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Hololistic veterinary medicinal options are more prevelant than ever in treating arthritis...

There are a number of choices for treating pets with arthritis, as there is truly no one best treatment for every pet. I share the holistic belief that each pet is an individual, and must be treated as such. Each owner is different and has different wants and a different budget for the pet. Some owners want to do everything possible for the pet. Cost is not a factor, and we can often experiment and try quite a number of unique treatments. Others opt for a bit less, and may not mind the pet taking medications such as corticosteroids or non-steroidal anti-inflammatory drugs for the long haul. Still others never want any medications, but will only opt for more natural therapies.

My holistic view, desired by most pet owners, involves looking at all options and choosing what works best with the fewest side effects. Drugs such as corticosteroids and non-steroidal anti-inflammatory medications (NSAIDS) are not by nature harmful when used correctly. However, when trying to do the best, most natural and holistic thing for the pet, it would be wise to consider all options before giving up and resigning ourselves to chronic steroid or NSAID therapy for the arthritic pet.

Keep in mind too, that holistic doesn't mean alternative. A truly holistic approach looks at trying to heal the entire pet, and not just cover up symptoms. A truly holistic approach chooses what's best for the pet, trying to give the pet relief while minimizing side effects. Conventional drug therapy can be a part of the holistic approach to the treatment of allergies IF the goal is to help the pet become a healthier pet and not just cover up symptoms while ignoring the pet's well being.

There are some problems with the conventional therapy of arthritis. First, many doctors fail to get a proper diagnosis, and therefore treat their patients incorrectly. While arthritis is certainly the most common diagnosis in older, lame pets, other more serious conditions can also cause lameness. These other causes include but are not limited to bone infections (bacterial or fungal), bone cysts, bone tumors, fractures, ligamentous injuries (cruciate injuries), and joint instability (hip dysplasia, shoulder dysplasia, elbow dysplasia, osteochondritis). I see so many pets that have not received a proper diagnosis, but are being treated for months or years with potentially harmful therapies. Yet often a simple radiograph (X-ray), a test that any doctor is able to perform, will reveal the true cause of the pet's lameness. There is no reason for failing to obtain a proper diagnosis prior to chronic treatment of a pet.

In the end, before we condemn a pet to chronic drug therapy, we should get a proper diagnosis and make sure that our treatment choice is correct.

What is Arthritis?
Arthritis, (also called osteoarthritis or degenerative joint disease (DJD),) is a common condition in older dogs and occasionally occurs in cats. Arthritis means inflammation of the joint. Inflammation is characterized by swelling, stiffness, and pain. When treating pets with arthritis, our therapy must seek to counteract these effects of inflammation. It is also advantageous if the therapy could slow down the progression of the arthritis or if possible, actually help the joint to heal. While many conventional therapies do a great job of treating inflammation and pain, they usually do not help the joint to heal (in some cases, these anti-inflammatory therapies actually cause more cartilage damage as time progresses.) Conversely, many of our complementary therapies relieve pain and inflammation and actually supply nutrients to help the cartilage heal and slow down the destructive forces of nature which act to destroy the injured joint.

Joints commonly affected with arthritis include the knee, shoulder, ankle, elbow, and most commonly, the hips. The joints between the vertebrae of the backbone also commonly develop arthritis, although this rarely results in clinical signs of pain and inflammation.

The joint includes the bones of the joint, ligaments from surrounding muscles which cross the joint space and attach to the bones, and the joint capsule which encloses the joint. The joint capsule contains a thick protective outer layer and a thin inner layer called the synovial membrane. The synovial membrane contains blood vessels and nerves and makes synovial fluid.

The end of each bone is covered with cartilage called articular cartilage, which acts as a shock absorber to protect the bone. The articular cartilage lacks blood vessels and nerves, and is dependent upon diffusion of nutrients from a special fluid in the joint called synovial fluid. The synovial fluid lines the joint space, nourishing the cartilage and acting as a lubricant and shock absorber.

The lack of nerves in the articular cartilage is an important factor in the progression of arthritis. A great amount of damage may occur to the cartilage before the surrounding joint tissues become inflamed and cause lameness.

The joint cartilage (articular cartilage) has a unique structure which allows it to handle the stressful loads placed on it as the animal walks and plays. The articular cartilage is made of cartilage cells (called chondrocytes in medical terminology) and the surrounding tissue called matrix. The major components of this cartilage matrix are collagen (a type of protein), water, and proteoglycans. The proteoglycan molecule is made of a central core of protein with numerous side chains of glycosaminoglycans (GAGS.) There are several different proteoglycan molecules in the joint cartilage including chondroitin sulfate (the predominant GAG in cartilage) and keratan sulfate. Glucosamine, a popular treatment for osteoarthritis, is a precursor chemical necessary for glycosaminoglycan synthesis.

With years of wear and tear on the joints, the cartilage breaks down and arthritis can develop. As wear and tear continue, the cartilage is disrupted and joint instability results. Chondrocytes, the cells that make up cartilage, are not able to synthesize enough of the proteoglycans to help the cartilage heal. As the chondrocytes become degraded, inflammatory chemicals are released causing inflammation and further damaging the cartilage. The inflammatory chemicals also disrupt the proteoglycans.

With enough degradation of the cartilage, underlying bone might become damaged, and the animal may refuse to use the affected limb. At this point, owners often seek medical care. Some pets can still be helped with nutritional therapies to heal the joint, whereas others may have arthritis that is too advanced to actually allow for healing. The earlier the pet is diagnosed, the greater the chance for healing to occur using complementary therapies.

Written by Shawn Messonnier,
DVM Holistic Veterinarian and Director of Paws & Claws Animal Hospital



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