Arthritis in Dogs and Cats

Arthritis is the most common chronic disease process affecting middle to senior age dogs and cats, causing a spectrum of clinical symptoms ranging from mild chronic joint discomfort to severe muscle atrophy and crippling joint pain. However, by following simple lifestyle adjustments and nutritional guidelines, pet owners have the ability to provide relief for, and even reverse the debilitating effects of arthritis.

Arthritis (definition): Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis.

* The type of arthritis associated with age or congenital malformation (e.g., hip dysplasia), is osteoarthritis.

Typical Age Of Onset Of Arthritis: Age of onset varies with species and size. Keep in mind, that congenital malformations and/or chronic obesity will lower the age of onset of osteoarthritis in any size or species of animal.

Cats and toy breed dogs weighing 10 pounds or less will not typically begin to show clinical signs of arthritis until approximately 9 years of age. For dogs weighing 11-30 pounds, approximate age of onset of arthritis is 8 years, dogs weighing 30-65 pounds 7 years, dogs weighing 65-85 pounds 6 years, and dogs weighing greater than 85 pounds 5 years.

Early Stage Arthritis: Animal may mildly limp in one or more extremities after prolonged exercise. May be slightly slower than normal to rise after lying down for long periods. Animal may not be able to jump as effectively and may manage going up stairs a bit more slowly than normal.

Treatment – This is the stage of arthritis where holistic remedies will not only be effective in providing the animal relief, but may slow the progression and even reverse the effects of arthritis. If the animal is overweight, this extra weight MUST COME OFF! This is the single most important aspect of arthritis management. Most owners have good intentions in spoiling their pets when fattening them up with excessive food and treats. However, spoiling them in this way has the potential to eventually cripple the animal and shorten its life considerably.

Next, the animal should be placed on a diet that is rich in protein, fiber, and low in fat.

The increased protein will help to sustain muscle mass for joint support, fiber will fill the tummy for better satisfaction when engaging in portion control for overweight pets.  The limited fat will keep body fat and excess weight in check. Many high quality senior diets such as Hills Science Diet, Purina Pro Plan, and Royal Canine, meet these requirements.  There are prescription level diets that are engineered for arthritis relief.  Hills Metabolic Mobility, for example, address weight management, while also supporting joint health with nutraceutical joint health supplementation (see below).

Finally, the animal should be placed on a nutritional joint health supplement fortified with “nutraceuticals” such as glucosamine, MSM, chondroitin, omega-3-fatty acids, and anti-oxidants. These nutrients combine to naturally decrease inflammation, increase joint fluid production to provide lubrication and ease of movement, and stimulate the repair of damaged cartilage and other connective tissues. One should be careful when shopping for these supplements. Make sure that the supplement that you choose has the approval of a veterinarian. Pet health supplements are not tightly regulated and many do not have the ingredients that the labels claim.  If a the pet is placed joint support diet like Hills Metabolic Mobility mentioned above, additional supplementation is not necessary.

This is also a good time to start monthly Adequan injections.  The active ingredient in Adequan, poly sulfated glycosaminoglycan, is the base molecule for all of the connective tissues of the body.  There is a lo of conflicting data on the efficacy of glucosamine and chondroitin, with most observations of their benefit being mostly anecdotal.  However, there is strong data that proves the benefit of Adequan.  Adequan and other nutraceutical treatments or joint support diets are safe for use in cats as well as dogs.

Mid Stage Arthritis: Animal consistently and moderately painful in one or more extremities after prolonged excercise. Moderate to advanced difficulty in rising after lying down. Marked difficulty junping, and managing stairs obviously painful – some animals may “bunny hop” up the stairs. Some muscle atrophy (decrease in mass) of muscle may be beginning to show in the thigh and gluteal muscles.

Treatment – Same program as for the early stage arthritis, but, in addition, class IV therapy laser should be considered for these patients. In addition to these modalities, at this point, occasional to daily administration of a non-steroidal anti-inflammatory drug (NSAID) may be necessary for relief. These drugs decrease inflammation and pain within the joints. The NSAID that I typically enjoy the most success with is carprofen and meloxicam in dogs.  These medications work by selectively inhibiting the COX-2 enzyme that causes inflammation and pain in arthritic joints, while sparing the COX-1 enzyme that is integral in helping to protect liver, kidneys, and the GI tract.  There are not currently long term safe NSAID options for cats.

Although the selective inhibition of COX-2 while sparing COX-1 is effective with NSAID medications labeled for dogs, it is not 100%, and disease of the liver, kidneys and/or GI can arise with long term use.  This is why dogs kept on these types of medications should have blood work checked once every 6 months to make certain there are no side effects.

There is a relatively recent arthritis product development called Galliprant for dogs.  It is unique unique in that it does not reduce inflammation by inhibition of the COX-2 enzyme at all.  Instead it blocks the the receptors that accept the final byproduct of the COX enzyme biochemistry pathway: prostaglandin.  This makes Galliprant a much safer bet for long term use, but in my own experience, it works best in moderate arthritis patients, but is not as effective as traditional NSAIDs in more advanced cases.

Advanced Stage Arthritis: Animal is severely painful to crippled after exercise. Severe difficulty or inability to rise after lying down. Animal cannot jump. Severely impaired or inability to manage stairs. Severe muscle atrophy of thigh and gluteal muscles.

Treatment – At this stage, I strongly advise taking advantage of new monoclonal antibody therapy.  This is especially exciting for cats, since there is no safe NSAID option for long term arthritis treatment.  Chief among the many inflammatory mediators and structural changes that occur within arthritis joints, is the synthesis and deposition of molecule called nerve growth factor on the cartilaginous surfaces of joints.  Nerve growth factor triggers the sprouting of small nerves on joint surfaces where nerves were not meant to be.  The result is that much of the pain experienced by pets with arthritis is driven by nerve pathways that in younger days, were not once there.  Monoclonal antibody therapy provided by Librela and Solensia for dogs and cats, respectively, specifically target nerve growth factor and prevents it from attaching to its receptors on nerve cells and interrupts the transmission of pain signals.  The result is significantly less pain and a dramatic increase is mobility within just 2-3 treatments.  Librela and Solensia are administered by quick, safe subcutaneous once a month.

Monoclonal antibody therapy often results in patients being less dependent on anti-inflammatory therapy that sometimes leads to adverse side effects in dogs when used long term.  This is especially important for cats that do not tolerate anti-inflammatory medication for extended periods, subsequently having very limited long term medication options for arthritis.  Monoclonal anti-body treatment appears to be the wave of the future for management of all manner of disease, and it is beyond exciting that we can now utilize this technology to safely treat the most common chronic disease in dogs and cats.  Often treatment with NSAIDs or Galliprant are also beneficial (for dogs), as well as all of the previous modalities noted in the earlier stages of arthritis for both dogs and cats.

End Stage Arthritis: Crippling is so severe that animal is no longer able to rise without help. Animal cannot even posture to void despite treatment and will often void where it lies. This is when corticosteroids like prednisone are necessary to keep the patient comfortable.  Euthanasia is common at this stage.

Roger L. Welton, DVM

Founder and Chief Editor, Web-DVM.net

CEO Premier Veterinary Care

Host Space Coast Pet Podcast

Author, The Man in the White Coat

Article updated 3/17/2024