Treatment In-depthMedical therapy, exercise restriction and loss of excess weight are the hallmarks to medical treatment. Treatment for DJD may include one or more of the following:
Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs primarily inhibit inflammation activity. In particular, NSAIDs they inhibit the synthesis of prostaglandins. While this is good, there is also a major side effect. In the stomach, prostaglandin helps protect the stomach lining from the normal stomach acids. People and animals on some of the early NSAIDs (aspirin, phenylbutazone and ibuprofen) experienced variable gastrointestinal side effects. Deracoxib (Deramaxx®), carprofen (Rimadyl®), meloxicam Mobic® or Metacam®), Tepoxalin(Zubrin®) and etodolac (Etogesic®) are cyclooxygenase 2 (COX2) inhibitors that specifically act against the pathway directed at the joints but selectively leaves the pathway to protect the stomach (COX1) intact. Although these drugs alone can produce idiosyncratic side effects, they appear to be superior over earlier NSAIDs.
Osteoarthritis agents. This slow acting class of drugs help to modulate the progression of DJD. Many of the oral varieties are not regulated by the FDA and fit in the classification of nutraceuticals (vs. pharmaceuticals). The majority of these supplements contain glucosamine and chondroitin sulfate (remember, these are the main chemical substances making up the cartilage matrix). Cosequin contains purified glucosamine, condroitin sulfate and manganese ascorbate. It is hypothesized that, with DJD, the demand for cartilage precursors or building blocks is greater than the body's ability to make them. This results in a diminished repair capacity. This is only theory and no hard scientific evidence illustrates the cartilage cells are nutritionally deprived. A number of studies have shown that these compounds do incorporate in healing cartilage and anecdotal reports are favorable. Many times these compounds are used in conjunction with NSAIDs.
Dietary therapy with diets such as Hill's® Science Diet® j/d™ or Purina® JM Joint Mobility™ brands may be beneficial in some dogs. These diets are formulated with Omega-3 fatty acids, glucosamine, and chondroitin sulfate and help to maintain weight, reduce pain and improve mobility in dogs with osteoarthritis. It is also extremely beneficial for dogs with joint disease to maintain an ideal body weight.
Surgical treatment of end stage DJD results in either removal of one side of a joint and allowing a "false joint" to form. Since there is no longer any rubbing of the joint surface, much of the pain is eliminated. This classically was done for hip dysplasia (femoral head ostectomy). Obviously the joint has been de-stabilized, but many smaller animals can accommodate very well.
In larger breeds of dogs, prosthetic replacement has a much more predictable outcome. Total hip replacement has been successfully performed for 30 years in the dog.
In other joints, surgical fusion of a joint might be helpful. By eliminating the joint surfaces and allowing the joint to fuse in a functional, anatomic position, many dogs can have a pain-free existence with adequate mobility.
Follow-up
It is extremely important to follow your veterinarian's instructions for pet care, especially if surgery was performed. Rest and limited leash walks are usually recommended for three to four weeks postoperatively. Watch any incision your dog has for heat, pain, swelling or discharge.
