Arthritis 101

Arthritis in dogs can take several forms, yet what they all have in common is pain. The least you can do is ease that pain.

Osteoarthritis is a wear-and-tear degenerative joint disease that progresses over time, causing stiffness, lethargy, a slowdown in activity, mood changes, and reluctance to climb stairs and jump. It is a common consequence of aging, but it can also happen due to an injury, genetics, such as hip dysplasia, and it can also be a consequence of obesity. Then there is also rheumatoid arthritis, a rare autoimmune condition. While the backdrop is different, their common ground is excruciating pain, and one that can be eased.

I will leave the diagnosis to your vet, with whom you will make a treatment and pain plan. But your responsibility is to provide supportive care and adjust your daily routine to ease your dog's struggle. This post will deal only with the latter, which you will also discuss in detail to get your vet's blessing. Therefore, the purpose of sharing this information here is being educational to equip you in providing the best at-home care possible for your furry angel as vets are also only human and shouldn't be expected to do all work besides the heavy lifting they already do- with all their heart.

While not curable, this condition can be effectively managed. While your vet might prescribe pain medication and/or physical therapy, you play a significant role when it comes to complementary care that can significantly ease the pain and help your dog feel more comfortable, while also slowing down the progression of this degenerative process.

1. Adjust your home- make it joint-friendly

- Carpets and non-slip socks

Senior dogs struggle on slippery floors that not only exacerbate the pain but can also lead to slips and falls. Putting rugs or non-slip socks provides crucial traction that helps them move more easily.

- Make sure the food and water bowls are placed at the right height

By positioning the bowls at roughly your dog's shoulder level, you will reduce pressure on joints as well as aid digestion.

- Ensure comfortable bedding

Like people, dogs will benefit from orthopaedic bedding that cushions the joints and relieves pressure points. Ideally, you get one with a washable cover for an easier clean-up. Needless to say, place it in a warm and draft-free spot.

- Provide ramps where needed and avoid stairs, if possible

The bottom line is you want to reduce joint strain even as an anti-ageing prevention measure. Once the damage is there, the least you can do is prevent painful jumps and ease your dog’s access to his or her favorite spots.

2. Grooming goes beyond being hygiene and aesthetic

Long nails to dogs are what walking in tight and uncomfortable shoes feels like to us. Long nails cause actual physical pain, alter their gait, strain joints, increase injury nails from a broken nail, and potentially even leads to arthrtiris they force unnatural weight distribution with every single step. On the other hand, trimming nails can be painful due to pressuring paws during the process (something you avoid in arthrtitic dog) so you want to plan for a regular nail care for it to be as least stressful as possible.

3. Remember that nutrition can both soothe as well as amplify inflammation.

Nutrition is still a developing field, with the microbiome clearly holding a lot of power for our overall health. While many integrative vets won’t tell you good things about commercial foods, one cannot stress enough the complexity involved in making the perfect homemade meals that meet all the needs of your dog. Therefore, I will leave that particular discussion for another time, and it will undoubtedly involve several experts, as my limited experience made me believe it should also be personalized while also being under the watchful eye of a vet. Instead, here are the things that can undoubtedly boost the nutritional value of whatever you choose to feed your dog. What is certain is that if you opt for commercial food, your vet will likely recommend a targeted medical line that provides joint support.

And again, you must consult your veterinarian before introducing any of the items below to your dog’s meal plan.

- Omega 3s

There’s a reason why we can’t get enough of Omega 3s these days, it’s because dogs, just like us, can’t produce them themselves. Unfortunately, we are all stocked up when it comes to Omega 6 that is in most commercial foods, sunflower oil, etc- hello inflammation! Omega 3s are one of those miraculous one size fits all players: these essential fatty acids (EPA & DHA) come with major benefits for dogs of all ages: from supporting brain development in puppies and boosting immunity, heart and kidney health, they are also anti-inflammatory which is what we need both for joint as well as skin issues. Unfortunately, there is a downside which is that the market of this materialistic world is filled with low-quality supplements so finding a high quality omega 3 product can be a challenge.

What we want is a high count of EPA&DHA, molecularly distilled, meaning purified and we want it to be third-party tested, as marketing is not known for its honesty. One such brand could be Nordic (as many as 22%) with fish oil from anchovies, sardines, mackerel and herring, with only the addition of gelatin, water, glycerine and d-alpha tocopherol (an ok preservative), but it’s not as simple as just making it free of chemicals and non-natural aromas etc.

While salmon oil usually has a bit lower concentration, it still has higher concentrations of these beneficial omega 3 fatty acids than cod liver oil, but cod liver oil has high levels of vitamins A and D, and we definitely want those when it comes to osteoarthritis! Therefore, mixing and testing for yourself sounds like the best way to go, and after all- our dog’s gut, just like ours, thrives on diversity. The only precaution would be pancreatitis as the pancreas does not like fat, and the risk of pancreatitis is significantly higher in older dogs. Therefore, in this case scenario, you want it to be as low in fat as possible, don’t overdo it, and make breaks in usage- most importantly, stop immediately in case of a loose/mushy/greasy stool.

There's also the debate for plant-based omega 3s from algae, and this greener choice is claimed to have more direct and concentrated form of EPA & DHA. The good news is that algae oil has better bioavailability compared to other plant-based sources like flaxseed, so it's worth a shot to try with this more sustainable form. Just make sure it has no additives besides vitamin E as mixed tocopherols. Again, caution is required in case of renal defficiency as algae are quite rich in phosphorus and just minerals in general that they absorb. o pherols (antioxidants)

- Beef bone broth is THE natural supplement.

If the long process of slow simmering is not easy to add in your schedule, you can alternatively take 100% bone broth in powder form and put one spoon in 1 dcl of water, make ice cubes out of it and give your dog 1 cube a day by mixing it into their food. It will not alter the taste of food and it is food for everything: bones, tendons, cartillage and even has gut-healing properties. Unfortunately, when it comes to dogs with renal defficiency, even something this natural and good can be risky due to its rich mineral content. especially potassium and phosphorus that you have to avoid.

- Green-lipped mussels

This natural supplement (it needs to be 100% pure GLM powder) contains unique omega 3s, especially ETA which blocks inflammation-causing enzymes, therefore easing both pain and swelling. Moreover, these mussels are rich in glucosamine and chondroitin, the first stimulates cartilage repair while the latter protects cartilage, joints, and connective tissues from further degeneration. They are also rich in zinc (regulates cartilage-damaging enzymes and reduces oxidative stress) and magnesium (whose low levels are linked to worsened osteoarthritis symptoms), which jointly support joint health. GLM's effect is not instant, but over time, GLMs can reduce reliance on NSAIDs. Please note that heat can destroy their active compounds so don't put it in warm foods. Caution and veterinary guidance is needed when kidney function is compromised as they contain phosphorus, sodium and could affect uric acid levels.

- MSM

MSM is used for its anti-inflammatory properties. To sum up the scientific mumbo jumbo, its biggest power is that it helps boost collagen production because it provides essential organic sulfur, which is a key building block for collagen, cartilage, and connective tissues. Especially when it comes to senior dogs, we prefer to use ‘boosters’ that stimulate and/or activate functions whenever possible as opposed to burdening the kidneys and the liver with heavier stuff like collagen, amino acids etc.

- Turmeric or more precisely, its active compound curcumin

A powerful anti-inflammatory and anti-oxidant tool, it needs to be mixed with fat and pepper to increase bioavailability so you will usually find in high-fat treats that include duck meat, coconut oil and pepper extract. But it can be a GI irritant and should not be used with anti-coagulant medications or in the presence of stomach ulcers and gall bladder issues. Therefore, if your dog has a sensitive tummy, skip.

- Herbs to the rescue

While phyto and aromatherapy always require great caution, there are safe options like alfa alfa, which is advisable not only for joint issues but also for digestive and urinary issues (especially in the case of crystal formation). You can take it as a microgreen or in powder organic form (100% pure) or simply make a herbal infusion. Being not a fan of tea infusions myself and being wary of herbs that can be poisonous especially to dogs when improperly used, I also tend to avoid tinctures as I find them too strong. My choice is always to begin with a less strong cold extract by soaking the herb in cold water overnight (twice the measure compared to a warm infusion). When it comes to dry herbs, keep in mind that they are best used within a year.

However, herbs adore synergy- it is something that my aromatherapy guru, Lejla, taught me long ago. So whenever you have the privilege of combined power where 1+1 does not equal 2, but 11, it's a shame not to take advantage of it. Fortunately, Pet Wellbeing is a rare brand that makes such herbal supplementation, but free of chemical additives. Their herbal mixtures contain only deionized water, natural bacon flavor (although we also try to avoid flavourings in general) and vegetable glycerin. In other words, nothing that will disrupt the gut microbiome that holds the key to pretty much everything, not just longevity. My only regret is that I didn’t discover this brand sooner, both due to its products and exemplary customer care with such compassion that my soul will remember for as long as I live. They are also the only brand I found that makes a cautionary note on its labels (for example, its Healthy Gums supplement is stated not to be adequate for renal patients), and with a serious team of vets behind the brand, you can even get a free consult to ease your selection process. In this particular case, they have a joint-loving mixture called Agile Joints. What I love about it is that it goes beyond targeting 'only' joints superficially and looks at the bigger picture. Boswelia is the #1 joint supplement due to active boswellic acids that do the work of NSAID's without their gut-disrupting side-effect. Devil's Claw has also long been known to lower the reliance/dosage of NSAIDs. Dandelion root is a liver-loving herb that is the star of spring detoxes but in this case, it's an indirect joint helper to get all the stuff burdening the joints out as it is a natural diauretic. For this reason, I'd avoid using it alone and without supervision, as it could lead to dehydration which renal patients must avoid at all costs. Besides a few other beneficial herbs, it contains a digestive enzyme from pineapple, bromelain, for which I can only applaud this brend for combining the best of natural and scientific worlds. Clinical studies have shown the beneficial effect in the form of proteolytic enzymes helping to break down damaged proteins and to reduce fluid accumulation (edema) in tissues which leads to less pain and stiffness, and therefore, greater mobility. Yes, working on the gut microbiome can also aid in the battle against osteoarthritis... to be continued.

Unfortunately, there are quite a few herbs that can't be used in combination with drugs (for all those that argue that traditional medicine are herbs - sometimes, you just can't replace chemical drugs, unfortunately). The priority is to provide the greatest quality of life to your dog, so the vet makes the call if you can include herbal medicine.

- CBD oil without any traces of THC

When it comes to osteoarthritis pain, stronger drops are advised- you can start with 16% and if needed, progress to 24% that is for the heaviest cases, including cancer. Being currently in the Balkan region, I have only found one that has trace of THC to which animals respond poorly to it as their receptors simply don’t accept it – Vet Health claims to have isolates of CBG and CBD molecules that have an analgesic effect while also being immunity boosters. While it does not cure, it interacts with a network of receptors (Endocannabinoid System) and by doing so, helps regulate pain perception, reduces inflammatory signals, therefore reducing discomfort and improving the quality of life. CBG is another natural compound found in cannabis/hemp plants, it is less common and stronger, also known as the mother of all cannabinoids, because even CBD actually develops from CBG as the plant grows. Both are non-psychoactive, but research suggests CBG might be stronger in neuroprotective and anti-inflammatory properties.

- When it comes to soothing arthritis symptoms, vitamins C, E, A and D are your allies so make sure that your dog's needs are met on their fronts. When it comes to vitamin C, Dr. Pitcairn's advises 500-2,000 mg a day (divided into 2 portions a day), but now you can also find liposomal forms for improved absorption (ideally in MCT oil as there are many with sunflower lecithins which I avoided both due to high Omega 6 content as well as due to high phosphorus to avoid burdening senior dog's kidneys). Also, even vitamin C can potentially do harm when in excess when it comes to renal patients (it can help protect kidneys from oxidative stress, excess amounts can be metabolized into oxalate and potentially form painful calcium oxalate stones) so again, your vet makes the call whether to add supplementation and the exact dosage.

I will not be discussing glucosamine simply because not every animal will benefit from it so I opted for those that are most likely to succeed to avoid burdening you with too much information.

- When it comes to veggies, it is advisable to include carrots, beets and celery- they can be used to enrich kibbles. With a sensitive digestive tract, microgreens are always a good idea- but in case of kidney deficiency, you must be aware that they can be up to 40 times richer in nutrients, including not only antioxidants and vitamins but also minerals like potassium. Do your research, but always consult a vet, and even after introducing something, do regular blood checks.

Explore complementary treatments with your vet

These are all different roads to the same goal – and the only roadmap is that the dog is always the one who chooses what is right. If the dog stays- it feels good. If the dog moves, you do not insist. Your vet needs to give his or her blessing but after that, you still let your dog make the call.

- Swimming is the best therapy

Whenever possible and ideally in warmer months, swimming is literally an all-in-one remedy for arthritis. Water allows easier movement and eases stress on painful joints, improving flexibility, building strength, and favoring cardiovascular health. It is literally ideal because it eases stiffness while strengthening muscles- and without the strain on joints.

- Myofascial Release therapy

Undoubtedly, Maza's favorite treatment of all time. MFR tells the story of fascia fantasia, a gentle yet strong net that holds the body's power of alchemy. If you ever prepared a chicken breast, you know that thin, whitish, film-like membrane like a natural wrapping that is insanely tough. Well, that is a fascia. It is a net wrapped around our muscles, organs and tissues, providing support to our body like an internal 3D web of tissue. In simple words, it is wrapped around everything and it connects everything. When her majesty, the fascia, is tense, the whole body suffers, and our dogs feel physical pain, or better said- limitation or restriction. Fascia also stores emotional tension so if you want to relax your dog, you want to begin with fascia and very often, you end up completing the job altogether as once that tension is released, the body’s self-healing mechanism does the work for you. This is because fascia can be thought of as the highway of the body with information flowing through it more quickly that our mind can comprehend. MFR helps with easing or even eliminating pain, it eases stiffness, helps correct postural changes, boosts movement capacity and so on. It’s a gentle touch with the whole palm, both hands on deck, remaining still for at least 90 seconds in order to activate collagen production and indirectly letting the body respond. Working on the fascia is a touch like no other, as too strong of a pressure will cause the body to stay locked in protection mode, yet it needs to work its magic gently enough to allow the body to relax. What you feel under your hands is literally the Universe.

As difficult as it is to put it in words, this technique helps the body rearrange itself, by releasing the tense fascia, the body retrieves its free flow which is everyone’s best shot at being well and our dogs are no exception. It is undoubtedly something that everyone needs to experience and dogs deserve it more than us as compensation for this dreadful world they are so generous to accompany us in. Training yourself to perform this treatment at home is possibly the best gift you could give to your dog, not to mention the stress-free power you’ll have prior to vet appointments and medicine application.

*Stretching has been left out on purpose as in this kind of condition, it can cause pain and even harm when used without proper guidance. The MFR treatment does include carefully selected mild stretches and only those that the dog allows and enjoys.

- The EMMETT Technique

I have recently discovered this technique as I met two of its practitioners. Through third finger pressure on specific so-called EMMETT points, it uses gentle, light-touch to relieve muscle tension, improve movement, reduce pain, and correct posture. The thing I disliked is that the dog should not be touched afterwards for a specific time frame to allow optimal working of the treatment, however its benefits for athletic, aging, or stressed dogs is unquestionable, especially when it is used as part of a combined treatment (so for example, upon completing the MFR treatment which most commonly leaves the dog asleep in deep relaxation). The reason why I prefer MFR is that it gets the soothing and relaxing impact almost immediately upon commencing treatment while it is the end result of the EMMET technique.

- Warm compress (herbal or Epsom salt with essential oils)

This is my favorite way to complement the MFR treatment during the winter to fight the cold that aggravates arthritic issues. It’s like combining touch and warmth that does more than feel good- it increases blood flow (circulation), delivering oxygen to fatigued tissue, helping to eliminate waste products, while also stilumating nerve fibers that ‘close the gate’ of pain signals traveling to the brain, further deepening relaxation and so on… most importantly, fascia loves it too as cold, like dehydration, makes it stiff, but warmth and hydration help it change it state to become more fluid. We simply spice it up either with herbs that you will steam for 5minutes or just warm Epsom salt and put a few drops of dog-friendly oils like ginger (warming and circulation-boosting) or lavender (relaxation) and frankincense (bones love Boswellia but as a supplement, it does not have what you’d call an enjoyable flavor alone), but literally like 2 drops total. I was lucky that my dear friend and aromatherapist, Lejla, got inspired from our exchange to create a blend Fascia Relax that includes the non-negotiable frankincese, circulation-boosting rosemary, warming black pepper, fresh and antimicrobial litsea and the sharp vetiver that promotes a deeply rooted tranquility.

You put the herbs or the salt with essential oil drops in a sock, tie it and voilà. Remember, less is best. Keep it simple and let your dog do the talking. Make sure it is not too hot, put the improvised 'ball' gently on your dog’s shoulder, elbow, throughout the spine and don't worry, you will be told where it feels good!

- Cabbage compress

No matter how much science progresses, cabbage leaves remain nature’s miracle aid. While they cannot cure, they undoubtedly help with swelling and pain. You can either crush or roll the leaf to make it release its juicies, wrap it around the joint, you can use elastic bandaid to fix it and ideally, keep it overnight or at least 20-60 min). I’ve also used it with castor oil in attempt to heal Maza’s paws from IVs.

- Low level laser therapy or Luma Soothe

While laser therapy will usually be part of the physical therapy treatment at the vet as it targets deep tissues, you can use a safe at-home aid which uses LED lights at specific wavelengths. This so-called light energy stimulates the healing process, from increasing circulation and blood flow to reducing inflammation, targeting joint and hip discomfort as well as sore muscles. It is also used for other purposes, such as for skin issues and wound healing.

- Homeopathy

For me, homeopathy is a tool that helps restore one’s factory settings’. What I adore about animals is that you can see the effect straight away and in Maza’s case, she even learned to choose her own remedy (by spitting out the one that is not right for her, despite being the one 'by the books').

When we speak of dogs, you will usually see the potency 30c. This is the ‘beginning’ of homeopathic magic, a gentle form that is more than enough when it comes to both dogs and children.

When it comes to arthritis, you will always hear of Rhus Tox which is the #1 when it comes to chronic joint and muscle pain but more importantly, its magic works best when stiffness that eases with movement. What I like to do is make a ‘musculoskeletal tonic’, by combining it with Ruta Graveolens that targets tendons and ligaments that also suffer with stiff and sore joints, and last, but undoubtedly not least, the universal Arnica Montana. Arnica has a long history and such a variety when it comes to use, you will find it in skin creams and gels as well, but when it comes to any injury or discomfort on any level, Arnica is always the first stop with its analgesic and anti-inflamatory properties.

A homeopath will be able to dive in deeper and seek the root cause as just like us, every dog is different. For example, Dr. Pitcairn (DVM), whose book I cannot recommend enough as it has been my loyal companion for almost 15 years, developed homeopathic protocols for inherited joint and bone disease, as well as for when the condition comes on suddenly and is accompanied by a fever.

- Acupuncture with moxibustion

Especially advised for seniors with stiff joints and tense muscles, but also for dogs that need to recover from whatever and benefit from an energy boost. While it might get a bit uncomfortable as let's be honest, who loves needles, no one can dispute its magic. Working the right acupuncture points can relax stiff muscles, improve joint mobility, reduce pain by stimulating the release of endorphones (known as natural analgesic), reduce inflammation by promoting the release of vascular factors and stimulate regeneration. But, for me- for the dog to feel at ease and comfortable is just as important as the effect when selecting the treatment, which is why MFR remains my top choice.

Besides needles, the treatment can be complemented with moxibustion. My personal prefence is a moxa box as opposed to stick (distance method), it is kept 30cm away, with mild heat, one stays 30-60 seconds per area and continues to move throughout the acupunture points. Needless to stay, if the dog moves away or shows any form of stress, panting, whinning- you stop immediately. Remember, dogs have more sensitive skin their humans.

- Kinesiotaping

This technique applies elastic, adhesive tapes to the skin (therefore trickier in longer hair dogs as one ideally should shave the are in question) in order to improve the function of the injured muscle, facilitate movement in the joint, reduce swelling as it aids lympathic and blood congestion, consequently improving micro-circulation which altogether results in pain reduction. Although you'll find plenty of courses on KT, what makes it work miraculously is when it's being placed by an anatomy expert.

- Bemer Therapy for boosting microcirculation

Promotes regeneration and relaxation as it supports parasympathetic processes in the organism and thus promote regeneration and relaxation.⁽Improves suppleness able to reduce muscle-related back pain. It can also help to improve the flexibility of the spine. Improves response to anesthesia during surgery. What’s more, it can aid recovery following surgery. Maza enjoyed it without any doubt but I was lucky to have this machine in my posession, otherwise investing in 42 days of therapy would not be among my priorities to be honest, as its effect is quite subtle, it definitely accumulates over time especially in terms of preventive care and boosts all your other efforts significantly, but on its own, its effect remains subtle.

Walks will be shorter and jackets during winter are no longer optional - but that does not mean they cannot remain just as enjoyable for both of you, maybe even more as they take on a somewhat meditative form, as slowing down helps us to stay and appreciate the present moment.

That is all folks when it comes to osteoarthritis - for now :) The post will be supplemented with images and video for further clarification and like the remainder of this blog, will be updated and expanded whenever new knowledge comes so I am waiting for your in the comments section below- constructive criticism, feedback, input and suggestions are always welcome.

If you feel like supporting further creation and contributing to the development of the KahuLand concept, feel free to email ivana.rzehak.popovic@gmail.com.

PLEASE NOTE: the various treatments described are for educational purposes only and definitely not for you to feel pressured to do all of them. My goal was for anyone whose dog is struggling with arthritis to know that many ways to help him or her feel better. But at the end of the day, what matters is that you do your best, as your love and loyalty are what ultimately count the most. I think that what we fail at the most is being present. They show us and teach us how simple it is, yet we tend to get lost in checklists... but especially when our dog is not at its best, we get lost and somehow addicted to treatments and all that action... forgeting that just being present is perhaps the greatest power we've got, as they are so pure that it is that simple... that small measure of peace that activates that miraculous exchange and creates a love bubble that only the two of you can create.

With love,

Maza's Ivana

DISCLAIMER: Nothing can replace a veterinary consult and/or treatment. If your dog is under medical treatment or has a diagnosis that requires it, any advice should be used under veterinary supervision. This blog's purpose is purely informative and educational. The author is not held responsible for the reader who chooses to self-medicate his or her dog.

References:

Dr. Pitcairn’s Complete Guide To Natural Health For Dogs & Cats - Richard J. Pitcairn, DVM, PhD, and Susan Hubble Pitcairn

Canine Manual Therapy MFR 4 DOGS – Kristina Radović, with my gratitude for contributing to this post.