive disease, it can be successfully managed so that the disease is slowed and remaining joint function is preserved.

How Common is OA?

According to numerous studies, many of which analyze radiographs, an alarming number of (especially older) cats suffer from degenerative joint disease in one form or the other. The studies have helped us realize that OA is very common in cats and even more severe in older cats. Most affected joints include the hip, stifle (knee), tarsus (ankle), and elbow. Older cats are more likely to be clinically affected by OA.

OA Causes

Joints are cushioned by cartilage, a rubbery connective tissue, found at the ends of bones. When this cartilage starts to deteriorate it leads to inflammation and discomfort and the damage continues.

Natural wear-and-tear of daily life, joint injury as well as certain abnormalities may contribute to OA, but the specific causes are still unclear. The primary cause of OA often cannot be identified in cats and the disease is less well understood compared to dogs. 

Signs of OA

Cats are natural survivors and masters at hiding pain, which means discomfort and illness often go unnoticed. Signs of OA may include:

• Less mobility: change in activity level; reluctance to jump; stiffness in legs; struggles to use stairs, litter tray and cat flap
• Lameness or changes in gait
• Less activity: increased sleep time; decreased exploring and interaction; choosing more accessible sleeping spots
• Grooming changes: less frequent; more time spent on affected joints; overgrown claws; a scruffy/matted coat
• Change in character/mood: more solitary; irritable when handled, stroked or interacting with other animals
• Inappropriate elimination: urinating and/or defecating in areas where they didn’t previously

THE FOLLOWING MAY INCREASE RISK OF OA

• Obesity
• Trauma / injury, e.g. fractures or dislocations
• Certain breeds are more prone to
  • Kneecap dislocation formally known as Patella luxation e.g. Abyssinian and Devon Rex breeds
  • Abnormal hip joint development, formally known as hip dysplasia (e.g. Maine Coon, Persian and Siamese breeds)
  • Abnormality of cartilage causing severe arthritis which affects multiple joints (the Scottish Fold breed particularly)
• Acromegaly (unusual and uncommon): increased growth hormone secretion, caused by a tumor, leads to diabetes and/or arthritis

DIAGNOSIS OF OA

• Mature cats (aged 7+) should be checked frequently and thoroughly and owners should communicate any changes and signs noticed to their veterinarian.
• A veterinarian should be able to detect issues during an examination. X-rays are recommended to make specific diagnoses and rule out other conditions.
• Blood and urine tests could help reveal other problems and help to ensure that the cat’s organs are able to cope with chronic medication.

MANAGING OA

Making environmental changes could greatly improve your cat’s comfort and quality of life. Such changes include:

• Placing comfortable, warm beds in easily accessible areas where your cat will feel safe
• Providing basic steps or ramps to reach higher areas
• Making sure water and food are easy to access
• Grooming your cat and cut overgrown claws
• Providing a litter tray with a low side
• Ensuring the cat flap is easy to use

Weight Management

• Manage your cat’s weight or seek help if your cat is overweight

Medical Treatment

A multimodal approach is best for the treatment of OA in cats.

• Some options are nonsteroidal anti-inflammatory drugs (NSAIDs) that have been found very effective in treating pain and inflammation caused by osteoarthritis in cats.
• Sometimes NSAIDs can’t be administered, in which case, medications to treat chronic pain may be prescribed.
• Dietary supplements, physical rehabilitation and surgical techniques are other therapies that could be included to improve quality of life.

An Overview of Pain

Experts define pain as localized or generalized unpleasant bodily sensation or complex of sensations that causes mild to severe physical discomfort and emotional distress. Pain has been seen as simply the transmission through nerves of information about damage or potential damage to parts of the body.

Pain is a defense mechanism, telling the dog that it is injured and urging it to move away from what may be causing it. Pain is very subjective and difficult to measure.  

Pain typically results from bodily disorder, such as surgery, trauma, arthritis or disease. Acute pain can be obvious and distressing. Chronic pain can be subtle, and masked as ‘getting old’ or ‘slowing down’.

DOGS OFTEN HIDE PAIN

Dogs suffer from pain just as humans do; however, dogs cannot easily tell us that they are in pain and signs may be subtle. There are many misunderstandings regarding pain in animals. For example, it is thought that a dog that is not moaning or crying out is pain free. This may not be the case. Most animals are not vocal about their pain. From a survival point of view, it was to an animal’s advantage, when still wild, to suffer silently and not draw the attention of predators to themselves.

CHRONIC PAIN OF OSTEOARTHRITIS (OA)

Humans are not the only mammals that can suffer from osteoarthritis (OA). Unfortunately, dogs can develop OA too.  This is a chronic disease also known as degenerative joint disease. It is considered the primary cause of chronic pain in dogs and it tends to get worse with age. 

JOINT PAIN AND OSTEOARTHRITIS

With the onset of OA, the protective cartilage in joints wears down and this leads to painful swelling, stiffness and eventually lameness (or loss of mobility). The long-term deterioration of the cartilage is progressive and permanent.  

OA can affect one or more joints anywhere in the body; however, the most common joints affected in dogs are the hips, knees, shoulders and elbows. Most of these joints depend on a layer of cartilage acting as a cushion which also provides a smooth surface so the adjoining bones can move freely over each other.

PAIN AND BEHAVIORAL CHANGES

Many diseases can cause behavioral changes and osteoarthritis is one of them.

Signs of osteoarthritic pain include:

• Decreased level of activity
• Occasional lameness
• Stiff gait that worsens with exercise
• Avoiding stairs or hesitating to go for walks
• Taking a long time to urinate or defecate
• Crouching or snapping
• Decreased appetite
• Lethargy or sad, tense look on face

If you suspect that your dog is experiencing any pain, contact your veterinarian. He or she will most likely perform tests to determine the source of the pain. Once a diagnosis is made, a treatment plan can be put in place and your dog’s comfort level and quality of life can improve. 

POSSIBLE CAUSES OF OSTEOARTHRITIS

The main cause is not clear, but many secondary causes have been identified. They include:

• Physical trauma, for example shoulder/kneecap dislocation and abnormal development/birth defects, for example elbow or hip dysplasia. 
• Obesity should also be taken into consideration since excess weight puts additional, unnecessary stress on joints.
• Prolonged steroid treatment or if a dog already suffers from other diseases such as, diabetes or hyperlaxity.

DIAGNOSIS OF OA

A diagnosis of OA may be done based on an assessment of historical symptoms, such as decreased activity or stiffness, as well as a physical examination which may reveal:

• A decreased range of motion
• Stiff-legged gait
• Deformity of the joints
• Swelling or pain in the joints

If it is found that your dog is affected, there are pain management medications. The right medication can help put your dog back in motion by effectively relieving pain and inflammation.

PAIN MANAGEMENT FOR DOGS WITH OSTEOARTHRITIS

There are many types of drugs used to prevent and lessen pain. Your veterinarian will choose the appropriate drugs based on your dog’s specific needs. Some common veterinary pain-relief medications include:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) 
• Opioids 
• Corticosteroids 

Unfortunately, there is no cure, but medications can help relieve osteoarthritic pain and improve quality of life by making the condition more manageable. Physical therapy can also be explored and some owners have turned to surgery.

AN OVERVIEW

Because there are variables amongst the many breeds, the anatomy of dogs varies. However, there are physical characteristics that all dogs have in common, from the small Pomeranian to the large Afghan Hound.

This article will provide an overview of the structure and function of the canine joints and ligaments. It will outline the general structure of joints and ligaments, how they work, some common diseases that affect joints and ligaments and common diagnostic tests used to evaluate these joints and ligaments. 

THE FUNCTIONS OF JOINTS AND LIGAMENTS

Joints are found throughout the body wherever two bones meet. A joint is formed when two bones come together and are held in place by supporting tissues. The joints provide motion and flexibility to the skeletal frame and act as shock absorbers. 

A ligament (slightly elastic tissue) is a short band of tough, flexible fibrous connective tissue which connects two bones or cartilages or holds together a joint. Ligaments prevent dislocation and excessive movement that might cause breakage. They typically stretch over joints, connecting bones.  

THREE DIFFERENT TYPES OF JOINTS

Joints may have large ranges of movement such as the shoulder and hip joints, or have very little movement, such as the joints between the bones in the skull.

These three different types of joints are:

• Synovial: They allow free movement, such as knees, elbows and wrists. Synovial joints are the most numerous in the body and the most susceptible to inflammatory disease. Examples of synovial joints include the joints in the legs and the temporomandibular joint which joins the skull to the lower jaw (mandible).
• Cartilaginous: As the name suggests, these are between cartilage, for example the vertebrae. There is some movement. An example of cartilaginous joints are the joints where the ribs meet the sternum.
• Fibrous: Since these are connected with fibrous tissues, the length of the fibers will determine movement capabilities. Typically, movement is none or very limited. Fibrous joints include those that join the bones of the skull together. The canine skull is actually made up of over 40 different bones, all tightly held together by this fibrous tissue.

WHAT MAKES UP A SYNOVIAL JOINT?

The synovial joints are the most common type of joint, and they provide free movement between the bones they link. They are typical of nearly all limb joints, such as the knee, elbow and wrist. Their name is derived from the synovial fluid (lubricating substance within the joint cavity).

Synovial joints are the most susceptible to inflammatory disease.

A synovial joint consists of:

Bones:

• Such as the upper thigh (femur) and humerus bone

Ligaments:

• Sheets, cords or bands of fibrous connective tissue that connect bones or cartilage
• Can be found either inside or outside the joint capsule

Joint capsule:

• Bound by a tough fibrous capsule, which contributes to the mechanical stability of the joint
• Lined inside by a very thin synovial membrane that functions to supply nutrients, joint fluid and to mediate immune or inflammatory processes
• Both the fibrous capsule and the synovial membrane have nerve and blood supply

Synovial (lubricating) fluid:

• Transparent, viscous fluid which bathes the joint
• Lubricates the joint, reducing friction between articulating surfaces
• Also supplies nutrients and removes waste from cartilage, which has very poor blood supply of its own

Articular cartilage:

• Lines and protects the articular surfaces of bones in a joint
• Flexible, compressible type of connective tissue that is more resilient than bone
• Reduces friction between articulating bones
• Cushions the bones by acting as a shock absorber

FUNCTIONS OF JOINTS

The skeletal frame on its own is not flexible and needs help to move and absorb shock. Joints connect bones within the body, bear weight and enable movement. Without the right support, bone ends are prone to breakage caused by dislocation and excessive movement. Fortunately, bone ends are bound by ligaments.

JOINT AND LIGAMENT DISEASES IN DOGS

Some common diseases of joints and ligaments in dogs are:

• Dislocation of the hip, usually caused by trauma, causing lameness.
• Osteoarthritis (OA) or degenerative joint disease (DJD) is a common condition in which the joints become inflamed, swollen and painful. Symptoms can range from slight stiffness to loss of mobility. 
• A collapse of the wrist can result from carpal hyperextension injuries, for example, jumping from an unnatural height and landing on the front legs.
• Hip dysplasia is an abnormal hip joint development that causes progressive lameness, stiffness and pain (more common in larger and giant breeds).
• Rupture of the cruciate ligament in the knee.
• Septic arthritis, a bacterial infection within a joint, can lead to systemic illness.

EVALUATION OF JOINTS AND LIGAMENTS

Diagnostic tests used to evaluate joints may include:

• Routine lab tests including blood and urine tests as well as immune tests.
• Orthopedic examination: simply use arms and hands to test motion capabilities.
• Regular X-rays can pick up dislocation, arthritis, hip dysplasia, joint effusion and other joint abnormalities.
• Arthrography, a type of contrast X-ray, relies on injected dye for enhanced assessment.
• Arthroscopy: typically, a knee or shoulder examination via a small scope inserted into joint.
• Arthrocentesis: a microscopic examination and bacterial culturing of fluid drained from the joint.
• MRI and CT scans as well as surgical exploration are other (more costly) options to help diagnose abnormalities.

HELP MAKE YOUR DOG MORE COMFORTABLE

When pets are happy, pet owners are happier too, so don’t ignore canine joint or ligament abnormalities, even if they seem minor. If you are concerned about your dog’s joints and movement, seek the advice of your veterinarian.