Integrative Treatment of Dogs with Arthritis such as Canine Hip Dysplasia

R.M. Clemmons, DVM, PhD


Osteoarthritis associated with degenerative joint disease (DJD) is a common problem in all dogs, but particularly in large dogs who are susceptible to hip dysplasia (a genetic disorder of dogs controlled by 5 gene pairs). Even without a genetic predisposition in patients to arthritis, many dogs will develop joint disease for the same reasons that we as human beings do so. Often patients are overweight and the micro-traumas associated from carrying this extra weight takes its toll as the patient ages. One important aspect of the treatment of patients with arthritis is to reduce or maintain an ideal body weight. Most dogs in the United States are overweight due to dietary habits or from lack of exercise. It is clear from longevity studies in animals that lean body weight is associated with improved overall health and increased resistance to disease, including arthritis and cancer.

Dogs do develop immune-mediated joint diseases (Systemic Lupus Erythematosis, non-SLE immune joint disease and Rheumatoid arthritis), infectious joint diseases (Lyme disease, Rocky Mountain Stopped Fever, and septic joint disease), and traumatic joint diseases (ruptured anterior cruciate ligament and traumatic hip dislocation). The diagnosis of these diseases requires laboratory tests (CBC, Chemistry profiles, urinalysis, and immune tests), radiographs of the affected joints and joint fluid analysis. In some cases, special diagnostic procedures like bone scans, computer axial tomography (CAT scans) or magnetic resonance images (MRI scans) are necessary to make the correct diagnosis. In acute disease, traditional medical and/or surgical treatments can be extremely effective in providing relief and assisting in repair of the damaged joint. This is particularly true with traumatic disease. On the other hand, traditional therapy may fall short in the long-term control of immune-mediated joint disease and in the control of chronic degenerative joint disease. Even following surgical repair of acute lesions, the patient must still heal and will benefit from the principles of integrative medical therapy.

In dogs with a breed or familial predisposition for developing DID, regular exercise, good nutrition and supplemental support may moderate or forestall the development of joint disease. Once DJD does surface, the same principles can be use to treat and control the process of joint deterioration. This involves the use of anti-oxidants, anti-inflammatory compounds and condroprotective agents. Western medicine powerful steroid medications which can reduce inflammation, but these drugs do possess many detrimental effects during long-term usage. In addition, steroids may reduce collagen synthesis, which delays healing. Non-steroidal anti-inflammatory drugs (NSAIDs) reduce inflammation by controlling prostaglandin production and reduce discomfort through their analgesic properties. On the other hand, NSAIDs increase stomach acid secretion and diminish the muscosal protective barriers, leading to gastrointestinal (gi) irritation and upset. Although many new medications have developed which have less gi side-effects, little data is available to show that NSAIDs actually delay the onset or progression of DJD. NSAIDs appear to be most useful in reduction of discomfort from joint pain. Many herbal products have anti-inflammatory properties similar to NSAIDs, yet do not appear to cause the same gi irritation, making herbal products ideal in treating DJD. While veterinary pharmaceutical preparation of condroprotective drugs are available, there is no data to suggest that they are more effective than less expensive products available from health food stores. In fact, no condroprotective drug may be more effective than supplementation with dietary cartilage (which contains the condroprotective compounds and additional useful materials).

Treatment of Acute and Chronic Joint Disease:

Treatment of Acute Joint Injury:

All dogs may from time to time suffer from acute joint injuries (stretching of ligaments, partial tears of ligaments or sprains). These conditions are different from chronic DJD. Although the healthy dog diet and supplements may help these patients from developing injuries and speed their recovery from the injuries, nothing can specifically prevent accidental injury to joints. In acute lameness secondary to joint disease, rest is very important to minimize further injury in the acute phase. Rest should continue until significant healing has taken place, usually for a minimum of 14 days up to 6 weeks. To accomplish this may require kenneling the dog to enforce the rest. Walks should be limited to leash-controlled potty duties. Cold compresses may help minimize swelling and reduce pain and inflammation (this is the opposite of chronic DJD). One way to apply cold is to use bags of frozen peas which can be held in place with a loose "Ace" bandage. This should be applied for 15 minutes 2-3 times a day. Sometimes, application of moist heat following the initial and subsequent "cold" treatments (5-15 minutes after each "cold" treatment) will improve circulation and help rid the area of toxic metabolites. This can be done by placing a slightly moistened towel into the microwave (or oven) for a short period. The towel should be warm, but not so hot as to burn the patient. (Cautiously, test it on yourself. If you feel it is too hot, it is too hot for your dog. Don't burn yourself!!!)

In addition to "cold" and "heat" therapy, NSAID compounds may help reduce pain and inflammation. NSAID compounds should only be used for the first few days (3-5) when the inflammation is most acute. Aspirin (particularly enteric-coated, buffered aspirin) is usually well tolerated by dogs at doses of 1-5 mg/kg up to 3 times a day. This can cause gi upset and gastric bleeding in some sensitive dogs or dogs with inherited bleeding tendencies. Carprofen (Rimadyl) may also be a good NSAID product which dose not appear to have the same level of side-effects as other NSAID drugs. Acetaminophen (Tylenol) does not have an anti-inflammatory action and, therefore, does not help in acute joint injury (other than providing analgesia (never exceed 20 mg/kg/day since it can cause liver damage in dogs) Ibuprofen seems to cause (sometimes severe) gi upset much more frequently than aspirin and I do not recommend it for dogs. An alternative to the NSAID drugs with fewer side-effects is to use a cocktail of garlic powder, dry ginger and dry mustard (¼-1 teaspoon each, depending on your dog's size) 2-3 times a day with food. These can also be dissolved in a small amount of vinegar (1 teaspoon, mixed with 1 tablespoon of honey and diluted with an ounce of warm water) and given orally. Another natural NSAID compound which can be given is feverfew (see below).

If your dog's lameness does not improve rapidly in a few days or worsens, see your veterinarian for proper diagnosis and additional therapy. Some acute joint injuries require surgical correction. Others may need specific therapy. On the other hand, if the resolve quickly, the injury was likely to be self limiting. Recurrent symptoms could indicate a chronic disease process.

Prevention of DJD:

The methods of prevention of arthritis are based upon the principles of exercise and dietary measures useful in maintaining health in all dogs. Of these components, antioxidants and membrane stabilizers are most important. Vitamin C is necessary for normal bone development and may stabilize the vascular supply to healthy bones and joints. Tofu has phytoestrogens which improve bone development and calcium incorporation into the bone matrix. Garlic, ginger and mustard provide anti-inflammatory actions to minimize micro-traumas during the life of the patient. In those dogs who have a genetic predisposition to DJD, the addition of dietary cartilage and Perna mussel (see below) as dietary supplements may provide additional condroprotection to minimize genetic influences. While it is not always possible to prevent genetic diseases, reducing their impact may allow the patient to lead a longer, desease-free life.

Therapy for Active DJD:

Additional Measures for Treatment of DJD:

Acupuncture: Physical & Massage Therapy: Healing Touch:

Disclaimer: The information presented here is for educational usage. It is not an endorsement of any particular product. You will need to discuss the measures and natural alternatives with your veterinarian. If the problem worsens or new signs develop, discontinue medication and seek appropriate veterinary medical care. This material represents the views of the author and does not necessarily reflect the views or policies of anyone else.

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Last updated 28 August 2002