My dog has arthritis, Is there any point exercising them now?
Exercising our arthritic dogs can be daunting and a bit of a balancing act initially as if we over exercise them we cause pain and discomfort, but if we just leave them and don’t exercise them we can make the joints more uncomfortable and degenerate quicker. Exercise is important for our arthritic pets, not just for mental stimulation but by staying fit and active you will keep your dogs muscles strong and conditioned as well as ensuring that their circulation to those sore joints is at it optimum capacity. If we reduce or cut out the exercise we will make those joints worse, causing the condition to deteriorate and the joints to quite quickly become more stuff and uncomfortable. When it comes to setting up exercises and appropriate plans we would always advise consulting your vet and a veterinary physiotherapist who will implement and over see these plans. This is to ensure that those exercises used are appropriate to the patient and that plans are altered when necessary.
I'm interested in trying out physiotherapy for my dog but I feel that maybe I should just accept these changes are part of old age...
Absolutely not! A multimodal approach which includes physiotherapy as well as sensible husbandry management, weight control and the implementation of a suitable controlled exercise program can not only stop the progression but in some cases can actually reverse the symptoms that we see in our arthritic pets. A veterinary physiotherapist will work with your vet to establish the best plan to help you improve your pets quality of life.
I want to try physiotherapy for my dog but I don't think my vet will agree, can I just arrange an appointment without my vet?
Physiotherapy can be useful in most animals to help maintain fitness and muscle mass and also for the management of chronic conditions such as arthritis. The use of therapies must be discussed carefully with your vet before commencing. This is not only a legal requirement but it is also to avoid making painful joints worse. We always advise that you discuss complementary therapies with your vet prior to arranging appointments.
What do veterinary surgeons think of physiotherapy?
The majority of vets are generally extremely positive about physiotherapy. This is because they have seen the success which can be achieved when an animal receives this form of treatment. When a vet considers that an animal could benefit from physiotherapy, they will be more than happy to refer the case to a physiotherapist. One common reason I find for vets not referring is that they do not know of any specific veterinary physiotherapists in their area so can be reluctant to offer suggestions. The key is to source one yourself and discuss with your vet as they will need to refer the patient for treatment – this is a legal requirement for all therapists that treat your pets.
My dog has recently been diagnosed with arthritis in multiple joints. I am keen to find a safe and “natural” way to manage this and not become reliant on anti inflammatories. A friend says I should use homeopathic treatments but I am finding mixed opinions regarding this approach. Please help.
It is understandable to want to minimise use of anti-inflammatories as they can have side effects. A review into the type and frequency of side effects in dogs did highlight that considering the wide spread use of non-steroidal anti-inflammatory drugs, the actual incidence of side effects is low. (Monteiro-Steagall BP) The side effects seen often relate to inappropriate use such as a higher dose than prescribed, or inappropriately combined with another medication such as a steroid, or may be linked to comorbidity such as concurrent gastric, liver or kidney disorders. To reduce the chances of seeing adverse effects the US Food and Drug Administration have created owner and vet guidelines which can be found via this link. https://www.fda.gov/AnimalVeterinary/SafetyHealth/ProductSafetyInformation/ucm055434.htm
CAMs believes employing multiple approaches to minimise pain and progression of the disease, is essential and imperative to reduce NSAID reliance, which will ultimately reduce the chances of potential side effects. However, we feel that NSAIDs have shown themselves to be foundational in reducing the inflammation of arthritis, and very effective at controlling pain quickly, as well as being effective in managing chronic pain which is commonly seen with arthritis. https://www.caninearthritis.co.uk/what-is-arthritis/identifying-signs/chronic-pain/
Veterinary homeopathy has many supporters, as well as many sceptics. It is a highly emotive topic, and it has been in the limelight recently with the Royal veterinary College releasing a statement that can be found here https://www.rcvs.org.uk/news-and-views/news/college-publishes-complementary-medicines-statement/.
In summary the RCVS have decided that homeopathy is classified as a complementary therapy and not an alternative therapy. This means that it should be used alongside therapeutic interventions that have strong scientific evidence, and not used instead of. Their reason for their decision being, the promotion of using therapeutics with sound scientific principles and more reliable outcomes. As well as ensuring animal welfare is the first consideration when designing a treatment strategy for any disease, which requires rapid and reliable effect.
So what is homeopathy and why the controversy?
Homeopathy bases its therapeutic approach on a system of “treating like with like”. This means that certain medicines/remedies, derived from animal, vegetable, mineral and man-made sources, that are known to provoke a certain effect are matched as closely as possible to the clinical signs the animal is already exhibiting. The intent is to stimulate the body’s inherent healing potential to combat the underlying cause of those original clinical signs. The medicines/ remedies created to stimulate the body’s active response are highly diluted, having been prepared through creating a solution of the remedies component parts, then performing serial dilutions combined with succussion (a forceful striking) which is believed to increase its effectiveness through potentization. This diluted state is also believed to be in its favour resulting in no induced side effects.
Homeopathy is considered a holistic therapy, meaning the whole animal is considered when formulating a treatment strategy, rather than just the symptoms of a disease, and thus pays close attention to removing or minimising any factors and influences that could obstruct or impede the healing process, with attention being paid to the patient’s diet.
It is through this holistic approach, involving long in-depth consultations, which can result in other suggested changes to the dog’s lifestyle etc; as well as the supportive/ counselling nature of the discussion, that sceptics feel influences owners perception of the efficacy of the treatment.
As you can see homeopathy is polar opposite to conventional medicine, which aims to target the source or the pathway that causes the clinical signs and affect it. As well as gain strong evidence of the effectiveness and reliability of that intervention alone, through rigorous placebo controlled, blinded and randomised clinical trials, and reviews.
CAM prides itself on being open minded and respectful with regards to owners chosen treatment strategies. The whole team all can recount cases where homeopathy has been employed with some good and some bad results. We certainly would not discourage an owner from exploring homeopathy if that is what they wish to do, but we do advise that rapid onset and effective pain control is imperative, and treatment strategies that have proven effect must be employed for obvious reasons. With this in mind, we suggest utilising conventional veterinary medicine initially and complementing it with homeopathy, if chosen. When the dog is considered stable, the treatment plan can be reappraised.
We advise, as we do with all treatment strategies initiated, that close attention is paid to clinical efficacy. This can be achieved through using objective measures, such as validated scales such as the Canine Brief Pain Inventory http://www.vet.upenn.edu/research/clinical-trials/vcic/pennchart/cbpi-tool , the LOAD questionnaire courtesy of Elanco, Vetmetrica https://www.vetmetrica.com/Auth/Login or using our non-validated chronic pain indicator chart downloadable from https://www.caninearthritis.co.uk/wp-content/uploads/2017/03/Chronic-Pain-Indicator-Chart-V1.pdf.
Through discussion with owners that use homeopathy within their management plan, it is evident that the holistic approach employed by veterinary homeopaths, such as extended consultation and clinical assessment, and multimodal treatment plan provision is appreciated by the public, and is a model we should review.
Please refer to http://www.bahvs.com/ for more information
My dog has been on the same NSAID for a long time and recently we went to the vet because he was not doing so well. They took a blood sample and found his kidney values were higher than they should be so have advised us to taken him off his pain relief. But I know he is in pain. What can I do?
We have no real evidence to suggest the NSAIDs damage the kidneys when used at the correct dose, however, it is possible they may do harm if the kidneys have become less effective through other diseases or causes. This is why vets are cautious about using NSAIDs if blood tests reveal a sub-optimal kidney function. There is a veterinary version of paracetamol available and this can be surprisingly effective (paracetamol must never be given to cats). Your vet is also allowed to prescribe medications licenced for use in people if the veterinary medication is unsuitable. Depending on their experience some vets may want to consult the knowledge of a specialist for advise on the best medication option. It is very dangerous to give your pet your own pain killers as they may respond differently and require a different dose. Pain relief is about more than just pills. There are lots of other ways to relieve pain. These may include: making household adaptations (putting non-slip rugs on slippery floors, removing trip hazards, providing steps onto high surfaces such as the sofa or back of the car, raising food bowls) or adjusting exercise regimes to avoid excessive strain whilst maintaining mobility. It is very important to maintain a lean body condition, avoiding excess weight. This has been shown to delay the onset of signs of arthritis. Not only does carrying excess weight represent physical strain on the joints, fat tissue is actually driving an inflammatory process in the body and may speed up the process of arthritis. You may consult a veterinary physiotherapist for a course of treatment where you will also learn a lot about how to help your pet. Other therapies include acupuncture, massage, hydrotherapy (with a trained therapist), laser and ultrasound therapy, heat therapy. This list is not exhaustive. We have some evidence that certain supplements, such as omega-3 fish oils, may reduce pain and inflammation. Finally, there may be surgical options to resolve or reduce pain. Speak to your vet about the options available to you.
My vet has diagnosed significant arthritic changes in many my dog’s joints. Due to the multiple locations of arthritis, he has prescribed long term use of NSAIDs, but are they safe?
Each drug is rigorously tested for toxicity and adverse reactions before being given a ‘licence’ for market by the Veterinary Medicines Directorate. Furthermore, we have a lot of experience of using these drugs and the benefits and risks involved. The nature of the way NSAIDs work involves interrupting the body’s metabolic pathways which cause inflammation and pain. Unfortunately, these same physiological processes are needed by the body to perform other tasks such as renewing cells in organs such as the stomach, intestines and kidneys. Much research has been done to develop the safer NSAIDs which we now have available but all have potential to cause side effects, though they are thankfully rare. It is impossible to predict if your dog may be the one to have a problem such as a gastric ulcer. However, it is important to carefully follow the dosing advice given on the label and the medication should come with an information leaflet. This gives specific instructions, for example – to give with food (this is not the case for every NSAID) and warning you of what signs to look out for, such as vomiting or diarrhoea, and to stop the medication and seek the advice of your vet if this occurs. We have no real evidence to suggest the NSAIDs damage the kidneys when used at the correct dose, however, it is possible they may do harm if the kidneys have become less effective through other diseases or causes. This is why vets are cautious about using NSAIDs if blood tests reveal a sub-optimal kidney function. One of the other things your vet will discuss with you is finding a balance between a good quality of life for your pet and avoiding what seems to be a small risk. It is right that we should avoid unnecessary medication and this may include making changes to the way you exercise your dog, avoiding household hazards which cause repetitive injury such as slippery floors, jumping and tripping, or using supplements and complementary therapies in a treatment regime. However, if your dog is in pain his quality of life may be compromised and we need to be careful not to be so concerned about safety that we insist on our pets living out a life of pain.
My dog has painful arthritis in both his knees, and he is only 8 years old and I have been advised that I need x-rays? Is this necessary?
Whilst it is possible to start treatment without x-rays there are several reasons why your vet may want to obtain this imaging of the joints to confirm a diagnosis and stage the disease. Your vet will want to rule out other causes of pain including abnormalities such as cranial cruciate ligament rupture for which surgery may be an important choice. Whilst your dog is under sedation or anaesthetic for x-rays, your vet can carry out some diagnostic examinations which are difficult or impossible to do in an awake dog. There are a few options for treatment other than simply using medication and some of these require a deeper understanding of how the joints are effected. For example, with physiotherapy some exercises may be especially useful or conversely, important to avoid depending on the condition. It may be possible to directly medicate the joint by injecting with regenerative therapies such as platelet-rich-plasma or stem cells. This requires knowledge about the condition of the joint.
I’m scared to take my dog to the vet as they are old and I don’t know what the vet will say to me, what if they want to put him to sleep?
There are very few instances where euthanasia is the only option and even fewer where it would need to be done there and then, without any time for you to say goodbye. We know that speaking with your vet can be nerve racking but we promise we are here to help and work with you to get the best treatment plan for you and your dog. If you’re worried about forgetting what you wanted to say then why not write it down or take a friend or relative along with you. You can even take a note pad and jot down what the vet tells you as you go along. Trust me, we’ve seen it all before and honestly don’t mind. You could always ask to speak with a veterinary nurse if your not sure that your dog needs to be seen by a vet and they can advise you as to what to do as the next steps
Will my pet insurance help cover the cost of my dogs arthritis treatment?
Probably yes, but it will depend on your insurance company and the type of policy you have with them. Where possible we would advise taking out a lifetime policy as any condition your pet develops, including arthritis will be cover for their whole life. Some companies will even pay out complimentary therapies such as hydrotherapy or acupuncture. The best thing to do is call your insurance company and ask them if they will help cover costs and how to make a claim. Most vets, nurses and receptionists deal with insurance companies every week so ask at your practice as they may be able to guide you too.
My dog is slowing down. He's just getting old isn't he?
Slowing down and getting old should not be just accepted as simply that. It is also not just arthritis that causes your dog to slow as he ages. Slowing down could be related to: Pain elsewhere such as spinal, or spinal nerves. Lethargy due heart or lung disease. Poor coordination and weakness from a neurological disease. Lack of energy due to hormonal disease or cancer.
It is essential to get a diagnosis from your vet, which minimally requires a clinical examination, a neurological and orthopaedic exam, and ideally imaging plus urine and blood testing.
If your dog is slowing down, do not just presume he has arthritis, and seek veterinary attention.
What is the best harness for my arthritic dog?
We don’t have a number one harness that we recommend at the moment, but here are a few things that we suggest you look for when purchasing one for your dog.
Ensure a good fit – many harnesses are ill fitting and actually impede your dog’s mobility. The harness should allow free movement but fit snugly without rubbing. Fleece lined harnesses help to avoid this.
Consider your dog’s arthritic joints. For example a dog with elbow arthritis will find it painful to have their forelimbs lifted up and through a harness when it is put on. Think about one that secures without having to bend the legs.
Consider a handle. There are a few harnesses on the market that have a handle on the back. This allows you to support your dog over rough terrain, or take some of their weight as they climb hills or steps for example. Handles get more useful as the disease progresses.
We have previously tried and tested some harnesses. See our product blogs for more info.
My dog is young but is less inclined to walk, and limps occasionally. Could this be arthritis?
Yes sadly it could be arthritis, however there are many other conditions it could also be, so it is important that you consult your vet, have a thorough examination and take their advice if they feel further investigation is needed such as x-rays. If it was early onset arthritis it is likely secondary, which means it is developing due to another reason rather than simple wear and tear seen with ageing. This may be a developmental issue where your dog’s joints has not grown to perfectly fit and are unstable. Or due to trauma to the joint structure. Other causes may be your dogs own immune system attacking its joint, or it may be due to an infection within the joint. As you can see there are many possible causes that lead to the osteoarthritis. Thus, it is important to identify the joint/ joints affected, the underlying cause and treat appropriately. This may involve simple lifestyle changes, supplements and regular further check- ups. Or it may lead to the identification of an underlying cause that requires more complex investigation and potentially surgery. Whatever the cause, ignoring the condition could end to an early onset painful poor functioning joint and a significantly less optimal long-term outcome.
Firstly there is no overall superior anti inflammatory. There are many available in the non steroidal anti inflammatory drug family, but none can be classified as superior, at this stage we can only suggest they all work slightly differently. Secondly, when choosing an anti inflammatory it is imperative that you work with your vet to minimise the risks of potential side effects. Studies have shown that common causes of the side effects are not related to the drug itself but the frequency of administration, the amount administered, co-morbidities that affect the action and disposal of the drug, as well as co-administering contraindicated medications. CAM strongly recommends you discuss with your vet what anti inflammatories are available to you. How to use them safely and effectively, and how to monitor for effect and the early signs of potential side effects.
I have been advised by my vet to start a supplement for suspected early stage arthritis. Is this normal? Is it effective?
Canine joint supplements are a multi-million pound business and there are thousands of dogs in the UK taking supplements, with or without veterinary supervision, to try and prevent or treat arthritis. It is fairly commonplace now for vets to recommend a supplement along with medication and other advice as part of an arthritis management plan. The exact supplement recommended by vets will often depend on personal preference and experience.
The question is do they work? The simple answer is we don’t know.
There have been numerous studies carried out looking into the subject and unfortunately the evidence for use of supplements is weak at best. A lot of effort has gone into researching and developing nutritional means of managing arthritis in recent years and there is an ever expanding market of options available. Add to this that regulation of the nutraceutical market is managed by the food standards agency who are mostly concerned with food safety, composition and labelling rather than proven efficacy of a product (ie. supplement manufacturers don’t have to prove they work), and choosing a supplement for you dog can become a real mine field!
One of the big problems we have is that the studies that have been carried out are not always of great quality- most don’t involve a huge number of dogs and are not carried out over a long period of time.
The results of the various studies give us quite contradictory findings too- one study of 35 dogs showed that the gait (the way the dogs move) improved on glucosamine supplementation but another involving 71 dogs showed there was no change in dogs taking a supplement whereas dogs taking a pharmaceutical pain relieving product did improve.
In saying this, there is a huge amount of anecdotal evidence to support their use and vets, nurses and those with a more natural approach to arthritis care are all likely to say that giving these supplements is worth a try.
So why do we bother to use supplements at all?
It is understandable for owners, and vets, to wish to be able to give something adjunctive that will alleviate the inflammation and pain of arthritis and/or prevent or slow the development of this debilitating disease. This is even more true in cases where dogs cannot tolerate certain drugs well, or show an incomplete response to certain drugs. While there is no scientific evidence that supplements have clinically meaningful effects in dogs, the individual components of the supplements have quite good evidence behind them when tested experimentally, or in a lab.
Glucosamine is found in almost all joint supplements and has been shown to positively affect the way chondrocytes (the cells lining the end of bones that produce cartilage) work. Similar findings have been seen with chondroitin. There is also evidence in lab testing that glucosamine can reduce inflammation, which would be great news in an arthritic joint. The concern is that in our patients, we don’t know if these products actually reach the joints in a usable form and in high enough levels to have an effect. As far as using these products in a “normal” joint to prevent arthritis, we think that even less of the product probably reaches the joint than when it is inflamed, so its use in this circumstance is questionable. Essential fatty acids, in particular omega 3, are another common component of joint supplements. This component has perhaps more evidence of being beneficial than do other components, with a study showing 82% of dogs had improved gait and could apply more force on their leg following cruciate surgery compared to dogs without omega 3 in their food. They act by affecting the joint fluid, helping to lubricate the joint. The main positive research indicating the anti-inflammatory and chondroprotective (cartilage protecting) effects of omega 3 fatty acids was conducted through investigating the response in guinea pigs with naturally occurring osteoarthritis (Knott, et al., 2011).
Undenatured type II collagen shows some promise and is thought to work by dampening the body’s auto-immune attack on collagen in the joint. However, available supplements do not necessarily contain the same ingredient as has been tested in clinical trials (Gupta, et al., 2011). What about using other at home remedies? Even less is known about the benefits of using products such as cod liver oil and coconut oil for arthritis. Coconut oil is currently extremely popular and has claims of antiviral, antibacterial and antifungal properties as well as benefits on joints, skin, digestion and metabolism. It contains lots of medium chain fatty acids which are highly digestible. It doesn’t however contain any omega 3, the fatty acid with the most evidence for use in arthritis and even its advocates say you will likely need massive doses to get any clinical effect.
Omega 3 is however found in high levels in cod liver oil. You should bear in mind though that it also contains high levels of vitamin A which can be toxic if given in too high of a dose. Green lipped mussel is another fished based product containing omega 3 and there is some evidence that it helps in reducing arthritis pain in humans.
Omega 3 is also found in many plant products such as flax seed, a common component of many dog foods. However, dogs may be less able to convert vegetable sources of omega 3 into the useful anti-inflammatory substances compared to fish oil sources (Bauer, 2007).
So which supplement should I choose?
There are a host of options available to choose from. Each company gives its own claims. Beware of any claims to cure or totally prevent arthritis. In the book Multimodal Management of Canine Arthritis (Fox, 2016) the author outlines the ACCLAIM criteria for choosing a nutraceutical as follows:
A – a company name that you recognise, an established firm that provides veterinary educational materials.
C – clinical experience, i.e. companies that invest in clinical trials, and who publish data for respected journals.
C – content, all ingredients should be clearly indicated on the label
L – label claims, i.e. if they sound too good to be true, they probably are. Reference to clinical trials is better than simple testimonials. Any label suggesting they treat arthritis, cure arthritis or prevent arthritis are likely to be suspect.
A – administration, the dose recommendation should be accurate and easy to calculate
I – a lot identification number to indicate some form of surveillance is possible to test product quality
M – manufacturer information and ideally a link to website.
Some food companies also offer prescription diets containing ingredients claiming to support the joints. These foods are often also aimed to help with weight control, something that is very important for the management of arthritis.
What’s our conclusion?
There isn’t, unfortunately, much evidence to support the use of supplements in our patients but that’s not to say these products definitely don’t work and certainly there are thousands of dogs, cats and people out there who seem to benefit from their use. If given in safe doses, there is no reason these products should cause harm to our pets. Veterinary supervision whilst using supplements is important as some supplements can interact with certain medications. Furthermore, supplements should not be used instead of getting the basics of arthritis management in place first. These basics include weight management, exercise modification, home and lifestyle adaptations, appropriate therapies, appropriate medication and effective monitoring.
If it is financially viable to use one of these products without compromising other aspects of your pet’s care then we would fully support this. It’s important to remember though that they are just one piece of the puzzle and that alone, they are unlikely to be enough to control the pain associated with moderate to severe cases of arthritis. Monitoring of your dog while they are on these products is essential. Try to use an objective measure, write things down, ask people who don’t see your dog as often how they think they are improving and importantly, speak with your vet and vet nurse to get advice.
Bauer, J.E., 2007. Responses of dogs to dietary omega-3 fatty acids. JAVMA, 231(11), pp.1657-1661.
Gupta, R.C., Canerdy, T.D., Lindley, J., Konnemann, M., Minniear, J., Carroll, B.A., Hendrick, C., Goad, J.T., Rohde, T., Doss, R., Bagchi, M. and Bagchi, D., 2011. Comparative therapeutic efficacy and safety of type-II collagen (uc-II), glucosamine and chondroitin in arthritic dogs: pain evaluation by ground force plate. Journal of Animal Physiology and Animal Nutrition 96(2012), pp.770–77.
Fox, S.M., 2006. Multimodal Management for Canine Osteoarthritis In: Multimodal Management of Canine Osteoarthritis. 2nd Ed. New York: CRC Press.
Knott, l., Avery, N.C., Hollander, A.P. and Tarlton, J.F., 2011. Regulation of osteoarthritis by omega-3 (n-3) polyunsaturated fatty acids in a naturally occurring model of disease. Osteoarthritis Research Society International 19(2011), pp.1150-57.
My dog was diagnosed with arthritis last year and since finding this site I would like to take her to a physiotherapist or for hydrotherapy but my vet won't refer us as he doesn't believe it works. What can I do as nowhere will see her without a vet referral?
There are a couple of options here, some easier than others! Firstly, and ideally, you could talk to your vet about complementary therapies, why you think physiotherapy and hydrotherapy would benefit your dog and that you would only go to a registered therapist. Another route is to try another vet within the practice as not all vets in the same practice share the same opinion but equally some vets won’t see a colleagues patient. As a last resort you could look to change vets, look for one that maybe offers alternative treatments like acupuncture or that a friend has recommended. You can always ring and ask the receptionists if they refer for these sort of things or speak with the therapist you are thinking of going to see to find out if they have a good relationship with this veterinary practice. Remember, she is your dog, you have to be happy with the treatment she is getting.
My friend has recommended I try physiotherapy and hydrotherapy for my old arthritic boy but I don't see how they will help? I also have no idea how I go about finding somewhere to take him.
There are multiple benefits to these treatments on their own but they also work really well when they are used together. Physiotherapy will help to pinpoint the specific areas of discomfort, muscle tension spots and secondary compensations (tight spots elsewhere because of how the dog is now walking/standing/compensating). The physiotherapist can also offer alternative pain relief options such as laser therapy, ultrasound and massage and they can then provide specific exercise plans for you to do at home which will try and maintain your dog’s muscle and joint range of movement. Once sufficient pain relief is in place hydrotherapy will also help to encourage improved range of motion in the joints (by using warm water to help “loosen” any stiff joints) and an improved muscle mass to help support the joints (The resistance of the water helps the dog build up muscle mass while in a easier environment due to the buoyancy of the water meaning there is less impact through the joint). This will help correct any gait abnormalities that have developed. It is important to remember though that all of this should be part of a multi-modal approach to managing arthritis, none of it will fix the condition.
When looking where to go your vet is likely to be able to suggest somewhere, but if not there are a few things to look for. For hydrotherapy you want to make sure the Centre and therapist is registered with either the Canine Hydrotherapy Association (CHA) or National Association of Registered Canine Hydrotherapists (NARCH). This is because it is an unregulated industry so anyone can set up a hydrotherapy centre but these associations ensure the therapists are suitably qualified. They also have to undergo annual CPD (courses to keep them up to date) and the Centres themselves are checked, in terms of hygiene, record keeping etc. Furthermore, these Centres are the only ones that an insurance company will recognise. When looking for a physiotherapist you want to make sure they have a suitable qualification, such as being ACPAT or IRVAP registered. This is to ensure they are using recognised techniques and keep up to date with the best treatment options.
My dog has been on his medication for a long time and I know he is fine but the vet insists on seeing him every 3 months and doing blood tests on him at least once a year - are they just trying to make money out of me?
The simple answer is no. Under the Royal College of Veterinary Surgeons code of professional conduct vets are only allowed to prescribe medication to animals under their care which means they need to have been seen recently or often enough for the vet to “have personal knowledge of the condition of the animal”. These check ups are a great opportunity to check your dog’s weight which if it has dramatically changed might mean they need more or less medication or a new diet plan needs to be implemented. It also enables the vet to check for other conditions that might impact on the arthritis (such as lumps near joints) or are more common in older patients. A detailed discussion on how they are getting on in everyday life, along with gentle joint manipulation might also flag up that they need a change in their medication protocol (adding in new drugs or stopping some of the current drugs). For some of the drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs), the product data sheet states that regular blood tests need to be done to monitor liver/kidney values as the earlier changes in these are detected the better – there is another question on this page that addresses this in more detail.
My vet wants to add in a human drug to my dog’s medication protocol - can they do this? Is it safe?
In the UK this is allowed, if there is no suitable veterinary medicine available to treat the condition, under what is known as the cascade. This means the vet has to first use a drug that is licensed for use in another animal species for that condition or for a different condition in the same species. If there is still no product available then they can use a medicine licensed for human use. The side effects of these drugs will vary depending on the drug but this is no different from veterinary products and should be discussed with your vet.
Is there a way to get the drugs any cheaper than from the vet as I can’t afford to keep paying for them at this cost?
All vets are obliged to offer you a written prescription to enable you to obtain the medication from elsewhere such as an online pharmacy but there is often a cost involved with this. If you are struggling to afford the cost of your dog’s medication it is always worth talking to your vet as they may be able to suggest alternative options.
If my dog has medication he feels better and wants to do more which I have been told will only make his arthritis worse in the long term, so isn’t it better he feels some discomfort so he doesn’t want to do as much and to then just use the pain relief if he does do too much?
The Animal Welfare Act 2007 lists five freedoms which are your responsibility when caring for a pet. The most relevant is “Freedom from pain, injury and disease” but three of the other freedoms are also relevant when thinking about the answer to this question – Freedom from discomfort, freedom to behave normally and freedom from fear and distress. It is much better to manage your dog’s desire to do more when they are less painful (hopefully pain free) by giving them alternative activities to do (such as snuffle mats, kongs, hide and seek etc) than to leave them painful. Furthermore, it is very important that joints are kept moving and muscles are strengthened through use, but in a controlled way. Arthritic dogs are not candidates to be “weekend warriors” – where they are asked do lots more exercise at the weekends compared to during the week. They may then struggle the following day are more likely to have done more damage to their joints thus progressing the arthritis quicker. See elsewhere on this site and the Facebook page for more ideas on low impact activities for your arthritic dog.