Arthritis & Joint Pain in Your Dog

If you are a dog lover, then you know instantly and instinctively know that arthritis and joint pain in your dog is painful to both them and you. If your dog is getting older, then you also know that lurch of the heart the first time your dog struggles to get up off her mat when you say “Walk?”.

When she doesn’t run or play like she used to.  When getting up the stairs seems more and more difficult. The love we have for our dogs is so overwhelming, it makes it so much harder to watch them age, to watch them struggle with pain and discomfort.

So what can we do?

Well, first of all, it is important to know what is causing your dogs’ pain. Is it just age? Is it arthritis? Your vet is the best person to diagnose what is going on. But as an educated dog owner, you likely have a good idea already. But once you’ve got an “official” diagnosis of arthritis, is there anything you can do to help?

You bet you can!

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Here are 7 Proven Ways to Help Relieve Arthritis and Joint Pain in Your Dog

A Comfortable Bed – A well-padded bed, away from cold or damp floors will support your dogs joints.  Choosing the right size of bed, as well as a filling that supports their weight is also important. Non-skid flooring (to prevent falls) and even carpeted steps or a ramp to help your dog get around the house are also some options to consider.

Massage – just like us, some dogs benefit from massage for aching muscles, and massage also helps to stimulate blood flow to atrophying muscles. Canine massage therapy is an emerging specialty based on the human fields of remedial massage and human movement, though many qualifications in this field are through online courses, so a recommendation is a good idea.  Treatments can cost upwards of $30 per session.
https://animalrehab.com.au/collections/courses

Heat – Warm compresses, or heat packs, can sooth sore joints, though it’s important to take care as dogs (and plenty of humans!) can be injured by burns caused by excess heat and your dog can’t tell you if the heat pack is too hot until it is too late.

Dogs that have short hair, hair loss or are very small are at a higher risk of suffering from thermal burns. Burns can range from 1st degree to the more serious 4th degree burns. It’s common for vets to see dogs being brought in from well intentioned dog owners trying to help their dogs with heat lamp or heat packs / heating pads, but you really must be very careful.

Please take care when using heat as every degree in heat provides a different result – some disastrous.

Exercise to Relieve Arthritis and Joint Pain in Dogs (But Does It Come with a Catch?) – this is no surprise to any of us with joint issues. Maintaining a healthy exercise routine is one of the best ways of maintaining mobility, even with arthritis and joint pain.

We know that exercise stimulates circulation to joints. But if it’s a weight bearing exercise like walking, there’s a risk of doing increased damaged to joints already suffering from osteoarthritis. So this is where non-weight bearing exercise comes in.

The upside for exercise is all the secondary benefits that come with it. It stimulates your dog which is good for their mental health. It can also help with weight reduction via burning calories / energy with has a flow on effect for reducing pain associated with arthritis and joint pain in dogs.

For us humans, non-weight-bearing exercise is often recommended for people with severe arthritis (think aqua-aerobics!). This can also be an option for dogs with joint pain, if there is a centre in your area ( https://www.aquapaws.com.au).

Be sure to check with your vet, as aqua therapy is not recommended for dogs with open wounds, certain spinal or skin conditions. (https://rehabvet.com/rehabilitation-physiotherapy-hydrotherapy-contraindications-cautions/).

Aqua therapy for dogs generally requires an initial consultation, with follow up sessions based on the dog’s needs and prices vary depending on the centre and services available.

Supplements and food – There is a lot of information out there about how diet and supplements can affect your dog and help with arthritis, with dozens of products that are said to promote healthy joints.

Some of these contain glucosamine, chondroitin and other substances to help improve joint health (https://www.petbarn.com.au/petspot/dog/food-and-nutrition/feeding-dog-hip-joint-health/)

Others dog food supplements aimed at helping joint pain contain Omega-3 fatty acids to help reduce inflammation. It is always important to check with your vet before making radical changes to your dog’s diet!

One really important consideration with any supplementation is a dog’s circulation. It’s a commonly accepted concept that “the better a dog’s circulation, the more they stand to benefit from joint pain supplements”.

As dogs age, circulation diminishes in a similar way as humans experience. Dog’s extremities (their legs and feet) and considerably more bony and less fleshy than humans so a focus on improving circulation can go a long way to getting more bang for your buck with the supplements and joint pain foods you invest in.

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Alternative therapies – Many dogs (and their humans) have found pain relief and increased mobility through complementary and alternative therapies such as acupuncture and homeopathy. Acupuncture in dogs is often used to treat arthritis and relieve pain, usually through needles, acupressure or heat applied at specific points, referred to as meridians. Homeopathy for dogs tends to be used to treat minor stomach upsets, scratches, insect stings and in some cases, remedies are used to treat anxiety in dogs. (https://animals.howstuffworks.com/pets/medical-treatment-for-dogs-ga5.htm)

It is important to do your research though and find someone with experience working with dogs.  As Veterinarian Dr Haussler, assistant professor at Colorado State University put it when interviewed for TheBark Magazine:

“Make sure that if the person working with your dog is not a veterinarian, he [or she] is at least a licensed professional, whether a [human] licensed massage therapist, [human] physical therapist… As long as they’re working together with a veterinarian, I think that’s great.”

https://thebark.com/content/complementary-and-alternative-medicine-right-your-dog

Medications – This is an area best discussed with your vet.  There are several options when it comes to prescription medications for dogs, ranging from regular injections, analgesics that provide pain relief, steroids to reduce inflammation, and NSAIDS (non-steroidal anti-inflammatory drugs). Very few medications are completely without side effects, so it is important to discuss all options with your vet and, if medication is recommended, your dog will need regular monitoring and tests to keep on top of any symptoms or side effects. Vets have some great advice for relieving arthritis in dogs.

https://thebark.com/content/vet-advice-relieving-your-dogs-arthritis

So all of these things can help, and to ease our dogs’ pain, we would move heaven and earth and drain our savings. But there are only so many hours in the day! How do we fit in vet appointments as well as massage, acupuncture, aqua-therapy and everything else?

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One of the (hundreds!) of interesting things about dogs and their humans, is that arthritis is a problem for both and, even more interesting, “arthritic dogs are an almost perfect model for arthritic humans, which means that while researchers are developing new treatments for arthritis in humans, dogs also benefit (and vice versa).”

https://thebark.com/content/new-pain-management-canine-arthritis

Translational Studies – What Are They? And Why Are They Relevant

Translational research is the process of applying knowledge from basic biology and clinical trials to techniques and tools that address critical medical needs. Unlike applied sciences, translational research is specifically designed to improve health outcomes. [1]

When researchers want to test a particular therapy, they may use a translational study to determine the benefit this could have on human patients. Many translational studies use animals to test new therapies, before moving on to human studies.

For arthritis, however, this has been more difficult, as animals such as mice, which are often used in animal studies due to low cost and ease of handling and care, are not a good model for human joints. “The canine model is probably the closest to a gold-standard animal model for OA currently available. The canine stifle (knee) joint is remarkably similar to the human knee” [2]

Dogs, it turns out, are a great model for human arthritis. But for lots of reasons (all of which we dog lovers would agree with!), animal studies involving dogs are far less common.  Luckily (for your dog), Translational studies also work the other way – if a study is undertaken in humans, the results can be applied to dogs, because of the similarities in joint structures.

Arthritis in humans (and how this can help your dog)

In a 2017 study, twenty (human) patients with knee osteoarthritis were treated with localised muscle vibration therapy (LMV), with some pretty amazing results. The group who had LMV could climb stairs faster and had increased “knee flexion” after the treatment. [3]

After vibration therapy to their quadricep muscle, the people in this study showed improvements in standing up from sitting, walking and climbing stairs and not just that, but also reported “a significant reduction in pain” [4].  But how did they measure this? They used the WOMAC Index.

Arthritic Joint Pain & the WOMAC Index

The Western Ontario and McMaster Universities Arthritis Index (WOMAC), was developed in 1982 at the Western Ontario and McMaster Universities, and is widely used in the evaluation of Hip and Knee Osteoarthritis. It is a self-administered questionnaire consisting of 24 items divided into 3 subscales: pain, stiffness and physical function.

Pain is assessed in 5 ways: during walking, going up or down stairs, sitting or lying, and standing upright.

Stiffness asks patients to rate stiffness after first waking, and also later in the day.

Physical function rates 17 different items: using stairs, rising from sitting, standing, bending, walking, getting in/out of a car, shopping, putting on/taking off socks, rising from bed, lying in bed, getting in/out of bath, sitting, getting on/off toilet, heavy domestic duties, light domestic duties.

Patients are asked to rate their pain, stiffness and physical function on a scale of 0 to 4 and the results are tallied to give a total WOMAC score.

WOMAC is available in over 65 languages and has been linguistically validated. [5]

The researchers used the WOMAC index to measure the difference people felt before and after the vibration therapy. You can see the difference in the results from the patients who received vibration therapy  (LMV) in figure 3. The group who received vibration therapy are shown with a white dot.

The 2017 study of patients with arthritis treated with vibration therapy showed an improvement in WOMAC index in the treated group. Standing up from a sitting position and walking (called a timed up and go, or TUG), and climbing stairs are two of the most used bed-side functional tests to assess participants with pain due to osteoarthritis of the lower limbs, and improvements were observed in both these measures. [6]

In fact, vibration therapy was considered to be effective for pain control because it had a much more specific mechanism of activation of the gate control compared with TENS because of its specificity in activating highly myelinated fibers [7], and therefore with a strong homotopic gating effect [8].

The study also showed that these effects were long-lasting, with patients’ improvements “statistically observable 2 days after the end of the vibration sessions” [9].

So what does all this mean for your dog?

Well, for dogs with arthritis, who have trouble exercising, vibration therapy could increase their joint mobility, make it easier for them to climb stairs, and reduce the pain they feel.

This study was important because it showed that pain from arthritis can limit active exercise, and muscle weakness can make arthritis even worse! Vibration therapy was introduced “as an alternative with the aim of providing muscle strengthening” [10].

Decades of Research, but in Humans!

It turns out, vibration therapy has been studied (in humans) for decades.

For several years, researchers in the fields of physical therapy and allied health have been researching “Whole Body Vibration” therapy, examining the impacts this has on muscles, strength and power, and the potential for whole body vibration therapy to be used “as an alternative to traditional exercise programs.” [11]

A study (on humans!) from 2008 looked at skin blood flow improvements from whole body vibration and found that just 5 minutes of vibration therapy led to a “significant increase” in skin blood flow in humans. [12]

Why is this important?

Well, increased blood flow, or just plain old improved circulation, plays an important role in tissue healing, increased muscle flexibility and strength [13] and can even prevent bone loss due to osteoporosis [14].

The 2008 study concluded that vibration therapy was a good method to increase circulation, especially when compared with some of the alternatives: heat packs, which can cause burns when used incorrectly, and medications, which can have side effects [15].

Of course, exercise also increases circulation, but as the study pointed out, that can be difficult for older people (and dogs!), so vibration therapy offers a safe and effective alternative.

Another study in 2007 looked at whole body vibration therapy and the impact on blood flow to the lower extremities.  This study was comparing skin blood flow (in humans) after exercise alone, after vibration therapy alone, or a combination of the two. Now, you would think that the combination of the two would show the greatest increase, right? Well guess what? The group receiving only vibration therapy showed the greatest increase in blood flow. [16]

One of the reasons for this was that during high intensity exercise, “blood flow is directed away from areas where it is not immediately needed” [17] (p.75).  So, in other words, blood flows to organs and large muscles during exercise, rather than to the hands and feet.

The authors of the study concluded that vibration therapy could significantly increase skin blood flow and that this would be effective “in populations where aerobic exercise…is not feasible.” [18]

An area of medical research where vibration therapy has been studied in some depth is wound healing.  Circulation plays a vital role in wound healing and a study of people with leg ulcers from 2002 showed that vibration therapy three times a day for 30 minutes resulted in 62% of leg ulcers healed in 12 weeks, compared to only 40% healing rate for compression bandages alone. [19]

Even more interesting was that 81% of the participants in the study reported either a complete absence or a reduction in pain. So just having vibration therapy three times a day reduced the pain from a nasty wound like a leg ulcer.

Increased mobility, pain relief, improved circulation, wound healing, muscle strengthening and maintenance… these are all areas where vibration therapy has been shown to work in humans.

So, what about dogs?

30,000 Years of Animal Instinct in Our Domestic Dogs

Dogs descend from pack animals. 30,000 years ago, the only dog on planet earth was the wolf. All dogs are descendants of the wolf and over time these breeds have grown to approximately 440+ different breeds today.

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But here’s what most people don’t know about this 30,000 year old animal instinct…

Dogs go to great lengths to hide their pain. Signs of weakness made a dog the weak link of the pack. Not only did it become vulnerable to predators, but even to its own pack that had to remain strong in order to survive.

So what does this mean to our domestic friends?

It means if your dog is limping, it has already been hurting for some time. And if you’re like me, the thought of them suffering in silence for some time sits a little uneasy – almost like we’ve neglected to notice but it’s not your fault. Dogs are good at hiding their pain because of this 30,000 year old animal instinct.

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Well, asking an old lady to exercise on her arthritic joints is the equivalent of cruelty in dogs. There are other ways to get the same benefits of exercise without the pain infliction. It’s the essence of what we’re doing here at Dog Cloud to help educate Dog Lovers globally to better care for their best friends.

Sources:

1. https://health.ucdavis.edu/ctsc/area/education/DETR/index.html 
2. https://www.hindawi.com/journals/arthritis/2012/764621/
3. Benedetti, M. G. et al. Localized muscle vibration reverses quadriceps muscle hypotrophy and improves physical function: a clinical and electrophysiological study. International Journal of Rehabilitation Research 40, 339-346 (2017) – https://pubmed.ncbi.nlm.nih.gov/28723717/
4. Benedetti et al, p.7
5. (https://www.physio-pedia.com/WOMAC_Osteoarthritis_Index)
6. Benedetti
7. Lundeberg et al., 1984;Salter and Henry, 1990a, 1990b)
8. (Staud et al., 2011)
9.  Benedetti, M. G. et al. Localized muscle vibration reverses quadriceps muscle hypotrophy and improves physical function: a clinical and electrophysiological study. International Journal of Rehabilitation Research 40, 339-346 (2017) – https://pubmed.ncbi.nlm.nih.gov/28723717/
10.  Maloney-Hinds, C., Petrofsky, J. S. & Zimmerman, G. The effect of 30 Hz vs. 50 Hz passive vibration and duration of vibration on skin blood flow in the arm. Medical Science Monitor 14, CR112-CR116 (2008) https://pubmed.ncbi.nlm.nih.gov/18301353/
11. Maloney-Hinds, p.113
12. Maloney-Hinds, p.113
13. Maloney-Hinds, p.113
14. Lohman III, E. B., Petrofsky, J. S., Maloney-Hinds, C., Betts-Schwab, H. & Thorpe, D. The effect of whole body vibration on lower extremity skin blood flow in normal subjects. Medical Science Monitor 13, CR71-CR76 (2007) https://pubmed.ncbi.nlm.nih.gov/17261985/
15. Stewart, J. M., Karman, C., Montgomery, L. D. & McLeod, K.J. Plantar vibration improves leg fluid flow in perimenopausal women American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 288, R623-R629 (2005) https://pubmed.ncbi.nlm.nih.gov/15472009/
16. Lohman III, E. B., Petrofsky, J. S., Maloney-Hinds, C., Betts-Schwab, H. & Thorpe, D. The effect of whole body vibration on lower extremity skin blood flow in normal subjects. Medical Science Monitor 13, CR71-CR76 (2007) https://pubmed.ncbi.nlm.nih.gov/17261985/
17. Lohmann et al, p.75
18. Lohmann et al, p.75
19. Wilson, J., Arseculeratne, Y., Yang, Y. & Cherry, G. Healing venous ulcers with cycloidal multidirectional vibration therapy. Journal of wound care 11, 395-398 (2002) https://pubmed.ncbi.nlm.nih.gov/12494831/)