I thought I would start a thread on OA as it is something that affects a lot of older dogs; it's certainly one that I've had a lot of experience of dealing with over the last few years with Tilly, so it might be interesting to share stories and maybe pick up some new or different treatment and management ideas.
Osteoarthritis:
also known as degenerative joint disease (DJD), is defined as the progressive and permanent long-term deterioration of the cartilage surrounding the joints. Arthritis is the medical term for inflammation of the joints, while osteoarthritis is the term referring to a form of chronic joint inflammation caused by deterioration of joint cartilage. Older dogs are at the highest risk.Tills is now 10 (
) and was diagnosed with severe OA about 3 years ago, with noticeable deterioration in the joints showing on the x-rays at that time. She has it particularly badly in her hips and shoulders, but also in her elbows, spine, knees, neck, hocks, wrists and toes, and she has spondylosis in her lumbar spine. She also has a condition called IOHC (incomplete ossification of the humeral condyle) which has been evident from a very young age (diagnosed via CT scan at around 2 years old) which causes elbow lameness, although luckily she never fractured it which is extremely common. She has a very limited range of movement in her hips and especially her shoulders, which are the worst-affected joints. I initially took her for the x-rays as she was suffering from chronic lameness on her front legs, especially after playing with a tennis ball, and seemed generally stiffer and slower than usual. Her ball obsession was undoubtedly a factor in worsening her underlying condition and unfortunately for her had to stop immediately, the sudden sharp movements and heavy impacts involved in chasing and catching tennis balls is very bad for the joints.
She also has eosinophilic inflammatory bowel disease, having been diagnosed with this when she was 5. The vet believes that the two are linked, both being immune-mediated conditions. Her IBD is well under control though and the OA causes us far more problems on a day to day basis. It's interesting to me though that the two are linked, under vet advice Tills hasn't had any vaccinations since she was 6 as he believes that it would be very detrimental to her health. She has also always suffered from chronic ear problems (malassezia), and again, this is probably linked to immune issues.
Tilly's OA is quite severe, it affects most of her joints and she is probably in a degree of pain most of the time. This obviously causes me huge concern, but it is currently still manageable and so she is still happy, waggy tailed, stubborn and playful, and still eats like a horse, rolls in poo and goes mad to go out for walks (even if they are more gentle trots than runs now) and is as tennis-ball obsessed as she ever was (I don't ever throw them for her any more though, her shoulders give way and she chins the ground if she tries to turn suddenly to fetch a ball
). She isn't chronically lame but she walks with a rolling gait - a bit like a bear - and she sits and stands with her front legs bowed to take the weight off her shoulders.
There is no cure for OA, and it is progressive, so she is gradually deteriorating, and barring her developing cancer etc. it will be a life-limiting condition in her case. However we have found an effective management system for her symptoms that has so far let her maintain a good quality of life. She is currently on daily Tramadol (3x50mg), Pardale-V (paracetamol and codeine) as Tramadol works more effectively when given alongside a NSAID drug, plus the steroid/painkiller combination drug Prednoleucotropin (PLT, or 'poorly leg tablets' as the vet calls them
). This is an extremely hefty dose of painkillers; it's basically a post-operative management system which she has on a daily basis, but she tolerates it extremely well, has very few side effects (the Tramadol makes her a bit sleepy so I the highest dose in the evening), and it gives her a good quality of life in terms of managing her pain.
She still manages at least 2 daily walks, although I don't bring her on long hikes and she can't remotely keep up with Rodaidh and Caoimhe any more, but she pooters along quite happily on shorter walks. In terms of additional treatment, she goes to hydrotherapy once a month, she's always enjoyed swimming, and I think it does help her. She has had acupuncture and massage but she didn't particularly like either of them, and I was doubtful as to their efficacy in her case, so stopped taking her. In terms of supplements she has daily Yumove and fish oil along with Ro and Caoimhe - her condition is so advanced they are unlikely to make any real difference to her now but they can't do any harm so I give them anyway. I started giving all of them coconut oil and turmeric ("golden paste") every day last year as well, again my rationale with Tilly being that it can't do any harm. I monitor her weight carefully, I have always kept my dogs on the lean side of average and this helps, the less weight she has to bear on her joints the better.
Practically speaking, keeping her warm helps, she definitely suffers more in the winter and slows down considerably when it's really cold. I got her a new Equafleece with a zip up the back as it was impossible for her to get her front legs into the normal one. She doesn't wear the Equafleece on walks as she doesn't like it when she's moving around, but I make sure she gets dried off immediately on return from a wet walk and put it on to warm her up and she'll happily go to sleep in it. She finds lifting her back legs up difficult so I stand her on a towel and just dry the tops of her paws with another one. I lift her in and out of the car - she hates this but she's no longer capable of jumping in and out safely. I have considered getting a ramp for her, and as she doesn't really like being picked up I may actually do this fairly soon.
OA is a difficult condition, it causes pain and undoubtedly affects quality of life unless carefully managed, but it's not something acute that's going to actually kill them, so you have to constantly monitor and weigh up said quality of life. It's a very individual thing, but with Tilly I have always taken the view that while she still wants to go for walks and can still manage to pooter along and she's not chronically lame, falling over or in severe pain, then I will manage her symptoms like this for as long as possible. As soon as she no longer wants to or is capable of coming on walks, loses her playfulness and appetite and/or she has a level of pain that cannot be managed with the medication she is on - I will not up her current dosages any further, put her through surgery or consider putting her on morphine etc. - then I will make a decision for her, because I know her and what reasonable quality of life is for her.
I've gone on a bit here, but any other thoughts or experiences of dealing with OA or other chronic joint/mobility conditions would be welcome!
