1. Thorough Exam:
In addition to checking the rest of the body for gum disease,
cataracts, ear and skin disease, lymph nodes, heart and
lung sounds, we will ask a lot of questions such as the
duration of the symptoms and when the symptoms are worse.
We will palpate the neck, spine, and limbs and do range
of motion tests and tests that differentiate between ligament
disease, old injuries, and arthritis. We will be looking
for signs of inflammation, fever and chronic bacteremia.
Gait and posture will also be evaluated for telltale clues.
We will discuss the benefits of doing blood work to see
if the stiffness, etc might be due to something else like
kidney disease, poor digestion, cramps or malaise
associated with liver disease or diabetes. These same tests
will make anesthesia for the x rays safer, and they will
give us a base line for your dog to compare with later to
make sure the arthritis medicines we choose aren't affecting
3. Discuss X-Rays:
To get good radiographs we will sedate your pet heavily
to allow good positioning and we will take advantage of
this sedation and the good muscle relaxation that goes with
it to repeat palpation and manipulation of the limbs. We will be looking
for excessive wear-and-tear. The x-rays will help
us confirm that there is arthritis, stage how much damage
there is, rule out fractures and rule out cancer.
If the arthritis pain and weakness is mainly coming from
the hip region, x-rays will help us determine how much destruction
is present, whether the problem is mostly on one side or
the other and will help us decide on treatment. Sometimes
the arthritic destruction is so bad that a surgery called
a FHO (removal of the femur head so it doesn't grind against
the pelvis) would be helpful.
4. Treatment Trials: Whether
or not you elect to do blood testing or radiographs, we
have several new medications that often work great and are
safe enough to try on a trial and error basis to see if
your pet shows obvious improvement.
The first medication I like to try is
a dietary supplemet (neutraceutical) that is available online, over the counter,
in health food stores and in pharmacies. I'm talking about a glucosamine and chondroitin supplement,
either alone, or, preferably mixed with some combination of MSM, Hyaluronic Acid, Yucca Root and Boswellia Serrata Resin Extract.
Glucosamine is my first
choice as a trial treatment for several reasons: There
don't seem to be any significant side effects, there's
often good and obvious improvement within just a couple
of weeks of treating, and it doesn't just cover up pain. It
actually increases the amount and quality of the joint
fluid and slowly repairs damaged cartilage.
The glucosamine molecule is a basic part
of mammalian synovial joint fluid and is also a basic
building block of the cartilage matrix. The body apparently
can use this molecule to increase the amount and quality
of synovial fluid as well as to repair defects in cartilage.
Quite a claim, but studies are pretty convincing that
this is true. How much improvement? It seems to depend
on the patient. The bottom line is that if you try this
very safe product you have about a 30% chance of seeing
great improvement in the way your pets feels and moves.
You have another 60% chance of seeing modest improvement.