Tuesday 21 June 2011

More info. on HD and ACL - Holistic Treatments to try...

 Piglet's Story  ( http://www.dogaware.com/ )
My dog Piglet (whose picture appears at the top of this page) had surgery for elbow dysplasia on both elbows before her second birthday, followed by surgery for a ruptured cruciate at age 3. She was on daily Rimadyl/Etogesic with occasional doses of prednisone up until age 7. At that time, I switched her to a raw, grain-free diet with natural supplements. She improved so much that I was able to discontinue all medications. At age 10, she ruptured her other cruciate and again had surgery (April, 2002). It took about three months for us to build back up to her usual 2 mile daily walks, but she did extremely well, became just as active as ever, and was still on no medications for her arthritis, despite the fact that x-rays confirmed severe degenerative joint disease in both elbows. At age 11, she became lamer in one elbow, and after many months of struggling to get her back to where she had been before, I put her back on NSAIDs (Metacam). She continued to be slower than before and I had to cut back on walks because she couldn't go as far. After about a year, she improved again, and while still slower than she used to be, could  go on full length walks again at age 13. Then I discovered a very small tumor in her foot, between her toes. It was removed immediately, and when she recovered, she began taking very long walks, longer than ever before. Now, at age 14, she walks 1 1/2 to 2 hours at a time, going sometimes 3-4 miles, almost every day. I suspect that the tumor had been bothering her to walk on. It never hurts to keep looking for other possible causes of lameness, even when you know your dog has bad joints.
Here is what I have done with her:
  • First, I feed a raw, grain-free diet. I also weigh all her food using a small postage scale, originally to gradually reduce her weight and now to maintain it (she weighs about 33 pounds and is lean but not skinny; she weighed 36 pounds at the age of 10 months and has been as high as 42 pounds). Keeping dogs with arthritis lean is one of the best things you can do to help them. Also, grains tend to increase inflammation and aggravate arthritis. Many dogs improve when grains are removed from the diet (most dry foods are high in grains, though there are a number of grain-free foods being offered, see my Dry Dog Foods web page for more info; note that there are also some canned foods that are grain free).
  • I give fish oil(body oil, not liver oil), Vitamin E(which should always be given when supplementing oils), and antioxidants, usually Cell Revive 880 (same as Cell Advance 880) or sometimes Thorne Veterinary Immugen. I also give a Vitamin B-50 complex daily -- note that niacinamide (a form of vitamin B3) has antioxidant and anti-inflammatory properties, and may help to rebuild cartilage. According to a vet who recommended it to me, the dosage for Piglet's size (35 lbs) is 50 mg, which is what I get in the B-50 vitamin complex that I use. See Nutrition Q & A (scroll down to the last question) for more information on niacinamide.
  • It is important that dogs with arthritis get adequate, but not excessive amounts of calcium, vitamin D and magnesium. If you are feeding a commercial diet, there should be no need to supplement with any of these. If you are feeding a home made diet, it might be helpful to supplement with small amounts of vitamin D (such as from cod liver oil) and magnesium. If your diet includes raw meaty bones, they should not account for more than around 50% of the diet. If your diet does not include bones, then you need to add calcium at the rate of around 1000 mg per pound of food (1/2 teaspoon of ground eggshell yields about 1000 mg of calcium). Piglet gets raw meaty bones as about half of her diet, and I have not been supplementing with magnesium or vitamin D.
  • I have rotated among Yucca Intensive, Bromelain, Quercetin, Boswellia, Turmeric (or its extract, Curcumin), Sam-E, Borage Oil and other natural anti-inflammatory herbs and Nutraceuticals. It is difficult for me to tell how much any of these have helped, but I believe all have had some benefit. Note that Bromelain is most effective when given away from meals for an anti-inflammatory effect (otherwise, it is used for digestion), and may work best when combined with Quercetin. See Natural Anti-inflammatories for more information.
  • Piglet has been on a glucosamine/chondroitin supplement for most of her life. I believe this is one of the most important things you can do, as these substance don't just treat the symptoms, they can actually help rebuild cartilage and restore synovial (joint) fluid. I currently use Arthroplex, which includes bromelain, boswellia, Green Mussel (Perna Canaliculus, which is a source of chondroitin) and DLPA for chronic pain. I give these supplements away from meals, which may make them more effective.
  • Piglet also gets fresh crushed raw garlic (one small clove per day), alfalfa, organic (raw) apple cider vinegar (about half a tablespoon daily) and fresh raw ginger in her food, all of which may help with arthritis.
  • Before starting Piglet on Metacam, we used Willow Bark instead of Aspirin for occasional pain relief when she overdoes it, as it is easier on the stomach. You can also use buffered aspirin, such as Ascriptin or Vetrin (which comes in smaller doses). Giving with food may help prevent stomach upset, but not ulceration. Do not combine Aspirin with Willow Bark or any NSAID, such as Rimadyl or Etogesic. Also, do not use enteric coated aspirin, which can be dangerous for dogs. See Chronic Pain for more info on aspirin and other NSAIDs.
  • Piglet got something called DogLeggs for Christmas. They keep her elbows warm and padded at all times. They appear to be comfortable, she wears them all of the time except when we go on our walks and during the day when it is hot, and she seems to enjoy them.
  • In June, 2003, I started Piglet on a supplement called Arthroplex, and have been very happy with the results. For a couple of months, she had been favoring her left elbow -- it's usually her right that gives her the most trouble, so having to favor the left made her fairly lame. I chose Arthroplex because of the DLPA, but it also includes glucosamine, green-lipped mussel, bromelain and boswellia, so I discontinued the Flexile Plus and Green Mussel and instead gave her two capsules Arthroplex twice a day (maximum dosage for her size). Within four days,  she was no longer lagging on our walks, and within a week, there was no longer a noticeable limp. She also still gets Yucca Intensive and fish oil, but no other supplements for arthritis currently. Unfortunately, after about a month of doing well, Piglet got worse again. We have continued the same regimen of supplements, including the DLPA.
  • In June, 2004, I tried switching from Arthroplex to SynoviG3, which several people had reported good success with. Unfortunately, it did not work for us and Piglet immediately got worse, even when I started adding DLPA back in separately. We have since returned to the Arthroplex, and also Yucca Intensive, which I had discontinued after starting Metacam. In fact, I am not sure how much the Metacam is helping, and have discontinued it for now, she seems to do as well on Arthroplex and Yucca Intensive as she did with Arthroplex and Metacam.
  • In October, 2004, she went back on Metacam, which really does seem to help Piglet's mobility. She's still not very fast, but she's going on much longer walks now than she was when things were bad. She continues on Arthroplex, and I switched from Yucca Intensive to an herbal blend that has yucca, alfalfa and some other ingredients (Animals' Apawthecary Alfalfa/Yucca Blend), so that may also be part of why she's doing better. I've been having very good luck recently using herbal blends in tincture form for dogs, including products from Animals' Apawthecary (Alfalfa/Yucca Blend and Senior Blend), Tasha's and Azmira. Piglet will be 13 in December.
  • In September, 2005, I found a small tumor between her toes and had it removed. When she recovered from surgery, she began taking very long walks, going 1 1/2 to 2 hours at a time, often as far as 3-4 miles. As of January, 2006, at age 14, she is walking further and longer than ever before. She is not fast, but keeps a good walking pace and does not slow down toward the end. She continues on Metacam, though I take her off it periodically and she still does pretty well, but I figure she needs all the help she can get, and since she tolerates it very well (no digestive upset at all), I keep her on it most of the time. She remains on Arthroplex and is also currently getting curcumin.
  • It's December, 2006, and Piglet has just turned 15. She continues to take me on 1 to 2 hour walks every day. I let her set the pace and decide how far we go, so as not to push her, though I occasionally have to ask her to turn back when we've gone a very long way and she wants to keep going. She currently takes Arthroplex (source of glucosamine, green-lipped mussel, DLPA, boswellia, bromelain and vitamin C), high dose fish oil, turmeric, SAM-e, vitamin E, as well as alternating between the herbal Senior Blend and Alfalfa/Yucca blend (both from Animal’s Apawthecary). In addition, she takes Metacam, and I give her one dose of Tramadol in the morning to help with walks. She is also on sertraline (Zoloft) for anxiety, which may help with pain as well.
  • Piglet turned 16 in December, 2007. She slowed down quite a bit early in the year, taking shorter walks at a slower pace. We tried shock wave therapy in August and September, which has helped a little, letting her take longer walks (usually 45 minutes to an hour, with occasional longer walks up to 2 hours, which she had not done for six months prior to the therapy), and sometimes at a trot rather than her usual walk. She remains quite healthy. She currently takes Arthroplex (source of glucosamine, green-lipped mussel, DLPA, boswellia, bromelain and vitamin C), fish oil, turmeric, SAM-e, vitamin E, as well as alternating between the herbal Senior Blend and Alfalfa/Yucca blend (both from Animal’s Apawthecary). In addition, she takes Metacam, and I give her one dose of Tramadol in the morning to help with walks (I would give more but have to be cautious about combining it with Zoloft, which she gets for her generalized anxiety disorder). I also began giving her amantadine a couple of months ago, which is supposed to enhance the effects of other pain medications; I'm not sure if it's made any difference or not. I was able to get it in liquid form thru Costco (needed in order to get the correct dosage, as the pills are too high). Zoloft (sertraline) may help with pain as well. I should also note that I have gradually decreased the amount she is fed and the amount of fat in her diet as her exercise level has decreased to help her maintain her body weight at 34 lbs.
  • July, 2008: Piglet is now 16 1/2, an amazing age for a Shar-Pei. She remains quite healthy and still enjoys her walks, but continues to be very slow. I've decided to try Pulsed Signal Therapy (PST) in the hopes that it will help her be able to go further. I stopped giving Piglet Arthroplex, as she has high blood pressure and the DLPA it contains can make that worse -- her kidneys and heart are fine, but she has some corneal degeneration and pigmentary keratitis that interfere with her vision, and I was afraid that she might blow out her retina due to the high blood pressure (she's also now on blood pressure medication). I first tried Dasuquin as a replacement, but she seemed a little worse on that, so I switched to Sea Mussel Plus and I've been happy with that. I also added three anti-inflammatory supplements in the hopes it might make enough difference that she would not need PST, but no such luck -- she may be a little better, but not a lot. The new supplements I added were Microlactin, Boswellia, and a combination Bromelain and Quercetin (I get all of these, including Sea Mussel Plus, at vitacost.com). That's in addition to her usual supplements of  fish oil, turmeric (curcumin), SAM-e,CoQ10 and a multi-vitamin, and her usual medications, Metacam and Tramadol. Piglet starts PST next week, going every day for 9 consecutive days. I will update this site if I notice any improvement.
  • October, 2008: Piglet has continued to be quite lame. The pulsed signal therapy (PST) did not help her at all. I tried switching her from Metacam to Previcox, which seemed to help but upset her stomach. I then tried prednisone, which helped a lot, but not being sure it was necessary, I tried another new NSAID, Zubrin. This one she tolerated well, but she returned to being quite lame. I've since switched her back to prednisone, which she is likely to remain on for the rest of her life. At almost 17, I don't have major concerns about its long term effects. Her dosage is every other day, which is also supposed to decrease side effects. Note that I kept her off all drugs for 72 hours in between each change in medication, as it's dangerous to switch from one NSAID to another, or to pred, too quickly.
  • January, 2009: Piglet is now 17. She is doing well on the prednisone; although still favoring her right elbow, she is able to take long walks again, averaging around an hour a day, though she is very slow. I have discontinued all her other supplements, as it's unlikely that any natural anti-inflammatories would add anything over and above what prednisone provides, and she's developed some digestive problems that seem to do better when she's not getting supplements.
  • March, 2009: Piglet is gone. She went downhill sharply in the last few weeks of her life, developing dementia and unable to cope with her limited vision. She was still mobile to the end, though very slow. She had a wonderful life, far longer than I ever dreamed when she was diagnosed with elbow dysplasia at a year old. Her condition helped me find the path to a natural diet and supplements, and to learning more about dog health and nutrition. She will always be in my heart.
From the age of 7 to 11, Piglet was in better shape with no medications than she had been at a younger age, and she did not slow down much at all. At age 11 1/2, her left elbow became quite a bit worse, and she began slowing down. In general, she has been very active and fit, but our walks decreased from an hour a day, to half an hour a day, down to 15 minutes on bad days, at age 12 1/2. She then improved again (I think she had injured her left elbow and it gradually got better), and at age 13, she went back to about 45 minutes a day. At age 14, following surgery to remove a small tumor, she began taking longer walks than ever. She slowed down again at age 15, but then gradually improved following shock wave therapy. Moderate exercise is good for dogs with arthritis, as long as you don't overdo it (tired muscles make for lax joints, which is not good).
Return to Top of Page

Surgical Options
There are email lists called OrthoDogs and CanineHD at Yahoo Groups that offer additional information about surgery for joint problems. Also see AbleDogs and Dodgerslist for dogs with back problems. There is a list called TPO that talks about surgical options for hip dysplasia and cruciate ligament repairs (also see the site at http://www.lauriebryce.com/tplo/ for a great deal of information and links about orthopedic surgery).
Note I am not advocating TPLO surgery for cruciate ligament injuries (and that is not what I had done on Piglet) -- it works well for some dogs, but I've heard of others where the joint doesn't heal properly and the dog is worse off than before. The skill of the surgeon may be a factor. Strict activity restriction is required, and failure to do so may contribute to complications. I have also heard reports, both directly and indirectly, of dogs developing bone cancer following this surgery, as well as other long-term complications. Removal of all implants six months to a year following the surgery may help to reduce this risk. I would seriously consider TPLO surgery for large, active dogs, but probably not for smaller or less active dogs, for whom conventional surgery seems to work well. See TPLO Awareness for more information. Also see Tibial Plateau Leveling Osteotomy - TPLO for a good overview. There are other forms of leveling osteotomies available as well, such as TTA (tibial tuberosity advancement). See TPLO vs. TTA for Cranial Cruciate Ligament Repair  for more information.
MSU has recently begun offering arthroscopic cruciate ligament (knee) surgery for dogs. This is combined with traditional cruciate repair, involving sutures to stabilize the knee.
There is a new cruciate surgical procedure developed in 2006 at the University of Missouri, called TightRope, named after the rope-like material used to link the two bones in the knee joint. While the material used is new, the procedure is similar to traditional extracapsular cruciate repair surgery, not like TPLO or TTA, which cut the bones. TightRope is considered an easier procedure than TPLO or TTA, especially for a general practitioner (as opposed to a surgical specialist). While the TightRope procedure is relatively new, the results look quite promising. It is more costly than traditional repair, but less expensive than TPLO and similar leveling osteotomy procedures. See the following for more information:
MU veterinarian develops 'TightRope' surgical technique
Walking the TightRope on cruciate repairs
Tightrope CCL for treating canine cranial cruciate deficiency
TIGHTROPE CCL FOR TREATMENT OF CRANIAL CRUCIATE DEFICIENCY IN DOGS: Technique and results of a prospective comparison to TPLO using a validated outcome measures
If your dog has orthopedic surgery, there are a couple of things you should be aware of that your vet may not be current on. The first is pain management, see my my section on Pre- and Post-Op Care for more information (I also have links at the bottom of that section to braces, slings and carts). Also ask about using intra-articular injections of either bupivacaine or morphine during surgery, which has been shown to provide more pain relief in the first 24 hours after surgery (see Postoperative analgesia for stifle surgery: a comparison of intra-articular bupivacaine, morphine, or saline).
The second is that recent research shows that it is important to start doing physical rehabilitation right away, at least in the case of knee surgery, rather than waiting six weeks. Contact me privately if you want a copy of the rehab instructions the surgeon gave me when Piglet had her second knee surgery in 2002 (contact information at bottom of page). See The American Association of Rehabilitation Veterinarians to locate a rehab specialist in your area.
Conservative management may be tried in place of surgery if your dog has a cruciate ligament (knee) injury. If no improvement is seen within six to eight weeks, you should then move on to surgery. It is imperative that activity be limited during this time. It is my opinion that a ruptured cruciate will do better with surgery than without, but if there is any doubt about the diagnosis (which cannot be done via x-ray alone), then it may make sense to wait. As long as activity is restricted, no harm should come from waiting for up to two months. See Treating Canine Ligament Injury Without Surgery for more information. Also see How to Confirm Partial ACL Tear for some technical information on how vets try to confirm ACL injuries and differentiate between hip and knee pain. There is a Yahoo Conservative Management group for discussing this option with others.
Changing Views On CCL Repair, written by a vet who practices "Integrative Pain Medicine and Natural Healing," talks about the use of Prolotherapy for treating cruciate ligament laxity (looseness), but I don't know whether it would help with a torn ligament, and it's hard to find a vet who does it.
See Other Therapies above for more information on rehabilitation following injury or surgery. Also see Post Surgical Aids for information on a variety of devices that may be helpful, including e-collar alternatives, slings, braces, support harnesses, and more.
The University of Tennessee is studying "The effect of diet on muscle atrophy following surgery for cranial cruciate ligament rupture." The study is ongoing as of September, 2009.
Return to Top of Page

Links to More Information

Supplements & Diet Guidelines for Dogs with Arthritis

More information on arthritis:
Also see these articles:
size=2 width="100%" align=center>
Disclaimer: I am not a veterinarian, nor do I have any formal training in any medical field. The information presented here is not meant to replace your vet's advice or prescribed medications, but only to suggest additional options to explore, based on your dog's condition.
size=2 width="100%" align=center>

Supplements and other Natural Therapies for Dogs with Arthritis

Glucosamine and other GAGs (Glycosaminoglycans)

Glucosamine is one of several supplements that help rebuild cartilage and restore synovial (joint) fluid. These types of supplements may be helpful in preventing disease as well as treating it. Note they treat the actual problem, and not just the symptoms. They include Glucosamine Sulfate, Glucosamine HCl, Chondroitin Sulfate, Green-Lipped Mussel (Perna  Canaliculus, found in products such as Sea Mussel Plus by Food Science of Vermont, also sold as Green Mussel Plus by Mountain Naturals, available at Vitacost and Amazon), Sea Cucumber (such as NutriSea's Vetri-LOX, Sea Jerky and related products), other forms of cartilage (including from food sources, such as chicken necks and bovine trachea), hydrolyzed collagen protein, and the injectables Adequan and Cartrophen (Adequan is used in the US, Cartrophen is used elsewhere). These supplements may also work better when they include a small amount of manganese.
When giving glucosamine and chondroitin for arthritis, start out at high doses: at least 500 mg glucosamine plus 400 mg chondroitin daily for a small dog (up to 25 lbs), 1000/800 mg for a medium-sized dog (25 to 50 lbs), 1500/1200 mg for a large dog (50 to 100 lbs), and 2000/1600 mg for dogs over 100 lbs. If you see improvement, you can try backing off to a smaller dosage. Some dogs do well on less, some need the higher amount to get relief. If you don't see any improvement in four weeks, try a different brand. Different dogs seem to respond better to different brands. Glucosamine/chondroitin can be given with food.
There are many arguments about which form of Glucosamine is best. I have yet to see anything I find convincing, as most of the arguments are made by commercial companies in support of their own products. However, if giving Glucosamine HCl, it should always be combined with Chondroitin Sulfate for better uptake, whereas Glucosamine Sulfate can be given alone. It is best if supplements also include Manganese, which can help increase absorption.
It is unknown whether giving glucosamine helps to prevent arthritis, but there is no harm in doing so. If you are looking for plain glucosamine, for a dog not yet in need of anti-inflammatories, the Greyhound Gang rescue organization offers high quality supplements at very low prices, with proceeds going to benefit rescue (they also offer MSM, Vitamin C and other supplements).
Some people report success with injectable glycosaminoglycans, such as Adequan (US) or Cartrophen (elsewhere) even when oral glucosamine and chondroitin have not worked (they can also be used together). Note that Adequan is giving intramuscularly (IM), while Cartrophen is given subcutaneously (sub-q). There appears to be no reason for this difference. I have heard of a number of people and vets giving Adequan sub-q with comparable results (sub-q injections are less painful for the dog and easier for the owner to give at home, if desired). See my post for more info on this topic.
ConsumerLab.com has tested various brands of glucosamine supplements for people and pets and found several that do not contain as much glucosamine and/or chondroitin as they claim, and a few are contaminated with lead. Here are the products that failed their tests:
  • Dogswell Happy Hips Chicken Breast with Glucosamine and Chondroitin contained almost none of the claimed glucosamine and chondroitin.
  • Joint Complete for Dogs and Cats (Liquid Solutions) contained far less chondroitin than it claims.
  • Joint Max Regular Strength capsules (Pet Health Solutions) contained far less chondroitin than it claims.This product also failed the same test in 2007.
  • K-9 Liquid Health Glucosamine with Chondroitin and MSM contained almost no chondroitin.
  • BioGenesis Nutraceuticals ArthroGenX contained almost no chondroitin and was contaminated with lead.
  • Joint Strength Essentials (MegaFood) contained no chondroitin and was contaminated with lead.
  • Source Naturals Sodium Free Glucosamine Sulfate Powder was contaminated with lead.
  • Estroven Joint and Bone (Amerifit Nutrition) was contaminated with lead.

Hyaluronic Acid

There is also a  substance related to glucosamine called Hyaluronic Acid (also called Sodium Hyaluronate) that has been helpful for some dogs. Hyaluronic Acid has been used in intra-articular (into the joint) injection form for horses with great success. There is some question how effective it is when given orally.
I've seen dosage recommendations that range from 2 to 20 mg per day for large dogs. Following are hyaluronic products I've heard about:
  • See the human product Synthovial 7 (and this study) and the product made for dogs by the same company called Hyaflex for more information (either product should be OK to use; the pet product has 2 mg HA per dropper, while the human product has 3 mg per dropper, so you would adjust the dosage accordingly). The Healthshelf site has directions on the amount to give and may have a better price as well.
  • HylaSport Canine is a new product for dogs from a company who has made products for horses; I've heard one direct report of this product helping.
  • Trixsyn is a similar product, which one person reported helping their dog considerably.
  • The liquid glucosamine product K9Liquid Health Glucosamine & HA (best price found here) also contains hyaluronic acid.
  • Cogent Solutions makes Baxyl Hyaluronan and Baxyl Pet RediDog.
  • One person reported using the horse product Lubrisyn for their dogs with great success, including a Dane with Wobbler's and a GSD with severe HD, she gives 1 1/2 tsps daily to each dog.
  • In the UK, look for Conquer K9 and Chondrogen EQ (also available in the US).
Hyaluronic acid may be much more effective when injected directly into the joint (intra-articular), but this must be done under anesthesia. One version, Legend, can also be given IV (when given via IV, treatment may be repeated weekly for a total of three treatments). It is approved only for horses, but has been used to treat other animals, including dogs. A veterinarian who treats both horses and dogs might know what the dosage should be.
The injectable form is sold for horses under the brand name Hylartin V (and maybe others). One person reported using the injectable form on their dog and said that the improvement from one injection lasted for about 3 months.
See New Options for Old Problems - Relief from Arthritis for more information on these supplements.

Natural Anti-Inflammatories

When the dog becomes symptomatic, usually inflammation is involved, so you can use supplements that help relieve inflammation. These include but are not limited to the following:
  • High doses of fish oil (body oil, such as Salmon Oil or EPA oil, not liver oil), as much as 1000 mg per 10 lbs of  body weight.
  • Vitamin E in high doses also offers some anti-inflammatory benefit. It is mentioned on this page about Arthritis in Dogs.
  • I have recommended high doses of Vitamin C in the past, but recent studies have found that vitamin C can actually make arthritis worse! See Excess Vitamin C May Worsen Osteoarthritis for more information.
  • Bromelain (enzyme) given away from meals.
  • Quercetin and other bioflavonoids (may work best when given with Bromelain).
  • Boswellia (herbal). A 2004 study on dogs suffering joint pain found that boswellia offered significant clinical improvement.
  • Yucca (herbal, may work best in tincture form rather than powder, such as Animals' Apawthecary's Alfalfa-Yucca Blend and Azmira's Yucca Intensive)
  • Curcumin (herbal, also called Turmeric) -- I've seen the Turmeric Force product from New Chapter specifically recommended. Dosage recommendations vary; I've seen recommendations for 1/4 tsp turmeric powder for small dogs, 1/2 tsp for medium-sized dogs and 1 tsp for large dogs daily (I've also seen dosages twice that high). Curcumin extract is much more concentrated; equivalent dosage would be around 65 mg for small dogs up to 250 mg for large dogs (again, dosages can go twice this high). Start with lower amounts and give with food to avoid stomach upset.
  • SAM-e (S-adenosylmethionine) is a nutraceutical used most often for liver support, but it can also help with arthritis. It is best given away from meals (preferably at least one hour before, or two to twelve hours after), and combined with a B-complex vitamin for greatest effectiveness -- more info here (human oriented) and here (dog-oriented). See dosage chart for recommended amounts to give. Never split pills -- if you have a small dog, you will need to use the smaller dosage pills, available at places such as VetAmerica, Medi-Vet , HealthyPets and PetFoodDirect. Also available at Amazon in both Home & Garden (marketed for dogs) and Health & Personal Care (marketed for people -- either is fine).
At this point, it appears that grains may increase inflammation and can make the dog much more painful, so a home made diet that does not include grains may also be helpful.
The Chinese herbal formula Mobility 2 (Shu Jing Huo Xue Tang) is designed for arthritis with inflammation. See Getting Started With Chinese Herbs for more information on brands that can be trusted and dosages to use for dogs.

Supplements that have been successful for others include:

  • System Saver contains boswellia, orange peel (source of bioflavonoids), curcuma longa (turmeric), and camelia sinesis, all natural anti-inflammatories. Two testimonials are from sources I trust: see Kiri at Wolf Park and Sandy Prantl Wolf Park Testimonial.
  • AR-Encaps from Thorne Research. This product made for people contains glucosamine, MSM, boswellia, curcumin, and devil's claw. One person reported marked improvement in their 12-year-old Border Collie mix using this supplement.
  • Oliver's Supplements contain boswellia and VitaCherry HiActives (flavonoids). "Mood Formula" also supplies DLPA (see my Chronic Pain web page for more information on this ingredient).
  • NutriSea Vetri-LOX from Coastside Bio Resources. A friend of mine used this supplement for her older Rottweiler who has had disk surgery on his neck twice, and had a lot of difficulty getting around. She used higher than (1 1/2 times) the recommended dose, but within three weeks this dog was playing like a puppy and able to go up and down stairs and get on and off the couch without help, which he had not been able to do for years before. She discontinued the NSAID he was on (Etogesic) as well as a muscle relaxant he was taking at night, and he's doing better then ever before. The orthopedic surgeon saw him after he was started on this supplement and was amazed at how well he was doing. She said others who know the dog have commented on how much happier he seems, in addition to being able to get around better. Available at VNF Nutrition, Botanical Dog, Critter Store, and elsewhere. Note this company also makes Sea Jerky and other mobility products for pets (and humans).
  • Oliver's Supplements are a mixture of boswellia, cherry extract, plus DLPA in their "mood enhancer" version. DLPA is helpful for chronic pain as well.
  • Turmeric powder, also available in extract form called Curcumin. One person reported success with his two 80-lb Labrador Retrievers with hip dysplasia by giving them each 3/4 tsp turmeric powder twice a day (the dosage he found was 1/16 to 1/8 tsp of turmeric root powder per 14 lbs of body weight). He also continued to give a glucosamine supplement. Both dogs regained full mobility and were able to discontinue taking NSAIDs. Start with a lower dose and build up gradually, to avoid stomach upset. Note that this dosage is equivalent to 375 mg curcumin extract daily. Turmeric may work best when combined with bromelain. An article on Degenerative Myelopathy German Shepherd Dogs recommends giving 400-500 mg each turmeric extract and bromelain twice a day to a large dog (400-500 mg turmeric extract would be equivalent to 7.2 to 9 grams of turmeric powder, or about 1.5 to 2 teaspoons of powder).
  • Cetyl myristoleate (CMO) is a medium-chain fatty acid that may inhibit inflammation. A couple of people have reported good results, including this video at SitStay (commercial site but reliable). More info at About.com.
  • Animal Naturals K9 Joint Strong: "Without Joint Strong, my 8.5-year-old giant schnauzer (one cancer toe removed from front foot, both cruciate ligaments redone, and arthritis) can barely get up from lying down and walks very stiffly.  With Joint Strong he pops right up, runs around and keeps up with the new, younger dog." Available at Amazon.
  • Some dogs seem to do better with liquid glucosamine supplements, such as the following:
  • Arthrisoothe Gold from NaturVet is a product that contains glucosamine, chondroitin and green lipped mussel, plus hyaluronic acid and a few other ingredients that can help with inflammation. I've heard directly from one person who has had very good results with her own dogs and rescues, and with working stock dogs owned by rancher friends. Also available as a liquid, and in powder or liquid form  for horses, which is cheaper, though the formulations are a little different. Can buy at Cal Vet Supply and elsewhere.
  • I have heard from two people whose dogs were helped by giving SynoviG3, when nothing else had worked (including one who tried giving SynoviMSM instead and saw her dog get worse). SynoviG3 is a glucosamine/green lipped mussel supplement that also contains creatine, which should never be used in dogs with any kind of kidney failure, and which can cause dehydration (which is very dangerous for the kidneys), so it is imperative that your dog always have access to fresh water if you are using a supplement like this.
  • One veterinary recommended product is Dasuquin, which is a combination of Cosequin (glucosamine/chondroitin) and "avocado/soybean unsaponifiables (ASU)." A review of human studies found that avocado soybean unsaponifiables show beneficial effects in people with osteoarthritis.
  • Homeopathics Zeel and Traumeel (find good prices at iHerb, Vitacost and Vitamin-Resource).
  • There is an herbal supplement called DGP (Dog Gone Pain) from Australia that a couple of people have said helped their dogs (Amazon has the best prices I've found). You should not combine this product with aspirin or any other NSAID, as it is an herbal COX inhibitor and the combination may cause serious gastrointestinal problems.
  • A couple of people have reported some success with Duralactin, a product derived from milk (Biovet has good prices; Puritan's Pride also carries this product, called Microlactin). Note that this product may cause gastric problems in dogs that have difficulty with milk products.
  • One person reported success using Natraflex Elk Velvet (they said that the Supraflex sold for pets by the same company did not work for them). They also used Life Extension Velvet Deer Antler (available at  iherb.com) and Valley Springs Elk Farm velvet with success. See Clinical evaluation of a powder of quality elk velvet antler for the treatment of osteoarthrosis in dogs for more info. Note that the way this product is harvested can be painful to the animal and may be inhumane. See this post for more information. Velvet antler might also be a source of chronic wasting disease (we don't know whether this affects dogs or not).
  • MSM, Nettle Leaf Extract, and Blackstrap Molasses are sometimes recommended.
  • Kaprex, which is marketed as an herbal replacement for NSAIDs (non-steroidal anti-inflammatory drugs, such as Rimadyl or Aspirin). I have heard only one direct report from someone who said it helped their dog, but have heard anecdotally that it has helped a few other dogs, and it would appear to be fairly safe, although since it acts in many of the same ways as the NSAIDs, it might also have some of the same dangers.
  • Inflavonoid Intensive Care from Metagenics is a blend of herbs and anti-oxidants that can help with arthritis (click here for better price).
  • Zyflamend is a new herbal supplement being recommended as an alternative to NSAIDs. I received feedback from one person who said it really helped her extremely arthritic dog, as well as herself and various friends she has recommended it to.
  • The herb Licorice is a natural anti-inflammatory that may be helpful for arthritis, and it protects the stomach as well. There is a possibility that Meadowsweet has some of the same components as aspirin and therefore might be usable as an anti-inflammatory even if your dog has problems with gastric ulceration, but studies are limited.
  • Enzyme therapy, such as Wobenzym, which uses systemic enzymes (also called metabolic enzymes, or proteolytic enzymes). A generic version called NSI Flavenzyme is less expensive and should be fine to use, as NSI is a reliable brand. Serrapeptase is a proteolytic enzyme that may also help with inflammation, though there have been reports of this supplement causing joint pain, and it's recommended that it not be taken continuously, but pulsed, by taking it every other day, or five days a week. Note that enzymes should be given away from meals in order to be beneficial for inflammation.
  • Pregnenolone, which is a hormone that may be helpful for arthritis due to anti-inflammatory effects. Not many studies have been done, and I could find nothing specifically related to dogs. It does appear to be pretty safe, although see this site for some info about possible side effects. I have heard from only one person who has used it, but she said it helped both her and her dog with arthritis. She gave 30 mg twice a day for two weeks, then 30 mg daily to a large dog.
See the human-oriented article on Joint Support for additional information on several of the supplements mentioned here.
Return to Top of Page

Diet Guidelines for Dogs with Arthritis

Some dogs improve greatly simply by removing grains from the diet. There are a number of new grain-free foods available these days, which I note in the Commercial Foods section of my web site. Remember that it is very important to keep a dog with arthritis lean, as extra weight will contribute to the problem and its progression. See Pudgy Pups for a good article on helping your dog to lose weight. Also see the section on Senior and overweight dogs on my Commercial Dog Food web page.
If you are feeding a home-prepared diet, here are some notes from Ian Billinghurst's seminar about how to feed an arthritic dog, along with my own comments (in brackets):
  • no grains [grains and possibly starchy carbs can contribute to inflammation]
  • don't let your dog get overweight If necessary, stop carbohydrates, reduce fat by feeding leaner meat, increase fiber by feeding more veggies. [High-protein, moderate-fat, low-carb diets are best for weight loss.]
  • no added salt, sugar, flavorings, colorings, preservatives No processed food, human or dog, not even treats [I don't worry about treats, as long as they're a small percentage of the diet.]
  • no cooked food, including grains and legumes [I have no problem with feeding cooked foods and do not believe they contribute to arthritis.]
  • less food of animal origins, less red meat [I disagree with this]
  • no dairy except raw. Yogurt is fine, cottage cheese is good.
  • feed 70-90% fruits and vegetables in the vegetable patties (especially colored fruits -- he mentioned tropical fruits, such as mango and papaya, are great). Note this applies to the veggie patties only, you would also feed raw meaty bones. Feed a large variety, fresh. Do not feed onions, peppers, white potatoes, tomatoes or eggplant (the nightshade family), though you can try to add peppers later if the dog is doing well. Avoid citrus, especially oranges, which can aggravate arthritis (again may be cautiously added later, include the whites). Lemon juice may be beneficial. Good veggies include celery (very good), carrots, parsley, asparagus, broccoli, cilantro, garlic. [Note that most dogs won't eat this much fruit and vegetables when not mixed with meat, but if your dog will, it's find to feed them. However, I still recommend feeding plenty of meat.]
  • cartilage from the ends of large bones is beneficial.
  • apple cider vinegar won't hurt, may help -- add 1/2 tsp.
  • a four pound patty would consist of 3 1/2 pounds fruits and veggies plus 1/2 pound chicken mince + 3 oz yogurt + 4 tbsp flaxseed oil + 3 tsp kelp powder + 2-3 eggs + lots of B vitamins [Use fish oil instead of flax seed oil. I would include more meat and eggs than he recommends.]
  • feed small amounts of liver (no more than 5% of total diet)
  • Use Ester-C (calcium ascorbate or sodium ascorbate) with bioflavonoids instead of ascorbic acid, which can be irritating.
Note that I feed more meat, including red meat, and fewer veggies than is recommended above. I also use fish oil (body oil, such as salmon oil or EPA oil, not cod liver oil) instead of flaxseed oil, as it is better utilized by the dog, and does not contain the pro-inflammatory omega-6 fatty acids that flaxseed oil has.
Piglet's diet is around 35-40% raw meaty bones (including canned fish with bones -- jack mackerel, pink salmon, sardines -- once a week), 5% liver and kidney, 25% fruit and veggies, and the rest is muscle meat, eggs, yogurt, etc. I do include garlic, ginger and celery in her veggie mixture, to help with arthritis. I try to feed as much variety as I can, including red meat.
It is important that dogs with arthritis get adequate, but not excessive amounts of calcium, vitamin D and magnesium. If you are feeding a commercial diet, there should be no need to supplement with any of these. If you are feeding a home made diet, it might be helpful to supplement with small amounts of vitamin D (such as from cod liver oil) and magnesium. If your diet includes raw meaty bones, they should not account for more than around 50% of the diet. If your diet does not include bones, then you need to add calcium at the rate of around 1,000 mg per pound of food (1/2 teaspoon of ground eggshell yields about 1,000 mg of calcium).
Return to Top of Page
Posted by at

1 comment:

  1. Unknown13 June 2013 at 06:54

    very interesting article, I'm currently taking Serrapeptase supplements

    ReplyDelete

Subscribe to: Post Comments (Atom)