My Golden Retriever, Zack, loves to go to the beach. He loves to run on the sand and chase his ball into the water. Three weeks ago, I took him to a beach and an unfortunate event happened. With his tail wagging, he pounded down the steep beach stairs to the water. Then, he raced across the sand to dive into the water. Suddenly, before he reached the water's edge, he stopped and held up his front left leg. I thought he stepped on something. So I ran over to examine him and discovered that he was pained when I extended and flexed his left elbow and shoulder. Sadly, I collected his ball and together we limped away from the beach.
The following day, I took radiographs of his forelimbs and discovered severe degenerative joint disease (arthritis) not only in his left elbow but also in his right elbow. It truly amazes me how he was so asymptomatic until this beach injury. Immediately, I started supportive medical therapy and restricted his activity to leash walks only.
Is your pet having difficulties going up and down the stairs or jumping onto the couch? What do you do when your dog or cat starts to limp? Here are some of my suggestions for potential therapy options for your aching pet to discuss with your veterinarian:
1. Complete physical examination. If your pet is showing joint pain, take your pet to your veterinarian and discuss his/her symptoms. Take radiographs to document your pet's problem and degree of pathology. If your dog is diagnosed with arthritis or a soft tissue injury, consider starting your dog on a non-steroidal anti-inflammatory drug (NSAID) to decrease joint inflammation. Did you know that an inflamed joint heals much slower than one that is not? By decreasing inflammation, a NSAID allows your dog to feel better and heal faster. For cats, in my opinion, there are no safe NSAID available today. In cats, NSAID can cause or aggravate kidney disease.
2. Pain medication. Today, there are a number of effective pain medications available to pets- like gabapentin, buprenorphine and tramadol. In addition, there is a drug, called amantadine, which enhances the effect of your dog's NSAID. It is an antiquated and non-compassionate thought to withhold pain medication in pet's with orthopedic injuries for fear that they will be more active and re-injure themselves. As pet owners, it is our responsibility to restrict their activity and minimize their pain. For cat owners, buprenorphine is a great drug choice because it can be given either orally or as a simple injection underneath the skin. Initially, my clients are nervous about giving injections to cats, but soon find it easy, non-stressful and relatively painless.
3. Evaluate your pet's body condition. Does your pet look like an ottoman? If you can't easily touch your pet's ribs or the belly swings when it walks, then I suspect your pet is overweight. Excessive weight is a burden for worn joints. By simple weight reduction alone, it's amazing how much better your pet will feel. Weight loss can be achieved by a combination of restricting your pet's caloric intake and by exercising your pet.
4. Start your pet on a glucosamine chondroitin supplement. Did you know that nutrapharmaceutical products are not FDA regulated? It is for this reason that I only recommend an independently tested product produced by Nutramax, called Dasuquin. This product supplies your pet's joints with building materials to help rebuild your pet's cartilage and decrease joint inflammation. For dogs, it is a tasty chewable product. For cats, it's available as a capsule that you sprinkle on their food. I find this product works well in most pets, but not all. Try it for at least six weeks before you evaluate its efficacy.
5. Add Fish oil -- omega 3's -- to your pet's diet. Omega 3's decrease joint inflammation up to 20 percent. This product can be purchased over-the-counter at any pharmacy. It does not have to be specifically labeled for pets only. I recommend dosing fish oil based on the omega 3 concentration of eicosapentaenoic (EPA). Dose 20 mg EPA for every pound of body weight ONCE daily. (Pets with fish allergies should avoid Fish oil.) For example, a 20 pound dog will need approximately 400 mg EPA per day.
6. Keep your pet active with horizontal play. Good muscle mass can help compensate for structural abnormalities. I do not encourage jumping activity or running great distances. Walking and swimming are great exercises for arthritic dogs. In Chicago-land area, there are a number of rehabilitation facilities that have swimming pools just for dogs. Swimming is a non-weight-bearing activity that can increase your dog's joint range of motion and muscle mass. For cats, I recommend playing with a flashlight, or putting their food in a food- dispensing ball and letting them play with it. Another inexpensive and fun toy for most cats are empty boxes . Cats love to climb in and out of cardboard boxes. Lastly, I have a few clients that put their cats on a leash and take them outside for walks. Try it! You and your cat may enjoy the walk together.
7. Physical and acupuncture therapy. Just like in human medicine, physical therapy and acupuncture can help pets recover from injuries. When choosing a therapist, make sure they are certified and licensed to work on pets. I believe a therapist should be a veterinarian or a certified veterinary technician working directly under the guidance of a veterinarian. For the greatest long-term success, I find it best if the therapist teaches the owner how to perform as many exercises as possible at home. With regards to laser therapy, I'm still unsure of its benefit. If you'd like to try it on your pet, go ahead -- in experienced hands, there are no side effects and only a potential gain.
8. Adequan -- polysulfated glycosaminoglycan (PSSG). For pets that have degenerative joint disease or have experienced a traumatic musculoskeletal event -- like a torn cruciate -- I really like this product. It helps decrease the rate of decay of cartilage, stimulates the synthesis of new collagen and hyaluronic acid (a lubricant in joints). In addition, Adequan works synergistically with Dasuquin. This is an injectable product that I teach clients to give their dog or cat underneath the skin. This product is initially given twice weekly for three to four weeks and then, once monthly. In both species, by the fifth or sixth injection, most clients usually see a more comfortable and agile pet. This product is extremely safe and well tolerated by most pets.
9. If your pet does not respond to the above recommendations, surgical intervention may be necessary. For an orthopedic evaluation, please consult a board certified veterinary surgeon.
So, it's been a few weeks since Zack's injury on the beach. He's doing much better but unfortunately we have had to make some major adjustments in our life together. We do go to the beach regularly. But now, it's only for 15-30 minutes to play in the water. I throw his ball in the water and he happily swims out to get it. We no longer walk or run along the shore. I'm sad about this, but I don't want to risk Zack re-injuring himself as he twists and turns on the sand chasing after his tennis ball. Yes, he's on a restricted caloric diet, Dasuquin, Fish Oil, Metacam (his NSAID), Adequan and occasional pain medication. And yes, I believe he is enjoying life -- which is the most important thing!
Finally, for this week's Adoptable pet; Mickey is a 10-year-old blind sweetheart of a boy who is a snuggle buddy through and through! While his favorite pastime is lying in the grass, listening to the world go by, don't let his age or impairment fool you -- Mickey also loves to explore the world, romp with other dogs and go for walks with his human companions!
In addition to his calm and docile temperament with people, Mickey lights up like it's Christmas morning every time he gets a chance to play with other laid back dogs. A home with another "vintage" canine companion could be the key to Mickey's happiness.
Though some dogs are relinquished due to lack of commitment from their owners, that is not the case with our buddy Mickey. This lovely gentleman was a beloved companion to a doting owner, but at the age of 91 she was no longer able to provide adequate care and decided Mickey would thrive most in a new home. Mickey is available for rescue through One Tail at a Time. For more information, please visit www.onetail.org.