Canine Arthritis Management: Stages and Tools for Helping Your Pet
Prepared by Dr. Alison Barulich, Animal Care Clinic

Degenerative Joint Disease or OsteoArthritis (DJD, OA, or arthritis) affects many dogs and often starts much earlier than we realize—x-rays find evidence of arthritis in about 40% of dogs by age 4. Arthritis is a slowly progressive, inflammatory disease of joints that can significantly interfere with quality of life and overall life span. Early identification and management are critical for best maintaining mobility and comfort. Here are the stages of arthritis and our approach to helping these patients:

Stage 1: At Risk

This dog will likely develop arthritis in the future due to having a known risk factor, such as:

• Overweight
• Genetic/breed predisposition for arthritis/joint disease
• Intensely active (working dog, hunting dog, agility dog)
• Joint injury
• Geriatric

This dog does not yet have symptoms of arthritis, and x-rays do not show arthritic joint changes. At home, this dog shows no signs of discomfort, has normal posture, and moves normally. In clinic, we would find no joint pain or abnormal joint movements.

Recommendations for helping delay arthritis development:

• The importance of optimizing body weight cannot be overemphasized. Reduced weight means less force applied to joints.
• Encourage moderate daily activity, especially consistent daily walks and swimming, for at least 30-60 minutes most days. Leashed walks on varying terrain like trails can be especially useful.
• Transition to a therapeutic joint diet (Hill’s j/d, Pro Plan JM, Royal Canin Joint Care) or start a quality fish oil supplement like Welactin to naturally reduce inflammation.

Stage 2: Mild Arthritis

This dog has a low level of discomfort at home. You might be seeing a mildly abnormal posture, weight shifting, or mildly altered movements like subtle stiffness or limping. This dog does not have any difficulty getting up. On exam, we might find mildly limited joint flexibility or slight joint thickening. X-rays will show mild arthritic changes in affected joints.

Recommendations for dogs in stage 2:

• Same lifestyle changes as for stage 1, plus consider increasing swimming or referral for underwater treadmill sessions for an especially effective way to support muscular fitness while reducing the impact of exercise on joints.
• Add on a non-steroidal anti-inflammatory (NSAID) medication trial for 1-3 months to significantly reduce pain and inflammation in arthritic joints, then adjust the dose over time based on individual response. NSAIDs often provide quick and dramatic symptom control, and extended use can contribute to continued improvements.
• This is also the ideal time to also start Adequan injections to support joint health. Adequan helps keep cartilage healthy and springy, so the bones in the joint do not rub each other causing worsened pain and joint damage. It proactively helps the joints instead of just addressing resulting symptoms—no other medication can do that! After an initial series of 8 injections, most dogs need a maintenance dose every 3 to 6 weeks.
• If a single joint is involved, consider referral for joint injections of Platelet-Rich Plasma (PRP) or stem cells to help address joint damage and/or pursue treatment here in clinic with therapeutic laser sessions to support joint health while controlling pain and inflammation.
• Nutritional supplements like glucosamine/chondroitin (Dasuquin Advanced) may be beneficial for supporting joint health. Additionally, hemp/CBD supplements from a reputable source have been shown in clinical trials to improve mobility and playfulness safely and effectively in the majority of arthritic dogs.

Stage 3: Moderate Arthritis

This dog is moderately uncomfortable at home. You might be seeing obvious weight shifting or altered stance, obvious stiffness, and some difficulty getting up. Activities are being moderately limited by progressive discomfort. On exam, we’ll see obviously reduced joint flexibility, reduced muscle tone, and obvious joint thickening. X-rays will find obvious arthritic changes at affected joints.

Recommendations for dogs in Stage 3:

• Same as for Stage 2, but also consider limiting high impact activities like running and jumping—it may be time to discourage rough play with other dogs or fetch unless your dog lives for these activities. Taking up lower impact activities like hiking, nosework/scent detection, or increased outings with the family may be better ways to keep an arthritic dog moving.
• These dogs will most likely benefit from a daily NSAID medication like carprofen every 1-2 days long-term.
• Consider adding on a supplemental pain medication like gabapentin or amantadine to help keep this dog moving comfortably.
• Consider laser therapy treatments of affected joint(s). A specific wavelength of laser is used to release endorphins, improve healing, relax muscles, reduce inflammation, and encourage tissue repair.

Stage 4: Severe Arthritis

This dog is really struggling, and you may be concerned the end of his life is drawing near. You’re seeing unbearable discomfort at home. Your dog has severely altered posture and is struggling or reluctant to move. He has obvious difficulty getting up, and he may seem restless when standing. He has obvious lameness/limping when walking, and his activities are severely limited by his mobility changes. On exam, we find severely limited joint flexibility, extreme loss of muscle tone, and severe joint thickness or misalignment. X-rays find severe arthritic changes and bone remodeling at affected joints.

Recommendations for dogs in Stage 4:

• Same as for Stage 3 but with full NSAID dose every day and increasing doses of gabapentin.
• Consider adding on tramadol, an inexpensive and well tolerated opioid pain reliever that also affects serotonin levels to possibly help depressive elements caused mobility changes just like a human with chronic pain may have.
• Consider purchasing an Assisi LOOP or Lounge to treat affected joints at home with an FDA-approved pulsed electromagnetic field device proven to stimulate the body’s own anti-inflammatory process.
• Consider referral for acupuncture to assist the body in healing itself by simulating nerves, increasing blood circulation, relieving muscle spasms, and releasing certain hormones.

We understand that managing a dog with severe mobility issues can strain financial budgets, family time constraints, and your own physical abilities to help them, and it’s stressful watching your companion struggle. Please don’t ever hesitate to reach out with updates, concerns, or questions—we’re here to help you know your options and decide how to help in whichever ways are best for your pet and your family.