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diagnosing arthritis in dogs

Arthritis is often considered to be a disease of old age, however it can unfortunately affect dogs of any age.

SIGNS OF ARTHRITIS

The signs of arthritis may be obvious, such as a limp, however frequently they are vague and nonspecific. These nonspecific signs may be picked up by your vet or vet nurse during a consultation, however it is more likely that the owner will have noticed subtle changes in their dog and will alert their veterinarian to their concerns.

Signs of arthritis may include stiffness after resting, slowing down on walks, lack of interest in walks or in playing, hesitating when using stairs, changes in behaviour towards other dogs, lameness and gait changes, licking the joints and coat changes… The list is extensive and more information can be found here.

Unfortunately most of the signs associated with the pain and disability that comes with arthritis can also be signs of other disease processes. It is very important that a thorough diagnosis is pursued and obtained before starting a treatment plan. Otherwise the dog may be treated for a disease it does not have, which can cause suffering for the dog as well as waste of resources for the owner.

YOUR VET

Your vet will start by taking a thorough history of your dog’s life. They will question you on your observations, as well as your dog's previous clinical concerns. This can be a lengthy process, so going prepared is sensible. CAM has created a questionnaire for owners to order their thoughts prior to a consultation. Download our helpful ‘What has changed for my dog’ form.

Your vet will then carry out a physical examination.

They will likely look at your dog’s overall health, assess heart and respiratory function, palpate their abdomen, check their mouth and ears etc.

The vet will then concentrate on an orthopaedic examination which involves looking at posture, muscle mass and mobility.

They may ask you to walk your dog around (or request a film of your dog moving around at home). For assistance in creating a video suitable for your vet to assess, please download the CAM guide to taking good quality videos here. These videos should include transitions, such as moving from a sit to a lying down position and vice versa.

The vet will also manipulate your dog’s joints to look for abnormal or restricted movement and sensations such as crunching (crepitus), as well as signs of discomfort.

MEDICATION

Once your vet has identified areas of suspicion, they may suggest further diagnostic tests such as radiography, CT scans or joint taps. They may also, or instead of, suggest a trial of anti-inflammatory medication.

Your dog’s response to anti-inflammatories is very important in the diagnosis of arthritis, as well as for treatment. If a dog does not improve when given anti-inflammatory medication, the diagnosis should be reviewed.

Uncomplicated arthritis responds very well to non steroidal anti inflammatory medications and a new medication, a monoclonal antibody to anti nerve growth factor, and if there is no response to NSAIDs this may indicate another disease.

CAM HAS A BOOKLET DESIGNED TO HELP!

You can purchase CAM’s ‘Has My Dog Definitely Got Arthritis?‘ booklet from the CAM online Shop in print format.

Or why not join our CAM MEMBER ZONE where you will gain access to all our CAM booklets in digital format as well as a wealth of information, videos, downloads, forum and much more...

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Blood Testing

Your vet will likely offer a blood test during the diagnosis of arthritis. This is an essential component of a good management plan for a number of reasons.

  1. Arthritis is most prevalent in older dogs who are more prone to other chronic conditions that can also cause lethargy and weakness. Having a blood test to rule out other possible diseases is crucial for an accurate diagnosis. A blood test may highlight other chronic conditions which will affect the way your dog responds to the medication prescribed. For example, a dog with liver disease may not process the pain relief drugs as well as we would expect, putting them at increased risk of toxicity.
  2. The blood test provides a baseline to refer back to during the treatment in case of complications.
  3. On finding a second condition, or possibly a third, an owner may question whether further management is right for their dog.

Urine Testing

Urine tests are a simple and non-invasive test which can be very helpful in picking up acute or chronic conditions that need to be taken into account when treating your dog’s arthritis. They may be used during diagnosis and monitoring of the disease. 

It is worth bearing in mind that they are much less sensitive at picking up important changes in your dog’s organ function than a blood test, so are not appropriate for long term monitoring on their own in most cases.

Radiographs

As osteoarthritis progresses, there are lots of changes in the affected joint. The articular cartilage erodes, bone below that cartilage hardens and becomes exposed, the protective joint capsule becomes inflamed and thickened, and small growths of bone (osteophytes) form around the joint.

Recognising osteophyte formation on a radiograph is a clear indicator of arthritic change in that joint. These changes may be seen in one or more joints. Knowing which joints are affected by arthritis will allow treatments, particularly rehabilitation therapies, to be targeted at problem areas. 

Radiographs can also help to rule out other conditions that can mimic the signs of arthritis, such as fractures, dislocations, bone tumours, or bone infections. An accurate diagnosis is really important in order to ensure correct treatment.

Your dog will need to be sedated or have a general anaesthetic to allow your vet to get a good, diagnostic set of radiographic images. Attempting to take radiographs without sedation can cause distress and discomfort to your dog,  as well as resulting in poor quality uninterpretable images. For radiography to be useful, the dog must be perfectly still during the procedure.

There are some limitations to interpreting radiographs, as changes in the bone may not be seen until late on in the process of arthritis, when a lot of damage has already been done to the joint. This means mild or early cases of arthritis could be missed, even though the joint disease is still present and the dog is still experiencing pain. 

Equally, a joint with a lot of boney changes on radiographs may be well controlled and not causing the dog pain, despite how it appears. For this reason radiographs need to be carried out in conjunction with a good physical examination by a vet, and good observations by the owner.

CT Scan

A CT scan is almost like a 3D radiograph - it is particularly helpful for looking at areas that are difficult to assess on a standard radiograph e.g. the elbow joint. It is likely your dog would need to be referred to a specialist hospital to have this type of diagnostic scan, as it is not available in most first opinion general practices.

JOINT TAPPING

Arthrocentesis (Joint tapping)

Osteoarthritis is the most common form of arthritis in dogs. However other forms of arthritis also exist, and if your vet is concerned about one of these other types of arthritis they are likely to want samples of your dog’s joint fluid to do a further assessment.

Your dog will need to be sedated or given a general anaesthetic to allow for this test to be carried out. A sterile needle will be inserted into the joint, in order for a sample of the fluid to  be removed and examined for signs of inflammation or infection.

MOST CANINE PATIENTS DO NOT VOCALISE THEIR PAIN FROM ARTHRITIS, AND MANY PET OWNERS DO NOT BELIEVE THEIR PET IS IN PAIN IF IT DOES NOT VOCALISE.

Fox and Mills