2 of 2: Does arthritis have to mean euthanasia?

I palpated nothing abnormal in Roscoe’s abdomen so I began to examine his legs. First I had Liz lead her pet around the yard so I could see how he did on a routine walk. His rear end was obviously weak, but I didn’t see anything more specific. When Roscoe stood up earlier for me to continue his exam, I had noticed definite weakness and difficulty in getting up. After walking a few minutes, I l had Liz stop him in front of me and I continued the examination.  Starting with his front limbs, I turned each of his feet over so that he was standing on his knuckles. With a normal placing response (evaluates neurologic function-not arthritis), he would immediately flip each foot back over to stand on the bottom.  He did this; there was no deficiency here. Please notice I am examining his front end even though I have seen no problems here yet. Every pet needs a complete exam regardless of where we think the problem is. Once we had finished our exam it was obvious that Roscoe’s discomfort was mostly in his hips. I could elicit no pain when examining any other joints.

“Have you ever heard of hip dysplasia?” I asked Liz.

“I’ve heard of it,” she responded, “but I really don’t know what it is.”

“This is most commonly diagnosed in large, older dogs but it can be seen in any size and age dog. It just causes the most obvious signs in these guys. The hip is a ball and socket joint, and in hip dysplasia (which is usually genetic) the socket isn’t as deep as it should be and as the dog ages (though this can be diagnosed in young dogs, also), the joint becomes more and more unstable. The body produces a lot of extra bone and arthritic changes as it tries to stabilize the hip but that only makes things more painful. With a younger dog, I would recommend x-rays to further evaluate the joint, but it would be difficult to get good pictures without some sedation because of the pain. At his age and with these symptoms I have no doubt about the diagnosis.”

“So what can we do to make Roscoe more comfortable? I will do anything I can to keep him around longer. I don’t care if it’s only for a month or two. I just want him to be more comfortable.”

“I would treat this the same way I would treat any joint disease in the older pet. First, we evaluate his weight and in Roscoe’s case, his weight is fine so we don’t need to make any changes there. He does belong on a diet for older dogs and there are some prescription diets for arthritis, but we’ll talk about diet later. Secondly, we need to talk about exercise. The less Roscoe moves around and the less you walk him, the more difficult it will become for him to get up and walk. We all need to keep exercising as we get older. That might begin as an easy five to ten minute walk once or twice daily. As he gets stronger we can increase that. I think walking your dog is also a quality of life issue. They just enjoy walking with us. Thirdly, he needs to be on medication for the pain. If he was much younger, I would talk about glucosamine, but at his age a non-steroidal combined with a pain medication like tramadol (a narcotic-like pain medication) tends to be very effective. Before we start these medications, we should run a blood screen to be sure we aren’t missing anything and that there are no contraindications to these medications. If he responds well, in a month we may want to repeat some basic blood tests to be sure that he is having no ill effects from the medication. Once you begin this exercise and medication regimen within a week you should be able to decide if we are helping Roscoe. Don’t try to read between the lines. If there is improvement, it should be obvious.”

After only a few days Liz called to tell me how thrilled she was with how well Roscoe was doing. He was up to two 10 minute walks each day. He was having no more trouble with the back steps; he was clearly enjoying life once again.

I had cautioned Liz that I didn’t know how much longer we could keep Roscoe comfortable and she understood. She explained that she would do anything she could to buy even a little more time with her best friend. He did quite well for close to four months and then began to slowly deteriorate again. When we met again at the cemetery, Liz and I were both thrilled with the four good months we had bought her pet. We both had tears in our eyes when we said goodbye to Roscoe one last time.

During almost 40 years of practice I have seen some dogs (and cats) respond to treatment and do well for years and I have seen others we simply could not help. More often than not, pets do well on medication, but unfortunately, it’s often hard to predict results; you just have to try. Again, this is a 3 step program that needs to be supervised by a caring veterinarian. . You have to be willing to evaluate your pet’s diet (he belongs on a quality senior diet and he needs to be weight appropriate), he needs exercise, and he needs prescription medication. Home remedies can be ineffective or even dangerous.