Page 671 - Small Animal Clinical Nutrition 5th Edition

Chapter
34

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Nutritional Management

of Osteoarthritis

Todd L. Towell
Daniel C. Richardson

“I don’t deserve this award,
but I have arthritis and I don’t deserve that either.”
Jack Benny

age, obesity appears to be a risk factor.
CLINICAL IMPORTANCE Because osteoarthritis is a heterogeneous disease with diverse
origins,it can present with a range of clinical manifestations.As
Osteoarthritis, also referred to as degenerative joint disease, is a a result, therapeutic recommendations should be customized
chronic, progressive disease characterized by pathologic for each patient. When appropriate, surgical correction of
changes of movable joints and clinical signs of pain and dys- underlying conditions should be considered. After osteoarthri-
function. Osteoarthritis is associated with degeneration of tis is diagnosed, clients should be educated to foster realistic
articular cartilage and loss of proteoglycan and collagen, prolif- expectations. Osteoarthritis is usually irreversible but good
eration of new bone and a variable inflammatory response. In management can minimize pain and slow progression of the
the United Kingdom, osteoarthritis is the most commonly disease.The goals of management include: 1) mitigation of risk
observed nontraumatic orthopedic condition of dogs (Clem- factors, 2) controlling clinical signs and 3) slowing progression
ents et al, 2006). Osteoarthritis has been estimated to affect up of the disease.Thus, effective treatment requires a multifaceted
a
to 20% of dogs over one year of age in the United States. This approach, of which therapeutic nutrition is an important com-
finding is supported by the fact that osteoarthritis was in the ponent (Figure 34-1). Foods designed for patients with
top 10 most common medical conditions reported in a 2006 osteoarthritis should supply age-appropriate nutrition and spe-
b
survey of insurance claims in the United States. The most cific nutrients that may help reduce inflammation and pain,
common risk factors for osteoarthritis in dogs are developmen- slow the degradative process, complement prescribed medica-
tal orthopedic diseases, trauma including cruciate ligament tions and provide tangible improvement in clinical signs.
rupture and obesity.
The extent to which the general population of cats is affect-
ed by osteoarthritis is unknown but the disease is thought to be PATIENT ASSESSMENT
common. Radiographic surveys suggest that approximately
20% of cats older than one year may be affected (Godfrey, History and Physical Examination
2005). In a study of 100 well cared for cats over 12 years of age, Osteoarthritis in dogs and cats tends to be slowly progressive
90% had radiographic evidence of osteoarthritis (Hardie et al, and clinical signs are often subtle early in the course of the dis-
2002).The most common sites of radiographic osteoarthritis in ease.As a result,many owners are unaware that a problem exists
cats are the elbow, vertebral column and hips. In addition to or may attribute changes in their pet’s behavior to normal