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The Stages of Joint Disease

February 15, 2021 at 4:00 a.m.

Following December's article on "Pain in Pets," I heard several comments and questions from my clients wanting more information. So, this article will focus on a well-known source of pain -- degenerative joint disease, with a focus on arthritis pain.

We know there are genetic factors involved in why some animals develop arthritis and others do not. Developmental issues that result in hip dysplasia, luxating patellae, etc., are commonly found in dogs and (even) cats. There is testing that can be performed in breeding dams and sires to better determine the likelihood of their offspring developing these conditions, but many breeders do not provide this testing, and testing is not a 100 percent guarantee.

The best we can do to help prevent the early onset of arthritis and painful joints is to keep our pets at a lean weight, feed a high-quality diet, and work with a veterinarian to evaluate joint health on a regular basis. We also have to monitor closely for any changes in mobility, behavior, or any indication of pain.

The first signs of joint pain may be subtle. You may not notice them at home. Your dog will not whimper or yelp due to chronic joint pain. Your cat's pain will be undetectable. Your veterinarian knows what to look for and how to properly examine for risk factors and early signs of pain. If observed, he/she may recommend fatty acid or glucosamine supplementation. At this stage of the disease, our goal is to prolong the time before symptoms of pain begin and stronger medications are required. By the time we are able to notice outward symptoms of pain at home, significant changes may have occurred in the joint that limit our options for treatment.

As arthritis progresses to a moderate stage, common symptoms include difficulty standing up, hesitation to go up or down the stairs or jump on or off the furniture, etc. On exam, we often find a change in the range of motion of the affected joint(s). Your veterinarian might now consider a therapeutic diet, and/or cold laser therapy (photobiomodulation). It might also be time to consider additional diagnostic testing. This might include X-rays, blood work, or other testing. Knowing the results of these tests can help to determine the best course of action in proactively treating pain and screen for side effects of medications.

As we reach a severe stage of arthritis pain, we see animals experiencing daily or continual levels of pain associated with their joints. It becomes necessary to provide daily pain management, as well as continued supportive therapy to protect any healthy cartilage that remains. It is possible that surgical intervention might be an option. We cannot reverse the changes within the joint or the effects on muscle or nerve function. Our goal is to manage pain and keep our patients comfortable while retaining the function of the limbs and joints for as long as possible. This requires medication, as well as routine evaluation to ensure they are doing well on the treatment.

In some of our patients, arthritis becomes an end-stage disease, meaning that the pain and symptoms the animal is experiencing overwhelm our ability to keep them comfortable. This is a painful condition that causes extreme difficulty in standing and/or walking. We often see a significant loss of muscle, weight loss, changes in appetite, refusal to interact with family, depression, etc., at this stage in the disease.

There may be additional medications or therapies we can suggest. However, at this point, any treatment we can provide will be short-term management of a painful disease for which there is no cure.

There may be difficult decisions that lie ahead. It may be a confusing and scary time for you. Please know your veterinarian is there for you and your family to guide you through decisions for treatment, and when necessary, for saying goodbye. No one plans for this time in their loved one's life. We take this time very seriously and consider your family as well as your pet in making recommendations.

If you are concerned that your pet may be experiencing pain, please talk to their doctor soon. Early intervention allows for many more options and the best possible outcome.

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