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

"Oh, he's fine, he's just slowing down." It's a common comment I hear during exams of middle-aged and senior pets. Just like us, arthritis is one of the most common reasons pets "slow down" as they age, and just like us there are many options for managing discomfort, improving quality of life, and ultimately "speeding them up" again. Like most problems, the key to dealing with arthritis effectively is understanding what it is and why it happens. That's the topic of this article;  in Part II we'll cover the tools we have for treating arthritis.

A visibly swollen ankle. Inflammation
also made it warm to the touch.

Osteoarthritis, simply put, is discomfort and inflammation of the joints. It's the long-term result of abnormal wear and tear, which may be due to irregularities in the joints or cartilage pets are born with - such as hip dysplasia or unstable kneecaps - or, they may damage the cartilage, ligaments, or bone later on. Major abnormalities or trauma will likely be noticed early on and may be dealt with surgically, but minor abnormalities may only be evident much later as arthritis develops over time. Likewise, pets that ask a lot of their joints over their lives - such as athletes, or conversely, obese pets - may ultimately develop arthritis even without other abnormalities or damage.

The most important thing to understand is that arthritis is an inflammatory process. I intentionally emphasize both words. Inflammation is the body's response to damage. Irritated cells release proteins into the bloodstream, which in turn recruit specialized cells and more proteins back to the site. These cells and proteins are intended to repair damaged tissue or fight off infection. This is why a cut on your skin inevitably swells up and turns red - the area is filling with fluid and cells. The inflammatory process cleans up, repairs the damaged skin with a bit of scar tissue, and subsides. However, when the process can not fix the underlying problem - such as with a defect in joint cartilage or a misaligned joint - it just keeps going and going. Thus arthritic joints tend to stay swollen and painful (though how much may vary daily). Moreover, with time the inflammation will induce production of new bone, similar to scar tissue left in skin. Unfortunately, the end result is more irregular joints, and thus more inflammation, more arthritis, more pain, and less mobility. Inflammation is a process, and unless we interrupt it things will only get worse.

Arthritis itself is rarely a surgical disease; however, it is worth pointing out that many of the problems that lead to arthritis can be corrected surgically. Most joint diseases that can be treated surgically don't see the vet initially, and they run a course like this: the pet becomes acutely lame, improves back to normal-ish over a few weeks or months (while we "wait and see"), then a few months or years down the road the lameness returns (arthritis) and slowly gets worse. If abnormalities in the joints of young animals are recognized early it is often possible to correct them surgically and prevent a lifetime of progressive arthritis and pain. Traumatic damage to the joints of adult pets, such as torn ligaments in the knee, also doesn't have to turn into serious arthritis if it's fixed right away. For this reason alone, at the first concern of lameness you should see your veterinarian.

So, that's arthritis in a nutshell - joints are abnormal or damaged, the body tries to fix it with inflammation, but it can't and ultimately just winds up making things worse. In the next part, we'll talk about the different therapies available to interrupt the inflammatory process, slowing or stopping the ongoing joint damage it causes. That's the key to reducing pain, increasing mobility, and ultimately improving quality of life for pets suffering from arthritis.

Continue to Part II.

Pet of the Week - Mr. Turtle

Mr. Turtle. C'mon. He's handsome.

Four Good Habits for Your New Pet

This time of year we start seeing a lot more new pets at the clinic, and we spend a lot of time talking about "to-do" and "don't-do." Many of the most common problems I deal with in older pets - behavior issues, dental disease, and obesity - may never develop into issues in the first place if good habits are established right off. So, with that in mind here are four good habits I recommend to every pet owner.

1. Make Them Work for Treats

Food rewards can be extremely effective at teaching your pet new behaviors. They can also be extremely effective at making your pet fat. Too often we get in the habit of giving a favorite treat on a regular basis not as a reward, but as an expression of affection toward our pets. Food is not love, folks. When you just want to show your pet some affection, grab their favorite toy or offer up a good belly rub. Start the habit now of only giving treats as a reward for a requested behavior or during training sessions, and only giving treats in moderation. This will make training much more effective and the resulting behaviors that much more reliable, as they aren't over-satiated with treats and they know the only way to get those tasty morsels is to work for them.

2. Brush Their Teeth

Heavy calculus and inflammed gums

Imagine that your significant other never brushed their teeth. Yuck.

I see about a patient a day with severe dental disease - we're talking rotten teeth trying desperately to get out of an animal's head. While it can sometimes be difficult to get adult pets on board with toothbrushing, almost any pet will learn to tolerate and even enjoy it if you're persistent (even cats). All that gunk that builds up on your pet's teeth is actually mineralized bacteria. Not only does it irritate the gums, leading to periodontal disease and tooth loss, it also serves as a source of infection that can spread to other organs like the heart. Every animal will need professional cleaning (just like us) at your vet a few times over the course of their lives, but daily toothbrushing has been shown to reduce how often it is necessary. So, if you get in the habit of daily toothbrushing now you will improve your pet's long term health, as well as reduce the need for cleaning under anesthesia, saving your pet some risk and yourself some cash.

3. Feed Individual Meals

I would be so fat if I lived at a buffet. While the occasional dog or cat will have the willpower to restrain themselves and stay slim with free-access feeding, those guys are by far the minority in my experience.

Feeding multiple small, measured meals is the only way to control your pet's food intake. Get in the habit now and you'll likely keep your pet from ever getting fat, and if they should start gaining weight (metabolism and activity level can change, after all) it's easy to cut back the food a bit before things get out of hand. Plus, life will be much easier if you have multiple pets and one should need a special diet at some point - say a limited ingredient diet for food allergies or a senior diet for an older pet. On that note, when you begin feeding meals the food should only be offered for a few minutes and then taken away, eaten or not. After a couple weeks they'll learn to wolf it down when offered, and you shouldn't have to worry much about Muffy finishing Spot's leftovers.

4. Experience!

Morgan digs people.

Earlier this week we had a 110lb, goofy, outgoing Mountain Dog in the clinic. I went to get him out of his run for treatment, and he balked, cowering back in the corner and refusing to come out. A pink plastic disk had fallen in the floor in front of the run, and who knows why, but he was terrified of it.

During the first few months of a puppy or kitten's life they go through critical phases where they learn what's "normal" - what the world is like, and that they don't have to be afraid of it. Exposing your pet to new experiences - places, things, animals, and most importantly people - will help them turn out happy and well-adjusted. Make a habit of seeking out new experiences with your pet and making them positive. For example, carry some treats with you when you go for a walk or to the dog park, and ask people to have them sit (work) and give them a treat. And while the early months are an important, special time, this is a habit you should keep up - you can still wind up with a pet that is afraid of everything and everyone if you later turn them into a shut-in, who never interacts with anyone but you. And be honest, you're going to feel pretty silly if your big, manly dog is terrified of a pink plastic disk.

Is Your Pet Fat? (Probably)

He's cute - but he needs to lose weight.

Let me start with a simple, bullet-proof argument for why you should care about your pet's weight. Nestle-Purina studied 48 Labradors over the course of their entire lives. They were split into two groups, with only one difference - one group was allowed to over-eat and grow fat, while the others were kept at an ideal body weight.

On average, the overweight dogs died almost two years earlier. They also developed more health problems, and at earlier ages.

A recent study found that over 50% of dogs and cats are overweight. That means if you have two pets, the odds are one needs to trim down, whether you realize it or not. And you likely don't realize it, because our society has normalized pet obesity to the point where many think an ideal weight looks "skinny," overweight animals are "just right," and obese pets are...cute. Well, fat pets may be cute for all I know, but as a veterinarian I can promise you this - they aren't healthy. Their lives will be shorter, and they will have more health problems.

So, what does a healthy weight look like? Dogs and cats come in every shape and size, so we can't just look at animal and say it should be <x> weight. Instead, veterinarians use body condition scoring to evaluate pets, looking at many specifics to come up with a numerical score. However, you can easily use three quick checks at home to get an idea of where your pet sits. An ideal weight pet should:

1. Have a waist when viewed from above
2. Have a waist when viewed from the side
3. Have ribs that are easily palpable - you shouldn't see them (that's too skinny), but there should be little if any fat over them.

Click here for an interactive guide.

Put your hands on the pet and feel for a waist - especially with long-haired furballs, since all that fluff can make even skinny dogs look hefty. If your pet passes all those tests, you're in good shape (and so are they). But if they look and feel like a straight-case sausage from ribs to rump, or they're bulging at the seams - it's diet time. If they're just a little overweight, that's okay, right? Wrong. They're still overweight, and they'll still have real health benefits from trimming down.

Cutting the Fat

First off, if you're trying to take a large amount of weight off your pet I strongly advise you to put together a plan with your veterinarian and their staff. You can run into some significant nutritional concerns when cutting calories way back, not to mention a little support and guidance goes a long way toward reaching those goals. They can help you estimate how many calories your pet needs, and help you figure out an appropriate food - especially important since virtually no pet food companies make calorie counts available. Worse yet, terms like "weight management" are not regulated - there are "weight management" foods out there with as many calories as puppy food. That said, the general principle of weight loss boils down to a simple concept: calories used need to be greater than calories taken in. And, with that in mind, here are five general tips to help your pet slim down and live a longer, healthier life.

1. Stop treats and table scraps: Treats are the single biggest factor in obesity. An ounce of cheese typically has over 100 calories - for toy breeds this may be 1/3 of their daily calorie needs! Limit treats to no more than one a day - it's supposed to be special, after all - and replace fatty store-bought stuff with raw veggies. Most dogs love carrots and green beans.
2. Replace treats: Attention, touch and play are just as rewarding to pets as food; when you have the urge to give them a treat, grab a toy or laser pointer instead and give them some exercise!
3. Change to "Light" food: The term "light" is one of the few regulated words on pet food packages; it guarantees the calories per cup are less than most foods. Note that other terms like "weight management" are not regulated and may have just as many calories (or more) than normal adult diets. 
4. Switch to multiple small meals: No animal (me included) will lose weight while living at a buffet. You need to offer a set amount of food per day - this is best settled on with your veterinary staff, but you can try estimating what weight they should be and feeding the bottom end of what the bag recommends for that weight. Feeding several small meals is beneficial on two counts - it reduces hunger throughout the day, and digesting each meal burns a little extra energy .
5. Make an exercise plan:  Set goals for walking or playing - be specific on how often and for how long. A great way to exercise your cat is to make an event out of one meal a day - take the allotted kibble and throw it across the room, one piece at a time. I've yet to meet the fat cat that won't run for dinner.

For mild to moderate weight loss you can likely succeed just by following the simple guidelines above. For heavier pets or stubborn pounds, your veterinarian can help with special diets and more specific advice. But the most important job is yours - deciding your pet needs to lose weight, needs to live a longer, healthier life, and deciding that you need to make it happen.