pet arthritis | Fur the Love of Pets

When working with the Animal Medical Center veterinarians participating in our post graduate training programs, I often say, “Cats are not little dogs.” What I really mean is, a particular disease in dogs does not appear the same as the disease does in cats. For example, dogs with heart disease typically have heart failure from leaky heart valves, while cats with heart disease commonly have abnormalities of their heart muscles, not their valves. When it comes to disorders of the thyroid gland, dogs suffer from an under active thyroid and cats from an over active thyroid.

Normal hips in a cat. Arrows point to nice, smooth joint surfaces.

A pet’s behavior in response to arthritis pain is also different between cats and dogs.

Arthritis is a common cause of pain in dogs and owners of arthritic dogs are quick to point out their dog is limping. Despite the fact that x-rays show evidence of arthritis in somewhere between 15-65% of cats, limping is really uncommon in feline patients. 

Cats with arthritis suffer from weight loss, anorexia, depression, urinating outside the litter box, poor grooming and, in some cases, lameness. One of my 21-year-old feline patients had to be moved onto a single floor of the house because he was too painful to use the stairs to the basement to get to his litter box. He got a new litterbox too, which had lower sides since he couldn’t step into his old one with higher sides.

Both hips in this cat are affected by arthritis. Arrows point to roughened edges of joint.

Pain in cats is difficult for both veterinarians and cat owners to assess. From my veterinarian’s viewpoint, if I put a cat on the exam room floor in an attempt to watch it walk, it will immediately run under the desk and hide. It will definitely not limp as it rockets underneath the desk.

In a recent study evaluating pain assessment in cats by veterinary researchers in North Carolina, cat owners reported they found it difficult to identify mild pain in their cats. Cat owners believed they could correctly identify changes in their cat’s function and activity. Dog owners more readily identify how pain interferes with their dog’s activities, possibly because dogs participate more fully in family activities such as ball toss, Frisbee and hiking.

If you notice your cat moving around less, not using the litter box or showing reluctance to go up and down the stairs, see your veterinarian for an arthritis evaluation.

________________________________________________________

This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Making certain decisions for your pet can be pretty simple. Yes, I give heartworm medication every month, because the drug is effective and much safer than treating my dog for heartworms. Yes, I know spaying my dog prevents mammary gland cancer and unwanted puppies. Yes, I keep my cat indoors to protect against cat fights, automobiles and feline leukemia virus infection. There are some decisions, however, that do not come so easily.

Recently, I spent time with a dog-owning family facing one of these tough decisions. The dog was older, but age should never be the sole criteria used to guide decision-making. The dog was in reasonably good shape until he collapsed earlier that day. Emergency evaluation discovered a life-threatening problem requiring an emergency surgery. It doesn’t get tougher than that — you’ve got your back against the wall and the clock is already ticking. Luckily for these owners and their dog, there was a surgical procedure to correct the problem, but (and there is always a “but” in these situations) the procedure was not without risks and no veterinarian could guarantee a positive outcome for the dog. Scientific research into this disease had identified four factors which decrease a dog’s chance of surviving the procedure. Unfortunately, this dog had three of the four factors. Does this information mean the dog should not be taken to the operating room? Not necessarily.

Just to illustrate the point, let me tell you about a cat and its owner I saw this week. Four years ago this cat experienced congestive heart failure, meaning his heart muscle was too weak to pump blood and fluid built up in his lungs. Sounds bad, and usually it is. Once a cat experiences congestive heart failure, the typical survival time is about one year. So why is this cat still alive four years later? Is the scientifically collected data wrong? Data gives probabilities about an outcome in a population of patients with a particular condition but cannot predict how a condition will affect an individual patient. Statistics will never tell the whole story since each pet is an individual and may respond better (or worse) than the typical pet with this condition. This lucky cat defied the odds and lived to tell about it.

So what is a pet owner to do in situations like this? First, listen to your veterinarian. Ask questions about the quality of life after the procedure, the length of hospitalization and the follow up care required. Some pets have the personality to cope with many trips to the hospital for follow up care, others do not. Some families have the time and energy to nurse a pet back to health; others do not. Only your family can determine what is right for you and your pet. Sometimes your veterinarian will give you grim statistics, but if your heart tells you not to quit or if you know your pet is not a quitter, then go forward with an informed and realistic expectation of the outcome of the procedure.

By the way, the dog with the three or four bad factors was discharged from the hospital three days after surgery. Go figure.

Sometimes, even after you speak with your veterinarian, you are still confused about what to do. Maybe your friends and family are giving you conflicting advice. Perhaps you have concerns you feel are too private to share with most people. You may need more time to talk things through than your veterinarian can give you. The Animal Medical Center is the only hospital in the tri-state area with a full-time counseling department. Trained social workers can speak with you by appointment, on the phone or during your pet’s visit to help you sort through your options, figure out what questions to ask, and help you decide what is right for you and your family.

If after careful consideration you decide not to pursue treatment and have chosen to let your loved one go, the Counseling staff will be with you through our pet loss services, including The AMC’s Pet Loss Support Group. To reach a counselor, call 212.329.8680. There is no charge for counseling services.

For more information about our counseling services, visit www.amcny.org/counseling. To contribute to the Counseling/Human-Animal Bond Program, visit www.amcny.org/contribute and ask that your donation go to support those services or consider joining our partnership with Margo Feiden Galleries.

__________________

For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

What is acupuncture?
Developed in China over 3,000 years ago, acupuncture uses small needles inserted into specific points on the body to achieve a desired healing effect. This technique has been used in both human and veterinary patients to treat existing conditions and also to prevent new problems from arising. According to Chinese medical philosophy, disease is a result of imbalance of energy in the body. Acupuncture is believed to balance this energy and assist the body in the healing process. In Western terms, acupuncture stimulates nerves, increases blood circulation, relieves muscle spasm and releases hormones such as endorphins that aid in pain control. Further research is needed to uncover all of acupuncture’s effects and for science to fully understand how this ancient art of healing truly works.

What conditions can acupuncture treat?
In veterinary medicine, acupuncture has been most successful in treating musculoskeletal disorders, such as:
• Arthritis
• Intervertebral disc disease
• Hip dysplasia

Acupuncture may be a successful therapy for other diseases in conjunction with traditional Western medicine to treat:

• Skin problems such as allergies and lick granulomas
• Gastrointestinal problems such as inflammatory bowel disease, diarrhea and constipation
• Genitourinary problems such as chronic renal failure and urinary incontinence
• Respiratory problems such as feline asthma
• Endocrine problems such as diabetes mellitus and hyperthyroidism
• Neurological problems such as seizures
• Neoplasia such as lymphoma, mammary cancer and mast cell tumors

Is acupuncture painful?
During acupuncture treatments, your pet lies comfortably on a padded mat. The insertion of acupuncture needles is virtually painless, and once the needles are in place there should be no discomfort to your pet. Most animals will become relaxed or even sleepy during their treatment. Sensation varies from animal to animal and some points on the body may be more sensitive than others. Human patients describe feelings similar to tingles, cramps or numbness, which may translate to mild discomfort in some pets.

Is acupuncture safe for my pet?
Acupuncture is one of the safest forms of medical treatment when performed by a trained veterinarian. Side effects are rare but do exist. In the first 24-48 hours following a treatment, some animals may appear sleepy or lethargic and the condition may appear to be worse. These symptoms reflect a physiologic change brought about by the treatment and are most often followed by an improvement in your pet’s condition.

How long do treatments last and how often must they be given?
The length and frequency of treatments depends on the condition of the patient and the technique used by the veterinary acupuncturist. Stimulation of a single point may take as little as 10 seconds or as much as 30 minutes. A simple, acute injury such as a sprain may take one treatment, while a more severe or chronic disease can take multiple treatments.

When multiple visits are necessary, they usually begin intensely and are tapered to maximum efficiency. A positive response is usually seen after the first to third treatment. Once a maximum positive response is achieved (usually after 4-8 treatments), sessions are tapered off so the greatest amount of symptom-free time elapses between them. Many animals with chronic conditions can taper off to 2-4 treatments per year.

To learn more about acupuncture treatments and The AMC’s Rehabilitation and Fitness Service, join us at AMC’s PAW Day 2010, a day of pet and wellness fun for families and their furry companions, on Saturday, June 5 from 9am-12pm in Carl Schurz Park in Manhattan.

Acupuncture at The AMC
Dr. Steven Chiros graduated from Tufts University School of Veterinary Medicine in 1998 and completed an internship in 1999 at The Animal Medical Center. He is a certified veterinary acupuncturist through the International Veterinary Acupuncture Society and has received extensive instruction in Chinese herbal medicine. To schedule an acupuncture consultation or to make an appointment with Dr. Chiros, please call 212.329.8610.
___________________
The Tina Santi Flaherty Rehabilitation and Fitness Service at The AMC
The only facility of its kind in New York City, The AMC’s Rehabilitation and Fitness Service provides innovative and state-of-the-art therapies for cats, dogs, birds and exotic animals. The Service specializes in non-invasive therapies to prevent the need for surgery, and in cases where surgery has been performed, it helps to accelerate and achieve a more complete recovery. Therapies offered include hydrotherapy, treadmills and deep-tissue ultrasound, as well as holistic therapies such as Reiki, Acupuncture and Acupressure.

The Service is directed by a team of professionals who are experts in the rehabilitative care of companion animals, including New York City’s only Certified Canine Rehabilitation Practitioners and Therapists.

The Animal Medical Center
For 100 years, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts.  Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

May 2-8, 2010 is National Pet Week and this year the theme is “People and Pets – Healthy Together.” Common human health issues such as obesity, diabetes and cancer are now also health concerns for our pets. Since so many of these health concerns are preventable, this year’s theme spotlights how we can help ourselves and our pets to achieve better health.

In the United States, there is currently both a human and pet obesity epidemic. We no longer work in the field to cultivate and harvest our food; we work in offices and shop in grocery stores. Our pets no longer hunt for their food; we provide them with highly nutritious pet food. This shift has resulted in too many calories going in and not enough calories expended.

Just like overweight or obese humans, overweight pets are predisposed to disease. Diabetes, joint problems and urinary stone formation are increased in obese cats. Respiratory problems, congestive heart failure and orthopedic disorders are compounded in dogs carrying extra weight. Overweight or obese dogs have a shorter lifespan than their thinner counterparts.

Being “Healthy Together” involves finding ways to spend time with your pet without food as a motivator. Instead of sitting on the sofa together, go to the park and throw the ball for your dog. It is even possible to exercise your cat. Get a laser pointer and shine it on the wall. Make them run and jump. While you are having fun, you’ll probably forget to go the fridge for a snack. If you need exercise suggestions for your pets, here’s the link to AMC’s canine and feline exercise posters.

Smoking is another behavior affecting our health. In my practice at The AMC, I have learned from our clients that many people don’t realize smoking may affect the health of their pets. Cats and dogs living in households with smokers have measurable levels of nicotine metabolites in their urine, indicating environmental exposure to smoke may pose risks for pets. Furthermore, cats exposed to secondhand smoke are more likely to develop lymphoma or oral squamous cell carcinoma. Being “Healthy Together” involves your entire family, pets included, which are all good reasons to quit smoking now.

The good news is that studies have shown that just having a pet helps keeps us healthy. Dog owners maintain a greater level of physical activity than non-dog owners and cat owners who have had a heart attack are 40 percent less likely to die than non-cat owners. Interestingly, the converse is not true. Cats don’t make us exercise more and dogs don’t seem to protect against heart attacks! 

All of us pet owners know that if we are sick, pets always seem to make us feel better. In one study, the health of humans undergoing radiation therapy for cancer felt an improved sense of well-being when randomly assigned to a dog visit compared to a human visit or a quiet reading period.

See why “People and Pets – Healthy Together” is such a great theme? To continue celebrating this great theme, join The Animal Medical Center staff and supporters for PAW Day 2010 on June 5th at Carl Schurz Park in Manhattan.

_______________________________
For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts.  Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

*The following was originally printed in the Metropolitan Dog Club’s 2010 Blue Book.

Charlie, a 5 year old mixed breed was Sharon’s best pal and exercise buddy. Together the two would jog a couple of miles a day and on weekends hike the nearby hills. But recently, Charlie was not as enthusiastic about their workouts as he had been. In fact, he was even having difficulty standing from a lying down position. Sharon took Charlie to the vet, who considered orthopedic disorders of the hip, forelimb and knee as part of the dog’s reluctance to run.

The following blog post is part three of a three-part series about orthopedic disorders found in our pets — how they are manifested, potential methods of diagnosis and treatments. The decision to pursue these treatments would typically be made in concert with a canine orthopedic specialist and a canine rehabilitation specialist. 

Forelimb Disorders

Shoulder OCD – Osteochondrosis (OC) or osteochondrosis dissecans (OCD) is a developmental orthopedic disease affecting young, large breed dogs.  An area of bone fails to mature and mineralize properly, creating a thickened area of cartilage within the joint. The thickened cartilage becomes susceptible to injury from normal activity and can form a flap of cartilage exposing the underlying bone. The shoulder joint is the most common site for OCD.  Genetics plays a role in the development of this disease and affected dogs should not be bred.   

Dogs with OCD typically begin to show lameness before 12 months of age and the diagnosis is made by localizing pain to the shoulder and confirming the abnormality on x-rays. Treatment includes arthroscopic removal of the cartilage flap. While most dogs fully recover, nearly all develop OA in the joint.

Elbow Dysplasia – Elbow dysplasia is a group of developmental orthopedic diseases that includes: fragmented medial coronoid process (FMCP), ununited anconeal process (UAP), OCD, and incongruous growth between the bones that form the joint (radioulnar or humero-ulnar). The cause is unknown, but genetics are strongly implicated and affected dogs should not be bred. Cartilage degradation and fragmentation of a portion of the ulnar bone results in FMCP, the most common manifestation of elbow dysplasia. FMCP affects young, large breed dogs. UAP and OCD are diagnosed with an x-ray, FMCP and incongruity often require a CT scan, MRI, or arthroscopic evaluation of the joint. Treatment includes arthroscopic evaluation of the joint for removal of cartilage defects, fragments, and flaps and correcting the incongruity of the joint. Some cases of UAP can be treated with surgical reattachment of anconeal process. Formation and progression of OA is inevitable, but most dogs can have a comfortable and functional life.  Some dogs may require osteoarthritic medications to maintain comfort.

Like all of us, our dogs sustain minor sprains and strains that require no medical treatment. However, if your dog is a known breed at risk for developmental orthopedic disorders, or if you notice your dog’s condition persists or worsens, it is important to consult a veterinary specialist to determine if invention is required. Early diagnosis and treatment can help limit the severity of the injury and help reduce the progression of osteoarthritis.   

Rehabilitation therapy plays a role in the management of orthopedic diseases as an adjunct to surgery or in cases not requiring surgery. Low impact exercise, including work on an underwater treadmill to provide buoyancy to the limbs as the pet works to regain strength and stamina, can be very beneficial to recovery. Deep tissue ultrasound and electrostimulation are also gaining in popularity for the treatment of canine musculo-skeletal disorders. Acupuncture benefits many dogs with orthopedic diseases.    

If your pet appears to be having trouble standing, walking or running, please consider consulting an orthopedic specialist at The Animal Medical Center. The AMC also provides rehabilitation therapy and acupuncture for dogs with orthopedic disorders. To make an appointment, call 212.838.7053 today.
________________
About the Authors:
Dr. Marc Havig, DACVS is currently a staff surgeon at The Animal Medical Center, and the interim Chair of the Department of Surgery.  Dr. Havig specializes in orthopedic surgery and has a special interest in canine sports-related injuries.

-

Dr. Ann E. Hohenhaus is a Diplomate of the American College of Veterinary Internal Medicine, certified in both Oncology and Small Animal Internal Medicine.  She has over 20 years of experience as a practicing veterinary oncologist in New York City.

-

__________________
For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts.  Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

*The following was originally printed in the Metropolitan Dog Club’s 2010 Blue Book.

Charlie, a 5 year old mixed breed was Sharon’s best pal and exercise buddy. Together the two would jog a couple of miles a day and on weekends hike the nearby hills. But recently, Charlie was not as enthusiastic about their workouts as he had been. In fact, he was even having difficulty standing from a lying down position. Sharon took Charlie to the vet, who considered orthopedic disorders of the hip, forelimb and knee as part of the dog’s reluctance to run.

The following blog post is part one of a three-part series about orthopedic disorders found in our pets — how they are manifested, potential methods of diagnosis and treatments. The decision to pursue these treatments would typically be made in concert with a canine orthopedic specialist and a canine rehabilitation specialist. 
 

Hip Disorders

Canine hip dysplasia (CHD) is an abnormality of the hip joint. CHD occurs most commonly in rapidly growing, large breed dogs but also occurs in small breeds. Joint laxity results in cartilage degeneration, osteoarthritis (OA) and loss of muscle mass, range of motion and limb function. CHD occurs due to a combination of genetic and environmental factors. 

CHD may manifest itself in either young (less than one year) or older (skeletally mature) dogs. In young dogs, lameness associated with CHD is attributable to joint laxity; as a dog ages, lameness is attributable to OA. Clinical signs include abnormal or bunny-hopping gait in young dogs, and difficulty rising, exercise intolerance, or hip pain in any age dog. CHD typically affects both hips and is diagnosed by localizing pain to the hip on exam and x-ray evidence of laxity and/or OA. 

Veterinarians tailor treatment to the dog’s age and the amount of OA. In dogs less than 1 year of age and before the onset of OA, surgery may be performed to improve biomechanics and help prevent or slow the progression of arthritis. In dogs that are skeletally immature, either a juvenile pubic symphysiodesis (16 to 20 weeks of age) or a triple pelvic osteotomy (6 to 12 months of age) may be performed. These procedures are surgeries that decrease the laxity of the hip joint by rotating the pelvis (acetabulum) over the femoral head.  

In dogs older than one year of age, those who have severe hip laxity or those that already have evidence of OA, CHD may be treated either medically or surgically. There are many dogs with CHD that are asymptomatic and may not require treatment. Weight loss, dietary management, medications and activity modification are recommended in all patients before surgery. Acupuncture may also benefit some dogs. For those that do not respond favorably to medical therapy, surgery may be of benefit. A total hip replacement is the “gold standard” to normalize comfort and function in dogs with CHD. A femoral head and neck ostectomy (FHO) is an alternative procedure that can alleviate pain and improve function. FHO is a surgical procedure to remove the arthritic femoral head and neck, creating a comfortable and functional pseudoarthrosis or false joint; however, the rear limb gait and limb carriage typically remain slightly abnormal.  

Veterinarians do not recommend breeding dogs with CHD. For dog owners considering breeding their dog, hip evaluations can be performed by Penn Hip® or the Orthopedic Foundation for Animals.       

Click image to enlarge

Legg-Calve Perthes Disease is also known as avascular, aseptic or ischemic necrosis of the femoral head. While the cause is unknown, the loss of the blood supply to the bone just below the hip joint results bone loss and lameness. This condition affects young, small and toy breed dogs between four and 12 months of age. There is an increased incidence in Manchester terriers, miniature pinschers, poodles, Lakeland terriers, West Highland white terriers and Cairn terriers but there is no sex predilection. Although occasionally both hips are affected, the condition typically affects only one hip and is manifested as lameness in one of the rear limbs. Diagnosis is made by localizing pain to the hip on examination and by having an x-ray that demonstrates bone loss. While there is no cure for this condition, one of the procedures used to treat CHD, FHO often alleviates pain and improves function in dogs with Legg-Calve Perthes Disease.  

Rehabilitation therapy plays a role in the management of all these diseases as an adjunct to surgery or in cases not requiring surgery. Low impact exercise, including work on an underwater treadmill to provide buoyancy to the limbs as the pet works to regain strength and stamina, can be very beneficial to recovery. Deep tissue ultrasound and electrostimulation are also gaining in popularity for the treatment of canine musculo-skeletal disorders. Acupuncture also benefits many dogs with orthopedic diseases.

If your pet appears to be having trouble standing, walking or running, please consider consulting an orthopedic specialist at The Animal Medical Center. The AMC also provides rehabilitation therapy and acupuncture for dogs with orthopedic disorders. To make an appointment, call 212.838.8100 today.

_________________

About the Authors:

Dr. Marc Havig, DACVS is currently a staff surgeon at The Animal Medical Center, and the interim Chair of the Department of Surgery.  Dr. Havig specializes in orthopedic surgery and has a special interest in canine sports-related injuries. 

-

Dr. Ann E. Hohenhaus is a Diplomate of the American College of Veterinary Internal Medicine, certified in both Oncology and Small Animal Internal Medicine.  She has over 20 years of experience as a practicing veterinary oncologist in New York City.

-

For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts.  Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Oftentimes the owners of my older patients dismiss changes in their pet’s behavior by saying, “Well, you know he is 13.” I would like to caution all of us to think critically about the changes we are seeing in our older pets and examine the potential causes of these changes.

The American Association of Feline Practitioners classifies a senior cat as one that is older than 11 years of age and the American Animal Hospital Association defines a senior dog as one older than 6 or 7 years of age. There is great variability in the expected lifespan of dogs compared to cats and your veterinarian may not consider your dog to be senior until 9 or 10 years of age, depending on the breed. Panels of the American Association of Feline Practitioners and the American Animal Hospital Association recommend the senior pet be seen biannually.

Weight Gain
Older pets tend to pack on the pounds as they age. Your Dalmatian may be sluggish because she is carrying around too much weight for her slender frame.  Pet owners who are successful with a weight loss plan often comment on how much more active their pets are after they reach an ideal body weight. Veterinarians can help you to design a safe weight loss program which includes both diet and exercise for your pet. Obesity not only slows your pet down, but is a risk factor for diabetes, arthritis, respiratory disease, urinary tract disease and, worst of all, a shortened lifespan.

Arthritis
Slowing down may be a clinical sign of arthritis. Arthritis brings to mind the limping Lhasa or the achy Afghan, but did you know arthritis is commonly under-diagnosed in cats? Diet change, weight loss and non-steroidal anti-inflammatory drugs, specifically developed and tested in pets, can completely revert your arthritic pet’s personality back to normal.

Dental Problems
Tooth problems can also slow your pet down too. When a pet experiences pain, it often causes a pet to be quieter than usual and dental pain is no different. An oral examination should be part of a complete physical examination. Removal of plaque build up, extraction of diseased teeth and treatment with antibiotics may be necessary to bring your Persian with a pout back to its usual vigorous self.

Cancer
When some types of cancer occur in a senior pet, the only clinical sign seen by the pet owner is a general decrease in activity. The decrease in activity may be due to pain or may be due to the growth of the cancer. Internal cancers, such as those of abdominal organs, lungs or nasal passages are types that can progress undetected, with the only sign being general malaise in your pet. Your veterinarian my recommend diagnostic imaging, such as x-rays, an ultrasound or CT scan to detect a possible cancer.

So remember, age is not a disease. Be sure to have your senior pet checked on a regular schedule and whenever your Abyssinian is apathetic.

To make an appointment for your pet, please call The Animal Medical Center’s appointment desk at 212.838.7053.
_______________________________
For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts.  Send your contribution to: The Animal Medical Center 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Arthritis is an important disease in geriatric dogs and is also becoming more widely recognized in cats. Estimates indicate as many as one in five dogs will suffer from arthritis as they age. This is the second in a two-part series on arthritis. The first blog covered the standard therapies for treatment of arthritis. This blog features expert information from Dr. Pamela Schwartz, Diplomate American College of Veterinary Surgery, of The AMC’s Surgery Department. She has an interest in the use of stem cells for the treatment of canine arthritis.

Stem cells are purified mesenchymal stem cells harvested from subcutaneous (under the skin) fat in dogs. These stem cells are not the controversial embryonic stem cells we hear about on the evening news, but they do possess the ability to develop into any cell in the body. In animal models, researchers have shown these stem cells have the ability to develop into cartilage cells if they are injected into the appropriate environment. Once they are injected into an inflamed, arthritic joint, they will turn into new cartilage cells to help repair the damage caused by osteoarthritis. 

Every dog is not a candidate for stem cell therapy. Stem cell therapy is currently indicated for osteoarthritis and is not considered applicable to other chronic medical or neurological conditions. Dogs with cancer are not good candidates for this treatment. If there is a surgically repairable disease (i.e., ligament tear), we recommend surgery and reserve the use of stem cells for the future. 

Owners interested in having their dog evaluated for stem cell therapy must have a consultation with a stem cell credentialed veterinarian (The AMC currently has five stem cell credentialed doctors, including Dr. Schwartz). The evaluation includes a physical examination, blood work and chest radiographs.

If the dog is found to be a good candidate for stem cell therapy, an outpatient “fat harvest” will be scheduled. During the harvest, a small incision is made in either the groin, behind the shoulder blade, or into the abdomen. The dog is discharged from the hospital the same evening and the harvested fat is shipped overnight for processing. Forty-eight hours later, when the stem cells arrive back at AMC, the stem cells are injected into the affected joints while the dog is under sedation. Multiple joints may be injected on the same day and we’ve seen good results in arthritis of the hips, knees and elbows. 

Following stem cell therapy, the degree of lameness is reevaluated 30, 60 and 90 days after the injection. During these visits, both the owners and the vets will evaluate the degree of lameness to assess the dog’s improvement. We are pleased with the results we have seen in the patients we have treated with stem cells. They can go for longer walks, jump on and off the bed again and have a more comfortable life. 

For further information about stem cell therapy at The AMC or to schedule a consultation, please call Dr. Pamela Schwartz at 212.329.8756.

____________________________________
The Department of Surgery at The AMC
The surgeons at The AMC, who are certified by the American College of Veterinary Surgery, provide seven-day-per-week expertise, state-of-the-art surgical techniques and emergency surgical care.  We also offer specialty services such as veterinary dentistry, rehabilitation and pet fitness services, orthopedics and soft-tissue surgery.  Our surgeons work closely with internal medicine, oncology, radiology, critical care and pathology specialists to coordinate testing and to determine the least invasive and effective procedures necessary to optimize patient outcomes.

Orthopedic Surgery
• Marc E. Havig, DVM, DACVS
212.329.8709
marc.havig@amcny.org
• Pamela Schwartz, DVM, DACVS
212.329.8756
pamela.schwartz@amcny.org
• Jason Syrcle, DVM
212.329.8809
jason.syrcle@amcny.org

Soft Tissue Surgery
• Janet Kovak McClaran, DVM, DACVS
212.329.8710
janet.kovak@amcny.org
• Pamela Schwartz, DVM, DACVS
212.329.8756
pamela.schwartz@amcny.org
• Jason Syrcle, DVM
212.329.8809
jason.syrcle@amcny.org

What is arthritis?
Arthritis is “doctor speak” for inflammation of one or more joints. It can be caused by infections such as Lyme disease or other tick borne organisms.  Uncommonly, aberrant responses of the immune system to medications, or unknown factors also causes arthritis in multiple joints at the same time. By far the most common cause of arthritis in dogs is due to injury to the cranial cruciate ligament (the cause of football knee in humans) or as a result of the developmental abnormality known as hip dysplasia. These forms of arthritis are often referred to as osteoarthritis. Most dog owners are aware of the possibility of osteoarthritis in their pets; however, veterinarians are just now beginning to diagnose osteroarthritis in older cats.

How is arthritis diagnosed?
You may be the first to suspect a diagnosis of arthritis in your pet. You may notice she is not moving around as much as usual or he is not racing to the door to greet a returning family member. Your dog may cut short her favorite walk or your cat may develop a limp. A routine annual physical examination by your veterinarian will give additional clues to the diagnosis.  He may detect a swollen joint, elicit pain during examination and feel crunching when the joints are manipulated. An x-ray will confirm the diagnosis.

How can arthritis be treated?
The main management strategy for osteoarthritis is exercise, diet and administration of analgesic medications and your veterinarians can determine if some or all of these interventions are right for your dog.

Exercise has a dual purpose in the management of arthritis. First, it facilitates weight loss. Overweight pets suffer more from arthritis than pets of an ideal body weight. Second, exercise will strengthen muscles which have become weak due to the inactivity resulting from the pain of arthritis. Your veterinarian may recommend rehabilitation therapy to strengthen muscles around the affected joint to improve function. Never undertake an exercise program in your pet without first consulting with your veterinarian. Your veterinarian can check the AMC website for posters which contain examples of exercises for both cats and dogs.

Diet also plays a dual role in the management of arthritis.  Certain pet foods have been formulated to support joint health. These foods contain glucosamine, chondroitin sulfate to promote improved joint function. They also contain optimized ratios of fatty acids which help to decrease inflammation in arthritis joints. If your veterinarian determines your pet is overweight, she may recommend a diet formulated to promote weight loss, which will improve your pet’s ability to get around. 

As recently as 10 years ago, there were very few medications on the market to control the pain of arthritis in dogs and cats. Today, there are multiple non-steroidal anti-inflammatory drug (NSAIDs) available by prescription from your veterinarian. These medications are similar to drugs like ibuprofen and piroxicam for the treatment of arthritis in humans. These have been developed specifically for pets and overcome the toxicity problems with administering human arthritis medications to dogs and cats. These products are available as tablets, chewable pills, liquids and injections to meet the needs of every pet. Pet owners should never administer human arthritis medications to their pet as they can be toxic and result in serious life-threatening illness.

Finally, in some cases where the osteoarthritis is severe, surgery may be of benefit. Damaged ligaments in the joint may result in joint instability and surgical repair of the ligament may improve joint function, slow the progression or arthritis and eliminate pain. Removal of damaged bone may decrease pain and improve joint function, especially in small pets.  Replacement of the hip or knee joint is an option in the severely affected pet.

The newest treatment for arthritis in dogs is stem cell therapy. Your dog’s own stem cells are harvested from surgically collected fat.  The tissue is specially processed to allow the stem cells to be injected back into your dog. Our next blog will feature information from Dr. Pamela Schwartz, AMC veterinary surgeon, who will discuss her experience with stem cell therapy for arthritis.

_____________________________________

For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts.  Send your contribution to: The Animal Medical Center 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org.

To make an appointment at The AMC, please call 212.838.7053.