by Shawn Messonnier, DVM
Holistic Veterinarian and Director of Paws & Claws Animal
Hospital
Article used with permission.
Dr. Shawn Messonnier is the author of The
Arthritis Solution for Dogs, The Allergy Solution
for Dogs, the award-winning The Natural Health Bible
for Dogs & Cats, and his latest book, 8 Weeks
to a Healthy Dog (Rodale.) Check out Dr. Shawn's Holistic
Pet column each week in your local newspaper, distributed
by Knight Ridder News Service.
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.
Continue
to Conventional and Complementary Therapies for Arthritis
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