Pet Health Insurance Considerations

The doctors and staff of Wilmington Animal Hospital recommend that you purchase pet health insurance for your dogs and cats. Because of the high quality of care available to your pets, costs may be prohibitive if your pet has an accident or severe illness. For example, orthopedic care for a broken leg or anterior cruciate ligament tear can cost $3000-5000. A splenectomy with transfusions can cost $10,000. Cancer therapy can cost $7000 or more.

There are many points to consider when selecting pet health insurance. We have listed a few below, with comments based on our experience. We highly encourage you to search the Internet for websites that compare plans, and call the top two or three companies that seem to fit your needs.

1. Cost. In general, this will be related to your deductible and co-pay, decreasing with a higher deductible and co-pay.

2. Well-pet care versus sick pet care. This includes annual and puppy/kitten exams, vaccinations, heartworm testing and preventative, flea and tick preventative, spaying/neutering, and possibly dental work and routine blood testing. At this time, we do not recommend purchasing additional coverage for well-pet care, unless it is already included in a sick-pet care plan that you like. We have found (by running the numbers) that you’ll put a certain amount of dollars into a premium for the well-pet care and get that exact amount out of it. Better to keep your money and spend it yourself.

3. Deductibles. This is the amount that you will pay first before services are rendered. Note that in some plans, because of other terms of the plan, you may not see a decrease in your premiums unless you set a very high deductible, like $500.

4. Co-pay. This is the amount, usually expressed in a percent, that you will pay for each occurrence.  Be careful here. Some companies will reimburse you for a straight percent of what the veterinarian charges you; others will reimburse you on the agreed percent of their allowance for that problem. For example, if you are traveling to Los Angeles and your dog gets food poisoning, a night in the ER with IV fluids and medications, X-rays, ultrasound, etc. might cost $3000, and one company might reimburse you a straight 90% of that. But another company might have a “cap” for this condition, allowing only $1500, and then will reimburse you 90% of that amount.

5. Limits per occurrence. Make sure you select a number that is realistic. For example, a limit of $1200 per occurrence is no longer a realistic number for serious medical and most surgical conditions. We recommend at least $7500, preferably more if you can afford the premiums.

6. Lifetime and annual limits. These might not be as critical. In most cases, if your pet were to incur a lifetime bill of $100,000 for you, the condition might have been such that you would not have wanted to continue putting your pet through this or you would not have been able to afford the co-pays and deductibles.

7. Office visits/examinations. See if this is covered. Most companies cover some portion of the sick patient visit, but other companies do not, which is one way of keeping the premiums affordable and minimizing the deductibles.

8. Prescription coverage. Find out if the company covers prescription drugs. Medications, especially for large dogs, can be very expensive.

9. Pre-existing conditions. Most plans will not cover these, so we recommend enrolling right after your first vet visit. Yes, anything abnormal found on this visit will be considered a pre-existing condition, but most companies will not enroll your pet without a physical exam.

10. Selecting your vet. Make sure your plan allows you to select whichever vet you want. Most plans allow this, although HMO-like plans are springing up.

11. Congenital and hereditary disorders. These are conditions present at birth (whether or not they show symptoms or signs) and can result in very expensive treatment. Most pet insurance providers exclude or severely limit coverage for hereditary and congenital disorders while others cover many or most of these conditions. This can include something as common as hip dysplasia (in which surgery can cost $8000 or more to repair both hips) or less common like cherry eye.

12. ACL tears: Some companies have exclusion periods for conditions like anterior cruciate ligament (ACL) tears. For example, if your pet is enrolled in a plan with one of these terms, and your pet tears his ACL during a 12-month waiting period, he will never be covered for the surgical repair or other treatments of this condition.

13. Cancer coverage. This is included with some companies but exists as an additional rider with other companies.

14. Complementary/alternative therapies. Find out if the company covers acupuncture, chiropractic, homeopathy, and other complementary/alternative therapies. All of these services are offered at WAH.

15. Premium increases. Check to see what makes the premium increase. These factors could include increasing age of your pet, previous claims, and inflation.

16. Age limits. Some companies discontinue coverage when your pet reaches a certain age, while others will continue your coverage if your pet has been enrolled for a certain number of years.

17. The company itself. Find out how long they’ve been in business and what the turnover time is for a claim.

Search the Internet for pet health insurance companies and do your own comparisons. Once you think you’ve settled on a company, (and you’ve spoken to them on the phone to ascertain how helpful they are), contact a competing company to get the other side of the story.

Chiropractic Care for the Elderly Dog and Cat by Steven S. Fries, Animal Chiropractor

Would your elderly dog or cat benefit from chiropractic care? Do you notice that your 10-year old dog is not running as far as she used to?  Does your cat hesitate before jumping up on the couch?  Perhaps your pet appears stiff right after awakening.

While growing older is inevitable, so are certain skeletal disorders, like osteoarthritis.  Just like us, dogs and cats often suffer from painful and disabling arthritic conditions. 

Joints, which in health are glassy smooth and surrounded with fluid, often lose their cartilage surface and become rough with calcium deposits.  This can result from poor nutrition, unusual overuse (such as those of a dog who works or competes in sports), old injuries, and chronic misalignment (subluxation) of joints- which is where I come in!

Signs that your pet may be suffering from misaligned or subluxated joints include: 

-Stiffness when getting up from a laying position

-Reluctance to sit squarely on haunches

-Crying or snapping when the back is touched

-Limping without a known medical condition

-One hip appearing higher than another

-Walking differently than usual

-Holding the head to one side, or being unable to bring the head up or down

-Arching the back

-Hesitation on jumping

-Weakening in the hind limbs

-Worsening of signs with cool or stormy weather.

All of these signs can result from subluxations. These cause joints  to lose their normal mobility, often becoming more restricted in motion.  The signals to the brain become altered- these are  necessary to coordinate the gait and posture of  our pets.  Eventually, the joints become stabilized by calcium deposition (which is part of the changes  associated with osteoarthritis). 

Chiropractic care is aimed at correcting joint immobility in elderly dogs and cats before the disorder develops.  Chiropractic has been used successfully on the human patient for over one hundred years now.  For over  10 years, I have treated thousands of cats and dogs, working with the veterinarians at Wilmington Animal Hospital. The improvements we can accomplish are very rewarding, restoring a better quality of life to many of our beloved pets. For more information on chiropractic, visit: http://wilmingtonanimalhospital.com/services_chiropractic.php. You can read more about me on: http://wilmingtonanimalhospital.com/veterinarians.php.  Appointments can be made at the Wilmington Animal Hospital by calling Dr. Fries' at (215) 629-8311.

References:

American Chiropractic Association 442154 E. 140 Road   Bluejacket, OK 74333

Boal R & Gillete R (2004).  Central neuronal plasticity, low back pain and spinal manipulative therapy.  Journal of Manipulative Physiologic Therapeutics June:  27(5):314-26.

Carrick Institute for Graduate Studies.  203-8941 Lake Drive Cape Canaveral, FL 32920.

Delamarter Rick B et al. (1990) Experimental lumbar stenosis-  analysis of the cortical evoked potentials, microvasculature, and histopathology.   J Bone Joint Surg Am72(1):110-20 1990 Jan.

De Risio, Luisa, DVM et al. (2000) Degenerative lumbosacral stenosis.  Veterinary Clinics of North America:  Small Animal Practice.  Volume 30 . Number 1 . January 2000.

Healing Oasis Wellness Center 2555 Wisconsin St.  Sturtevant, WI 53177-1825.

Kim N H & Yang I H (1996) A study of motor and sensory evoked potentials in chronic cauda equina compression of the dog.  Eur Spine J (1996) 5:338-344.

Postural Rehabilitation @ Maximum Horsepower, LLC 305 Nottingham Road  Nottingham, PA 19362.

Squire, L & Bloom F et al.  (2003) Fundamental Neuroscience (2nd Edition) San Diego Academic Press 772-785.

Acupuncture and Arthritis: Is your dog tired of ice skating? By Lexie Hanna, VMD

Large dogs don't always age well, but acupuncture could be a way to help them. Failing hips can lead to difficulty getting up, "splaying" of the hind legs, fear of crossing non-carpeted surfaces and a general hesitation to do more than lie around. These challenges can be devastating for both the dog and owner. Non-carpeted floors begin to look like ice-skating rinks, and the thought of crossing them sends many of our canine friends into a state of incontrollable shaking.  If any of you have a geriatric large breed dog, you know what I'm talking about.

As larger dogs age, their hip joints are prone to arthritis (especially Labradors, Golden Retrievers, and Rottweilers, who often have a genetic predisposition). The hip joint is a "ball and socket" style joint. As the joint deteriorates, the muscles in the hip area atrophy (waste away) making the joint less stable. This leads to hind end weakness and splaying of the hind legs. The cycle makes it harder and harder for these poor guys to move around on any surface that is at all slippery. 

There are a variety of arthritic drugs available. But some of these can damage other parts of the body (like the liver) and they do not work for every animal. Non-drug options, like chiropractic, laser and acupuncture, are available at WAH and can really help!

Acupuncture has been around for thousands of years. It is a gentle way to stimulate the body to help heal itself. By placing tiny needles into specific points along the body, many “feel good” hormones, like endorphins and oxytocin, are released from the brain. Acupuncture also stimulates the nervous system, which helps muscles become stronger. You might wonder why any dog would allow needles to be placed in its body for an acupuncture session. The answer is, it feels good!

The needles relax the animal (gotta love those feel good hormones), and often they even fall asleep! Needles are left in anywhere from 5-30 minutes. Sometimes liquid is added through the needle (aqua-puncture). Heat can also be used in the needle tip (moxa), and electric stimulation can be attached to the needles to give a little "boost." However, "dry needling" is the most common form of acupuncture. 

As a holistic modality, acupuncture treats not just arthritis in the joints, but the whole body, and without causing harm. Nothing will stop the body from aging, but acupuncture is one natural way to help dogs age more gracefully.

For more information on acupuncture at WAH, visit: http://wilmingtonanimalhospital.com/services_acupuncture.php

Dr. Hanna is a 2004 graduate of the University of Pennsylvania School of Veterinary Medicine. She completed her certification in Medical Acupuncture for Veterinarians in the summer of 2004.

For more information on Dr. Hanna, visit: http://wilmingtonanimalhospital.com/veterinarians.php

This is Basco getting acupuncture for arthritis:

When Dogs Itch in Winter by Shelley R. Epstein, VMD, CVH

This has been an unusually itchy winter for dogs here at WAH, so we thought it might be a good idea to discuss this topic. Typically, November or December comes, and the number of itchy dog cases drops off precipitously. But this year, the opposite has occurred!

Believe it or not, the number one cause is fleas! Yes, fleas. In the cold weather.

Itching from fleas is typically random on the body. Some dogs will “corn cob” their legs, chewing them up and down the length. Most dogs just chew and scratch anywhere on their bodies, with some dogs focusing on the lower back/tail/anal area.

And we’re seeing these problems even on some dogs that have been faithfully wearing flea/tick preventive products! Why is this, you may be wondering?

Quick flea trivia for edification and cocktail party banter:

Fleas love 80 degrees and 80% humidity. Obviously, not the current conditions, but sure describes this past summer.

Another fact: One adult female flea will lay 2000 eggs, which drop off your dog or cat and land wherever the dog/cat goes: your yard, house, bed, sofa, etc. Fleas are particularly appreciative of you if you have carpeting. They get way down in the pile where it’s really humid. They don’t love you as much if you have hardwood or laminate floors because the surface exposes their precious eggs to the air and dries them out. But they can make due with the cracks those floors provide.

So, putting these facts together, we had a tremendously fruitful season for flea reproduction! And even though it’s getting cooler and occasionally drier, many fleas have survived and found a safe haven on your dog (or cat).

What about those expensive flea products that you’ve been using faithfully? Could you still have a flea problem?

Yes, for a few reasons.

First, the products all work in slightly different ways. The best products, of course, would kill the fleas before your dog is bitten. By the way, it is believed that the flea saliva is what stimulates an allergic reaction in the dog. So of course, you’d like the flea to diet before it bites your dog.

Advantage and Advantix (the latter also kills ticks) both kill the fleas before they bite your dog. But occasionally we’ll see dogs with fleas who are wearing this product. Take a close look at your dog. If you can easily catch a flea and it doesn’t hop off your finger, it was already poisoned by the product. The fact that your dog had fleas this late in the season means your dog’s environment has a flea infestation.

Here’s a trivial fact, actually studied by a Pew family member. We’ve known that the flea life cycle is egg-larva-pupa-adult. Well it’s those pesky pupa that can survive a nuclear holocaust, or at least the climatic ravages of winter. And (here’s what the Pew person found out) those pupa sense the vibrations of the normal host- dog or cat- walking by and instantaneously molt into adults and hop on the dog or cat. Then the Advantage/Advantix starts to poison them, before your pet is bitten.

It’s a common misconception that if your house were infested, you would have the fleas hopping on you. As you can see from the Pew studies, the fleas (thankfully) much prefer the dog or cat, and will only hop on you if your dog or cat is too filled up with fleas. We’ve heard numerous stories of people going into abandoned homes that were previously occupied by pet-owning people…and the fleas swarmed onto the poor unsuspecting person, actually coating their pants black! That’s really gross, but you get the point.

For these situations, we recommend one dose of Advantage/Advantix now and one in a month, then resume when the ideal flea climate returns. Oh-here’s another great trivia fact about fleas and Advantage: The product coats the skin cells which fall off around the house, and the poor unsuspecting larva eat them and DIE! This gives the product an environmental effect. In the past 15 years or so that the product has been out, we’ve seen a marked decline in the need for house products to kill fleas.

But in those rare cases in which the fleas are still in the house and hopping on the dog, even if you are using one of these products, you may need to call in an exterminator. Most companies use products to instantly kill any adult fleas, and they use growth regulators to kills the eggs. Most will give you a 90-day guarantee.  But remember, nothing kills the pupa, so expect the problem to resume, hopefully to a lesser extent, when the weather warms up. Hopefully the flea product on your dog will suffice next season.

But what about Frontline? Honestly, for the past few years, we’ve observed that this product is not working as well for flea problems. The company insists that independent studies on fleas collected from all over the country show no resistance to the product. They offer two explanations for why their product might “seem” to not be working:

1.     There’s a wild animal roaming your yard at night, depositing flea eggs in the yard, a source of reinfestation for your dog and

2.     Perhaps your dog is at the high end of the dose range so naturally there will be less product spread on a larger surface area.

But this doesn’t explain why Advantage seems to be working under those same conditions. We have no doubt that Frontline placed in a petri dish with fleas will kill them. So we don’t have any great explanation for the failures that we’re seeing many times a week. In any case, we’ve stopped recommending this product for flea control.

This blog is not to promote any particular flea product. We’re just letting you know which ones we use and have the most experience with, good or bad. This past season, we started using Vectra, and we have not had any complaints about its efficacy. And if you prefer natural products, we’ve found the cedar oil sprays are very effective, although they require much more frequent application, up to daily if you have a bad problem. They are more labor intensive as you must be sure to coat every square inch of your dog or the resilient fleas will find that one area that you’ve missed. We do currently carry Dr. Ben’s cedar oil flea/tick spray.

So the #1 cause of itching this winter is likely fleas.  The warm humid weather is a conspirator. And some flea products aren’t working that well.

The #2 cause of itching in the winter is inhalant allergies. Of course, dogs can have both problems (allergies exacerbated by fleas).

Typically, allergies appear as licking/chewing the toes and feet, with some dogs rubbing their eyes, muzzles, ears, and armpits/groin. In contrast to flea-induced itching, allergies tend to focus on these areas only.

Allergies can be to just about anything. In the winter, the most common allergens are house dust mites and molds. Some dogs are even allergic to cats and humans.

The treatments are numerous and largely palliative.  Here is a list of possibilities:

1.     Antihistamines

2.     Diet improvement. Visit our webpage on diet: http://wilmingtonanimalhospital.com/info_nutrition.php

3.     Dietary supplements, like fish oil, Missing Link, etc.

4.     Allergy testing and allergy vaccines at a veterinary dermatologist’s

5.     Steroids like prednisolone. We use Natural Hydrocortisone which has far less side effects than its chemical derivative prednisolone.

6.     Immunosuppressive drugs like Atopica.

7.     Shampoos to soothe the itching or treat secondary infections

8.     Antibiotics for secondary infections.

It’s important to emphasize that fleas and inhalant allergies comprise about 85-95% of the skin problems we see in dogs in the winter. However, there are many other causes of itching in the winter. It’s always best to let one of our veterinarians examine your dog to assess the condition and make individualized recommendations for treatment and prevention. Please see our website for more information about our hospital and how to schedule an appointment: WilmingtonAnimalHospital.com. If you're already a client, you can visit our website and sign on to Pet Portal to access your pet's reminders, receive email reminders (and text messages if you'd like), and many other great free services.

Vaccinations Part I – Canine Vaccinations by Alison Ladman, VMD

If you’ve been searching the Internet, talking to certain breeders, or possibly hearing the experience of friends, you’ve likely heard that there’s some controversy when it comes to vaccinating dogs and cats. On the one hand, more vaccines exist to protect your pet from illnesses varying from the deadly parvovirus to the preventable periodontal disease. On the other hand, cancer, allergies, and autoimmune diseases are becoming more and more common. Is there a connection? Should we minimize the number of vaccines we give?  It is important to note that vaccines can prevent disease or minimize symptoms of a disease, but they will never make your pet healthier. 

A little background first:  For many years, it was common and routine for most veterinary hospitals to give yearly vaccinations to dogs and cats.  The focus of annual hospital visits was on the “shots” and not necessarily on the health of the pet.  Approximately 16 years ago, WAH changed the focus of annual visits to focus on the overall health and wellness of pets, making vaccinations secondary.  After all, wellness is about the big picture, not just administration of any and all vaccines on the market.  In all circumstances, doctors at WAH make every effort to avoid giving more than one vaccine on a given day.  We find that this approach limits vaccine reaction frequency and severity – which is always a relief to pet owners and to us!

 

Of course, it is important that all dogs receive certain “core” vaccines to prevent them from getting life threatening diseases like canine parvovirus.  At WAH, we start all puppies out with the pediatric series of vaccines.  We only recommend the core vaccines – parvovirus, distemper virus, and rabies in puppies.   We advise vaccination of puppies with a parvo and distemper vaccination every 4 weeks until they have reached 16 weeks of age.  Rabies vaccination is given as the final vaccine in the pediatric series in compliance with Delaware law and is considered “good” for one year this first time it’s given.

At WAH, we also treat our adult patients differently than what was the historical norm for vaccination in veterinary medicine.  Instead of giving adult dogs yearly “shots,” we tailor protocols to the pets’ lifestyle and risk.  Does your dog visit nursing homes or hunt in the woods?  Or does your dog never leave the house except to use the bathroom?  Do you take in foster pets from local shelters? 

The doctors at WAH use this information to determine  the best approach to vaccination and assessment of immunity for your individual pet.

We aim to limit vaccinations, so we advise checking “titers” for parvovirus and distemper virus.  A titer is a blood test that assesses the level of immunity an individual patient has developed to previous vaccines.  This titer helps us to assess whether a patient needs to have “booster” vaccinations.  In many cases, dogs have lifelong immunity from the vaccines they were given as puppies.  Unfortunately, titers are not permitted for rabies virus, so the rabies vaccination is given every 3 years as required by the state of Delaware.

There are two “non-core” vaccines available at WAH – bordetella (kennel cough) vaccine and canine influenza vaccine.  We only offer these upon request for patients that will be boarding in a kennel or daycare where this sort of vaccine is required.  If your pet boards at WAH, we do not require dogs to be vaccinated for either bordetella or influenza.  To learn more detailed information about vaccinations, please visit our website where we discuss them in more detail.  http://wilmingtonanimalhospital.com/info_vaccines.php

The bottom line is that at Wilmington Animal Hospital, we make every effort to focus on the overall health of our canine patients.  Vaccination is important, but it isn’t the most important part of keeping your pet healthy.  We will work with you to determine the best way to provide and assess immunity for your dog – we want your pet to be protected and to be as healthy as he or she can be!

Feeling Better with Kidney Failure, Part 1 by Shelley R. Epstein, VMD, CVH

Kidney failure in dogs and cats has many causes, but it does not have to be a death sentence. As you know, at Wilmington Animal Hospital we integrate whatever therapies work to do the most we can to help our patients. We have many tools in our box when it comes to helping dogs and cats with ailing kidneys!

Kidney failure in dogs and cats is not an all-or-none diagnosis. Pets don’t have either “good” kidneys or “bad” kidneys, but rather have varying degrees of good or bad. What does this mean?

The kidneys are made of millions of little functional units called nephrons. As we age- and by we, I mean our dogs, cats, and us- the nephrons start to shut down, one by one.  A human by the age of 40 has lost about 20% of these nephrons, and the only difference she would notice is possibly needing a little bathroom trip in the middle of the night. The rate at which this aging of the kidneys occurs varies from individual to individual.

The most common cause of kidney failure is getting old. As the healthy pet ages, if he is not afflicted with a problem that leads to his death, Mother Nature holds in reserve her mechanism by which no being may live forever- and that is called kidney failure. In other words, we all will die sometime, and if nothing else causes our death, then kidney failure will.

But…At Wilmington Animal Hospital, we have many tools that we use to slow down the rate of kidney failure while making cats and dogs feel good. In this first of two blogs on kidney failure, we’ll review the conventional options, including an exciting relatively new one.

First, what are some of the time-tested “conventional” treatments?

Conventional therapy for kidney failure is usually aimed at addressing the excesses and deficiencies that occur from a lack of kidney function.

The excesses include:

1.      Build-up of “uremic toxins.” The kidneys are not able to filter these out, so they remain in the bloodstream and suppress the appetite and sometimes cause ulcers in the mouth and gastrointestinal tract.

2.      Build-up of phosphorus in the blood. Like the uremic toxins, the kidneys simply lose their ability to filter this out of the blood and place it in the urine. High levels of phosphorus also suppress the appetite.

3.      Elevated levels of parathyroid hormone (PTH). This hormone increases as kidney failure progresses. And, like a vicious cycle, elevated levels of this hormone make the kidney failure worse. Wouldn’t it be nice to neutralize this pesky hormone?

The deficiencies include:

1.      Fluid loss. The blood runs through the kidneys, at which point the kidneys are supposed to put the fluid portion back into the bloodstream and put a limited amount of fluid down into the bladder for urine. With decreasing kidney function, more water goes into the bladder and less back into the bloodstream, causing dehydration.

2.      Protein loss in the urine because damaged kidneys leak protein from the bloodstream into the urine.

3.      Anemia. The kidneys produce a hormone which tells the bone marrow to make more red blood cells. In some cases of kidney failure, the kidneys stop making this hormone, and less red blood cells are produced. In addition, the presence of uremic toxins, or “uremia,” can shorten the lifespan of the existing red blood cells.

Collateral damage: Hypertension (high blood pressure)

Not every patient develops every problem above. Likewise, the conventional therapy is tailored to the individual patient’s needs:

1.      Fluid therapy to rehydrate and help flush out the uremic toxins. Some patients need hospitalization initially, but most can receive this therapy at home.

2.      Phosphate binders taken orally to bind up the phosphorus that is eaten in the diet. This prevents the phosphorus from being absorbed from the intestines into the bloodstream in the first place, so the phosphorus levels stay low.

3.      Diet modifications if the pet will allow it. Good luck with this with cats.

4.      Erythropoietin (EPO) injections to stimulate the bone marrow to make more red blood cells. Sound familiar? This is the “blood doping” hormone that got all those Tour de France cyclists in trouble. But at least we know it works.

5.      Oral medication to slow down the protein loss from the bloodstream into the urine

6.      Blood pressure medication which slows down the kidney failure and prevents other problems associated with high blood pressure

7.      Calcitriol therapy to combat elevated PTH levels. Read the next paragraph!

Calcitriol therapy is relatively new- it’s being increasingly used in veterinary medicine. We’ve been using it for the past 3 years with tremendous results. By lowering the PTH levels which are making the kidneys fail, the rate of the failure slows down, and, most importantly, the patient feels a lot better and eats more!

Calitriol is a vitamin D relative. It comes in a tasty liquid that is given either daily or twice weekly, usually with meals. Patient compliance is rarely an issue.  We are very excited to be able to offer this relatively safe and very effective treatment for your pets!

If your dog or cat is in kidney failure, or if you have an older pet who has not had his/her kidney function checked in a while, you might want to schedule a consult with one of our veterinarians:

WilmingtonAnimalHospital.com

(302) 762-2694

           

           

Options for Arthritis in Dogs: Not another article about drugs by Shelley R. Epstein, VMD, CVH

First, could your dog have arthritis? Arthritis can affect dogs of any age. This condition develops typically when the bones of a joint don’t move normally. The smooth lining of the joint, known as the cartilage, starts to wear down, and this is painful. Over time- weeks, months, and years- the body responds by forming new bone that looks like bone spurs on X-rays. The joints may swell, and the nice sticky joint fluid, or synovial fluid, becomes thin and watery, losing its ability to lubricate the joints. The most common locations for arthritis are the knees, hips, and elbows, with the wrists (carpi) and hocks (tarsi) less commonly affected.

Arthritis can develop in the knees secondary to a condition known as “luxating patellas,” which is fancy terminology for the knee cap moving around in the wrong direction- side to side, versus up and down in its designated groove. This condition affects mostly small dogs. People often report that their dog “skips” when on walks- that’s actually the kneecap locking in the wrong position, then moving back into its correct position. 

Arthritis can also develop in the knees after an “ACL” tear. This is a torn ligament in the knee, and it results in the knee being unable to move in its normal hinge motion. The result is the abnormal wear in the cartilage. Even dogs that have had surgical repair of torn ACLs will develop some degree of arthritis in that knee. This can be severe, too. The dog may persistently limp or act stiff in that leg. We see a lot of this condition in Pit Bulls and Labs, especially.

Larger breeds can develop arthritis in the hips secondary to poor formation of the hips known as hip dysplasia. German Shepherds, Labs, Golden Retrievers, and Rottweilers commonly suffer from this condition, but it can affect any breed. These dogs are slow to rise from lying down, especially after they’ve been lying for a while. Slippery surfaces are particularly difficult for them.

The veterinary pharmaceutical companies have been particularly effective in marketing drug answers for arthritis. The pain is gone within hours and the dogs can run through beautiful fields of grass. At WAH, we reserve these drugs for our cases that don’t respond to any other therapies. Why? It turns out that all of these drugs can have side effects, including potentially fatal ones. If your dog is placed on one of these drugs, it would have to have bloodwork testing every 3 months to make sure the liver and kidneys are still happy. And you would need to keep a very close eye on the stools to make sure there is no evidence of bleeding from the stomach or intestines. (The stools would look dark and tarry, signaling digested blood.)

What are the kinder therapies that we recommend at WAH?

The simplest therapies are joint supplements containing GAGs, which is short for glycosaminoglycans, and which is why we like to shorten that to GAGs. You’ve probably heard of glucosamine and chondroitin. These are GAGs. The green-lipped mussel is also a natural source of GAGs, and VetriScience makes a wonderful supplement from this called Glycoflex Classic. Most dogs find relief and an increase in joint function on this supplement. Some dogs, in more advanced stages of arthritis, require even more joint support, and VetriScience makes levels 1, 2, and 3 for these dogs. By the time you get to the Glycoflex 3, they’ve thrown in just about every nutritional supplement known to help joints, and it seems to work.

For the past year, we’ve also been using Trixsyn, which is a joint supplement made from hyaluronic acid, or “HA,” that is actually made by bacteria. HA is the substance that bathes the joints. This particular supplement, when taken orally, has been shown in studies to go directly to the joints. It seems to work well when Glycoflex doesn’t. This supplement is in an almost-tasteless thick liquid form.

Ozzie: Read his story:http://wilmingtonanimalhospital.com/site/view/143142_OzziesLaserTestimonial.pml

For the past 3 years, we’ve been offering laser therapy.  We use a Class IV laser, which is the most effective in treating arthritis. The dogs just hang out with the owners while a tech runs a probe over and around the affected joint(s). Depending on the size of the dog, this takes anywhere from 4 minutes (one knee in a small dog) to 16 minutes (2 hips in a large dog). While the laser is stimulating all the good inflammation and squelching the bad inflammation, while the cartilage is being stimulated to heal, and while the nerve pain is going away, the dog’s happy hormones known as endorphins start to flow, making this a great experience all around. The results have been AMAZING.  For more information, visit: http://wilmingtonanimalhospital.com/site/view/137905_ClassIVLaserTherapy.pml

Acupuncture is another therapy that we have found to be very effective in treating arthritis and the rest of the dog that is sporting the bad joints. We have two veterinarians on staff, Drs. Green and Hanna, who are trained in acupuncture. This usually requires a series of 4 weekly treatments. For more information on acupuncture, visit: http://wilmingtonanimalhospital.com/services_acupuncture.php

Steve Fries, DC, has been our right arm for many years now. He’s a chiropractor who’s trained for over 1000 hours in animal chiropractic, and who devotes most of his practice to animals. He’s been coming to WAH to adjust our patients for over 10 years.  Most dogs with arthritis develop misalignments (known as subluxations) in their spines secondary to shifting the weight unequally. Some throw out their backs at the time of the trauma that resulted in the ACL tear, for example. Dr. Fries has been absolutely indispensible in our anti-arthritis drive. By realigning the spines and working on the arthritic joints, he’s restored the quality of life to hundreds of our patients. Here’s more on Dr. Fries: http://wilmingtonanimalhospital.com/veterinarians.php

And finally, the diet. Many dogs find relief from converting to a raw or home-cooked diet. It seems that the less the food is processed, the more anti-inflammatory it is for the dog. We’ll talk about diets for dogs in a later blog. For now, you can visit:http://wilmingtonanimalhospital.com/info_nutrition.php