The Guide To Dog Joint Health

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Table of Contents

Introduction .................................................................................................................... 3

1. What Makes Your Dog “Go” – Joints ................................................................. 4

2. What Is Arthritis? .................................................................................................... 6

3. Common Causes of Arthritis ........................................................................... 8

4. Treatment of Arthritis ................................................................................... 15

5. Prevention of Arthritis ....................................................................................... 22

Copyright, Licensing and Liabilities ..................................................................... 23


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Introduction

Movement is a magnificent thing. Bodies in motion are beautiful and evoke the depths

of human emotion. Writers and artists for centuries have been fascinated by the poetry

that is movement. But how often do we stop to think about how our bodies move? What

are the “nuts and bolts” that make us “go”?

To answer this question, we must turn to art of science. It is the form and function of

our musculoskeletal system that provides the mechanics of movement; in creatures

great and small, from reptiles to marine mammals. Dogs have very similar anatomy and

physiology to other mammals and suffer from similar diseases, especially when it comes

to the joints.

Joint health has become increasingly important for dog lovers over the last few decades.

Our furry companions are living longer lives than ever, and with this comes age-related

health problems.

This e-book is to serve as a guide to how to keep man’s best friend healthy – from head

to toe – for life with good nutrition, lifestyle and supplementation.


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Chapter 1:

What Makes Your Dog “Go” – Joints

All the systems in the body work with each other and affect each other. The brain and

spinal cord control the muscles that pull on the bones to create movement. Our

“bending points” – or the joints – are in more places than you may think. The spine,

hips, shoulders and even skull contain joints. The joint is the place where two or more

bones meet. There are many types of joints, including:

Symphyseal – such as the joint that holds the bottom jaw together

Synovial – “cushioned”, high-motion joints between two bones

Specialized – such as the discs that are between the each vertebra in the back

Symphyseal joints are non-moving joints, such as in the jaw or skull. The joints that

most people think about when it comes to movement are synovial and specialized, such

as in the knee and along the spine. These are also most likely to be injured or suffer

from degenerative changes that come with age.

The largest and most active synovial joint in your dog’s body is the knee (also known as

the stifle). The long leg bone (the femur) and the shin bone (tibia and fibula) meet at

this location. This joint is covered in a thick fibrous capsule that holds the two bones

together. On each end of the bone is a protective surface called cartilage.

Cartilage is present in almost every type of joint and is especially important in high-

motion joints. Cartilage is slippery, providing lubrication and cushioning between the

bones. When cartilage is healthy, the bones glide easily across each other, keeping

movement efficient and pain-free. If cartilage is not there, the bones can touch each

other – causing pain and bone wear.


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What Is Cartilage Made Of?

Where bones meet each other is covered by cartilage. Cartilage is a cushion-y matrix

that resembles gelatin and is about 80% water. Cartilage cells or chondrocytes are

suspended in this matrix – full of support proteins. The support proteins are called

collagen and proteoglycans.

Most people have heard of collagen but proteoglycans (what a mouthful!) are a little less

familiar. Proteoglycans surround the collagen fibers almost like a wrapper. These

proteins are also very important when it comes to joint health and nutritional

supplements.

Proteoglycans contain GAGs (glycosaminoglycans) – which help to soak up water,

allowing the complete structure to be very slippery and moist. One important GAGs that

you may have heard of is chondroitin sulfate.

Cartilage cells are just as important as the GAG-filled matrix. They are the “mothers” of

the matrix – secreting both the proteins and GAGs. They must remain healthy to replace

old or damaged matrix with new throughout the life of the joint.

The Joint Capsule

The joint capsule (also known as the synovial membrane) wraps up everything that

makes up the joint – from the cartilage matrix to ligaments. The outer layer is tough and

fibrous- providing both stability and protection. It also keeps all the “Jell-O” inside the

joint where it belongs. The inner layer secretes joint fluid, also known as synovial fluid,

which nourishes the cartilage and helps to keep everything lubricated. This inner layer

produces another important, famous type of GAG, called hyaluronan, which helps keep

the synovial fluid nice and slick. The joint capsule also contains pain receptors that let

the nervous system know when injury or infection has occurred. Cartilage, however, is

devoid of pain receptors.


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Chapter 2: What is Arthritis?

Arthritis, also known as osteoarthritis and degenerative joint disease, is a condition

that happens within the joint of many different mammals. It occurs secondary to some

sort of abnormal force or injury to the cartilage, causing it to become damaged. Damage

can often harm or kill chondrocytes, setting off a chain reaction which changes almost

all aspects of the joint. When chondrocytes are damaged or killed, they cannot produce

the necessary collagen and proteoglycans necessary to lubricate and nourish the joint.

They also produce inflammatory chemicals.

Inflammation is a natural reaction to an attack in the body. It is how the body rallies its

forces to assess and repair damage. Infection and trauma are common causes.

Clinically, the three cardinal signs of inflammation are pain, redness and swelling.

At the cellular level, inflammation is signaled by chemicals and enzymes as a means of

communication and even repair. However, in the joint, inflammation can ‘backfire’. The

joint capsule is a very secure place and it is difficult for inflammation inside to dissipate.

When inflammation remains in the joint, it can damage cartilage further.


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Signs of Arthritis in Dogs

One or more of these signs can be present if your dog suffers from arthritis:

Whining or yelping when the joint is moved

Swelling

Heat

Limping or lameness

Stiffness

Reluctance or inability to jump

Reluctance or inability to walk stairs

Sleeping more

Licking at the joints

Sitting or sleeping on one side of the body

Popping or “crunching” of joints (crepitus)

Muscle loss (atrophy)

With physical exam findings, veterinarians are able to identify the location and severity

of arthritis on radiographs, or x-ray.

When damage occurs, the cartilage can suffer damage that cannot be repaired. Over

time, the condition can worsen, preventing the joint from functioning properly.

Progressive cartilage destruction is considered to be irreversible by experts, but the rate

of its progression can speed up or slow down.


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Chapter 3:

Common Causes of Arthritis

Arthritis can be caused by a variety of different problems, from genetics to infection. The

most common causes in dogs are often the result of genetic orthopedic diseases, obesity

and injury.

Genetics and Developmental Orthopedic Disease

Centuries ago, humans began to selectively breed dogs for certain traits and

characteristics. Many of these dogs today are known as certain “breeds” or “purebreds.”

Unfortunately, selective breeding can sometimes select for the wrong genes as well as

the desired ones. Even desirable characteristics, such as the short legs of the Dachshund

that allowed it to scurry into ground holes after rodents and badgers, can cause

problems when it comes to joint health.

Hip Dysplasia

Hip dysplasia is one of the most famous joint diseases in dogs and it causes arthritis in

animals as young as 6 weeks of age. Hip dysplasia is a genetic disease involving several

mutated genes in medium and large breed dogs such as the German shepherd, Labrador

retriever, Golden retriever, and other mixes. Some affected puppies show signs of hip

dysplasia as early as 6 months of age, which can include signs of arthritis.

What is hip dysplasia? In cases of hip dysplasia, the hip joint does not fit properly with

the head of the femur. Think of the hip joint as a “ball and socket” joint. In other words,

the “socket” of the hip is too shallow and does not allow the “ball” of the femoral head to

fit properly. This leads to looseness (laxity) in the joint and can cause abnormal wear on

the cartilage surface. The abnormal forces being placed on the cartilage subjects it to

damage and arthritis forming.


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Hip dysplasia is best diagnosed before the dog is of breeding age. Dogs that are

diagnosed with it should not be bred, as their genes can cause this painful problem in

future generations. Sometimes the genes can “skip a generation” or two, so just because

a puppy’s parents don’t have hip dysplasia, it can still occur in high-risk breeds.

Testing methods for hip dysplasia include OFA and PennHip techniques. Some experts

argue that PennHip is more accurate and objective in identifying hip dysplasia, but its

main benefit is that puppies can be successfully diagnosed as early as 16 weeks of age.

Early diagnosis can mean early intervention and spay or neuter before the dog reaches

breeding age. Many dogs that are diagnosed before 6 months of age can have procedures

performed to minimize painful arthritic changes to the hip joint.

Prevention can be difficult in this genetic disease. Proper nutrition is needed for high-

risk, growing large and giant breed dogs. Too much good nutrition can encourage too-

fast growth – putting growing joints at risk for cartilage abnormalities. Don’t over-feed

your puppy – follow feeding instructions and veterinary recommendations. If your dog

already has hip dysplasia and arthritis, maintaining a normal to lean body weight will

help alleviate symptoms.

Some dogs with hip dysplasia should undergo surgery. There are many different

procedures available, including Total Hip Replacement, Femoral Head/Neck Ostectomy

(FHO), Juvenile Pubic Symphysiodesis, and DARthroplasty.

If you have concerns about hip dysplasia and its treatment, please talk to your

veterinarian. Most dogs with hip dysplasia benefit from a multitude of different

therapies, including non-steroidal anti-inflammatories (NSAIDs), narcotics, physical

therapy, acupuncture, chiropractic and GAGs such as chondroitin sulfate and

glucosamine.

Elbow Dysplasia Syndromes

There are many causes of Elbow Dysplasia and developmental abnormalities of the

elbow, including osteochondritis dessicans (OCD), fragmented medial coronoid process

(FCP), joint incongruity and ununited anconeal process (UAP).


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It is the most common cause of front leg lameness in the dog. It occurs when the bones

that make up the elbow are not aligned or fused properly during growth, fractured or

cartilage has been damaged. Elbow dysplasia is seen in a variety of breeds, mostly large

breeds such as German shepherd dogs, St. Bernard, Great Dane, and Labrador retriever.

Depending on the type of elbow dysplasia seen, the cause can vary. Some breeds are

more predisposed than others, while other types are aggravated by trauma or injury.

Radiographs (x-rays) are commonly needed for diagnosis or arthroscopy.

Treatment varies depending on the final diagnosis and specific cause. Surgery and/or

medical therapy may be necessary. Most dogs with elbow dysplasia syndrome benefit

from a multitude of different therapies, including non-steroidal anti-inflammatories

(NSAIDs), narcotics, physical therapy, acupuncture, chiropractic and GAGs such as

chondroitin sulfate and glucosamine. If you suspect your dog may be suffering from an

elbow problem, talk to your veterinarian.

Luxating Patella (“Floating Kneecap”)

Many dog owners have heard of “floating kneecaps” – after all, some humans suffer

from this orthopedic condition. This condition occurs when the kneecap pops out of

joint, either due to a structural issue with the leg or traumatic event. The kneecap is a

small piece of bone that makes up a part of the knee or stifle joint. It sits at the very

front of the knee and you can easily feel it. When it is held in place between the ridges of

the trochlear grooves on the end of the femur by the patellar ligament and it helps to

stabilize the joint. However, sometimes genetic abnormalities, poor conformation and

trauma can allow the kneecap to slide out of place.

Short-legged or very straight-legged dogs can have “loose” ligaments that allow the

kneecap to pop in and out of place very easily. Most of the time, the kneecap will move

to the inside, or medial, side of the leg. Other dogs have trochlear grooves that are too

shallow. Falling on ice, turning too fast and other types of trauma to the knee can also

force the kneecap out of place.


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Luxating patellas are graded in severity by a grading system. Grade 1 is a kneecap that

goes in and out of place very easily. Grade 4 means that the kneecap is permanently out

of position and often requires surgical correction. Grade 4 luxations can also mean that

there has been a turn in the other long bone, the tibia, which meets to make up the knee

joint.

Many dogs may show periodic limping and a characteristic “hop” on one or both legs

when they run. Your veterinarian can diagnose a floating kneecap by history, physical

exam and radiographs (x-rays).Floating kneecaps are most common in toy and small

breed dogs, such as Dachshunds, Miniature Poodles, Yorkshire terriers, Silky terriers

and English bulldogs. Other medium and large breed dogs can experience it as well,

including Australian Shepherds, but it is more uncommon.

Over time, the chronic movement of the kneecap over the trochlear grooves will cause

pain and damage to the cartilage, leading to arthritis. Most dogs with luxating patellas

benefit from a multitude of different therapies, including non-steroidal anti-

inflammatories (NSAIDs), narcotics, physical therapy, acupuncture, chiropractic and

GAGs such as chondroitin sulfate and glucosamine.

Growth Plate Abnormalities

When puppies are born, the ends of their bones (called growth plates) are “open” and

allow for the bones to grow in length. As the puppy approaches adulthood, these plates

begin to close. Timing of when they close can vary slightly depending on the long bone

in question and between breeds, but often this happens from 6 to 12 months of age.

Problems during fetal development and nutritional abnormalities in puppyhood can

affect how the growth plates are formed and how they function. Poorly formulated and

unbalanced homemade diets and raw diets have been cited in cases of growth plate and

developmental bone abnormalities.

Many times a growth plate abnormality is not detected until the puppy shows signs of

lameness. Even if the growth plates have “closed” – something that happened while they


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were “open” could be the cause of pain or joint abnormality. Fractures and elbow

dysplasia syndromes are common findings.

It is important to feed a life-stage appropriate puppy or large-breed puppy food that is

nutritionally balanced as directed. Take care to not over- or under-feed.

Limit exercise while the puppy is growing up to 12 months of age. It is perfectly

appropriate to let puppies run, jump and play as needed. However, think twice before

taking your puppy on a run for several miles, even at a slow pace. The pounding on the

joints can cause damage that can predispose your puppy to future joint problems. Save

the 5k training for when he or she is older and the growth plates are closed.

Nutrition and Obesity

We’ve already discussed the importance of good, balanced nutrition promoting good

joint health, but did you know it is important for adult and senior dogs, too?

Nutrition for our pets is easier than ever, thanks to a variety of commercial diets

available. Dog lovers who choose to cook at home for their dogs also have great

resources in veterinary nutritionists and balanced recipes. Despite all of these resources,

our dogs are suffering through an obesity epidemic in most Western countries, including

Canada and the USA. The overweight and obesity rate in dogs is close to what it is in

humans – about 1 in 3. This translates to a host of potential health problems in those

that are too heavy. One of the most common obesity-related illnesses is arthritis. When

the joints are experiencing an increase in load over the course of time, it causes un-

natural wear and forces on the cartilage. This in turn leads to damaged cartilage and

arthritis. The cartilage is also more likely to be damaged secondary to an injury to

ligaments within the joint, including cranial cruciate ligament (ACL) tears and strain.

It is best to keep your dog at the recommended body weight for his or her breed and

body type. Some experts even recommend keeping dogs a little leaner than this “ideal.”


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If you are not sure what weight your pet should be at, consult with a body condition

score chart and your veterinarian.

Poor conformation

When speaking of abnormal joint wear and forces on the cartilage, it is important to

remember that certain breeds may be predisposed to these issues. Many breeds were

developed over the centuries for specific purposes. These purposes often drove selection

of certain characteristics. For example, let us take a look at the Dachshund. This “low

rider” of the dog world has very short legs, a very long body, and a narrow head with

long snout. This body design was perfect for the dog’s use hundreds of years ago – which

was hunting for badgers and other burrowing rodents in Europe. The dog could easily fit

into holes and drive out pests for their owners.

The Dachshund may have a very unique body design, but from a joint health standpoint,

there are many problems. The limb or leg conformation, or “design and mechanics” is

“un-natural.” The bones in the limbs often don’t meet up very well at the joints, leading

to increased wear on the cartilage.

Sometimes, these dogs appear to be “bow-legged”, which also affects how the bones

meet and joints function. Their rear legs tend to be too straight, or “post-legged”, which

can affect how the knee cap sits in the joint. Dachshunds are notorious for having back

problems, as their long back is often unstable, leading to increased wear on the disc

joints between each vertebra.

The Dachshund is not alone. Many other breeds experience joint issues secondary to

poor limb conformation, including: English bulldogs, French bulldogs, Yorkshire

terriers, Miniature Poodles, Shar pei, Airedale terriers, Silky terriers, Boston terriers,

and Basset hounds.

http://research.unc.edu/files/2012/11/CCM3_032387.pdf



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Trauma

Trauma is a large category that includes any abnormal force on the joint or limb.

Fractures, ligament rupture and torn cartilage fall into the category. Trauma is always

characterized by inflammation, pain and problems with mobility. As discussed

previously, the level of and length of time that inflammation is present can affect joint

health in the long term.

The March of Time

Over time, our dog’s joints will experience normal wear and tear in addition to abnormal

forces and trauma on the joint. The cumulative effect is that most senior dogs have some

form of arthritis. This process can be considered natural, as the body doesn’t repair itself

as well as time marches on.

The best way to combat the effects of arthritis is to keep your dog at an optimum body

weight for all of his or her life, provide appropriate nutrition, gentle exercise and joint

support through GAGs such as glucosamine and chondroitin sulfate. Even if your dog is

already a senior – you can take these steps to continue good joint health and slow the

progression of arthritis.


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Chapter 4:

Treatment of Arthritis

The treatment of arthritis is a multi-modal one, with many different therapies that can

work together to keep your dog as comfortable as possible. Many of these therapies will

not only improve joint health at the cellular level, but also can help strengthen the

muscles that support and move the joints.

Environment

If your pet suffers from arthritis, modifications may need to be made around the home

to improve their mobility and comfort. A few examples include:

Throw rugs or carpeting to improve footing

Add ramps to facilitate access onto a bed, sofa or entrance

o If a ramp is built or purchased, add a non-skid surface to prevent slipping

on the plastic or wood

Reducing the number of stairs the pet has to climb

Utilize the elevator or disabled access ramp

Elevate food and water bowls, so pet does not have to stretch down with the neck

Lift your dog into the car instead of asking/allowing them to jump

Soft beds in high-traffic areas of the house.

o Your dog may enjoy “taking it easy” and watching you cook dinner in the

kitchen or next to your sofa while watching television

Take the shortest route to the outdoor toilet area.


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For certain dogs with severe arthritis, reducing how much they have to move can help

with their overall comfort. However, dogs with mild to moderate arthritis may not need

this – movement can sometimes be a good thing in combating arthritis discomfort and

light exercise helps to keep muscles strong. While not all modifications are necessary or

practical for all circumstances, it can make a difference in your dog’s overall comfort and

quality of life.

Weight Control

As discussed in Chapter 3, proper weight management can be crucial in keeping your

dog comfortable. The heavier your dog is, the more strain that is put onto the joints,

which can cause or worsen arthritis. It is important to consider your dog’s body

condition score and speak to your veterinarian about an appropriate weight loss or

weight maintenance plan.

Physical Therapy

Physical therapy, also known as physiotherapy, is an important treatment tool for dogs

with arthritis. These dogs often experience muscle loss or muscle atrophy secondary to

arthritic pain. The discomfort discourages dogs from moving as much, and when the

muscle is not used, it becomes smaller, less strong and doesn’t support the joint as it

should. It is a bit of a ‘vicious cycle’ as far as mobility is concerned.

Many veterinarians recommend physical therapy after a traumatic injury or orthopedic

surgery, not only to keep muscles in tip-top condition, but to help keep the joints as

healthy and pain-free as possible. Light, gentle, low-impact exercise is recommended for

most dogs with arthritis and physical therapy techniques deliver just that.




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Certified canine rehabilitation specialists offer a wide variety of options, including:

Hydrotherapy

o Swimming

o Underwater treadmill

Stretching

Massage

Strength training

Flexibility

Cold or low-level laser therapy

Chiropractic

Veterinary chiropractic is a technique that is often used in conjunction with physical

therapy and acupuncture. The basis of chiropractic is to keep the spine “adjusted” to

facilitate proper nervous and muscular system function.

Acupuncture

The ancient art of acupuncture is based on the idea that energy fields lie within the

body. These energy meridians function to keep our body balanced. When the body is out

of balance, disease states occur. Certain points along meridians can be stimulated by the

insertion of small needles. Acupuncture has been scientifically proven to increase blood

flow and reduce pain in patients with arthritis. It is commonly used in conjunction with

chiropractic and physical therapy techniques.


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Joint Supplements

GAGs (glucosaminoglycans)

Glucosaminoglycans or GAGs, as outlined in detail in Chapter 1, are extremely

important for the health of the joint. These compounds are made by the chondrocytes of

the cartilage. As cartilage is damaged or depleted, GAGs are reduced within the joint.

Nutritional supplementation is important for providing the joint with a source of these

important compounds. Research from over the past 30 years has shown that mild to

moderate arthritis can be greatly impacted by the daily inclusion of GAGs into the diet.

Types of GAGs include: hyaluronic acid, chondroitin sulfate and glucosamine.

These are typically found through plant, bovine and marine sources such as shark

cartilage. Other, more sustainable sources include bivalves such as the New Zealand

Green-lipped mussel. These natural sources of GAGs are typically supplied in a powder

and very bio-available and easily assimilated for the body’s use.

MSM

MSM, or Methylsulfonylmethane, is a compound that is typically paired with GAGs such

as glucosamine/chondroitin sulfate for the prevention or treatment of arthritis. Its main

function is in its anti-inflammatory effects.

Amino Acids

Amino acids are the building blocks of proteins and are found in a variety of substances

from food (meats, dairy, fish, eggs, grains, etc.) to nutritional supplements. Cartilage is

always in need of good quality amino acids in order to properly make important

components of the matrix and repair damaged cells.


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Antioxidants

Common antioxidants found in nutritional supplements for arthritis include grape seed

extract, green tea extract, etc. These help to reduce the amount of free-radical or

oxidative damage to the cartilage secondary to inflammation or toxins. Antioxidants

also have a variety of benefits for the rest of the body, from brain and eye health to

cardiovascular support.

http://www.amazon.com/gp/product/B00O16BZ7Q


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Herbal therapies

Veterinarians who practice Traditional Chinese Veterinary Medicine (TCVM) are skilled

in the art of herbal therapy. Certain herbs and herb combinations can help to combat

inflammation, pain and cellular damage in the joint. Commonly, TCVM practitioners are

also skilled in acupuncture and chiropractic techniques – which are used concurrently

for the benefit of the patient. Herbs such as turmeric, boswellia, ginger, and devil’s claw

may be used. Herbal combinations should be selected based on the dog’s individual

needs by a trained professional. Some over-the-counter herbal mixes may be harmless

but may not suit every case. If you are interested in complimentary or alternative

treatments, contact a local holistic or TCVM veterinarian.

NSAIDs

NSAIDs, or non-steroidal anti-inflammatories are very commonly used in dogs with

arthritis. Many dogs with mild to moderate arthritis may be able to be managed without

NSAIDs, but as arthritis progresses, often they are necessary. They function to reduce

levels of inflammation not just in the joint, but in many aspects of the body. Veterinary-

approved NSAIDs are the safest, but are not appropriate for all dogs. Your veterinarian

will routinely check liver and kidney function as well as overall health every 3-6 months

if your dog is on long-term, daily NSAID therapy.

Many dogs that are treated by a variety of methods together (such as acupuncture,

GAGs, massage, NSAIDs, etc.) often need lower doses of NSAIDs than dogs that are

treated with NSAIDs alone.

Commonly used NSAIDs in dogs include:

Deramaxx (deracoxib)

Rimadyl (carprofen)

Metacam (meloxicam)

Previcox (firocoxib)


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Narcotics

Moderate to severe arthritis is often managed by opioids, also known as narcotics.

Opioids work by acting on pain receptors in the central nervous system. Sometimes

these are given alone or in combination with other therapies. While they have their own

set of side-effects, many pets use narcotics for arthritis pain control if they cannot safely

take NSAIDs.

Commonly used narcotics in dogs include:

Tramadol

Buprenorphine

Butorphanol

Gabapentin

Another class of drug that has some success in treating chronic pain associated with

arthritis is gabapentin. It is commonly used to treat neurologic pain (such as Shingles

pain in humans) and seizures as well. It can be used short-term or long-term, depending

on the particular needs of the patient. Many dogs tolerate gabapentin when they cannot

tolerate NSAIDs or if they need additional pain control.

Surgery

Uncommonly, pieces of cartilage may need to be removed from the joint via arthroscopy

and surgery in order to treat and prevent arthritis. Injury can sometimes produce what

are called “joint mice” which float around in the joint (commonly seen in dogs with

osteochondritis dissecans or OCD). These pieces chronically irritate the joint and

remaining cartilage, worsening pain and arthritis symptoms.


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Chapter 5:

Prevention of Arthritis

Prevention is worth a pound of cure. Starting a young puppy out on the right paw is the

best way to go. Engage in a healthy lifestyle and invest in good supplements at a young

age. Don’t wait for the signs of arthritis to start before taking action. Almost every

treatment for arthritis can be used as prevention.

A good checklist for great joint health:

Weight control

Appropriate nutrition

Gentle, daily exercise

Daily nutritional supplementation

o GAGs

o MSM

o Omega-3 fatty acids

o Antioxidants

Routine veterinary care

o Check-ups every 6-12 months


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Version 1.00 November 2014, Edited and Published by TaylorHappy

The Guide To Dog Joint Health

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