arthritis

Osteoarthritis Rehab for Dogs

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Pain is often the main hindrance to starting a rehabilitation program. If a dog responds to pain management quickly, rehabilitation can begin as soon as possible and can continue based on the dog’s abilities. A rehabilitative medicine program can dramatically increase strength and mobility, improving the overall quality of life for dogs with osteoarthritis. In many cases, improvement can be seen within days. Regular exercise should continue long term but must be carefully controlled to prevent further injury.

What Is Rehabilitative Medicine?

Traditionally, treatment for osteoarthritis (arthritis) in dogs has focused on using medications to relieve joint pain and inflammation. Many veterinarians also incorporate joint supplements, weight control, and other management tools to give arthritic dogs more help. However, medications cannot improve a dog’s strength or fitness level, which directly affects a dog’s mobility. Rehabilitative medicine, also known by the term rehab, can help meet this therapeutic need. With proper undertaking, a rehabilitative medicine program can dramatically increase strength and mobility, improving overall quality of life for dogs with osteoarthritis. Some consider rehabilitative medicine a tool that is reserved for dogs recovering from orthopedic surgery or injury. However, because the principles of rehabilitative medicine are fairly universal, this therapy can also be very useful for managing dogs with osteoarthritis.

The overall goals of rehab are to improve a dog’s comfort, joint motion, and strength. During the early stages of osteoarthritis, pain relief is a primary goal, and rehabilitative practices can help accomplish that. As osteoarthritis progresses, the body undergoes other changes including reduced joint motion, loss of muscle mass, and decreased muscle strength. A well-structured rehab program can combat these complications as well.

What techniques and equipment used in rehab?

Pain is often the main hindrance to initiating a rehabilitation program. If a dog is in pain, even passive stretching and massage are uncomfortable. In contrast, if a dog responds to pain management quickly, rehab can begin as soon as possible and can continue based on the dog’s abilities. Pain medications, joint supplements, and other products can continue as needed to keep the dog comfortable, control inflammation, and promote a continued willingness to exercise.

The techniques and equipment needed for rehabilitative therapy vary depending on the needs of the patient but can include the following:

  • Stretching. Stretching exercises are an important part of any rehab program. Your veterinarian can show you how to do this properly. Moist heat can be used first to warm the muscles. Once the target muscles are warm, manual stretching can begin. In some cases, a hinged brace can be used to control range of motion for weak joints as they are flexed and extended to improve mobility.

  • Controlled exercise. Depending on a patient’s abilities, ramps, controlled leash walking, and agility courses can all be used as part of a rehab program. The key is to control the exercise and range of joint motion to decrease the likelihood of injury. If building ramps and purchasing agility course equipment is not convenient, pet owners can often achieve favorable results using controlled leash walks. The goal is to provide the dog with low-impact exercise (no leaping or jumping) to build muscle strength and tone without injuring the joints.

  • Underwater treadmill and swimming. Although generally only available in a clinic setting, an underwater treadmill is a very useful piece of equipment for patients undergoing rehab therapy. An underwater treadmill consists of a tank filled to a certain level with water (usually just below the dog’s hip area), with a treadmill at the bottom. Compared with walking on land, the underwater treadmill is easier on the joints and decreases the risk of injury. Compared with swimming, another popular method of rehabilitation, the motion of walking is advantageous because the action of walking is more predictable, and the patient’s speed can be easily controlled. In contrast, it is difficult to control speed for a dog that is swimming. Swimmers are also likely to flex their backs while swimming, making range of joint motion more difficult to control. Also, dogs walk with all four legs but tend to swim primarily with the front legs, so walking is a better exercise for dogs with rear limb problems.

Swimming does have benefits for dogs with osteoarthritis — it strengthens the forelimbs and develops core strength (chest and abdomen); this can be helpful for a dog that has lost overall strength because of chronic joint disease. However, the underwater treadmill is likely a better option for its ability to protect the joints, control range of joint motion, control level of exertion, and provide an overall conditioning and strengthening activity.

What are the therapeutic outcomes with rehab?

Your veterinarian may recommend and structure a rehab program for your pet or may refer you to a rehab specialist to get you started. Once a dog begins a rehabilitative medicine program, results are generally observed quickly. Pain relief can be the most rapid result. If a dog is having an arthritis flare-up, ice can be used with pain medication to provide quick relief. Improved limb use can be observed within days to weeks of initiating a program. However, progress depends on the degree of disuse that was present initially. A more chronically affected dog can be expected to take a longer time to respond. Improvements in overall strength can also be observed during the first few weeks of therapy.

Once initial improvements are made, the goal is to continue the program, modifying and increasing as necessary, to maintain the patient at a level where strength and mobility remain favorable. Ideally, regular exercise should continue long term but must be carefully controlled to prevent injury.


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What is Hip Dysplasia?

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Hip Dysplasia typically develops because of an abnormally developed hip joint. However, hip dysplasia can also be caused by cartilage damage from a traumatic fracture. With such damage or a malformed hip joint, over the time the existing cartilage will lose its thickness and elasticity. The breakdown of the cartilage will eventually result in pain with any joint movement.

No one can predict when or if a dog will start showing signs of lameness due to pain. The severity of the disease may be affected by environmental factors, such as caloric intake or level of exercise. It is not abnormal for certain dysplastic dogs with severe arthritis that run, jump, and play as though nothing is wrong. There are also some dogs with very little arthritic x-ray evidence that are severely lame.

Screenings for hip dysplasia are done by a veterinarian with x-rays that are then sent to OFA for grading and certification.


 

Hip Screening: Grade Classifications

The OFA classifies hips into seven different categories: Excellent, Good, Fair (all within Normal limits), Borderline, and then Mild, Moderate, or Severe (the last three are considered Dysplastic).

 

Excellent Classification

Superior conformation; there is a deep-seated ball (femoral head) which fits tightly into a well-formed socket (acetabulum) with minimal joint space.

Good Classification

Slightly less than superior but a well-formed congruent hip joint is visible. The ball fits well into the socket and good coverage is present.

Fair Classification

Minor irregularities; the hip joint is wider than a good hip. The ball slips slightly out of the socket. The socket may also appear to be slightly shallow.

Borderline Classification

Not clear. Usually, more incongruency then what occurs in a ‘Fair’ classification, but there are no arthritic changes present that definitively diagnose the hip joint being dysplastic.

Mild Classification

It is significant yet partial dislocation is present where the ball is partially out of the socket, causing an increased joint space. The socket is typically shallow only partially covering the ball.

Moderate Classification

The ball is barely positioned into a shallow socket. There are secondary arthritic bone changes usually along the femoral neck and head (aka remodeling), acetabular rim changes (osteophytes or bone spurs) and various degrees of trabecular bone pattern changes (sclerosis).

Severe Classification

Marked evidence of dysplasia exists. The ball is partially or completely out of the shallow socket. Significant arthritic bone changes along the femoral neck and head and acetabular rim changes.

 

Treatment Options

Once osteoarthritis is present on a radiograph, dysplastic changes are irreversible and typically continue to progress over time. If a dog with hip dysplasia has secondary arthritis and pain, most owners opt to first treat their dog with medical management. The key is weight control and exercise. Studies have shown that up to 76% of dogs with severe dysplasia and secondary arthritis are able to function and live comfortable, quality lives with conservative management. With weight control, the goal is to prevent the dog from becoming overweight to reduce stresses applied to the joints. In general terms, ribs should be easily palpated and there should be an indentation in front of the pelvic wings (waistline).

Controlled exercise is to prevent or relieve the inflammatory process that leads to the pain associated with arthritis. The amount and difficulty of the activity is determined on a trial and error basis. Exercise should begin on short-leash walks and increase level of activity over time. If clinical signs begin to reappear, scale back the level of exercise to a point where the clinical signs do not reappear. Exercise should fit to each individual dog’s maximum intensity level with the goal to maintain muscle tone and cardiovascular function without causing pain, stiffness, and inflammation to the affected joint(s). Exercise helps maintain muscle tone, strengthens & stabilizes the unstable dysplastic joint, and improves joint range of motion (which in turn keeps the dog comfortable). Another useful activity is swimming, as it is a non-weight bearing exercise.

Keep the dog in a warm environment. Warmth tends to help control the pain of arthritis. As in people, arthritis pain in dogs tends to worsen in damp and cold weather. Provide a well-padded and warm bed will help alleviate some of the pain associated with osteoarthritis. An egg-crate foam bed for dogs is commercially available. Applying superficial heat in the form of heating pads may also alleviate pain, but do heed caution as not to burn the skin with electric heating pads. Heat works best for chronically inflamed joints while cold works better to treat acute (sudden) types of joint injuries.

There are drug treatments and surgical interventions that may help, but prior to initiating any therapy, the attending veterinarian should be consulted with a complete medical history and physical examination.


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How to Spot Arthritis in Your Pet

How to Spot Arthritis in Your Pet

It is common for middle age to older pets to suffer from arthritis. However, under certain circumstances, even younger pets are prone to joint pain. Arthritis can be mild and unnoticeable to you or be debilitating to a point it severely affects your pet’s quality of life.