Osteoarthritis

From Dog
Severe stifle osteoarthritis in a Great Dane[1]

Osteoarthritis (degenerative joint disease) is a common arthritic disease of dogs involving joint fluid, cartilage and bone changes.

Osteoarthritis is generally regarded as a noninflammatory condition of articular cartilage resulting from natural aging, trauma, or disease. It has a considerable hereditary component and is considered to be a polygenic disease[2].

It may be observed as a primary (age-related) or secondary disease (often due to earlier joint injury, surgery, trauma or infection). Early stages of disease are characterized by chondrodysplasia as a result of proteoglycan loss and collagen network disorganization at or near the articular surface, leading to degeneration of the articular surface, loss of viscoelastic behavior of the cartilage surface, inflammatory exudates within the synovial fluid and development of osteophytes[3].

Osteoarthritis is commonly seen in older dogs, especially large-breeds[4].

Diseases associated with this condition include:

Diagnosis is usually based on clinical history and supportive radiographic evidence of arthritis changes visible within joints.

A differential diagnosis would include osteomyelitis, panosteitis, cauda equina syndrome, hypertrophic osteoarthropathy and hypertrophic osteodystrophy.

In dogs with acute osteoarthritis, surgical intervention may be required, including arthroscopy and removal of joint osteophytes. With chronic hip dysplasia-related osteoarthritis, total hip replacement may be required. With vertebral osteoarthritis, such procedures as disc fenestration, arthrodesis or hemilaminectomy may be used judiciously.

Non-surgical intervention usually requires long term palliative treatment with NSAID-based medication such as carprofen, fentanyl, tramadol, meloxicam[5], robenacoxib, gabapentin or in severe cases, prednisolone.

Use of exercise has significant benefits in long-term therapy associated with osteoarthritis, and leash-held walking is recommended in dogs that are not unduly ataxic or in pain[6].

Adjunct medication such as pentosan polysulfate, glucosamine, amantadine[7], therapeutic diets rich in omega-3 fatty acids[8], curcumin[9] and root extracts of Brachystemma calycinum (an indigenous plant of southwestern China)[10] have predictable improvements in clinical amelioration of symptoms.

Products such as neutraceuticals[11] and fish oils[12] appear to not benefit pain scores in dog affected by this condition.

Managing chronic pain is the critical aspect of this relatively incurable disease, affording as good quality of life as possible based on economic feasibility and response to medical and physical therapy[13].

References

  1. Langford Vets
  2. Sandell LJ (2012) Etiology of osteoarthritis: genetics and synovial joint development. Nat Rev Rheumatol 8(2):77-89
  3. Desrochers J et al (2012) Viscoelasticity of the articular cartilage surface in early osteoarthritis. Osteoarthritis Cartilage 20(5):413-421
  4. Malek S et al (2012) Effect of analgesic therapy on clinical outcome measures in a randomized controlled trial using client-owned dogs with hip osteoarthritis. BMC Vet Res 8(1):185
  5. Wernham BG et al (2011) Dose reduction of meloxicam in dogs with osteoarthritis-associated pain and impaired mobility. J Vet Intern Med 25(6):1298-1305
  6. Bockstahler BA et al (2012) Hind limb kinematics during therapeutic exercises in dogs with osteoarthritis of the hip joints. Am J Vet Res 73(9):1371-1376
  7. Lascelles BD et al (2008) Amantadine in a multimodal analgesic regimen for alleviation of refractory osteoarthritis pain in dogs. J Vet Intern Med 22(1):53-59
  8. Moreau M et al (2012) Effects of feeding a high omega-3 fatty acids diet in dogs with naturally occurring osteoarthritis. J Anim Physiol Anim Nutr (Berl) Jul 14
  9. Colitti M et al (2012) Transcriptome modification of white blood cells after dietary administration of curcumin and non-steroidal anti-inflammatory drug in osteoarthritic affected dogs. Vet Immunol Immunopathol 147(3-4):136-146
  10. Moreau M et al (2012) Brachystemma calycinum D. Don Effectively Reduces the Locomotor Disability in Dogs with Naturally Occurring Osteoarthritis: A Randomized Placebo-Controlled Trial. Evid Based Complement Alternat Med 2012:646191
  11. Vandeweerd JM et al (2012) Systematic review of efficacy of nutraceuticals to alleviate clinical signs of osteoarthritis. J Vet Intern Med 26(3):448-456
  12. Hielm-Bjorkman A et al (2012) An un-commissioned randomized, placebo-controlled double-blind study to test the effect of deep sea fish oil as a pain reliever for dogs suffering from canine OA. BMC Vet Res 8(1):157
  13. Fox SM (2012) Painful decisions for senior pets. Vet Clin North Am Small Anim Pract 42(4):727-748