Joint and mobility problems

Joint problems in dogs

Joint problems are a fairly common cause for a visit to the vet. One in five dogs will develop varying degrees of osteoarthritis symptoms during their life. Joint problems can be difficult to detect because they often develop slowly over time, which means dog owners do not notice anything until the symptoms have become evident. Osteoarthritis typically occurs in elderly dogs, but if a dog is born with dysplasia or suffers an injury at an earlier age, osteoarthritis can develop and cause joint problems in younger dogs too. Joint pain usually becomes evident when a dog begins to limp or seems stiffer than before. It can be difficult for such animals to lie down and get up or jump up on a couch or into a car. When a dog stops eating or refuses to move, it is a clear sign that the pain caused by osteoarthritis has become intense.  

Osteoarthritis

Articular cartilage is an intermediate protective tissue that acts as a shock absorber in the joints. It primarily consists of water and a matrix of collagen and proteoglycans. Articular cartilage is flexible and tough, and its reticulated structure resembles that of a sponge. It has a very limited ability to regenerate and experiences no sensation due the absence of nerve cells. There are no blood vessels in cartilage, so it receives all necessary nutrition from synovial fluid.

Proteoglycan, an important building block of cartilage tissue, is formed from glycosaminoglycans (GAG) and a protein matrix produced by cartilage cells (chondrocytes). Chondrocytes also produce collagen, which forms the complex 3D structure of articular cartilage. The intercellular space of the reticulated matrix is filled with viscous synovial fluid and proteoglycan molecules. The typical water content of cartilage is 65–80% (1). As cartilage compresses, the intracorporeal water moves and is even compressed out of the tissue. As compression eases, the water binds back to the proteoglycans located in the cell spaces of the collagen fibre matrix.

In healthy cartilage, the collagen matrix is intact and contains large quantities of proteoglycans. In the early stages of cartilage loss (arthrosis), the decrease in proteoglycans is visible on the surface of the cartilage. When the collagen matrix that maintains the structure of cartilage begins to break down, osteoarthritis sets in and causes irreversible damage to the cartilage tissue. In osteoarthritis, the balance between the production and destruction of cartilage is disrupted. Cartilage-degrading enzymes are activated, and the destruction of articular cartilage progresses faster than regenerative processes. Even normal loads can cause cartilage to rupture. The joint becomes inflamed (arthritis), which results in pain and swelling. Inflammation further accelerates the action of enzymes that break down proteoglycans and collagen, and the cartilage can become so worn that the bones begin to rub against one another, which in turn leads to the formation of osteophytes on the joint surface (osteoarthritis).

There are different causes of osteoarthritis. A rupture of the cruciate ligament of the knee is a common problem for dogs, and if left untreated, it quickly leads to development of osteoarthritis in the knee joint. Genetically predisposed dysplasia (congenital joint malformation) may occur at birth or develop in early life. Dysplasia of the hip, elbow, and shoulders is a common cause of osteoarthritis in young large-breed dogs. Sometimes, pieces of the cartilage detach as a result of a developmental disorder known as osteochondrosis, which affects ossification and is influenced by growth rate, hereditary factors, and feeding habits. Osteochondrosis is most common in dogs of large and heavy ​​breeds and, according to some estimates, is more common in males than in females. Orthopaedic injuries can also cause osteoarthritis.

Osteoarthritis is difficult to treat because regeneration of articular cartilage is very limited and the chronic processes in the joint are practically irreversible. Successful management of osteoarthritis in dogs is based on a multimodal approach that eliminates inflammation, reduces pain, and delays structural changes in the joints with the goal of improving mobility and overall wellbeing. Weight management, including moderate exercise and a proper diet, are important elements in the treatment of osteoarthritis in dogs. Efforts must be made to attain the ideal weight, or slightly less, and maintain it. Heavy or intensive exercise should be avoided. A veterinarian may also prescribe painkillers, such as long-lasting NSAIDs, or hyaluronate or cortisone injections into the joints. Physiotherapy can improve mobility by increasing the range of motion in the joints, and proper nutrition is key to long-term management of inflammation and pain.

Brit VD Mobility

Brit VD Mobility is a specially formulated grain-free veterinary diet for management of osteoarthritis. It can be used to prevent joint problems in dogs and maintain mobility and overall wellbeing. It also makes an ideal diet following orthopaedic surgery. Brit VD Mobility is suitable for overweight or obese dogs at risk of related joint problems. Brit VD Mobility is rich in easily digestible herring protein with high bioavailability and energy density. The food contains no chicken protein or other common ingredients that cause hypersensitivity. Brit VD Mobility is a grain-free, gluten-free, and low-fat diet. It contains L-carnitine, an important amino acid for energy and fat metabolism. The live probiotic E. faecium promotes normal immune system function, gastrointestinal wellbeing, and maintenance of ideal weight.

Brit VD Mobility is rich in omega-3 fatty acids (3.3%), particularly EPA and DHA derived from plankton. Cartilage damage in osteoarthritis is caused by cartilage-degrading enzymes called aggrecanases, the action of which is inhibited by EPA and DHA. Omega-3 fatty acids have also been shown to reduce pain from osteoarthritis by suppressing inflammation.

A wide range of chondroprotectives have been added to Brit VD Mobility to help increase mobility and reduce stiffness and pain:

Collagen: An important building block of articular cartilage. More than 30 different types of collagen are currently known. Type I and type II collagens are important for articular cartilage.

Glucosamine and chondroitin sulfate: Glucosamine and chondroitin sulfate are cartilage building blocks that naturally occur in the body. Both of the substances form chains of proteoglycans, which are fluid-retaining molecules. Water plays a key role in maintaining cartilage elasticity. Proteoglycans and water also form the gel-like synovial fluid. Ingestion of glucosamine and chondroitin has been shown to slow the destruction of articular cartilage. Glucosamines can stimulate cartilage cells to produce new glycosaminoglycans, collagens, and proteoglycans, the main components of articular cartilage.  

Methylsulfonylmethane, MSM: MSM is a natural water-soluble compound that chondrocytes use as a source of sulphur to build up cartilage proteins. MSM works well when used in conjunction with other chondroprotectives.

Boswellia serrata: Boswellia serrata is a well-known herb with positive effects on the joints. Boswellia serrata plant extract contains boswellic acids (BA). Boswellia has been studied extensively in human osteoarthritis (2), showing that it is rich in anti-inflammatory ingredients and reduces the action of inflammatory mediators.

Green-lipped mussel extract: Green-lipped mussels (Perna canaliculus) contain building blocks of articular cartilage together with vitamins and minerals. Finnish and American veterinarians, among others, have studied mussel extract in dogs with chronic joint problems. It has been found that mussel extract can help alleviate problems caused by osteoarthritis (3) (4).

Egg shell membrane (ESM): ESM contains glucosamine and chondroitin sulfate. Studies have shown that ESM can promote joint mobility and help reduce pain (5).

1) Jurvelin et al: Fysikaaliset ja kemialliset menetelmät nivelrikon varhaisessa osoittamisessa. Duodecim 2008;124(16):1885–96
2) https://www.cochrane.org/CD002947/MUSKEL_oral-herbal-therapies-treating-osteoarthritis
3) Hielm-Björkman A, Tulamo R-M. Salonen H, Raekallio M. Evaluating Complementary Therapies for Canine Osteoarthritis Part I: Green-lipped Mussel (Perna canaliculus). eCAM, 2007 doi:10.1093/ecam/nem136
4) McPhee S, Hodges LD, Wright PF, etl a. Anti-cyclooxygenase effects of lipid extracts from the New Zealand green-lipped mussel, Perna canaliculus. Comp Biochem Physiol B Biochem Mol Biol. 2007;146(3):346–56. 
5) Ruff, K et al. Effectiveness of NEM® brand eggshell membrane in the treatment of suboptimal joint function in dogs: a multicenter, randomized, double-blind, placebo-controlled study