Bad kitty! Or…sad kitty?

Litter box problems, or “inappropriate elimination behaviors," are among the most common complaints I hear from cat owners.  If it has ever happened in your home, you're probably thinking “inappropriate” is a rather mild way to describe urine or feces in the middle of your carpet, but bear with me.  With some investigative work and patience, we can help most cats get over bad bathroom behavior. And, with the right information you may prevent future problems.

Medical causes

The first step in these situations should always be a visit to your vet to rule out underlying medical causes.  Conditions like kidney disease, diabetes, and hyperthyroidism can increase urine production, while urinary tract infections and bladder stones are uncomfortable and may result in frequent urination.  Likewise, issues such as parasites, constipation, and inflammatory bowel disease may make defecation urgent or uncomfortable.  Even arthritis can affect bathroom habits – imagine if you had to climb over a waist-high wall to get to the toilet!  So, it’s possible your feline friend doesn’t feel well and just can’t make it to the litter box.  A thorough physical exam, blood work, urine analysis and/or fecal exam will establish your cat’s general health status and help guide treatment if necessary.

Unacceptable, Human!

Behavior

Now that we’ve ruled out medical conditions, it is safe to start questioning behavioral causes… But before you send kitty to a psychiatrist to work out his anger issues, we need to talk about YOUR behavior too.  You may think that your cat doesn’t deign to notice you unless it’s dinner time, but cats are actually quite sensitive critters.  They can’t tell you with words that they are stressed out by something in the house, but peeing outside the litter box is one way to get your attention (my two cats prefer to barf in my shoes or self-mutilate, respectively).  Here are some things that might be ruffling kitty’s tail feathers.

Litter box issues:

• Hygiene – Is it possible that you and kitty have different standards when it comes to cleaning the bathroom, so he decided to seek out a cleaner facility?  Most cats are quite fastidious, so litter should be scooped daily and changed out completely on occasion (non-clumping litter should be dumped every few days). You might also consider tossing your box for a new one if it’s really worn, as plastic can retain urine smells.
• Availability – Are there enough litter boxes in the house?  I recommend having one box per cat plus an extra (e.g. 3 cats, 4 boxes) unless you have a very large number of cats, and then you will probably get into trouble despite the number of boxes.  There is a scientific study from the 80s showing that individuals with 10 or more cats have a 100% probability of becoming a victim of inappropriate urination, and a 90% probability of eventually being a crazy cat person (ok, maybe only the first half was shown in the study).
• Location – Maybe kitty was just settling down in his laundry room litter box to “read the Sunday paper” when that really loud timer on the dryer buzzed and startled him into Tuesday.  If you think location could be the problem, leave the current box in place but add one somewhere else in the house.
• Type of litter – Cats have preferences about their potties, and it may be your cat doesn't care for that fresh pine scent as much as you do.  Try a few different types (clumping, clay, recycled newspaper, etc.) at the same time to give kitty a choice of textures and smells.  Be sure to include a finely-textured clumping litter in your test, as it was chosen more than twice as often as other types in a thorough study by behaviorist Dr. Peter Borchelt.
• Type of box – Try out a new box shape or size.  However, a word of caution on covered boxes…  Many people favor covered litter boxes for obvious reasons, but I find most cats do not, especially in multi-cat households. For example, my cat thought his sister was playing hide-and-seek in the covered box we used to have, so he would wait outside and ambush her upon exit.  Needless to say, she did not enjoy this.

Environmental stressors – Pretty much any event or change in your cat’s life can fall into this category, but common issues include:

• New people – Houseguests, new spouse or roommate, new baby, etc.
• Disruption of environment – Moving, renovations, holiday decorations and celebrations
• Change in your schedule – New job, leaving for vacation
• Visiting the vet – I wish they all loved seeing me…
• Inter-cat aggression – self explanatory, and common.
• New pets – Introducing a furry family member can be a very delicate process, and strategy may depend on the personalities of your current critters. I recommend talking to your veterinarian if you are thinking of adding a pet.

These issues are tricky, as it’s often difficult to control them unless you plan on letting your cat completely run your life.  What you can do is implement some practices that will hopefully make kitty more resilient to life’s little blips. We've already discussed litter box recommendations, but additionally all cats should have fresh food and water, something they’re allowed to scratch, and a safe space where they can go to get away from other pets and people if they choose.  Perches can often provide such a space, and when placed near a window also serve as a source of entertainment.  You should also carve out some time each day to interact with your cat via play, grooming, or even training (yes, cats can be trained!).  Toys and catnip are great stimulation for some kitties, while others will be engrossed by “cat TV” or nature videos.  Feliway (http://www.feliway.com/us), a synthetic pheromone product, may also help reduce stress.  Be creative and try different things to find what lights your cat’s fire, but the message is that your cat may be bored or stressed if his basic needs are not met, and this can lead to health and behavior problems.  Ohio State University's Indoor Pet Initiative (http://indoorpet.osu.edu/cats/) has done a lot to further our understanding of how environmental enrichment can help our feline friends live happy lives.

No dice, Doc.  Now what?

So you’ve had kitty vetted, offered a Pu-Pu platter of litters and boxes, enriched his life and pheromoned the heck out him, and he’s still “thinking” outside the box.  Now may be the time to head back to your veterinarian, or a veterinary behaviorist if one is available and finances permit.  If the problem has been going on for a long time or your cat is particularly sensitive to environmental stressors, finding a solution can be very specific to the individual animal and situation.  There are anti-anxiety medications that can help, especially in cases where feline housemates are not getting along, but they are not magic pills and must be used in conjunction with environmental modifications, many of which have been discussed above.

To sum up…

• Rule out medical causes
• CLEAN the litter box
• Try different types of litter in different boxes in different locations
•  Reduce stress with environmental enrichment and interaction with your cat
• Medications can be useful in conjunction with behavior and environment modifications

-Dr. Courtney Smock

The Truth About...Cataracts

At least a couple times a week someone brings in an older dog and tells me the pet is getting cataracts. Fortunately, the changes they've noticed usually aren't true cataracts and don't significantly trouble their vision. True cataracts do happen in pets, though, and not uncommonly either. When cataracts are large or progressive they can lead to blindness or even painful glaucoma, so it's important they are recognized and closely monitored by your veterinarian.

The lens is #11; the pupil is #7.

Cataracts are imperfections in the lens - the clear disk which sits in the pupil and focuses light on the back of the eye, which in turn translates that light into an image*. So, the important thing about the lens is that it is clear and flexible (little muscles attach that deform it to focus the light so you can see near and far). There is a very intricate, highly organized structure to the proteins in the lens that allows this to happen. A cataract, then, occurs when this structure breaks down, turning part or all of the lens opaque. Light can no longer pass through that area, interfering with vision to a degree dependent on the size of the cataract. A small cataract may have no significant impact on vision, but complete (or mature) cataract essentially means that eye is blind.

Nuclear sclerosis. Note how the opacity is central
and surrounded by a halo of normally transparent lens.

Before we go any further, let's clarify what most owners get concerned about, a phenomenon called nuclear sclerosis - which thankfully doesn't have a noticeable effect on vision and isn't a true cataract. As dogs age, new lens fibers slowly develop from the outside edge and move inward, slowly compressing the center (nucleus) of the lens. The increased density results in a hazy appearance that is often confused with a cataract, but unlike a cataract light still passes through fairly normally. Indeed, one way we differentiate these from true cataracts is by shining a bright light into the eye; with nuclear sclerosis you'll see the iridescent reflection from the back of the eye, but with a cataract you won't. Since light still passes through, vision is still effective - perhaps it's a bit blurry, but I've yet to see a pet noticeably effected by it.

So, what can cause the delicate, highly-specialized lens structure to break down and lose transparency (i.e., form a cataract)? Genetics can certainly play a role, and there's a laundry list of breeds predisposed to cataract formation. Sometimes these are present at birth and sometimes they develop with age.

A true cataract. Note the completely
opaque lens.

Many other problems and diseases may cause cataracts as a secondary consequence - basically, anything that disrupts the environment within the eye can lead to cataract formation. Inflammation inside the eye (or uveitis) is a common culprit, and due to some quirks of structure the eye is a common place for inflammation to develop even when problems start elsewhere. This happens with many bacterial infections and autoimmune diseases, and it's another reason a complete physical exam by a veterinarian is so important in every animal -sometimes a good eye exam leads to discovering another problem, or vice-versa. Trauma to the eye, or (yikes) to the lens itself can certainly result in cataracts as well.

Vision loss is not the only potentially serious consequence of cataracts, however. When progressive, the lens may break down to the point that it leaks proteins into the rest of the eye, causing serious inflammation and even glaucoma - an extremely painful condition where pressure builds up inside the eye. Fortunately many cataracts are not progressive, but for this reason they should all be closely monitored by your veterinarian. Diabetic dogs merit special mention, as most of them will develop rapidly progressive cataracts due to differences in the way their lenses metabolize sugar. Considering this, all owners of newly diagnosed diabetic dogs get educated on how and why to monitor for cataracts. Likewise, any dog that suddenly develops progressive cataracts should be screened for diabetes.

While there is no proven medical treatment to slow or reverse cataracts, the same surgical procedure used in humans may be performed in pets. This involves breaking up the material in the lens, suctioning it out, and placing a prosthetic lens inside the remaining capsule. Obviously, it's a delicate procedure that requires lots of special (not to mention expensive) equipment and training, so it is only performed by veterinary ophthalmologists. Your family veterinarian should be able to direct you to a specialist and give you an idea of the costs in your area. The procedure has a high success rate for returning vision, but not everyone will be able to realistically afford the expense. Not every pet is a candidate, either - sometimes other problems exist that will prevent return of vision regardless. Fortunately, blind pets generally do quite well and have a good quality of life; your veterinarian and their staff should be able to offer tips for helping both you and your pet adapt if surgical treatment is not an option

Bad-Mouthed Pets, Part II: Home Oral Care

Click here for Part 1.

Dental cleanings by your veterinarian are necessary, just like going to your dentist for cleaning periodically is necessary. But just like your own teeth, oral health really starts at home.

There are many things you can do to keep your pet's mouth healthy between cleanings, and while none will eliminate the need for occasional professional cleaning, you can certainly reduce how frequently they are needed. Given that cleanings at the vet aren't cheap (though they are a great value, considering what your dentist charges without anesthesia), a little work at home can pay off on your pocketbook. Anesthesia is relatively safe nowadays but it is never without risk, so reducing how often it is necessary (again, it is necessary) is good for your pets as well. Home care also means you are paying attention to your pet's mouth, and this may be the biggest benefit of all - you are far more likely to catch problems that need veterinary attention early.

Tooth-brushing

Most pets tolerate brushing well.

Daily tooth-brushing is the single most valuable thing you can do for your pet's teeth. It effectively disrupts the bacterial film (plaque) that leads to dental disease, reducing gingivitis and staving off periodontal disease. Just as importantly, tooth brushing also means you're observing your pet's mouth regularly and are more likely to spot problems like fractured teeth or oral masses early - problems they might otherwise suffer with in silence until their next vet checkup.

Brushing your pet's teeth is generally not a big deal; most will tolerate it without much training on your part (cats included!), and many even seem to enjoy it. There are a wide variety of small brushes available at pet stores or online, and your vet likely stocks some as well. You don't need anything fancy, just something with a brush that your pet will tolerate. Personally, I find many animals take best to the thimble-style brushes you wear on your finger. Also, don't use human toothpaste as they contain stuff not meant to be swallowed. Many flavors of pet toothpaste are available, too, and with uncooperative pets finding something tasty can turn brushing from an argument to a treat.

Make sure to get those molars.

How to brush isn't rocket science - you want to cover all surfaces of the tooth, particularly at the gumline. Getting at the inner surface of the tooth (by the tongue and palate) can be difficult or even uncomfortable, so stick with the outer surface for the first few weeks and try to work up to that later. If your pet really needs some convincing, here's a video from Cornell with a four-week cat training plan. The same principles would work for dogs. Note that multiple studies have shown that to be truly effective, tooth-brushing needs to be a daily practice. Suck it up; keeping your pet healthy isn't a weekend warrior activity, right?

Diet
Yes, there's plenty of evidence that dry diets result in better oral health than soft foods. A recent Polish study also indicated better oral health in dogs and cats feed commercial diets versus home prepared foods. Both Hill's and Purina make prescription diets proven to significantly reduce plaque and calculus retention; typically these are large kibbles designed not to bust up easily when bitten. Your pet actually bites through them, mechanically scraping the tooth on the way. If your pet doesn't have special nutritional needs that make another diet necessary, these really are great for oral health. Some similar diets are available over the counter, too. Anyone can put a claim on a label and take your money, though, so check out the Veterinary Oral Health Council website to see which have been proven effective.

Chews & Other Products
Many studies have indicated that dental chews can improve oral health; which ones work best is a common question, and one I can't give a definitive answer to. One thing to keep in mind - the whole idea is to get that chew scraping against the pet's teeth, so something they don't bite into is by default only working on the flat surface of the tooth, and the gumline is what's most important. Anything too hard (i.e. - bones) can risk tooth fractures, not to mention there's always the concern of swallowing something large or sharp. Rawhide is probably my go-to product, but there are plenty of other good options. Chews impregnated with chlorohexidine, an effective antiseptic, are also on the market; rinses and gels are available as well.

The VOHC product seal, for reference only. 

There are hundreds of other products available at pet stores claiming to promote dental health - spending on pet supplies was $10 billion in 2010, and lots of people want a cut of that. Not surprisingly, some work, some don't, and I've even seen a few that might be dangerous. The Veterinary Oral Health Council, mentioned above, tests products for safety and effectiveness on a voluntary basis. The list of approved products can be found here. Note that just because a product is not on the list doesn't necessarily mean it is unsafe or ineffective; I would recommend running other products by your veterinarian first, though. There's virtually no regulation on these sorts of products and the claims they make, so caveat emptor all the way.

Bad-Mouthed Pets, Part 1

Let me start by saying that I understand ignoring oral care. I spent four years in veterinary school without a trip to the dentist. When I finally went, it took two trips and local anesthesia to get them clean. It hurt. It bled. I don't recommend it. It was a good thing I got in when I did, though. Bear in mind, I brush my teeth a couple times a day, and they didn't look nearly as bad as the pets I see every day.

February is National Pet Dental Health Month, and this is the first of several articles on oral care. I'm going to cover home care, what veterinary cleaning entails and why it is necessary, and the questions and concerns you should have as a pet owner when deciding where to get dental care. But first I need to convince you that oral health is important - important enough to spend your time and money, because dental disease does effect overall health and it does result in pain.

Like many things in medicine, most periodontal disease revolves around bacteria and inflammation. Bacteria in the mouth form a biofilm - basically a colony of germs that creates a slimy film to make them stick to a surface (teeth) and also serves to protect them from the environment. That biofilm is better known as plaque. Over time that slimy plaque layer will mineralize and harden into tartar; this creates a rough surface that is great for more plaque to attach to. It's a handy cycle if you're a bacteria.

Note the dark, heavy buildup (tartar),
and the red, puffy gumline (gingivitis).

Problem is, the body doesn't like bacteria, so the immune system gets fired up and causes inflammation of the surrounding gums. That's gingivitis, and it is readily visible as reddening and swelling at the gumline (go check your pet's teeth, I'll wait). Making matters worse, that biofilm does a good job of protecting bacteria from the immune system, so the inflammation just worsens without solving the problem. Over time all the inflammation damages the attachment between the tooth and bone (the periodontal ligament) and the gingiva recedes; eventually even the surrounding bone itself gets eaten away, leaving a loose, painful tooth.

That's the obvious part of dental disease - except it usually isn't obvious. You don't need a medical degree to see thick, dark calculus on the surface of teeth, but plaque buildup below the gumline causes the worst problems. Likewise, the front teeth often don't look nearly as bad as the molars in the back (see above) - I often call those the "vet" teeth, as the vet is usually the only one to see them. Worst of all is that the real problems for your pet - pain and loose, non-functional teeth - can be almost impossible to recognize. Most of the time the only signs of dental pain are subtle changes in behavior and attitude that often go unnoticed. The pet will avoid using the affected teeth, but if the other side of the mouth isn't too bad there's no change in appetite. Anyone who has ever had a toothache will tell you it's a dull, constant pain they wouldn't wish on an enemy - but they probably muddled grumpily through with it, pain meds in hand, until they could tell the dentist what hurts and wait for them to fix it. Pets can't do the latter; they rely on us to figure out the problem  so they don't have to muddle grumpily and painfully through.

The jagged, dark area is a large fracture
on the inner surface of the tooth.

Fractured teeth are a huge problem, too, given dogs' love for chewing. When a broken tooth exposes the pulp cavity - the vital, living part of the tooth - it is extremely painful. Eventually the root dies and the pain will subside, but now there's a tube leading right up to the bone, setting up for nasty infections. I find alot of fractured teeth wellness exams - and probably miss at least that many, since very few animals will permit a thorough oral exam without being heavily sedated. Indeed, I recently found a fractured tooth on my own dog during a dental cleaning - he'd broken part of it off on the inside surface, which is pretty much impossible to visualize on an awake animal. The pulp was long since dead, so it likely wasn't hurting anymore, but that hole was begging to set up a nasty infection in the jaw.

Speaking of infections - that's probably the most accurate way to think about periodontal disease. You have gobs of bacteria (plaque) causing inflammation (gingivitis) leading to damage of the surrounding tissues. But what's more, those inflamed gums are red and puffy due to increased bloodflow, which means all that bacteria gets quick access to the bloodstream. So, the bacteria could potentially spread anywhere, and studies have shown periodontal disease results in an inflammatory state throughout the body. Another study showed a correlation between dental disease in dogs and changes in the kidneys, liver, and heart. Indeed, in human dentistry correlations between dental health and all sorts of other problems are well established.

This is a long article, so I'll keep the summary short. Dental health is a vital part of overall health and well-being, and we owe it to our pets not to ignore it.

Continue to Part II - Home Oral Care.

Quick Tip: Training Your Dog Not to Jump

Dude. Chill.

Clients often ask me how to get their pets to stop jumping up on them. If you're patient and consistent, it's a very easy behavior to change. You just need to keep in mind two basic principles: all behavior is reward-seeking, and it's easier to learn a new behavior than to unlearn an old one.

First, we have to remove the reward the dog is seeking - attention. When asked how they've tried to get their dog to stop jumping, many say they yell "stop!" and push them away. Well, that's not the best attention in the world, but for a dog it's better than being ignored. To get rid of the behavior you have to stop rewarding it: ignore the dog completely by silently turning away.

Secondly, the real trick is to teach the dog to do different, acceptable behavior to get the reward. The simplest example is teaching them to sit instead. At some point while bouncing around, trying to get your attention, the dog will likely sit on its own - immediately look at them and give a verbal reward ("good dog!"). If they don't do it on their own, you can issue your "sit" command once they stop jumping, but do not look at or otherwise interact with them until they sit. Whenever they stop sitting, ignore them again.

Much like a child throwing a tantrum , the dog may escalate the behavior in an attempt to get your attention, but be patient and consistent - they'll give up eventually. A useful trick if they won't settle down is to walk into another room, then quickly turn and shut them in when they follow, instituting a time-out without actually interacting with the pet (which would reinforce the undesirable behavior). Being patient and consistent are the toughest, most important parts. But stick with it - your dog will learn that the way to get the attention they want is to sit obediently in front of you, rather than bounce annoyingly on top of you.

The Truth About....Anal Sacs.

In any other profession, if a little old lady walked into the office and asked me to "squeeze Muffy's butt," I'd be looking for hidden cameras.

I went to vet school, not art school. Obviously.

Anal sacs, also referred to as anal glands, are pockets that sit right by your dog or cat's anal opening at 5 and 7 o'clock. They produce a thin, nasty smelling fluid which is supposed to be excreted through a small pore every time the pet defecates (apparently in the animal kingdom, it doesn't stink enough on its own). There's muscle pressing up against them also, so pets can express them when stressed out, as anyone who's ever really ticked their cat off can testify.

So, there's my first point - every pet has anal sacs, it is perfectly natural that they fill up and empty, and unless there's a problem they should not need manual expression. There is absolutely no reason for your vet (or more likely, groomer) to empty them unless the pet has a problem that prevents them from doing so on their own. In fact, messing with them unnecessarily may even cause problems.

That said, it is not uncommon for pets to have trouble with their anal sacs. Because the opening they empty through is very small, if the tissue becomes irritated and inflamed those openings may become too constricted to allow complete emptying. As the fluid sits in the gland it tends to thicken, making emptying even more difficult and creating a cycle that will worsen without intervention. This is very uncomfortable for the pet - you can liken it to having a big zit that doesn't want to pop - and often results in signs like:

• Scooting (dragging their rear on the carpet)
• Licking/biting at their rear
• Acting uncomfortable when defecating

Moderately abnormal anal sac secretions.

However, anything that causes irritation of the anus, such as allergies or parasites, will also cause those signs. So when signs first crop up, you should visit your veterinarian to figure out exactly what the problem is. They can identify if the sacs are too full (again, it's perfectly normal for some fluid to be in there) or if the fluid is abnormal; and, if neither is the case they can pursue other problems that may be causing the irritation. Most of the time there's no infection involved, but when there is the vet can also flush the sacs out and infuse them with an antibiotic/steroid cream to calm things down. 

Likewise, if there is a problem with the anal sacs we should be trying to figure out why if possible. In my experience quite a few of these pets have underlying allergies that get the tissue inflamed in the first place; when we address the allergies, the other problems decrease or disappear. Small or soft stools may be part of the problem as well; in these cases adding some fiber to the diet can be quite helpful. Tumors may also develop in this area and prevent emptying of the sacs. 

There are definitely some pets who will have chronic, recurring anal sac issues regardless of the underlying causes or what we do about it. Once we know that, having them expressed by a groomer or technician is a great way to keep them comfortable and save some cash on veterinary visits. But it's important to remember that your vet is the only one who's really qualified to diagnose the problem and make sure something else isn't going on. Occasionally, with repeated infections or ruptures, we may even decide to surgically remove the sacs. And, for those brave, willing souls whose pets have trouble a few times a year, I'm happy to teach them how to properly express them. "Squeezing Muffy's butt" is one thing I have no interest in cornering the market on, after all. 

Don't Slow Down! - Dealing with Arthritis, Part II

Click here for Part I.

Since arthritis ultimately both results from and causes long-term changes to the joints themselves, we can't really expect to cure it. Fortunately, there are many options to improve comfort and interrupt the inflammatory process. A multimodal approach - one using multiple strategies in combination - is by far the most effective and safest; your veterinarian can tailor a plan to your pet's individual problems, monitor improvement, and adjust therapy when and if their arthritis worsens. The ultimate goal is always to keep pets happy and comfortable while slowing progression.


NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
These are drugs that work in the same manner as aspirin or ibuprofen. They are the medical treatment with the most proven benefits - the right NSAID will make pets more comfortable - but they also have the most risk of side effects. Major concerns include stomach ulceration, as well as kidney and liver damage. Dogs, and particularly cats, are much more sensitive to side effects from these drugs than people, and for this reason they should only be used under the supervision of your veterinarian. That said, when used properly they are incredibly valuable in treating arthritis because they both reduce pain and directly interrupt the inflammatory process, potentially slowing progression.

A practical note - while aspirin can relieve pain in dogs, please don't take it upon yourself to give it to your dog without talking to your veterinarian. It has a high incidence of gastric side effects, and due to the subtle differences in the way it works from other NSAIDs we have to stop aspirin and wait several days before starting more appropriate pain medications. Not doing so can have life-threatening consequences.


Exercise, Weight Loss, and Physical Therapy
While heavy exercise can exacerbate arthritis, moderate exercise is a pillar of dealing with it. Walking is ideal for keeping joints flexible and improving blood flow; swimming is even better when possible, since there's no impact involved. Weight loss is another pillar - it doesn't take a medical degree to realize painful joints hurt more when loaded with unnecessary weight. Fat also produces proteins that encourage inflammation, so it might even directly worsen arthritis. Check out this article for weight loss tips.

Just like with people, physical therapy can be immensely valuable for dealing with arthritis. Often this includes low-impact exercise such as underwater treadmills and specialized stretching. In many urban areas there are veterinarians with special training and facilities for physical therapy; ask your regular vet for recommendations.


Nutraceuticals
There's a laundry list of nutritional products with claims to reduce arthritis. I habitually start arthritic pets on omega-3 fatty acid supplementation, as much research supports their effectiveness at reducing inflammation. Glucosamine and chondroitin sulfate also have some support. I try to keep an open mind - if there's a reasonable body of evidence a supplement is safe for pets, it's worth trying if owners are interested. One thing to keep in mind about nutraceuticals - they are virtually unregulated, so there's no real guarantee of the amount or quality of the product on the label like there would be for an actual drug. For this reason, it's probably best to avoid the bargain product off the shelf at Wal-Mart. Your veterinarian likely carries some supplements who's quality they trust, or they can recommend specific products.

PSGAGs (polysulfated glycosaminoglycans) also have reasonable scientific support for improving comfort and function. They are given as an injection, and having personally seen some dramatic improvement from them recently, I strongly recommend talking to your veterinarian about them early on when trying to address arthritis.


Novel Therapies
Arthritis is very prevalent in older animals; not surprisingly, new treatments are constantly being proposed. Some of these hold promise - stem cell therapy, for example, is already being used in pets, has shown promising results, and has growing research support. Therapeutic lasers have also become very popular. Just like with people, many swear by things like acupuncture, herbs and the like. Myself, I'm skeptical of anything without verifiable research to support it. Believe it or not, the placebo effect has a prominent effect in animals too.  On the other hand, when proven therapies become insufficient, it's hard to argue against trying other modalities so long as there is reasonable evidence they are safe.

When treating any disease, our ultimate goal is to improve pet's quality of life. Considering that, treating arthritis is one of the most rewarding parts of being a veterinarian, because we so often see dramatic improvement in activity, energy, and enjoyment. It all starts with you recognizing that there is a problem, though. So if Muffy doesn't seem to have the spring in her step she used to, ask your veterinarian if there's a way to get it back!