Cat Henstridge BVSc ESVPS Cert GP (SAM) MRCVS
Cat graduated from Bristol University in 2003 and works as a small animal veterinary surgeon at Peak vets. Cat is a published author and writes a number of articles for various veterinary and non-veterinary publications. She is a vet on the BBC Children’s Television Show – The Pets Factor and is passionate about promoting animal welfare.
Cat kindly agreed to answer the following questions:
What are your feelings on how we currently manage this common debilitating condition in dogs?
Arthritis is one of the most common medical conditions in pets, particularly as they get older, but there is no doubt it is massively under-recognised, by both vets and owners, and also under treated.
The sad fact is, is that there are many thousands of pets suffering in silence!
The problem has many factors and an equal number of solutions!
Firstly, we need to get away from the belief that slowing down in old age for pets is ‘normal’ and inevitable. Their minds are still willing, it is just that their bodies are letting them down! Many pet owners just don’t realise that hanging back on walks, refusing to go further or insisting on turning home is not simply them being lazy but actually a sign they are too painful to go on! Similarly, sleeping all day or growling at other pets are not just ‘grumpy old man syndrome’ but actually because of constant, achey pain.
It is particularly challenging because although arthritis will cause significant suffering and a reduction in mobility, older pets will still have sprightly moments that can lead to their owners dismissing nagging doubts. We have to get the message across that our senior dogs are still puppies at heart! Also, we need to explain that cats are such natural, agile athletes that although they can still jump up onto the windowsill or have a ‘mad half hour’, it doesn’t mean they are ok! When leaping several times their height is nothing to a fit cat, managing a few smaller hops is still well within the capabilities of even the most debilitated moggy!
Also underestimated by most people is how much our pets want to please us and be happy. (And I am guilty of this one myself!) A wagging tail, a friendly head rub, a cheerful panting grin are all ways we fool ourselves into believing that actually are best friends are comfortable and pain free, when actually they are just masters at hiding their true levels of soreness!
Our family are Labrador owners and our current old girl, Millie, is starting to really struggle with her legs now. She is on a whole shelf of medications but I know she is still often hurting. However, she still trots about the garden, rushes to greet me in the mornings and barks at visitors! She loves her food and a good head rub. It would be so easy to think she is OK because of these things and dismiss the stiff walking and inability to go on long walks and I often think it is only because I am a vet that I don’t.
Secondly, we as veterinary professionals need to be better at discussing arthritis and mobility with owners. It can be really challenging to bring it up in a short consultation, especially if the pet hasn’t been presented the problem. Owners are often unaware of issues, for the reasons discussed above, and can sometimes be quite dismissive of our concerns, or suspicious we are just trying to ‘sell them something’. Also, it can get quite repetitive and time consuming over a long day at work!
However, it is SO important we overcome these issues and make an effort to discuss arthritis and it’s subtle symptoms with clients. Often I find when I chat about the problem, there is a lightbulb moment and owners realise there have been signs but not realised what they were seeing. And even if they don’t feel there is an issue, at least I have equipped them with the knowledge they need to spot a problem and, hopefully, the impetus to seek my help at the right time.
As a veterinarian what do you feel is essential for managing canine arthritis effectively?
This is another challenge of arthritis! There are so many ways we can help our pets, it can be really difficult to discuss them all with clients! I always say that it is a hugely individual disease and it can take time to figure out what works best for each pet.
Of course, the mainstay of treatment will always be effective pain relief. The medications we have are numerous and very safe. The latter is often a real concern for clients (whether they let us know that or not is another matter!) and I think they are often tempted to reduce doses or stop when they perceive an improvement in their pet. So, it is vital that the veterinary team dedicates time to explaining our drug choices, their importance and also their side effects, and lack thereof!
Weight reduction is challenging for elderly, sedentary pets but should be central to the management of their arthritis. This is where an experienced nursing team comes in and regular clinics for slimming down and also discussing progress and concerns will have a huge impact on the success of treatment and the pet’s welfare.
Although evidence for them is shaky, I do believe there is a place for high grade supplements and often recommend them alongside medications. Massage, physiotherapy and hydrotherapy are all hugely under-utilised in practice and I think can really help. We should be encouraging their use much more and, again, this is an area where the veterinary nursing team could have a real influence.
When it comes to alternative therapies I think there is a real risk of over-reliance on these, particularly because of our pets abilities to read our moods, their need to please us and often our own desires for them to be effective. The placebo effective is alive and well in pets, whatever alternative practitioners believe, and there is the real potential for harm and suffering of they are used in place of conventional medication that actually works.
How do you see treatment options for arthritis progressing over the next ten years?
I think we are really well served now with treatment options for arthritis, we just need to use them! Obviously medical advancements will continue and I absolutely welcome that but what will make the most difference is expanding awareness of the condition!
So go CAM! It is YOU that will make the biggest difference to arthritis, not the drugs!
If you could have the opportunity to give one tip/piece of advice to an owner with a dog suffering from arthritis what would it be?
Don’t hold back on the drugs! Fill them up until they are rattling! Side effects do occur but they are unusual and even so it is FAR better to live a (potentially) shorter life that is pain free and happy than a longer, painful and miserable one!