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Joint Pain in Pets – How to Recognize and Treat Osteoarthritis

An orange cat and a golden retriever with the text, "New Blog Post: Osteoarthritis in Pets.

What is it? 

Osteoarthritis (OA) is a degenerative joint disease. Cartilage is the connective tissue that covers and cushions the joints, allowing them to move smoothly and painlessly throughout their full range of motion. OA occurs when this cartilage breaks down because of certain risk factors. When the cartilage is no longer able to do its job properly, the bones in the joint rub against each other, causing pain and inflammation, a decreased range of motion, and the potential development of bone spurs. OA can occur in any joint, with the most frequent areas affected in your pet being the hip, elbow, shoulder, stifle (knee joint), and carpus (wrist).  

What are the risk factors in dogs and cats? 

A venn-diagram depicting risk factors for osteoarthritis. In the left circle: dogs; in the right circle: cats; in the overlap between the two circles: both species. Risk factors for osteoarthritis in dogs includes large or giant breeds. Risk factors in cats include abnormal joint development. In both species, the following are risk factors: overweight or obese, age (middle-aged to senior), repetitive stress from activities, previous injuries, infection, poor body conformation, improper nutrition and diet, genetics.

What are the signs and symptoms to look out for? 

In dogs, it is difficult to detect OA when it is in its early stages, and visual symptoms are not as pronounced until the joint has become really damaged. Dogs are also good at hiding their pain so it may not be detectable until their pain is severe. Nevertheless, signs that you can look out for include: 

  • Stiffness  
  • Lameness  
  • Limping  
  • Difficulty getting up after laying down 
  • Lethargy 
  • Exercise intolerance 
  • Weight gain 
  • Any changes in behavior 
  • Visible pain when touched 
  • Difficulty in urinating or defecating 
  • Any loss of muscle mass 
  • Asymmetric distribution of muscle mass 

In cats, it is even harder to detect! Cats are very good at tolerating bone and joint troubles because of their small size and agility. Like dogs, they are also very good at hiding their pain. When cats experience joint problems, the same joints are typically affected on both sides of the body. This means they can compensate well, and it can seem like they are walking and going about their day normally. Some signs that you can continue to look out for include: 

  • Decrease in activity at home 
  • Weight loss 
  • Appetite loss 
  • Depression 
  • Any changes in behavior and attitude 
  • Poor grooming habits 
  • Urinating or defecating outside of the litter pan 
  • Inability or hesitancy to jump, run, or play 

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How can you prevent or manage osteoarthritis in your pet?  

Implementing a weight management plan 

A common risk factor for OA in pets is bodyweight. Excessive weight in pets can result in increased strain on the joints. Adipose tissue also produces inflammatory markers, and an excess of this tissue can lead to increased inflammation in the joints, ultimately causing discomfort and increased risk of developing or progressing OA symptoms. With the pain and difficulty of moving that may accompany OA in your pet, it is possible that they may reduce their activity levels, resulting in weight or muscle loss. Muscle plays an important role in the structure and function of joints, and low muscle mass may further increase the risk of progressing OA symptoms. 

Several studies have demonstrated a relationship between obesity and OA in pets and the benefits of weight reduction on reducing OA symptoms, although more evidence exists for dogs than cats. A life-time study performed on 48 Labrador retrievers showed that those who were slightly restricted in their energy intake maintained close to an ideal bodyweight, on average, and had significantly less cases of dogs with hip, stifle, and shoulder joint OA at 8 years old compared to those fed to adult maintenance. The severity of OA for the dogs fed to adult maintenance was also significantly greater than those in the restricted group. Two uncontrolled studies of obese dogs with OA found that obesity management (loss of body weight resulting in optimal body condition) led to improvement in their ground reaction force, mobility, and clinical signs of OA. 

Weight management in pets refers to the process of adapting long-term lifestyle changes to maintain a pet’s healthy weight. This could involve weight loss, and/or muscle and weight gain, while considering individualized factors such as breed, age, gender, and activity level of the pet. If you are interested in developing a weight management plan for your pet to prevent/manage OA, the first step is consulting your veterinary team, and the second step is to schedule follow-up care or check-ins with your veterinarian to ensure you are on track throughout the weight management journey. For a successful weight management plan, your veterinary team will implement a multifaceted approach that includes both nutritional and physical therapy/physical activity counselling to ensure appropriate caloric intake, diet selection, physical activity levels, and physical therapy where appropriate to ensure body fat loss and/or restore the use of muscles, bone, and the nervous system.  

Implementing an exercise plan 

An important component of a weight management plan is ensuring an appropriate type and amount of daily exercise is included. Although you may be thinking that exercise will worsen your pet’s symptoms of OA and cause even more pain, exercise that limits joint trauma can significantly improve upon joint mobility, cartilage health, and strengthening muscle for joint support. Restricting exercise can lead to muscle loss, which ultimately affects the stability of the joints. In the past, prolonged rest was prescribed for patients with OA pain. However, this can cause stiffness in the joints from scar tissue build up (fibrosis) and can further impact cartilage health. 

Regular, low impact exercise is recommended for OA pain management, as it helps to decrease the loss of muscle mass and maintain physical health in pets. An example of this type of exercise includes daily leash walks for your dog (or cat). Playing with your cat for several minutes three times a day, in a way that avoids jumping or other strenuous acts, can also encourage exercise and mental stimulation. Enrolling your pet in a physical rehabilitation program that has individually targeted exercises or range of motion and massage techniques can also be beneficial. The type and frequency of exercise is largely dependent on the stage of disease progression and joints affected, and more recommendations for dogs can be found in the Proposed Canadian Consensus Guidelines on Osteoarthritis Treatment.  

Introducing an appropriate diet and supplements 

Appropriate nutrition can not only contribute to weight management, but also the management of OA in pets. Fortified therapeutic diets and supplements have been shown to have a possible beneficial or protective pharmacological effect on OA. Your veterinarian can help identify an individually tailored diet and supplement trial for your pet. The most used diets and supplements in the management of OA for pets include:  

Omega-3 based supplements  

  • Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are two omega-3 fatty acids primarily found in marine oils (e.g. fish oil, krill oil).  
  • EPA and DHA have been shown to be beneficial for the health of both humans and domestic animals in that they contain anti-inflammatory and antioxidant properties. 
  • For example, EPA acts as a precursor for the synthesis of eicosanoids, which are a group of immunoregulatory molecules that function as local hormones and mediators of inflammation. 
  • High evidence: Clinical trials in dogs and cats have shown the clinical efficacy of omega-3 based supplements for the treatment of OA. 

Omega-3 enriched therapeutic diets 

  • The role of therapeutic diets is to ensure nutritional needs are met for the pet while also providing active ingredients that can help modify conditions, like OA. 
  • Therapeutic diets are considered “complete and balanced”, meaning the diet must meet one of the Dog or Cat Food Nutrient Profiles established by the Association of American Feed Control Officials (AAFCO), or pass a feeding trial using AAFCO procedures. To meet one of the nutrient profiles, the diet needs to contain every nutrient listed and at the recommended level.  
  • The addition of omega-3 fatty acids EPA and DHA to therapeutic diets aims to provide the diet with active ingredients that can help modify the OA condition. Since the diet is already formulated with EPA and DHA, further supplementation of fish oil is typically not recommended. 
  • High evidence: Clinical trials in dogs and cats have shown the clinical efficacy of these omega-3 enriched therapeutic diets for the treatment of OA. 

Cannabinoid-based supplements 

  • Cannabidiol (CBD) is a phytocannabinoid, that acts on CB1 receptors and CB2 receptors within the body. CB1 is located mainly in the central nervous system and can affect memory, appetite, and neuronal excitability. CB2 is located mainly on immune cells and can help to inhibit production of proinflammatory cytokines, which are molecules that promote inflammation.  
  •  Although complex, altering the activity of CB1 and CB2 receptors could modify painful conditions created from OA. 
  • Medium evidence: Some clinical evidence exists supporting the use of cannabinoid-based supplements for OA treatment in dogs.  
  • However, it is important to note that CBD is not a regulated veterinary drug, and a therapeutic dosage has not yet been determined. Being aware of the potential for toxicosis when administering CBD to pets is necessary, and extra consideration should be given to pets with OA and concurrent liver disease. More information on CBD toxicity can be found on the Pet Poison Helpline.  

Collagen-based supplements  

  • Collagen is the most abundant protein in an animal’s body, and type II collagen is the primary structural protein found in cartilage and contributes to the connective tissue’s tensile strength, toughness, flexibility, and joint support. 
  • Medium Evidence: Lower quality clinical evidence exists supporting the use of collagen-based supplements for OA treatment in dogs compared to omega-3 supplements, diets, and CBD. Three of the clinical trials performed had small sample sizes, and many did not investigate the isolated impact of collagen on OA management. 

Chondroitin-glucosamine-based supplements 

  • Glucosamine is a sugar precursor for glycosaminoglycan, which is used as a lubricant or shock absorber in the joints.  
  • Chondroitin sulfate is responsible for inhibiting degradation enzymes in cartilage and joint fluid. 
  • They both stimulate collagen synthesis, inhibit inflammatory mediators, and reduce the degradation of proteoglycans, which helps with lubricating the joints. 
  • Low evidence: Little to no clinical evidence exists supporting the use of chondroitin-glucosamine-based supplements for OA treatment in cats and dogs. 

The table below summarizes the evidence available in the literature from peer-reviewed clinical trials for each supplement/diet mentioned above. The clinical trials were categorized by three factors: having an analgesic effect and improvement of the OA condition over time, only having an improvement of OA symptoms over time and no evidence of an analgesic effect, and no analgesic effect or improvement of OA over time in cats and dogs. 

Type of diet/supplement Number of clinical trials Showed an analgesic effect & improvement in condition over time Only showed improvement in condition over time No analgesic effect or improvement over time 
Omega-3 based supplements 10 (9 for dogs, 1 for cats) 70% (7/10) 20% (2/10) 10% (1/10) 
Omega-3 enriched therapeutic diets 10 (9 for dogs, 1 for cats) 50% (5/10) 40% (4/10) 10% (1/10) 
Cannabinoid-based supplements 7 (all dogs) 14.3% (1/7) 71.4% (5/7) 14.3% (1/7) 
Collagen-based supplements 11 (all dogs) 45.4% (5/11) 36.4% (4/11) 18.2% (2/11) 
Chondroitin-glucosamine- based supplements 9 (8 for dogs, 1 for cats) 11.1% (1/9) 88.9% (8/9) 

Modifying your home environment 

Another important strategy to consider is changes to your pet’s environment to help minimize pain and discomfort. Some options include: 

  • Providing steps to higher areas such as the couch or bed so they can easily reach the top without straining their muscles and joints 
  • Providing raised food and water dishes to relieve back pain and make mealtime more enjoyable 
  • Providing an orthopedic or memory foam bed to make sleeping as comfortable as possible 
  • Bringing along a ramp to enter and exit the car 
  • Keeping their nails short to reduce strain on their joints and increase traction 
  • Preventing access to stairs when no one is around to supervise 
  • Providing some form of slip-free flooring such as area rugs, or yoga mats 

Managing pain with pain medication  

Although the dietary and lifestyle factors mentioned above are excellent tools in the management of OA in pets, sometimes it may not be enough to manage their pain. Analgesic medications are another common treatment option to help minimize pain and discomfort. The most prescribed medication for OA management is non-steroidal anti-inflammatory drugs (NSAIDS), and its clinical efficacy has been well established. Other examples of pain medication that are commonly prescribed for OA pain management are corticosteroids, gabapentinoids such as gabapentin, and opioids such as tramadol. If your pet still feels uncomfortable, we recommend consulting with your veterinarian to discuss all options for pain medication and choose the most appropriate medication based on your pet’s needs.  

Has your pet developed osteoarthritis? An osteoarthritis (OA) diagnosis can be scary and overwhelming since we know that OA is a progressive disease the worsens over time. However, with successful management of the disease to maximize your pet's comfort and function, your pet can live a long and happy life. What are the best ways to help my pet with OA? Establish a relationship with your veterinarian. Schedule regular evaluations so your vet can monitor your pet's OA progression. Use a notebook to track all health changes in your pet and bring it to your vet visits. How can I manage my pet's OA at home? Changes that can be made at home include: implementing a weight management plan. Implementing an exercise plan. Modifying your home environment. Introducing an appropriate diet and supplements. Managing pain with pain medication.

In summary… 

Receiving the message that your pet has osteoarthritis can be a daunting diagnosis as it is known to be a degenerative disease with no specified cure. However, through understanding what the disease is and how it works, monitoring your pet for any of the risk factors mentioned above, and being proactive by providing your pet with an appropriate nutrition and exercise plan, you can significantly reduce the risk of your pet developing this disease. Understanding these things can also help improve upon your pet’s condition if they have already been diagnosed with osteoarthritis and will hopefully allow them to live with less or no symptoms, leading to a happier, healthier, and pain-free life! 

Written by:   

Shawna Morrow, BScH, MSc candidate  

Reviewed by:   

Dr. Francisco Poblanno DVM, DVSc candidate, ECVCN resident  

Dr. Adronie Verbrugghe DVM, PhD, Dip ECVCN  

References 

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Mejia S, Duerr FM, Griffenhagen G, McGrath S. Evaluation of the effect of cannabidiol on naturally occurring osteoarthritis-associated pain: a pilot study in dogs.  J Am Anim Hosp Assoc. 2021; 57(2):81-90. 

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