Combining nutritional supplements for long-term control and healing, and conventional therapy for immediate pain relief is a truly holistic approach to treating arthritis.
Duke is a 9-year-old male golden retriever with a one-month history of limping. His human companion first thought that Duke might simply have a strain or sprain as he liked to play really hard. However, when Duke did not improve after a few weeks of resting, his human companion decided to seek my advice.
Since simple strains and sprains heal within one to two weeks with rest and anti-inflammatories, I suspected Duke had another problem. Because arthritis of the hips and spine is quite common in dogs Duke’s age, I suggested x-rays to pinpoint the exact cause of his problem. Under sedation, I discovered moderate hip dysplasia with secondary arthritis.
In order for Duke’s human companion to understand the treatment options, I started by explaining the nature of the condition.
Arthritis (also called osteoarthritis or degenerative joint disease) means “inflammation of the joint”. Inflammation is characterized by swelling, stiffness and pain. When treating animals with arthritis, our therapy must counteract the effects of inflammation and, if possible, slow down the progression of the arthritis or actually help the joint to heal.
The end of each bone is covered with articular cartilage which acts as a shock absorber to protect the bone. The cartilage is made of cells (chondrocytes) and the surrounding tissue matrix. The major components of this cartilage matrix are collagen, water and proteoglycans. The proteoglycan molecule is made of a central protein core with side chains of glycosaminoglycans (GAGS.) There are several different proteoglycan molecules in the joint cartilage including chondroitin sulfate and keratan sulfate. With wear and tear on the joints, the cartilage breaks down and arthritis develops. When pain and inflammation occur, the animal may begin to limp or use the affected limb less.
Conventional therapies of corticosteroids (steroids) and non-steroidal anti-inflammatory medications (NSAIDS) inhibit the enzymes responsible for pain and inflammation. Corticosteroids are best used on an infrequent, short-term basis for controlling pain from mild arthritis. Depot injections of methylprednisolone can last in the body for 30-60 days and should be avoided.
Long-term use of steroids can decrease the ability of wounds to heal, increase the chance of infection, suppress the body’s immune system, and destroy arthritic joints by decreasing collagen and proteoglycan synthesis.
NSAIDS such as aspirin, phenylbutazone, piroxicam (FeldeneR), carprofen (RimadylR), and Etodolac (EctoGesicR.), if taken for an extended period of time, can cause gastrointestinal ulceration, kidney, liver, and immune diseases, neurologic signs, behavioral problems, drug interactions, and the destruction of cartilage.
To minimize side effects and the cost of therapy over the long haul, I prefer natural therapies to help dogs like Duke live comfortably with his arthritis. Complementary therapies are preferred for long-term control of pain and inflammation. Nutritional supplements containing chondroprotective (cartilage-friendly) glucosamine and chondroitin replenish the raw materials that are essential for the healing and synthesis of cartilage, its matrix and joint fluid.
Glucosamine is an aminosugar that is incorporated into (joint) cartilage. Glucosamine hydrochloride and glucosamine sulfate are more effective than N-acetylglucosamine. Glucosamine is rapidly taken up by cartilage cells and it helps stimulate the synthesis of synovial fluid and cartilage and also helps inhibit the destructive enzymes that can destroy cartilage and proteoglycans.
Dosages vary depending upon the product. As a guideline, a daily dose of 1000-1500 mg of glucosamine is recommended for a dog weighing 50-100 pounds, with the dose being lowered after four to eight weeks.
Chondroitin sulfate is the major glycosaminoglycan found in cartilage. It helps inhibit enzymes that are destructive to the joint and has been shown to be an effective treatment for osteoarthritis. Since chondroitin production by the body decreases with aging, supplementation with this compound may be especially helpful for older dogs with arthritis.
Chondroitin is often added to supplements containing glucosamine; 800-1200 mg of chondroitin is recommended per day for a dog weighing 50-100 pounds. While significant studies are lacking, many feel that adding chondroitin to glucosamine enhances the ability of both substances to repair cartilage.
Keep the following points in mind when using glucosamine or chondroitin:
1. They are equally effective when compared to NSAIDS but much safer for the dog.
2. The typical daily cost of using a glucosamine-chondroitin supplement is approximately $1.50/day for a 50-pound dog. This cost can decrease as the dosage required for pain relief is lowered. The comparable cost of the most popular NSAIDS is approximately $2-3/day.
3. Since these supplements nourish living cartilage cells, they are most effective when used early in the course of the disease. This requires adequate and early diagnosis.
4. Positive results may not be seen for four to eight weeks (In contrast, response to drugs is typically immediate.) During those first weeks, an increased “induction” dose is used and then the dose is lowered as improvement is seen.
5. The supplements can also be used effectively when no clinical signs are present but yet when disease, as confirmed through x-ray diagnosis, exists.
6. Purchase only quality products from reputable manufacturers as recommended by your doctor. Products that are not so pure cost less but may be less effective.
7. Because the supplements are so effective within four to eight weeks, the diagnosis should be reevaluated after this period of time if improvement is not seen.
Duke the German shepherd responded well to a popular glucosamine-chondroitin supplement for maintenance and to NSAIDS on an as-needed basis for pain. Combining nutritional supplements for long-term control and healing, and conventional therapy for immediate pain relief is a truly holistic approach to treating arthritis.