Degenerative Arthritis Advice

[DunesMom]

Finally got orthopedic surgeon's report on xrays of Kipper's paws, and no sesamoid fractures, but "obvious" degenerative joint disease in the carpal-metacarpal joints of both front paws.

 

We go in Tuesday for NSAID scrip options.

 

I'm going to start him on the same glucosamine-chondroitin-MSM tabs that helped Dune, plus he's already on salmon oil.

 

QUESTIONS:

1. He's been limping on a hind limb off and on for a month, but no injury/fall/run set it off. It's bad when he first gets up from a nap (no weight bearing), but after a warmup he walks almost normally. After a few days, seems fine and walks normally and will do zoomies and wants to run (which we're not allowing). Then suddenly he's limping again. No swelling (unlike front paws), and no pain on palpation of spine or limb, and he has normal range of motion (using Care of the Racing & Retired Greyhound for testing this). Could this also be arthritis in another joint?

 

2. Anyone have advice for long-term management of arthritis in such a young dog? He's not quite 2 and a half; I hate to think of him hobbled in pain before he's four.

 

 

[RobinM]

Acupunture.

 

Teddy had a limp at the age of 3 that was due to arthitis and a disk issue. It's made a world of difference.

[ShantisMom]

We have been dealing with arthritis and joint issues with my girl since she was 2. She is now 5. She will not use her right front leg anymore. We have had a long hard road and many diagnosis's. We did Previcox for quite some time. She did well on it for a while. We are currently treating for Valley Fever too. Tramadol is our pain killer now. Cheap and she does well with little side effects, but will still not use her leg any more.

 

With the NSAIDs, watch carefully and get the blood work done regularly. There are a lot of people who would never use them. Just learn about them if you do.

[Rickiesmom]

See a good holistic vet. I have Rickie off NSAIDs completely now, using a combination of Wobenzym and Zeel. His arthritis is from age and changes in gate due to surgeries, so your experience may be different, but this may be worth looking into.

[DunesMom]

Acupunture.

 

Teddy had a limp at the age of 3 that was due to arthitis and a disk issue. It's made a world of difference.

 

Oh yeah, I always forget to ask about this. Thanks. Will ask our vet to schedule.

 

 

 

We have been dealing with arthritis and joint issues with my girl since she was 2. She is now 5. She will not use her right front leg anymore. We have had a long hard road and many diagnosis's. We did Previcox for quite some time. She did well on it for a while. We are currently treating for Valley Fever too. Tramadol is our pain killer now. Cheap and she does well with little side effects, but will still not use her leg any more.

 

With the NSAIDs, watch carefully and get the blood work done regularly. There are a lot of people who would never use them. Just learn about them if you do.

 

Do you see any wooziness with the Tramadol?

 

Dune used it during his final months but it made him unsteady and a bit out of it, but maybe his age affected that.

[ahicks51]

Do they do the equivalent of a sed rate and C-reactive protein in dogs? Probably, but I dunno. Does your vet have any data on these?

 

One off-the-wall suggestion: knock wheat and corn out of the diet, if you haven't already.

[Guest Alexandra_W]

I do not know if you have it over there, but my girl who got arthritis/DJD in one of her toe joints after a fracture, became as good as new with cartrophen. NSAID didn't help, nor did cortisone, but cartrophen was real magic for her.

 

SHe did get four injections (intramuscular or subq, don't remember) with over forut weeks, once in a week. Noticed an improvement already after the first shot.

[ShantisMom]

Acupunture.

 

Teddy had a limp at the age of 3 that was due to arthitis and a disk issue. It's made a world of difference.

 

Oh yeah, I always forget to ask about this. Thanks. Will ask our vet to schedule.

 

 

 

We have been dealing with arthritis and joint issues with my girl since she was 2. She is now 5. She will not use her right front leg anymore. We have had a long hard road and many diagnosis's. We did Previcox for quite some time. She did well on it for a while. We are currently treating for Valley Fever too. Tramadol is our pain killer now. Cheap and she does well with little side effects, but will still not use her leg any more.

 

With the NSAIDs, watch carefully and get the blood work done regularly. There are a lot of people who would never use them. Just learn about them if you do.

 

Do you see any wooziness with the Tramadol?

 

Dune used it during his final months but it made him unsteady and a bit out of it, but maybe his age affected that.

 

 

No. But she has been on it for a while. She is gimpy in the back end and does not use one front leg. So wobble is normal for her. I don't notice any more or less on Tramadol. She just feels better. I use to have good luck on Synovi G3. They make it with MSM too. Now she won't touch it. I now have to pill her with a human tablet.

[greyhndz]

Coming from a human medical perspective (and also as the mom of an iggy with immune mediated polyarthritis), I'd be concerned about a 2 year old showing signs of degenerative arthritis, unless there were a known history of fracture or other joint trauma. There are several canine autoimmune diseases which can present this way, such erosive polyarthritis, rheumatoid arthritis or systemic lupus. The arthritis may also be due to an underlying infection (such as tickborne disease or, as Shanti's Mom is now all too aware, valley fever) so hopefully your orthopaedist has ruled all of these out. Drawing a sample of joint fluid out and sending it for an analysis can be very helpful in making a diagnosis.

 

They do test for sedimentation rate, canine rheumatoid factor and ANA, and but negative results don't rule out an autoimmune or inflammatory disease. And these diseases are treated very differently than a degenerative arthritis caused by past trauma.

 

This is a technical but excellent article about various causes of arthritis: http://www.vin.com/proceedings/Proceedings...5&O=Generic

 

Best wishes and skritches to your baby!

 

 

 

 

 

[GeorgeofNE]

I'm with the lady above me; it would be very unusual for such a young dog to have arthritis absent a prior injury. I'm not suggesting there isn't joint damage, but I would be suspicious of an underlying cause.

 

As to pain management, my last dog had very severe arthritis (two major surgeries on his leg) and he took Tramadol daily for about 2 years. It gave him 2 years he might not have had. I myself have athritis, and after many, many trips to doctors, they finally said, "Look. Your joints are never going to get better, we really can't do anything else, now we learn to deal with the pain." So when my vet suggested Tramadol, I said, "Can I share mine with him?" and she said sure. So Kramer and I took our Tramadol together and managed just fine. I never noticed any side effects (for either of us!).

 

I would look seriously into tick borne diseases; in the meantime, it sounds like you have a good plan for management.

 

 

[greylyn]

I do not know if you have it over there, but my girl who got arthritis/DJD in one of her toe joints after a fracture, became as good as new with cartrophen. NSAID didn't help, nor did cortisone, but cartrophen was real magic for her.

 

SHe did get four injections (intramuscular or subq, don't remember) with over forut weeks, once in a week. Noticed an improvement already after the first shot.

 

 

I'm glad to see this - my vet has suggested cartrophen for Kieran. She has corns so that's part of the reason for her limp but we have Xrayed and there doesn't seem to be anything out of the ordinary in her joints, so I think I will have the vet start her on the cartrophen - I'm happy to hear that it was successful for your pup!

[brandimom]

Several years ago my Brandi started limping and we did all sorts of PT including swimming in a heated pool but none of it worked. She could only walk down the driveway (on a leash of course) a little ways and then we had to turn around. Broke my heart as she loves her walks. The holistic vet suggested prolotherapy (www.getprolo.com) as he had it done on his knee. There were a series of 6 injections with a long needle. After one injection we saw an improvement but we continued on with the other series. Never had another problem. I think it is worth talking to a holistic vet. Our best to all of you!

[ShantisMom]

Coming from a human medical perspective (and also as the mom of an iggy with immune mediated polyarthritis), I'd be concerned about a 2 year old showing signs of degenerative arthritis, unless there were a known history of fracture or other joint trauma. There are several canine autoimmune diseases which can present this way, such erosive polyarthritis, rheumatoid arthritis or systemic lupus. The arthritis may also be due to an underlying infection (such as tickborne disease or, as Shanti's Mom is now all too aware, valley fever) so hopefully your orthopaedist has ruled all of these out. Drawing a sample of joint fluid out and sending it for an analysis can be very helpful in making a diagnosis.

 

They do test for sedimentation rate, canine rheumatoid factor and ANA, and but negative results don't rule out an autoimmune or inflammatory disease. And these diseases are treated very differently than a degenerative arthritis caused by past trauma.

 

This is a technical but excellent article about various causes of arthritis: http://www.vin.com/proceedings/Proceedings...5&O=Generic

 

Best wishes and skritches to your baby!

 

 

Jordan is a wealth of information!!! Shanti has had so many things I lost count. But yes, we had a Babesia, a TBD. We are now battling Valley Fever. We have done 4 joint taps for fluid. These gave us a variety of other issues to deal with as well. IMPA being one of them as well. Have they done a tap? From what I have learned better to catch it all early before more damage is done. Have they tested for TBD? Where are you located and where did your dog come from? Depending on the area, you may want to look into VF testing. So many things cause joint issues. It is a frustrating path! Have you looked up her race records? I finally found one out of Mexico on Shanti that said fell in turn. This could have something to do with her wrist or not. Sadly, I think it will be a lot of trial and error on supplements. I was told after a month if you see nothing better, try another source of glucosamine.

 

You can PM me anytime. We have been on a roller coaster of joint issues.

 

Ask your vet about Adequan injections as well. It is a series of shots. Some dogs have amazing results. Some don't. I tried it. No luck here, but worth the try to me.

[DunesMom]

You guys are amazing! What did I do before GT??

 

He tested positive for babesia last November, but not enough to warrant treatment. I don't think he was tested for VF, nothing in his charts. Will request Tuesday.

 

He came in with ticks and fleas, like most of the Caliente dogs seem to. So VF could be it.

 

We haven't drawn joint fluid, I think that's scheduled for tomorrow.

 

I'm also worried it could be rheumatoid arthritis or similar, and that's what's causing the back leg limp.

 

We may try Adequan, since I recall it helped Dune with his arthritis and LSS.

 

On a side note, a human arthritis patient told me that the last issue of a medical journal devoted to arthritis had a controlled study in which the glucosamine effect was determined to be ZERO!! She said the authors attributed the "success" to the supplement industry's biased research. I'm looking for that and will post if I find it. I really thought it worked for Dune, but maybe it was wishful thinking?

 

 

[ahicks51]

You can check through PubMed.

 

A cursory search shows there are good data to support osteoarthritis is improved with glucosamine- but rheumatoid arthritis, not so much. Which makes sense, as RA is an autoimmune disorder, while OA seems to be mechanical in origin.

[ShantisMom]

You guys are amazing! What did I do before GT??

 

He tested positive for babesia last November, but not enough to warrant treatment. I don't think he was tested for VF, nothing in his charts. Will request Tuesday.

 

He came in with ticks and fleas, like most of the Caliente dogs seem to. So VF could be it.

 

We haven't drawn joint fluid, I think that's scheduled for tomorrow.

 

I'm also worried it could be rheumatoid arthritis or similar, and that's what's causing the back leg limp.

 

We may try Adequan, since I recall it helped Dune with his arthritis and LSS.

 

On a side note, a human arthritis patient told me that the last issue of a medical journal devoted to arthritis had a controlled study in which the glucosamine effect was determined to be ZERO!! She said the authors attributed the "success" to the supplement industry's biased research. I'm looking for that and will post if I find it. I really thought it worked for Dune, but maybe it was wishful thinking?

 

 

Okay, he came out of Mexico. So did Shanti. Was he in Arizona before that? Mexico, So. California and Arizona are high on the Valley Fever list. Valley Fever is a fungal infection that attacks them. They inhale a spore and it takes off from there. Also, Babesia can cause joint issues. What was his titer? Shanti was low 1:80 and we treated due to all her symptoms. The only change I noticed is she does not pee in the house much anymore. No help on her leg, but we may have been too far gone in damage already.

 

A joint tap will tell you a world of info. If there is infection, what it is, what cells are present, etc. See if they are culturing the fluid too.

 

Shanti is gimpy in her back end as well. Could be from the Babesia, VF, IMPA or just from compensating from her front leg. We don't know the cause. Her rear xrays are rather clean.

 

Are you in California?

[greyhndz]

What Jenny said <g>

 

Analyzing joint fluid will give your vet a lot of info - as Jenny mentioned, not only can it be cultured for multiple bacterial, fungal, rickettsial diseases, but looking at the viscosity of the fluid itself, as well as the presence of various types of cells, can quickly determine an inflammatory arthritis.

 

Has your vet gone ahead and treated empirically for TBD with a course of doxycycline? Can't hurt, might very well help, especially diagnostically, as usually there will be some improvement in the first 2-3 days if it is TBD.

 

If this turns out to be an immune mediated arthritis, the first line treatment initially is a long steroid taper, and the addition of one of the immunomodulating meds, such as azathioprine or leflumonide. Hopefully this won't be the case, though.

 

You didn't mention if there are any systemic symptoms - such as fever, lethargy, loss of appetite, weight loss, etc.?!?!?

[DunesMom]

Okay, he came out of Mexico. So did Shanti. Was he in Arizona before that? Mexico, So. California and Arizona are high on the Valley Fever list. Valley Fever is a fungal infection that attacks them. They inhale a spore and it takes off from there. Also, Babesia can cause joint issues. What was his titer? Shanti was low 1:80 and we treated due to all her symptoms. The only change I noticed is she does not pee in the house much anymore. No help on her leg, but we may have been too far gone in damage already.

 

A joint tap will tell you a world of info. If there is infection, what it is, what cells are present, etc. See if they are culturing the fluid too.

 

Shanti is gimpy in her back end as well. Could be from the Babesia, VF, IMPA or just from compensating from her front leg. We don't know the cause. Her rear xrays are rather clean.

 

Are you in California?

 

Yes, SoCal. And Kipper was in Tucson before Mex. His Babesia titer was also low, 1:70, and no clinical signs, so he wasn't considered worth treating. Is frequent peeing a symptom? He pees a lot, but never in the house, even overnight. We've never left him more than five or six hours at a shot, though, so he's never been "tested."

[DunesMom]

What Jenny said <g>

 

Analyzing joint fluid will give your vet a lot of info - as Jenny mentioned, not only can it be cultured for multiple bacterial, fungal, rickettsial diseases, but looking at the viscosity of the fluid itself, as well as the presence of various types of cells, can quickly determine an inflammatory arthritis.

 

Has your vet gone ahead and treated empirically for TBD with a course of doxycycline? Can't hurt, might very well help, especially diagnostically, as usually there will be some improvement in the first 2-3 days if it is TBD.

 

If this turns out to be an immune mediated arthritis, the first line treatment initially is a long steroid taper, and the addition of one of the immunomodulating meds, such as azathioprine or leflumonide. Hopefully this won't be the case, though.

 

You didn't mention if there are any systemic symptoms - such as fever, lethargy, loss of appetite, weight loss, etc.?!?!?

 

Sounds like joint fluid is critical - can any lab do this, or do I need to request a special one? My vet's greyhound-savvy (owns her own & other sighthounds), but her boss isn't, and I get the feeling that she gets pushback sometimes for sending tests somewhere other than her boss's selected referrals.

 

No fever, lethargy, etc. No weight loss but he's still super trim even with free choice kibble (wheat/corn free) and raw supplement in the morning (Satin Balls). He's still at racing weight of 72, and it seems right for him - prominent hip bones but you can only barely see the last three ribs, and his coat is good.

 

I'm trying to upload a pic of the paw swelling. Weird thing is that it's hard, not mushy/soft like you'd expect, and it doesn't seem to hurt when you massage it.

[DunesMom]

Okay, here are a couple pics. Sorry, it's hard with a flash to get a good pic so you can see how large the joint is.

 

This one might be better:

 

I'll let you know what we hear from joint fluid...thanks!

 

edited to correctly place the pic

Edited March 3, 2009 by DunesMom

[ShantisMom]

We are in So. Cal as well. I know my VF tests get sent to a special lab in Arizona that specializes in VF stuff. It is not cheap to ship it there! I can look that up if you need. We do more in depth testing though. From the joint tap they will more than likely be able to see if there is VF present. Cocciodiomycosis is the technical term for VF. It often looks just like cancer in xrays.

 

Shantis joint is not very soft anymore. How long have you seen the swelling? How long have you had him? She has also lost the majority of her range of motion in that joint.

 

When you get the results back, usually 3-4 days depending on who runs them, let us know. I have a TON of information on a lot of this stuff. Most of it came from Jordan. I will happily forward any ones you may need, if you need any. Medications also vary in cost by location. I have researched a lot of those too.

 

As far as the Babesia and frequent peeing. I am not sure that is a clinical sign. I know a few other dogs that had it and were treated that peed in the house prior to treatment and not after. I don't think it is a coincidence, but I could be wrong on that. I am grateful for that though!

 

I am guessing Kipper and Shanti came out of the same race kennel.

[greyhndz]

As Jenny said, VF testing should go to a lab very well-versed in VF, and it sounds as if the lab in AZ is the way to go. Usually, joint fluid goes to a regular lab for routine analysis (viscosity, cells, routine culturing, etc.) Not sure if Protatek or NC State do TBD cultures on joint fluid. When Lexi had her joint fluid analysis run at Angell Memorial in Boston, they did all of the culturing either in house or at their regular outside lab.

 

Is the joint red from licking, or is it red and warm, which might indicate an inflammatory process?

[brandimom]

Have you had a chance to see my previous reply in regards to prolotherapy with a holistic vet. It might be an option. It certainly improved the quality of life in my grey and also a friend of mine with her dog. Wish you the best!

[ShantisMom]

As Jenny said, VF testing should go to a lab very well-versed in VF, and it sounds as if the lab in AZ is the way to go. Usually, joint fluid goes to a regular lab for routine analysis (viscosity, cells, routine culturing, etc.) Not sure if Protatek or NC State do TBD cultures on joint fluid. When Lexi had her joint fluid analysis run at Angell Memorial in Boston, they did all of the culturing either in house or at their regular outside lab.

 

Is the joint red from licking, or is it red and warm, which might indicate an inflammatory process?

 

 

Shanti's joint fluid went to a lab here. It was either Tustin or Irvine.

[greyhoundgang]

Osteoarthritis doesn't usually happen to that young a dog. Polyarthritis (which can get kicked off after vaccinations) does. Tick diseases do. Valley Fever does. Greyhound Gang has info on all of those. Go to Greyhound Gang. click on LEARN. Click on MEDICAL.

 

For osteoarthritis, Greyhound Gang has tons of info and natural products that can help.

 

1. Joint supplements. You need high quality. You need correct dose. 1500 mg of Glucosamine HCL, MSM and Chondroitin daily. I'd add Vitamin C and CMO to that. If one supplement doesn't affect a change in a month, then try another. Not all are created equal. Testimonials about Get Up and Go are here.

 

2. Acupuncture

 

3. Chinese herbs - consult with a holistic vet

 

4. Raw feeding

 

are just some ideas. Our booklet - When I am Older has many other ideas.

But I'm really thinking this is not osteoarthritis.