Sublaxation, Hip   

Luxation and dislocation are roughly the same term when discussing joints. So subluxation and partial dislocation would be analogous as well. The most common cause of subluxation of the hip joint in young dogs is hip dysplasia. It is sometimes possible to identify the subluxation as early as 3 to 4 months of age with X-rays. It can take up to two years for there to be clear evidence of subluxation sufficient to diagnose hip dysplasia although the great majority of dogs with this problem show signs much earlier.

In dogs with moderate subluxation, it is often possible to surgically alter the hip socket so that the luxation is corrected and reasonably normal hip function returned, using a procedure known as a triple pelvic osteotomy. This procedure requires considerable orthopedic surgical skill and equipment and is often done at referral centers and veterinary hospitals in the United States, rather than at a general practitioner's facility. It is also possible to replace the hip joint.

In large breed dogs this can be done at an early age due to their size. Both of these procedures are expensive enough that many owners find themselves in the position of having to consider euthanasia when the problem is severe and funds for surgical repair low.

There are some other causes of abnormal development of the hips. Infection with Neospora caninum causes muscular atrophy sufficient to prevent normal development of the hip joints in some dogs. Trauma can do this and there are probably other causes. Info from http://www.vetinfo.com

 

Fibrocartilaginous Embolization  

Spinal cord fibrocartilaginous embolization is caused by a small fragment of intervertebral disc material entering the spinal cord’s vascular system via the tissues attached to the intervertebral disc. Embolization is the sudden blocking of an artery by a clot of foreign material (an embolus). The tiny fragment of intervertebral disc material (embolus) results in varying degrees of damage depending on the portion of the cord supplied by the embolized blood vessel. Thus, the clinical signs are variable.

Fibrocartilaginous embolization of the spinal cord is the functional equivalent of a stroke to the spinal cord rather than to the brain. The events are acute, nonprogressive, and occur without any prior signs or warnings. Because emboli can occur in any portion of the cord, clinical signs can involve the rear limbs, all four limbs, one side of the body, or only one limb. The syndrome is not painful but can result in paralysis. After the initial spinal cord shock subsides, one side of the body frequently remains worse or is slower to show improvement.

In general, if deep pain perception is intact to the paralyzed limb(s), recovery will begin in two to three weeks with most clinical function restored by four months. In most cases, once the diagnostentative diagnosis of a fibrocartilaginous embolism is made based on history and neurologic examination. Radiographs (x-rays) are evaluated to ascertain the presence of degenerative discs and may outline other abnormalities in the spine including fractures and dislocations. A definitive diagnosis may require a myelogram (contrast dye study of the spine). Spinal cord swelling may be seen with a myelogram immediately after the embolus causes an infarction (a localized area of dead cells produced by occlusion of the arterial supply to that area). If several days have passed since the onset of clinical signs, the myelogram will be normal. Other findings with a myelogram may include intervertebral disc extrusions, tumors, fractures, hematomas, or hemorrhageis and degree of clinical damage is ascertained, an accurate prognosis can be made.

Dogs experiencing an acute episode of fibrocartilaginous embolism are immediately treated once the diagnosis is confirmed. Intensive medical therapies are of value only during the first 24 to 48 hours after the spinal cord damage has occurred. Medications used include corticosteroids to relieve spinal cord swelling and to prevent collateral damage. Surgery is not indicated in the treatment of spinal cord infarction. After initial medical management, intensive nursing care and physical therapy are required. The goal is to maintain muscle tone while the spinal cord tissue heals.

The prognosis in cases of fibrocartilaginous embolization depends on many factors:

• The severity of neurologic dysfunction
• The amount of disc material that has embolized
• The degree of accompanying spinal cord swelling
• The location of the spinal cord infarction
• The overall physical condition of the patient

In general, the ability to perceive deep pain in the affected limb(s) and tail remain the major prognostic indicator. Even if paralysis is complete, the perception of deep pain remains the key to determining if permanent damage has occurred. This means that, even if paralysis has occurred, if the conscious perception of deep pain is intact a functional recovery is anticipated. The time required for recovery and the degree of neurologic improvement are quite variable. Diligent physical therapy and good nursing care are important for recovery.

© 2004 Southern California Veterinary Referral Group

Patellar Luxation (Slipping Kneecap)  

by Jennie Bullock

Patellar luxation is the dislocation (slipping) of the patella (kneecap). In dogs the patella is a small bone that shields the front of the stifle joint. This bone is held in place by ligaments. As the knee joint is moved, the patella slides in a grove in the femur. The kneecap may dislocate toward the inside (medial) or outside (lateral) of the leg. This condition may be the result of injury or congenital deformities (present at birth). Patellar luxation can affect either or both legs.

The most common occurrence of luxating patella is the medial presentation in small or miniature dog breeds. Shallow femoral groove, weak ligaments and malalignment of the tendons and muscles that straighten the joint are all conditions that will predispose a dog toward luxating patellas. Indications of patellar luxation are; difficulty in straightening the knee, pain in the stifle, limping, or the tip of the hock points outward while the toes point inward. The diagnosis of this condition can usually be confirmed (by a veterinarian) by manipulating the stifle joint and pushing the patella in and out of position.

Patellar luxations fall into several categories:

1. Medial luxation; toy, miniature, and large breeds
2. Lateral luxation; toy and miniature breeds.
3. Lateral luxation; large and giant breeds.
4. Trauma induced luxation; various breeds.

Categories 1, 2, and 3 are either hereditary or strongly suspected of being inheritable. Beyond the categorization of patellar luxation there are 4 grades of deviation for this condition:

Grade 1: Intermittent patellar luxation - occasional carrying of the affected limb. The patella can easily be manually luxated at full extension of the stifle, but returns to proper position when pressure is released.

Grade 2: Frequent patellar luxation - in some cases luxation is more or less permanent. The affected limb is sometimes carried, although the dog may walk with the stifle slightly flexed.

Grade 3: Permanent patellar luxation - even though the patella is luxated; many animals will walk with the limb in a semi-flexed position.

Grade 4: Permanent patellar luxation - the affected limb is either carried or the animal walks in a crouched position, with the limb partially flexed. Medial Luxation in Toy, Miniature, and Large Breeds Termed "congenital" because the luxations occur early in life and are not trauma associated.

Clinical indications:

1) Neonates and older puppies - display clinical signs of abnormal leg carriage and function from the time they start walking. These cases are generally grades 3 or 4. 2) Young to mature animals - usually exhibit intermittently abnormal or abnormal movement all their lives. Generally evaluated when the symptomatic gait worsens.

Most often grade 2 or 3. 3) Older animals - may exhibit sudden lameness. Usually due to further breakdown of soft tissues or the degenerative nature of joint disease. These cases are usually grade 1 or 2. Lateral Luxation in Toy and Miniature Breeds Lateral luxation in small breeds is most often seen in dogs between 5 to 8 years of age.

The skeletal abnormalities in these cases is most often obscure. Most of these cases are grade 1 or 2 and the dog tends to exhibit a more functional disability. Lateral Luxation in Large and Giant Breeds Animals usually appear to be affected by 5 to 6 months of age, with bilateral involvement being the most common presentation. The most noticed symptom is a knock-knee stance. The patella is usually reducible.

Cranial Cruciate Ligament Rupture   

Cranial cruciate ligament rupture (CCL) is the tearing of an important ligament in the stifle joint (knee), resulting in partial or complete joint instability, pain, and lameness. Torn ligaments retract, do not heal, and cannot be repaired completely. If the injury is not treated, damage to connective tissues and degenerative joint disease often results.

The femur (large bone of the thigh) and the tibia and fibula (two smaller bones in the shin) meet to form the stifle joint. Articular cartilage attaches to and covers the ends of bones, protecting and cushioning them. Ligaments, tendons, and muscles hold the bones in place, stabilize the joint, and enable movement. A joint capsule, filled with nourishing and lubricating synovial fluid, surrounds the entire joint.
Four major ligaments (dense bands of fiber) support and stabilize the stifle joint by connecting the femur to the tibia and the joint capsule to the bones. The medial and lateral collateral ligaments are located outside the joint and the caudal and cranial cruciate ligaments are located inside the joint.

The cranial cruciate ligament (CCL) attaches to the femur, runs across the stifle joint, and attaches to the tibia. The CCL holds the tibia in place and prevents internal rotation and hyperextension.

The meniscus (fibrocartilage located between the femur and tibia) absorbs impact and provides a gliding surface between the femur and tibial plateau. The patella (kneecap) protects the tendon of insertion of the cranial thigh muscles.

Cranial cruciate ligament (CCL) rupture occurs in both dogs and cats. CCL rupture occurs more frequently in dogs than in cats.
CCL is one of the most common orthopedic injuries in dogs and is the most common cause of degenerative joint disease in the stifle joint. Female dogs (especially spayed), overweight, and poorly conditioned dogs have a higher incidence.

CCL rupture occurs in dogs of all sizes, but is most prevalent in large and giant breeds including:

• Bernese mountain dog
• Bullmastiff
• Chow
• German shepherd
• Golden retriever
• Labrador retriever
• Rottweiler
• Saint Bernard

Chronic onset (degeneration and rupture usually from aging) occurs in 80% of cases and occurs in dogs 5 to 7 years old. Acute onset (tear caused by injury) is most common in dogs under 4 years old. Young dogs of large breeds are more susceptible to rupture than young dogs of small breeds.

Causes

Acute rupture of the cranial cruciate ligament (CCL) is caused by sudden, severe twisting of the ligament. The injury usually occurs when the animal steps in a hole while running or turns with its paw remaining planted. The twisting motion causes the ligament to hyperextend or rotate excessively and partially or completely rupture. The meniscus is often damaged as well.

Chronic rupture occurs after the ligament has degenerated with age. The fibers weaken and partially tear, the joint becomes unstable, and degenerative joint disease develops. A partially torn CCL eventually tears completely.

Risk factors include:

• Age
• Arthritis
• Injury to stifle joint
• Large or giant breed
• Overweight
• Poor musculature near the joint
• Structural abnormalities (e.g., bow-legged, luxated patella)

Article found in www.animalhealthchannel.com

 

Legg-Calve-Perthes Disease (aseptic or avascular necrosis of the femoral head)  

Avascular necrosis occurs when the bone that makes up the ball portion of the hip is damaged from lack of blood supply. The reasons this occurs are not clear. Since a higher incidence of this disorder is noted in several dog breeds, including terrier breeds, miniature pinscher, poodles and possibly schipperkes, it is assumed that there may be a genetic component to the problem. In Manchester terriers, the genetic component appears to be a strong influence and heritability is pretty high for this problem.

Most of the time the clinical signs of this disease occur in 4 to 11 month old dogs and usually consist of lameness of one leg only. Pain may be mild to very severe. Some dogs have mild forms of this condition and do not require medical care. In other dogs, the condition cause sufficient pain and deformity of the hip joint to require surgical intervention. The disorder can usually be confirmed with X-rays. Atrophy of the muscles of the affected leg is not uncommon. If this is severe it can slow the recovery period considerably and may make medical therapy less likely to work. Treatment of this condition varies according to the severity of the signs seen. In mild cases, enforced rest may be sufficient to allow healing of the damaged areas to occur. In some cases, immobilization of the affected limb using an Ehmer sling may be beneficial to recovery. Many dogs have advanced cases of this disease by the time they are examined by a veterinarian and medical treatment is not likely to work. In these dogs, excision of the femoral head (ball portion of the hip joint) is often beneficial. Removal of this section of the bone diminishes painful bony contact in the hip joint. Recovery from this surgery can be slow with recovery periods of up to one year sometimes occurring before good use of the affected leg returns. If muscle atrophy is not present at the time of surgery the recovery time is usually much less. Pain relief and anti-inflammatory medications may be beneficial. There is a stronger tendency to treat this as a medical condition prior to surgery right now. A general rule of thumb is to allow non-surgical therapy a month to show a beneficial response. If one is not seen, surgical repair should be considered more carefully. http://www.vetinfo.com/dencyclopedia/deindex.html

 

Fragmented coronoid process and osteochondrosis dissecans in the elbowjoint of young, fast growing dogs. (S. Schleich)  

Introduction:

Osteochondrosis (-chondritis) of the elbow joint and/or fragmented coronoid process of the ulna are diseases of increasing importance in young and fast growing dogs of larger breeds for the last twenty years after they had been described for the first time. These diseases result in lameness and secondary arthrotic changes which influence the dog's further employment.

Aetiology:

Osteochondrosis (OCD) of the elbow joint is, like in other joints, defined as disturbance of enchondral ossification of the jointcartilage during the period of fast growing. The cartilage of the medial humeral condyle thickens, resulting in nutritional failure and leading to the development of fissures or cracks in the surface of the cartilage. In many cases cartilaginous pieces can be found, sometimes as free jointbodies.

The distal joint surface of the elbowjoint is shaped by two different bones. The proximal radius, carrying about 80% of the bodyweight during load and the proximal part of the ulna with a small lateral coronoid process and a bigger medial coronoid process both contributing about 20% of the bodyweight received from the distal humerus.

The medial coronoid process consists of cartilage until the 4.-5. month of life until ossification starts. During this period it is very sensitive for stress.Since it is not entirely understood why the coronoid process fractures, many possible aetiologies have been discussed, some of them representing a combination of individual theories.

Disturbance of enchondral ossification like in OCD-lesions is one possibility. In addition a step between ulna and radius (ulna too long) during growth can result in a stressfracture of the medial coronoid process. A to small semilunar trochlear notch leading to cranial subluxation of the humeral condyle and overload of the medial coronoid process can be an alternative reason. Both diseases, FCP and OCD can occur in one joint, but frequently both frontlegs are affected.

Both, fissures or cracks in the region of humeral trochlea and fractures of the medial coronoid process allow a contact between subchondral bone and degenerated material with synovial fluid causing inflammation, joint effusion, pain and lameness and secondary arthrosis (degenerative arthrotic changes) later on. FCP and OCD occur frequently in breeds like Rottweiler, Golden Retriever, Labrador Retriever, Bernese Mountain Dog, Newfoundland, St. Bernhard and German Shepherd dog. Most of the affected dogs show a higher bodyweight compared to other puppies of the same age ( weight about 17-25 kg and higher). Males are up to three or four times as much affected as females (possibly the result of the higher bodyweight and the faster growth of males). The disease develops during the 4.-5. month of age, when the highest rate of growth takes place. The development of OCD and/or FCP is promoted by overnutritition (high protein, high energy, additional supply of minerals, Ca++) because the genetic predisposition for fast growing will be used and disturbances of enchondral ossification becomes more likely. Dogs with early exercise are more often affected.

Clinical examination:

Lameness can occur in the age of four or fife month. In the beginning the puppy shows a mild to moderate lameness sometimes intermittent and mutual. Occasionally only a stiff and shortened gait is visible. Particular when the disease affects both elbows, owners notice first signs of lameness of one leg after an additional trauma, resulting in intensified pain of one elbow. At this time the dogs may have reached an age of 10-14 month and secondary arthrotic changes have increased.

In addition to lameness the dogs hold their elbows close to their chest and show an outward rotation of the paws. The affected joints may show effusion, pain on full flexion, extension and palpation in the region of the anconeal process and the medial jointspace. In advanced cases crepitation and muscular atrophy can occur. Lameness can increase to extreme degrees and is often resistant to conservative therapy.

Radiology:

Radiology plays an important, if not a key role, in the diagnosis of FCP and OCD. Different views of x-ray projections have been recommended in the past in order to diagnose the changes, but there is no doubt amongst all veterinarians that the pictures taken must be of excellent quality, since changes in the bone/joint structure can be sophisticated.

Furthermore arthrotic changes are important for an early diagnosis. First changes consist of sclerotic areas posterior to medial coronoid process or deformation of it, arthrotic changes at the dorsal part of the anconeal process and anterior to the head of the radius. Later on osteophytes in the area of the med. epicondyle and anterior notch of the trochlea occur.

Therapy:

Basically in cases of OCD and/or FCP two different possibilities of medical treatment exist. One is the conservative treatment: The dog receives non steroidal antiinflammatory drugs (NSAIDs), exercise is decreased and further examination 3-4 weeks later is recommended.
In some cases of OCD, with only small defects and no isolated jointbodies the complaints will disappear (occasionally very tiny pieces of cartilage can dissolve).

All others require early surgical treatment, before secondary arthrotic changes occur and the prognosis deteriorate.
Different approaches for surgery of OCD of the humeral trochlea and FCP, have been described, most of them being medial approaches. The common target amongst all is to remove the fragments of bone and/or cartilage and curette the defect in order to fill the defect with fibrocartilage.

Prevention:

The actual situation of FCP and OCD in breeds with genetic disposition for these diseases can be improved and manifestation can possibly be avoided in young growing dogs, if their surrounding conditions, like feeding, exercise and playing activities are changed or improved..
Once the puppies are three month of age, they must not be overfeed with proteins and minerals, (Protein app. 22-25%, no additional minerals (Ca++)), controlled exercise is of great importance as well. Controlled feeding will not lead to a smaller size, but the dogs will grow slower and they will be less susceptible for growth disturbances, which occur between the 3.-7. month, when fastest growing rates are present.
For early diagnosis it is important to perform a detailed examination in young dogs of affected breeds (first with about 4-5 month of age including clinical and radiological techniques). In case lameness exists without visible changes in the x-ray, continuos control of the dog's lameness is mandatory and all examination techniques should be repeated four weeks later (often secondary arthrotic changes have increased by this time and diagnosis is now possible).

The most important target is to prevent OCD/FCP by selection for breeding since both have proved to be a hereditary disease.
In 1989 a group of specialised veterinarians, like in hipdysplasia programs, from different countries formed a society in order to study the incidence of FCP/OCD and statistically analyse the disease in affected breeds (International elbow working group). Since numerous x-rays of different views are required to diagnose FCP/OCD, members of this group basically ask for one x-ray (flexed ml view) only, differentiating mainly some degrees of arthrosis (proceeding on the assumption that all different elbow diseases lead to the development of arthrosis). As a main condition for this examination dogs must be at least one year of age (similar to HD), in case lameness occurs earlier, the examination will be performed immediately.
The results of all these examinations should be open to the public and to all interested people (veterinarians, breeders, genetic scientists .a.f.m.) so that information about dames and sires are available before a partner for mating is selected.

Scandinavian countries, where these breeding programs operated for many years already, dogs with arthrosis are not automatically excluded from breeding, but the owners use the possibilities of the database to select healthy (unaffected) dogs for breeding. In consequence, the incidence of FCP and OCD and the severity of arthrosis was reduced already!

This information was obtained from:

http://www.vetprof.com/clientinfo/elbow-dysplasia.html

 

Some Incorrect Approaches to exercising dogs with Arthritis  

The use of a high quality liquid glucosamine will handle most pet arthritis very well. However, the nutrition and exercise components play a big role here. What often concerns me is the exercise portion and that is particularly so with arthritic pets. And that issue goes to some cautionary notes.

Range of Motion

This is likely one of the most important issues for pets with arthritis. It is very important when trying to get a pet started on some rehabilitation from arthritis. All you have to do is manually flex and extend (very gently) the affected pet's joints. Try to focus on going slowly and gradually extending out in all directions as you do it. Again, be gentle and do not force any joints. My personal recommendation is to do this three to four times daily. You can also make this more enjoyable for your pet by following each session with some gentle massage. The idea here is to get your pet back to using limbs that have not enjoyed full range of motion for some time.

Front and Back Legs

Think about this. If your pet has arthritis in the front legs, try to avoid exercises that have your pet jumping in a downward direction. It places more stress on the affected legs and joints. Likewise, when your pet has arthritis in the back legs, avoid any exercise that would require them to jump upward.

Fatigue Defeats the Purpose

Much like humans, an injured joint is not helped by fatigue. If you overwork your pet when you are getting them into exercise after arthritis problems, this is very much an issue. Just be cautious and keep one eye open for signs of fatigue. This can be an issue when your pet is in the early stages. A high-quality liquid glucosamine will almost certainly defeat the pain and get cartilage on the road to rehabilitation. However, that does not mean that they are ready for vigorous workouts.

Vary It for Their Sake

Pets love to play. We all know that this is part of their life. But a little variety does not hurt. To the extent possible, and dogs are more likely candidates than some pets, walk and jog them. If you have a place to do so, get them swimming. They love it and it is very safe aerobic exercise.

One Final Note

Pets should never exercise right after meals. I have discussed this issue before-it can cause bloating. It is not only uncomfortable for your pet; it can have serious health consequences.

Lyme disease or lyme arthritis is an infectious disease which has been spreading rapidly  

Lyme disease is caused by a bacterial organism, Borrelia burgdorferi which is closely related to the organisms which cause syphilis and Leptospirosis (A kidney infection of dogs).

Lyme disease is transmitted by ticks through contact with several intermediate hosts. Ticks hatch from eggs in the spring and develop into larvae which feed on field mice. It is believed that many mice are persistently infected with Lyme disease and that the larvae become infected when they feed on an infected mouse. After a few days of feeding the larve drop off the mouse and enter a resting phase for an entire year! The second spring the larve become nymphs and feed again on mice and other small rodents. Toward the end of their second summer the nymphs molt into adult ticks. During the summer and fall (as long as temperatures stay above freezing) the adult ticks are found on vegetation about 3 to 4 feet off the ground where they wait to attach themselves to passing mammals.

Ticks attach themselves to their host for 5 to 7 days, mate and lay up to 2000 eggs to start the next generation of ticks. The male ticks die shortly after mating but females can survive the winter. In areas where Lyme disease is common, up to 50% of ticks can carry the disease and transmission is nearly 100% when an infected tick bites a mammal.In humans, Lyme disease has 3 distinct stages: 1) skin rash, fever, headaches, and joint pain lasting for up to several weeks; 2) central nervous system disorders, and arthritis; 3) chronic arthritis which can last for months.

Dogs with Lyme disease usually are off their food, are weak and have poor haircoats, show signs of joint and muscle pain, and have a fever and swollen lymph nodes (swollen glands). Sudden lameness or swollen joints may be one of the first signs of Lyme disease in a dog. Lyme disease is rare in cats likely because of their grooming habits.Lyme disease can be diagnosed on the basis of history, exposure to ticks, clinical signs and serological tests (or blood tests).

Fortunately Lyme disease can be treated with antibiotics and most animals will respond

Treatment is usually given for a 3 to 4 week period.

Syn Flex can ease the pain and inflammation caused by Lyme disease.

 

Hip Dysplasia   

Hip dysplasia is an inherited trait involving multiple gene pairs - it is not congenital (meaning an animal is not born with it). The condition develops over time from instability in the hip joint which results from an improper fit of the femoral head (ball-like structure) into the acetabalum (hip socket). This instability, called hip joint laxity, results in abnormal weight bearing within the hip joint. From this, secondary changes and remodeling occur in an effort to stabilize the joint or avoid bone-on-bone contact. When cartilage disintegrates from abnormal wear, the femoral head and acetabalum rub together with every step causing pain and eventual osteoarthritis.

Parts of the hip include:

1. Femur
2. Femoral Head (ball like structure)
3. Acetabalum (hip socket)

What are the Symptoms of Feline Hip Dysplasia?

It has been suggested that cats with Feline Hip Dysplasia (FHD) are not in pain. Well, unless you can talk directly to your cat, and he can answer you, how can you know for sure? Cats are rather stoic creatures and it is speculated that they hide or mask their pain well. Out in the wilds if a cat showed pain by limping or moving slowly, he would appear vulnerable and be an immediate target for predators. Our domestic cats are still driven by natural instincts that tell them NOT to limp or not to move too slowly. There may be a gradual decrease in certain movements or particular activities that cause pain. For example, a cat in pain may not jump as high as usual, or it may move more and more slowly over time. These may be symptoms that most people simply would not notice or would attribute to other things. The gradual lack of movement may go undetected until one day - perhaps years from the onset of pain - the disease has progressed so that it becomes quite obvious with limping, not climbing, not jumping or the inability to go up stairs. Even then, because onset has been so gradual and there was not a drastic change in behavior from one day to the next, some people may still not realize there is a problem. (1)

Recommended Treatments for Feline Hip Dysplasia

More progressive veterinarians who are knowledgeable about recent studies, clinical trials, and overwhelmingly positive patient response will know that glucosamine is very beneficial for hip dysplasia.

Glucosamine is an over-the-counter dietary supplement that has been shown to be effective in the treatment of hip dysplasia, osteoarthritis, and joint pain in both pets and humans. Glucosamine stimulates the production of glycosaminoglycans (GAG's), important proteins found in cartilage and proteoglycans, the water holding molecules that make up the cartilage.

Used in the correct form and quality, glucosamine has been shown to not only ease pain, but also assists in the rehabilitation of damaged cartilage. Furthermore, glucosamine is safe to use and does not have any of the side effects associated with NSAIDs.

How To Select A Glucosamine Product

Glucosamine products differ greatly. While one may work wonders for your pet, another may do absolutely nothing. Your selection of a glucosamine product should be based on four factors.

You must consider the quality of glucosamine, method of delivery to body, additional ingredients in the product, and of course price.

Simply put, the higher quality of glucosamine you use, the greater the relief to your pet. Many companies use medium grade glucosamine so you must be careful to look for the highest quality. Pharmaceutical quality glucosamine is the highest quality of glucosamine. You should only consider products that use glucosamine which is pharmaceutical quality.

Secondly, the method of delivery can make the difference between no pain relief and complete pain relief. After the breakthrough news of the 1999 The Lancet medical journal glucosamine study, glucosamine products were rushed to the market. In this haste, these companies did not take any time to do tests on their products. They simply assumed pill form would be the most effective. The latest research, however, has shown that glucosamine in liquid form is much more effective. In selecting a glucosamine product, you should look for one that is liquid form.

Also crucial to the effectiveness of the product is the other ingredients that are included in the product. Glucosamine alone, for most people, is not a cure all. Simply put, there is no cure. To receive maximum relief, you need to look for products that combine a number of arthritis fighting ingredients. You should look for a product that besides glucosamine sulfate and glucosamine HCL, also contains arthritis-fighting ingredients such as chondroitin, boswellin, bromelain, omega 3 & 6, yucca, manganese ascorbate, and vitamins A, C, and E. Syn Flex is highly recommended.

References:
1. FHDA: The Feline Hip Dysplasia Association

Minimizing the risk factors associated with veterinary NSAIDs   

FDA-CVM offers suggestions based on post-marketing experience Veterinary practitioners must weigh the serious risks associated with non-steroidal, anti-inflammatory drug usage. Specific strategies can be implemented to reduce the likelihood of harming patients. Moreover, practitioners can educate their clients by communicating the serious risks that accompany the benefits of those medications.

Vital to the mission of the Food and Drug Administration's Center for Veterinary Medicine of fostering public and animal health is its pre- and post-approval regulation of drug labeling. Label content is painstakingly crafted during products' approval negotiations and is based on thorough review of all scientific data submitted to support claims of safety and effectiveness. That content is amended, as needed, to communicate post-marketing experience that reflects what happens to patients in the real world. Post-marketing experience is reported to the CVM by drug sponsors, as required by the Code of Federal Regulations governing approved drug applications. The companies report adverse drug experiences upon notification by veterinary practitioners, pet owners, and other stakeholders. The reports are stored in the CVM's Adverse Drug Experience database and analyzed by clinical veterinarians. They review the reports and classify the likelihood that clinical signs are or are not linked to the use of a veterinary drug product.

The four most commonly reported clinical signs are vomiting, anorexia, depression, and diarrhea. Further down the list of adverse events are gastric ulceration, intestinal ulceration, renal failure, hepatic failure, and death. Many of those injuries result from product misuse and could be prevented by understanding the risks imposed by NSAIDs. Another safeguard is exercising more judicious use of these products in such ways as screening patients for hydration and for hepatic or renal disease, and avoiding any overlapping treatment with other NSAID products.

Drug risk information is communicated to veterinary practitioners and to the public through the product labeling. Labeling includes the package insert, the vial or bottle label, the carton label, the client information sheet, and some types of promotional materials. Drugs that come with client information sheets are intended to be dispensed to clients with the client information sheet accompanying the prescription. In many cases of adverse drug experiences, pet owners report they never received the client information sheet from their veterinarian. In the Jan. 15, 2004, JAVMA, staff at the CVM published an article titled"Emerging issues regarding informed consent." That article reported evidence that pet owners are increasingly concerned about risks and benefits of commonly prescribed veterinary drugs. The article stated that most of the calls received by the CVM concerning adverse drug
experiences now come from consumers rather than veterinarians. All FDA-approved veterinary NSAID products have similar risk information on their labels, including the following: The products are for use in dogs only. All dogs should undergo a thorough history and physical examination before the initiation of NSAID therapy.

Appropriate laboratory tests should be considered to establish hematologic and serum biochemical baseline data prior to, and periodically during, administration of any NSAID. The products may be associated with gastrointestinal, hepatic, and renal toxicosis.

Concomitant use with other anti-inflammatory drugs, such as other NSAIDs and corticosteroids, should be avoided or closely monitored. Patients at greatest risk for renal toxicosis are those that are dehydrated, are on concomitant diuretic treatment, or have renal, cardiovascular, and/or hepatic dysfunction. Many NSAIDs possess the potential to produce GI ulceration. The risk information is there for good reason. Adverse events reported to the CVM have included substantial numbers of reports of renal toxicosis in cats (an extralabel use), and gastric and duodenal ulceration and perforations. GI injuries occur most commonly in dogs when higher-than-label doses are administered, following surgical procedures, and after treatment with more than one product, or when treatments with different products overlap. For example, suppose a referring veterinarian treated a patient for osteoarthritis with product A, and the referral practice treats the patient with a "postsurgical pain" dose of product B. Did the latter ensure an adequate washout period for the patient to eliminate product A? Did they provide fluid support during surgery? The most common factors predisposing patients to injury are overdose, surgical anesthesia, and in-tandem administration of another NSAID and/or corticosteroid.

The following practices could help veterinarians administering NSAIDs to reduce the likelihood of adverse drug experiences and injuries: Some products have two dosage levels—one for long-term use for patients with osteoarthritis; another, higher dosage for short-term, postoperative pain. Choose dosages strictly according to body weight. Individualize dosing by titrating the dose to desired effect. (Nies AS. Principles of therapeutics. In: Hardman JG, Limbird LL, eds. Goodman & Gilman's the pharmacological basis of therapeutics. 10th ed. New York: McGraw-Hill Book Co, 2001; 45-65.)

The NSAIDs can be nephrotoxic and hepatotoxic. Screen patients for renal and hepatic disease, and monitor patients during treatment. Optimize patients' hydration status. Provide parenteral fluids for surgical patients. Do not administer NSAIDs to patients that are dehydrated. Allow an adequate washout period for patients to eliminate the last NSAID or corticosteroid they were treated with prior to administering a new NSAID. The duration that constitutes "adequate" has yet to be determined. Contact product manufacturers to determine current
recommendations. Most important—read the label. Understand the risk. Make informed treatment decisions. Provide client information sheets. Communicate the important risk information to clients. If client information sheets did not arrive with a shipment of an NSAID product, contact the distributor and the manufacturer and request that they immediately send that information. We encourage you to report this problem to the CVM as well. The CVM has a Web site that explains its monitoring program for adverse events associated with the use of drugs in animals, and provides reported reactions for veterinary drugs: www.fda.gov/cvm/index/ade/adetoc.htm. Veterinarians and pet owners can report adverse drug experiences to the CVM by calling us at (888) FDA-VETS.

–Dr. Thomas J. Moskal, Office of Surveillance and Compliance, FDA
Center for Veterinary Medicine

 

Other Conditions  

Osteoarthritis is a chronic, slowly progressing condition that is caused by the breakdown and destruction of your pet's cartilage. As that occurs, the bony structures begin to rub against one another causing pain and discomfort.

Degenerative Joint Disease involves some kind of a breakdown or destruction in portions of the joint, usually cartilage. Just as in the case of osteoarthritis, this condition does not necessarily mean that your pet is experiencing any inflammation.

Hip Dysplasia is characterized by a malformed "ball and joint" socket in your animal. As you might expect, this ill-fitting combination causes a series of complications. Here, chronic inflammation is common; calcium build-ups occur; there is muscle pain; and the tissue in the surrounding areas begin to break down.

Elbow Dysplasia is a like condition that is typically hereditary and most generally found in larger breeds of dogs. Bones become malformed and usually with resulting "bone chips" that are very painful. Typically, your pet will exhibit some lameness when suffering from this condition.

Knee (Dysplasia) is also characterized by malformed bones and bone "chips." It is painful and often obviates itself since the pet will be lame and/or limping as the condition progresses.

Knee (Stifle) joint typically involves torn ligaments which cause instability in the joint. Dislocation of the knee joint is also a problem. Inflammation is common since this is a joint that is subjected to a lot of stress and strain. In most cases it is a result of poor breeding.

Osteochondrosis is a condition where you are contending with a medical condition that results from poor breeding. Improper or inadequate diet can also cause this condition. (Both factors may be at play) It is characterized by cartilage deterioration and tissue is generally both inflamed and painful.

Hypertrophic arthritis involves excessive bone growth and/or "spurs" on the joints themselves. In such situations, the pet is typically experiencing a lot of pain.

Shoulder (Degeneration) is usually a multi-factorial situation making a clear-cut cause difficult to isolate. An unstable joint, osteochondrosis or even trauma may be the cause. (Or, a combination of factors).

Wrist Arthritis (Carpi) might be compared to "carpal tunnel syndrome" seen in humans. Usually, this area of the pet's body is affected more frequently with those who are very active.

Kneecap (Dislocation) is usually caused by poorly formed leg bones which secondarily, allow the kneecap to move or "pop" out of its normal position. Usually, this is either an inherited condition or results from poor breeding.

Syn-Flex can be given to large breed puppies as a supplement for preventative measures.

The Pet Arthritis Resource Center
The Pet Arthritis Resource Center is dedicated to bringing you the very latest news and information regarding your pets health.