Browsing tag: orthopaedics

Osteoarthritis in dogs.

Stiffness in older dogs may be due to osteoarthritis which could be treated.

Stiffness in older dogs may be due to osteoarthritis which could be treated.

This week I met a lovely 12 year old Labrador called Amber, who has been suffering for some time now with osteoarthritis. She is on a combination of two treatments, which keep her quality of life good although her condition is getting worse.

This is a very common complaint in dogs, especially middle-aged and elderly ones, but the good news is that the treatments available are improving all the time.

One of the most common findings in a routine examination of an older dog is stiffness of one or more joints. On questioning the owner, we often find that there is occasional lameness or difficulty getting into the car, or stiffness for the first few minutes of exercise before the dog “gets going”. One of the most likely causes of such symptoms, although not the only one, is osteoarthritis or degenerative joint disease. Most people just call it arthritis, although there are other kinds of arthritis as well.

Medium to large breeds are most commonly affected by arthritis, but it can happen in any size of dog. Usually the onset is quite slow and may not be noticed at first by owners, or just put down to the inevitable process of ageing. Unfortunately this can mean that owners are not aware that their pet is in pain, or underestimate how much pain they have. Owners are often surprised when it is suggested that their dog has arthritis that would benefit from treatment, and equally surprised by the improvement they see when treatment starts. A very common reaction is that he/she is “like a new dog”. This is mainly because their joint pain has been removed or reduced.

Arthritis is a degenerative condition of the joints, where the cartilage overlying the bone becomes rough instead of smooth and movement of the joint becomes difficult and painful. The fibrous capsule surrounding the joint becomes thickened and restricts the amount of movement the joint can make. New pieces of bone called osteophytes can grow on the damaged surface, further restricting movement. The joints may make clicking or crunching noises when the dog walks, and the joints may also be swollen.

Diagnosis of arthritis is by a mixture of examination of the dog, history taking (asking the owner about the dog’s exercise tolerance etc) and further examinations such as x-rays. It may not always be necessary to take x-rays, but it can be very helpful to rule out other conditions which might also be treatable, but would require a completely different type of treatment. As well as helping to make the right diagnosis, the changes seen can help decide on the best treatment. While the dog is anaesthetised, the joints can be manipulated much more thoroughly than when the dog is awake, so a more thorough examination can be made.

Regular short walks are advised for affected dogs.

Regular short walks are advised for affected dogs.

Once the diagnosis of arthritis has been made, treatment can begin. Before even thinking about drugs, the vet will want to consider whether changes need to be made to the dog’s weight and exercise regime. Being overweight puts increased strain on all the leg joints, so slimming down if necessary should be considered as part of the treatment. Rest can also be very important. Regular, frequent, short walks will be tolerated much more easily than an occasional long run.

Often the first line of treatment involves “chondroprotective agents” like glucosamine and chondroitin. These can be given in tablet form or can be included in the diet. They help to repair the cartilage and maintain the lubricating fluid of the joint, the synovial fluid. Two points worth remembering about these are, firstly, that the full effects may not be seen until six weeks after starting, and secondly, the formulations on sale for human use may not be as effective in dogs as those formulated for dogs.

Another very common group of drugs used to treat arthritis are called non-steroidal anti-inflammatories, or NSAIDs for short. These reduce pain and inflammation and can be given as tablets, liquids or injections. These drugs are generally very safe, but if used for a long time it is sensible to monitor the dog’s liver function as a healthy liver is needed to metabolise these drugs. A routine blood test is carried out every 6 months or as recommended by your own vet. Like all drugs there can be side effects, including the possibility of diarrhoea and vomiting in some dogs. If your dog develops any new symptoms while taking any drugs, it is advisable to seek advice from your veterinary surgery.

In some more serious cases other drugs may need to be used, such as steroids or strong painkillers.

Surgical treatments can also be used in the treatment of arthritis. Operations which have been common in human medicine for many years, like hip replacements, are now more widely available to dogs too. In severe cases of hip arthritis, this can allow enormous improvements in quality of life. In younger dogs where arthritis may be the result of a developmental problem in a joint, surgery may be recommended. Not all veterinary practices carry out these sorts of procedures so your dog might need to be referred to a local specialist in orthopaedics.

Amber is a lucky dog in that her symptoms are well controlled even though her exercise is restricted. She has an examination and a weight check every 3 months and a blood test every 6 months. She spent a lot of our consultation lying on her back having her tummy tickled, and I had no doubts that she is still leading an enjoyable life.

If you are concerned about arthritis, stiffness or lameness in your dog, or any other health issues, contact your vet or use our Interactive Dog Symptom Guide to help you decide what to do next.

Cat Pelvis Operation – Vet Orthopaedics

Pelvis_surgery

Joe the TV vet performs difficult pelvis surgery on a cat.

Cats lead dangerous lives, dodging traffic, fighting over territory and being chased by dogs, so it is not surprising that we vets spend a reasonable proportion of our working lives patching up the results of their adventures. Whether it’s repairing serious damage caused by road traffic accidents, or patching up less severe injuries from bite wounds, cats that have been in the wars certainly keep us vets busy everyday of the week.

Most of the time these injuries are not too severe – cat bites, and bruises and strains from over-energetic leaping and climbing usually heal well and require nothing much more than antibiotics and painkillers to help the cat recover. Sometimes, however, cats are less fortunate and that is when things get much more serious and the outcomes can be less positive. Road traffic accidents are by far and away the main cause of these more serious injuries, and repairing the damage that a tonne of car can do to 5 kilos of fragile cat can be a very involved and difficult process.

Thankfully there are now many highly specialised vets who can offer amazingly hi-tech operations and treatments that can quite literally put broken cats back together. A friend of mine from university, Toby Gemmill, is now an eminent orthopaedic surgeon in Birmingham and I truly believe that provided the pet’s head and chest are in one piece, there’s not much he couldn’t put back together successfully. Using all manner of techniques, including external fixators (metal frames that hold shattered legs back together from the outside rather than the inside), bone grafts and much more, vets like Toby can work wonders on even the most severely injured animals.

There is a problem though, and that’s the age-old issue of money. The state-of-the-art treatments that Toby and other orthopaedic vets carry out are understandably expensive with costs often reaching many thousands of pounds. This puts them out of the reach of many pet owners, unless of course they have pet insurance, leaving them faced with some very difficult decisions – should they try to beg, borrow or steal the money required for a potentially life-saving operation? Or should they simply call it a day and opt to have their pet put to sleep? These are terrible decisions to have to make, and it is one of the reasons why vets like myself, who are general practitioners rather than specialists, end up tackling complex operations that are well outside our comfort zone.

Take Portia the cat underneath the drapes in this picture for example. She was hit by a car and suffered severe injuries to her pelvis and back legs, and required a major orthopaedic operation if she was going to have any chance of surviving. However, her owner had no pet insurance and could not afford to consider visiting a specialist – but she was desperate to try and save her beloved cat, so I offered to try my best and have a go myself.

The operation Portia required was something I have attempted before, but it really is not something I’m that comfortable with, so it was a very long and stressful operation. The end result was pretty good – definitely not as good as if Toby had done the procedure, but a whole lot better than nothing and I think there’s every chance that she will pull through as a result. In fact it’s me that I’m more worried about – I need a stiff drink and a lie down to recover from the stress!

Joe Inglis BVSc MRCVS is the vet for the One Show, This Morning and BBC Breakfast. He runs his own line of natural pet food called Pet’s Kitchen

More Useful Information

Examining your pet

Simple ways to check the health of your pet. Vets use these techniques as part of their clinical examiniation.

Medicating your pet

Arming you with the same simple techniques for stress free pill giving.

Worming & Flea Treatment

Information and advice in treating your pet for worms and fleas.