identifying the signs of arthritis
Arthritis causes chronic pain, which is often experienced as non-localised, insidious, consistent and low-intensity pain, that may intermittently flare up. It can be extremely hard to identify chronic pain, especially as humans tend to acknowledge pain as being sharp and severe which causes significant behavioural change, such as yelping or limping. Dogs with arthritis related pain will usually show much more subtle and gradual changes, particularly if the dog has learnt coping mechanisms for example being less interactive, or adverse to handling, or moving slowly and carefully.
Chronic pain presents very differently to acute pain. This can lead to significant confusion for owners and professionals. In the case of chronic pain, subtle behavioural changes suggesting anxiety, fear and lack of tolerance may precede a physical indicator such as a change in posture due to weight shifting, or a change in gait due to pain and associated weakness.
It is very rare for dogs to yelp or cry out with chronic pain, which is concerning as many owners expect, and in fact wait to see signs of acute pain, such as whimpering or crying. Waiting for these overt signs often means that more subtle, earlier indications of pain are missed. Many people don’t recognise pain until their dog is limping-unfortunately by this time the dog may be in significant pain.
If you were to learn only one thing from the CAM website, please let it be this.
Dogs express pain in many subtle ways, which we often identify and associate with the disease late in its course. Please don’t delay seeking veterinary advice, waiting until your dog limps or yelps to confirm your suspicions of pain, as by then they are likely to be in significant pain.
Take note, many dogs present with arthritis in both forelimbs or both hind-limbs, which will prevent them from having a classic limp.
By being aware of the prevalence of arthritis in dogs, acknowledging those predisposed due to breed, weight, lifestyle or previous injury, and being aware of how dogs express pain, we will be able to identify the signs of arthritis early and initiate treatment quickly. Identifying the disease late means the disease is likely to have progressed significantly, which can reduce treatment options and negatively affect the success rates of available interventions.
Any dog can develop arthritis, but those that may be more predisposed to arthritis are:
- Dogs of certain medium to large breeds such as rottweilers, labradors and springer spaniels. Visit the Orthopaedic Federation of Animals website for more information
- Dogs with known developmental joint problems such as hip dysplasia, elbow dysplasia, patellar luxation or osteochondrosis
- Dogs that are overweight or obese
- Dogs that have sustained trauma to a joint
- Dogs that have had previous surgery on a joint
SIGNS & CHANGES TO LOOK OUT FOR IN YOUR DOG
signs of arthritis in dogs may include
- Slowing down on walks or being reluctant to go for a walk
- Hesitating when jumping up or down, or using stairs
- Sleeping more
- Changes in temperament
- Licking the joints
- Difficulty settling down or getting comfortable
- Difficulty posturing to go to the toilet or walking while toileting, or unable to eliminate completely
- Changes in body shape
- Changes in posture eg roaching spine
- Behavioural changes such as becoming more reactive to dogs or people
- Noise sensitivity (this could be a new sensitivity or an exacerbation of an already-existing sensitivity)
- Decreased tolerance to handling/husbandry
- Asymmetrical sitting or drop position
- Unsettled and restless
- Changes in coat (patterns/directions of fur)
- Asymmetrical nail wear
- Lower head carriage
- Loss of appetite
This list is not exhaustive, and only aims to give you a glimpse of the wide array of clinical presentations that may indicate arthritis and the associated chronic pain.
Some of the signs of chronic pain indicate anxiety, which makes sense, as pain causes stress and fear. Professional help may be needed to not only determine the underlying cause of the clinical signs, but also to support resolving them as the underlying condition is being managed.
Identifying pain in animals continues to challenge us and a number of tools exist to support us.
LOAD TOOL: Liverpool Osteoarthritis in Dogs tool (LOAD for short) is a respected and validated tool commonly used in veterinary practice. This questionnaire-based tool can be supportive in identifying and quantifying a dog’s pain, as well as being used during the management plan to assess improvement and deterioration in the dog’s condition.
CANINE BRIEF PAIN INVENTORY TOOL: Another widely used and validated tool developed by the University of Pennsylvania.
HELSINKI CHONIC PAIN INDEX: Another questionnaire commonly used by vets and therapists to identify and monitor pain related to osteoarthritis.
ACVS ORTHOPAEDIC INDEX: Yet another tool useful in monitoring a dog’s changing pain state.
SUSPICION OF CHRONIC PAIN TOOL: CAM created this tool which aims to help identify unexpected and unexplained changes in behaviour, posture, physical appearance, and capabilities and gait. This tool helps the user clarify and categorise their thoughts, and present clear concerns to their veterinarian.
If you see any of these signs in your dog it is important to speak with your vet. Some of the signs associated with arthritis can also indicate other diseases, so a thorough history, clinical examination, and possibly further diagnostic tests such as blood testing or radiographs, are needed to ensure you are managing the actual disease your dog is suffering from. An assumption that ‘slowing down’ or ‘getting old’ always suggests arthritis is likely to lead to misdiagnosis, wasted funds and potentially unnecessary suffering for your dog.