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Caring for a Dog With Arthritis Research Paper

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Updated: Oct 22nd, 2021

Introduction

Arthritis is a disease of the joints and can occur in both humans and other animals, including dogs. The onset of the disease is slow and debilitating. The disease, which causes inflammation of the joints, is said to occur in about one in five adult dogs. Collier, P. (2003) states that “arthritis may be suspected as having affected a dog or cat if thunderstudyands up slowly or limps after it gets up, or if it limps on a leg previously injured or operated upon, or generally moves around slower, and is more inclined to be inactive, specially while climbing stairs or getting up onto furniture”. Dinger, B. (2006) lists “abnormal bone/joint development, damage to joints, infection, the instability of surrounding ligaments and tendons, and injury due to immune system as possible causes of the disease”. The Ingleburn Veterinary Hospital (www.Ingleburnvet.com.au, Aug 2002) also lists other symptoms of the disease in dogs like “lagging behind when on walks, yelping in pain when it is touched, reduced appetite, change in behaviour, often into aggression, and licking or chewing at joints”. The Hospital also mentions methods of nursing intervention like “exercise, weight control, pain relief, and environment”. One study by Dybdall et al (2007) has even found that “environmental change, including choice of boarding kennels, can cause a severe adverse effect on the health and behaviour of an animal”. The degree of comfort and care that can be provided to a sick dog can help reduce the pain and physical distress caused by arthritis. In this regard, proper choice of a dog’s home and kennel, choice of bedding, space available to the dog, etc can provide considerable relief to a dog struck with arthritis, particularly in its old age. For Monty, the dog under study, the size, and disposition of the dog, the stage of the disease as also its specific symptoms and behaviour need to be observed and then a suitable choice of home environment, kennel etc needs to be arrived at.

Choice of Kennel

A dog house or kennel is a place outside the house where a dog can be warm in the cold season, dry during rainy days, and cool during the hot summer months. Also, it should be happy and secure in its home. Dog kennels are designed for every kind of dog. A doghouse or kennel should be of correct size, neither too large nor too small so that the dog is both comfortable and has sufficient space to move. The kennel must also be well ventilated, just above the ground, has a proper entrance which keeps out the adverse elements of nature outside like wind, cold, rain, etc. The roof of the kennel should also be detachable so that the inside can be periodically accessed and cleaned. The kennel also should have sufficient space for keeping food and water bowls. The doors of the doghouse may not be too large, and the size of the walls sufficient to prevent cold outside from affecting the dog. While these requirements in a kennel or doghouse are true for both a sick and a healthy dog, the type of house and its specifications assume more importance in case of a dog with arthritis like Monty, the Labrador to be interned for treatment.

Bedding is another important choice in case of a dog struck with arthritis. How comfortable Monty can be during its pain in the kennel depends on the choice of bedding material, floor of the doghouse, and other such matters. In this respect, a bed that is raised up from the ground, preventing incoming cool draught, and providing dry and comfortable sleeping environment, and, ideally, a trampoline-type bed, is suitable for Monty. Also a warm blanket must be provided and good padding may prevent pressure from being applied on the joints of the dog, contributing to comfort and relief from pain. Boras, D. in an article in 2008 mentions several steps that can be taken to help provide comfort to the sick dog in a kennel and these include “the placement of gates across stairs (which help prevent stressing the dog’s weak, painful and swollen joints, elevating bowls/dishes for keeping water or food, providing portable steps or ramps for the dog home, placing a rubber mat to prevent the food and water bowls from slipping while the dog is eating or drinking, and also placing orthopedic dog beds art least 4 inches thick to help cushion the dog’s swollen and painful joints. Also, dog kennels need to stress exercises, walks, and the provision of a clean home environment for the dog”. For Monty, stricken as it is with arthritis, this cannot be overemphasized.

The Ontario SPCA mentions that “doghouse exteriors must be weather-coated with suitable materials or non-leaded paint, and the location needs to be changed with a change in seasons to control effects of sun, shade, and wind. Additionally, suitable bedding materials like straw instead of blankets, with the same changed every 1-2 weeks, as also an outside flap made from canvas could provide the best protection to the dog during winter. In summer, the hall may be separated from the sleeping area by making the wall detachable for providing maximum coolness. Elevation of the house on bricks or cinder blocks could keep the house floor dry with a ramp provided for the dog to enter over the raised sill. Also, the base platform could be kept low, and an insulated ceiling and a separate hallway if provided could keep the dog warmer in the cold season. The roof could be insulated by using an insulation board between plywood pieces, and a small rainproof vent could be provided which would help dissipate any moisture accumulated inside the dog house, thereby reducing the possibility of mold” (www.ospca.on.ca, 2008). The Ontario SPCA also mentions the dimensions of the dog house as 36 inches of floor space for each inch of the dog’s height, and 1 to 2 inches more than a dog’s height when measured in its sitting position to yield the height of the ceiling from the floor of the sleeping area. For a retriever like Monty, the Labrador, the following table (Table 1) would list the ideal dimensions of a kennel according to the SCPA:

Table 1. Areas and Ceiling Heights 24” (Shoulder) / 27” (Sitting) (Inside measurements)

Areas and Ceiling Heights 24”
Figure 1. Areas and Ceiling Heights 24”

Monty’s Nursing Care Plan

Is the dog
Able to
Ability before admission
(Client responses)
Actual
Problems
Potential
Problems
Nursing
Intervention
Eat adequate food 1.Eats Pedigree food, once a day around 6 pm and quantity is about two cups daily (the owner says that he still seems hungry)
2. Also gets to eat 2 Bonios (dog treats) in the morning
The treats may be contributing to the overweight Symptoms of arthritis-like pain, pressure on joints, and discomfort can aggravate
Under managed or intractable pain could mean criteriafor euthanasia”.(The Journal of the American Animal Hospital Association, 2005)
Introduce a planned diet considering the size, activity, body weight, possible exercise regimen, etc
Drink adequately Appears to drink about a liter of water. Sometimes takes gravy with food Appears Normal
Urinate normally
  1. Does do so normally, taking about half an hour normally to urinate in the winter mornings
  2. Appears to urinate like a bitch, without showing a marked preference for any particular spot
2. May imply pain in the joints and discomfort in limbs
  1. Pain can become

Unbearable

Defecate normally Defecates normally, twice a day, in the yard or dog park, ejecting out dark brown feces Appear Normal
Breathe normally 1.Sometimes gets out of breath in hot weather

2. He often snores while sleeping after a long exercise session

Could indicate respiratory problems and/or nasal congestion Could lead to acute asphyxia.
Maintain Body Temperature He often gets too hot, and he mostly likes to be in the shade
Mobilize adequately 1. Exercises thrice daily, with 10 minutes in the morning, 20 minutes at lunch time and 10 minutes in the evening
2. Recently slowed down and does not like chasing balls
1.Too much strain on the joints

2. Pain in the joints and debilitation

Pain could increase unbearably, if too much exercise. If too little, may lead to muscle wastage and greater stiffness. Joints may be further damaged, particularly due to persisting obesity
Life span may decrease. Also, risk of diabetes, respiratory problems, etc which can occur in future, if left untreated
A gentle massage daily, which can increase flexibility, blood circulation and calmness in the dog.
Also implement and maintain a weight loss program coupled with regulated calorie intake by way of selective dietary elements like vitamins, minerals and protein.
Groom and clean himself He sometimes washes his paws, and neither minds being groomed nor his nails being cut Normal
Sleep and rest adequately Does so normally, getting up every morning at 6.30 am and going to sleep at 11 pm at night Otherwise normal
Behave normally 1. Not so lively as before, chews up his toy into pieces, and although gets on well with other people, does not like other male dogs
2.While walking, pulls on lead which is required to be put on him
Sign of aggression, common to a dog having paid due to arthritis The degree of such behaviour could increase due to unmanageable pain Medication is advised, under prescription of vet
Hear and see normally Appears normal Normal
Take injections and vaccinations Does not mind his vaccinations and antibiotics often been given in sausages Normal

Weight Loss Program

A weight loss program aiming to decrease weight at a rate of 0.5 to 2 % of the bodyweight per week is envisaged. The diet would attempt to provide calorie deficit, maintain the levels of protein, vitamins, and minerals required for maintenance, as also achieve a gradual and safe weight loss. While adopting the weight loss program for achieving a targeted reduction in weight over some time, the dietary management would also help check the progress of arthritis, alleviate pain and other clinical symptoms, safeguard the heart from possible attacks caused by obesity complications and also safeguard against failure of secondary organs. The program would also help alleviate respiratory troubles, if any, improve tolerance of Monty to exercise, aid in countering arthritis, alleviate pain, prevent other diseases like skin disease, heart disease, and diabetes mellitus from occurring as also help prolong the dog’s life and strengthen the quality of life, particularly in the old age. Since Monty appears to crave more food even after feeding him his regular dosage, a nutrient-rich diet at regular periodicity coupled with regular waste elimination, exercises, walks, and phasing out of treats could be essential to reduce body weight, alleviate joint pain and bring him around to normal life and activity. A gradual and safe weight loss coupled with a balanced diet of protein, vitamins, and minerals is envisaged thus.

Depending on the degree of cooperation that can be achieved from the dog, a mix of regular exercise and food habits through a controlled diet regimen, Monty could be well on the road to recovery. In addition, depending on the severity of the physiological conditions, a controlled regime of exercise twice daily may be attempted to bring around the wellness of the dog. Hawkins, K. (Mar 2006) maintains that “most dogs take around ten to twelve months to achieve their target reduced weight and this depends on the actual weight that can be lost by a particular dog”. Blanchard, G has also acknowledged, like many others, that “obesity is a disease, and that its treatment is now regarded as beneficial to health and life expectancy of pets” and also further stated that the “problem is more pronounced with age, gender, and sexual status, and particularly, the Retriever breed of dogs are more vulnerable to obesity” (2008). For effecting a gradual weight reduction, exercise and regular regimen as part of a nursing schedule can be given as follows:

7.00a.m. Dog to be taken out and walked. His feces to be noted for constitution, color, quantity, and odour

7.30 a.m. Medications as prescribed by the vet to be given

8.00 a.m. Food to be given Quantity of food taken and water drunk to be noted

8.30 a.m. Grooming, bathing, if required, motion exercises, etc to be done

9.00 to 11.00 a.m. Note down specific problem issues to be given to the Vet

11.00 a.m. Take out Monty on a walk and record on eliminations

11.30 a.m. to 3.30 p.m. Monitor and record activities of the dog

3.30 p.m. to 4.30 p. m. Medications to be scheduled and Monty to be walked under

Observation

5.30 p.m. TO feed Monty, give water to drink, and record observations

6.00 p.m. to 10.00 p.m. Monitor and record observations on the dog’s activities

10.00 p.m. Take him on a supervised walk

11.00 p.m. Give Medication, before he goes to sleep

Monty would be fed 60% of the daily MER at a bodyweight set at 15% less than actual weight during the first assessment. The MER was calculated as per the formula: MER (MJ) = 06. X 0.42 x BW0.75 Once the target is arrived at, an estimation of time for achieving the same as also the diet to be planned is the next step in the program. The time required to effect the weight reduction is approximated to be around 1% per week in the case of Monty, a conservative estimate considering the present lameness of the dog. The ideal diet needs to restrict calorie intake (low in energy) and at the same time maintain satiety, and contain less fat but have more fiber. “Certain nutrients help the dog’s health and joint management which include Glucosamine and Chondroitin Sulfate, Shark Cartilage, Bovine Cartilage, Perna Canaliculus, Sea Cucumber, etc”. (pet-supplies-review.com, 2008) The body weight also needs to be weighed on a fortnightly basis and monitored to see if the program is on track. Table 2 below shows the minimum protein requirements for an adult dog (8 to 12 years old)

Table-2: Minimum Nutrient Requirements of Dogs for Growth and Maintenance (Amounts per kg body Weight per Day)

Protein

Nutrient Unit Growth Adult Maintenance
Arginine mg 274 21
Histidine mg 98 22
Isoleucine mg 296 48
Leucine mg 328 84
Lysine mg 280 50
Methionine – cystone mg 212 30
Phenylalanine – tyrosine mg 390 86
Threonine mg 254 44
Tryptophan mg 82 13
Valine mg 210 60
Dispensable amino acids mg 3414 1266

(Adapted from: Compendium of Pet Animal Practice, Dr Chander, S., 2004)

It may be more useful to remember that an adult, non-reproducing dog requires about 22% of the diet dry matter as an average quality protein. Carbohydrates may safely supply 60% of dietary calories without causing a deficiency of proteins, fats, minerals or vitamins. Dietary fat supplies concentrated energy and essential fatty acids, and makes the diet palatable. While only 2% fat as com or soy oil (50%. linoleic acid) s needed to provide the essential unsaturated fatty acids, fat levels of 6-8% on dry matter basis are frequently added to diets for palatability and to help meet the energy requirement”.

Table-3: Minimum Nutrient Requirements of Dogs for Growth and Maintenance (Amounts per kg Body Weight per Day)

FATS

Nutrient Unit Growth Adult Maintenance
Fat gm 2.7 1.0
Linoleic acid mg 540 200

(Adapted from: Compendium of Pet Animal Practice, Dr Chander, S.,2004)

The most recent estimates of the energy requirement of dogs are given in following table 4:

ENERGY

Table-4: Caloric and daily food allowance for the maintenance of adult dogs

Bodyweight (Kg) Kcal ME/Kg bw Dry Food (g) Semi moist (g) Canned (g)
1 132 36 45 104
2 106 62 73 168
5 88 126 154 347
7 81 160 202 448
10 75 213 263 591
15 70 297 364 829
20 62 350 454 980
35 53 524 650 1465
50 48 678 840 1893

(Adapted from: Compendium of Pet Animal Practice, Dr Chander, S., 2004)

Dogs require at least 13 vitamins and the table below shows the ideal intake:

Table 5: Minimum Nutrient Requirements of Dogs for Growth and Maintenance

(Amounts per kg Body Weight per Day)

Nutrient Unit Growth Adult Maintenance
A IU 202 75
D IU 22 8
E IU 1.2 0.5
K
Thiamine μg 54 20
Riboflavin μg 100 50
Pantothenic acid μg 400 200
Niacin μg 450 225
Pyridoxine μg 60 22
Folic acid μg 8 4
Biotin
B12 μg 1.0 0.5
Choline mg 50 25

(Adapted from: Compendium of Pet Animal Practice, Dr Chander, S., 2004)

Table-6: Minimum Nutrient Requirements of Dogs for Growth and Maintenance (Amount per kg body weight per day)

Nutrient Unit Growth Adult Maintenance
Calcium mg 320 119
Phosphorus mg 240 89
Potassium mg 240 89
Sodium mg 30 11
Chloride mg 46 17
Magnesium mg 22 8.2
Iron mg 1.74 0.65
Copper mg .016 0.06
Manganese mg .28 0.10
Zinc mg 1.94 0.72
Iodine mg 0.032 0.072
Selenium μg 6.0 2.2

Table-7: Examples of semisolid foods for dogs (%)

Ingredients Diet 1 Diet 2 Diet 3 Diet 4
Cereal flour 10 05 10 10
Soybean/Groundnut meal 15 15 15 15
Meat and bone meal (50% CP 15 15 15
Skim milk 45
Dried skim milk 10
Eggs 40
Sucrose 20 15 20 20
Animal fat 05 05 02 -2
Water 30 33 13
Propylene glycol 02 02 02 02
Sorbitol 02 02 02 02
Minerals & vitamin supplement 01 01 01 01

(Adapted from: Compendium of Pet Animal Practice, Dr Chander, S.,2004)

Conclusion

One study by Mlacknik, E. et al notes in the JAVMA (Dec 20060 that “The negative impact of obesity on health is well documented. In addition to an association with various medical disorders such as compromised immune function, abnormal glucose tolerance, acute pancreatitis, greater risk for anesthetic and surgical complications, heat and exercise intolerance, and cardiovascular disease, obesity in dogs is thought to be a risk factor for the development and progression of osteoarthritis. In humans, a correlation between osteoarthritis and obesity has already been detected; however, the exact role in dogs has not been fully investigated. The theory pertaining to the pathogenesis of osteoarthritis is that excessive body weight causes additional mechanical stress on joints, thus promoting their degeneration. Treatment of obesity is based on a restriction of caloric intake. Restricting calories to 60% of the calculated maintenance energy requirements for a dog’s target body weight has been recommended. Restriction of caloric intake and maintenance of lean body condition cannot only increase median life span but can also prevent the manifestation of chronic diseases such as osteoarthritis. In overweight dogs, osteoarthritis changes appear earlier in life and are more severe, compared with their restricted-fed siblings”.

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