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CAM Meets Dr Judy Puddifoot

Dr Judy Puddifoot BVetMed MRCVS MSc BSc

Judy graduated from the Royal Veterinary College in 2014 and since then has worked in both first opinion and charity small animal practice. Her interest in arthritis and pain management began as a young teenager when her first Labrador was diagnosed with osteoarthritis and since becoming a vet she has always had a strong drive to improve the quality of life of all arthritic animals in her care. Her current incumbent dog is a 12 year old black Labrador whom she rehomed in January of this year expecting a slow OAP but has since happily discovered Jax is actually a spring chicken instead!

 

Judy kindly agreed to answer the following questions:

What are your feelings on how we currently manage this common debilitating condition in dogs?

Sadly I feel arthritis is a condition that is still very much overlooked, misunderstood and therefore dismissed. I hear many people say things such as “Well he’s old so I expect him to be slow and a bit rickety” or “Well he’s just old but he’s ok, he’s still eating and drinking fine” and I find this quite upsetting and yes, if I’m honest, as a bit of a challenge to change that viewpoint. Old age is not a disease but old age absolutely does mean we are more prone to suffering from diseases. Despite arthritis being a very common condition in elderly humans and therefore many people being familiar with and having empathy for how it affects someone, I fear there are still sadly many dog owners who still dismiss the signs of arthritis as simply being a ‘normal’ part of the aging process in their dogs. Many owners readily acknowledge seeing that their elderly dog has slowed down, stumbles over the back door threshold and can now only manage slow 10 minute walks but what may often go unnoticed are the other, more subtle, changes that their dog has made to their daily life to accommodate for the constant low grade, chronic pain they are suffering. The fact he no longer cocks his leg to urinate but instead squats to ease the pain of all his weight on one hip, the fact he doesn’t jump onto the owners’ bed of a morning anymore or even attempt to climb the stairs at all to avoid the pain in his hips going up the stairs and the pain in his elbows when he comes down them. Or the fact their OAP dog is now defecating in his bed or whilst still walking along because it is simply too painful to lift his whole body weight up on his arthritic hips and hobble outside to do his business several times daily or because it is simply too painful to balance in a squatting position on arthritic hips. Dogs can’t tell us that something is wrong or where it hurts and so it is our duty as owners and vets to do that for them. Dogs are very stoic and they will persevere for years without making too much of a fuss but these subtle changes are there, once we know what to look for.

I hope that vets are keeping abreast of new changes in the management of arthritic pain and are also offering lifestyle changes alongside the pain medications. Things that make a huge difference to arthritic dogs’ daily lives such as shorter more frequent walks every day of the week instead of 10minutes Monday to Friday then a marathon walk at the weekends. Rugs or runners placed across slippery floors allowing dogs to walk without fear of slipping over, placing water bowls in carpeted areas as opposed to on the other side of an ice rink-like linoleum kitchen floor, ramps or steps into the car, raised water and feeding bowls for larger dogs who may have painful necks and of course weight control to ease the extra burden on joints. All these small changes can make a huge difference to these dogs on a daily basis.

 

As a veterinarian what do you feel is essential for managing canine arthritis effectively?

Education, education, education! As mentioned above I find that many of the clinical signs of arthritis can easily be missed by even the most well intentioned owners. I have lost count of the times I have asked about certain lifestyle elements of their dog and once I have explained why he may be doing this they remark they had no idea but it totally makes sense now. This is further confirmed to them after a week or 2 trialling some non-steroid anti-inflammatory medication and subtle lifestyle changes. The vast majority or owners will come back to see me after their dog has been taking the medication for a couple of weeks and say something like “Oh my, he is like a puppy again, I had no idea” and this makes me so very happy, because if we can educate the dog owning public about arthritis we can make so many more dogs’ lives pain free. It’s not only about educating them what the signs of arthritis are to look out for but just as important is letting them know that arthritis isn’t going to end their dog’s lives. It is so important to me that we get the message out there because once there is awareness through education then there can be treatment and ultimately we can  extend dogs’ lives and make them pain free! After all that is what we all want at the end of the day. More pain free years with our beloved dogs.

Ultimately taking a more holistic view of our elderly dogs is vital; the pain management shouldn’t just rely on medications but may also involve laser therapy, joint supplements, hydro or physiotherapy, lifestyle changes, diet and weight control, exercise regimes. There are so many elements that can be manipulated and incorporated to ensure a better quality of life, after all it’s about the quality not the quantity of life we can give our dogs.

 

How do you see treatment options for arthritis progressing over the next ten years?

I feel arthritis management is a constantly evolving area with new ways of managing pain emerging all the time. I hope to see many advances in pain management generally but also that we as vets can learn from the excellent research being done by human researchers in the management of arthritic pain in humans and that we can extrapolate from that and apply it to our own patients too to continually improve their welfare. Arthritis should not be an early death sentence!

I also hope that changes can be made in areas in terms of prevention. Such as improvements in the breeding of certain dog breeds that we know suffer arthritis. As a lifelong Labrador owner I know all too well that if you take on a Labrador, you also take on arthritis. By making better choices in breeding we can lessen the incidence of arthritis in those breeds most affected. But also it comes back to education again, as owners of young puppies can help to maintain healthy joints in their dogs by taking the advice of their vets with regard to exercise, joint supplements and weight control, these can all have either a negative or positive impact on the future health of a dog’s joints and a large part of that control is within our hands as owners and vets.

 

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?

Oh man, just one? Crikey, I guess it would have to be to please understand that old age is not a disease, that your dog has changed for a reason and that reason may well be related to pain. Please, please get your old dog checked over by your vet and if they recommend some pain relief may be beneficial please just give it a try and see if it helps your best friend.