Arthritis in Dogs: Treatment Options, Pain Management, and When Euthanasia may be the most compassionate choice
All dogs get some degree of arthritis. And in most cases, it never leads a pet parent to contemplate something so drastic as euthanasia. But a small percentage of cases become serious enough to significantly affect a dog’s quality of life – due to either severe pain, difficulty walking or even complete inability to walk, or both.
This article is aimed at pet parents whose dogs have severe arthritis that is leading to quality of life concerns. It includes treatment options, things you can be doing at home to support your dog, and how to know when euthanasia might be the kindest decision.
If your dog is struggling with severe arthritis and you don’t know what to do, consider scheduling a comprehensive quality of life teleconsult with one of our compassionate veterinarians.
What Is Arthritis in Dogs?
Arthritis (also called osteoarthritis or degenerative joint disease) is the gradual deterioration of cartilage in a dog’s joints. Over time, the loss of cushioning and the development of inflammation cause stiffness, pain, and reduced mobility.
The most commonly affected joints are the hips, elbows, knees, shoulders, and spine. Some dogs may only show subtle signs at first, but the condition typically worsens over time.
Symptoms of arthritis in dogs include limping or lameness (especially when first getting up), difficulty getting up or down, reluctance to jump, climb stairs, or go for walks, stiffness that improves with mobility, muscle loss or decreased activity, and in severe cases even crying out in pain.
Arthritis can sometimes be confused with other diseases, especially neurological disorders such as degenerative myelopathy or intervertebral disc disease (slipped/herniated discs in the back). It is important that your vet perform a thorough physical exam and sometimes imaging to determine the cause of your pet’s mobility or pain issues, because the treatment can be very different depending on the underlying cause.
Treatment Options for Canine Arthritis
1. Medications
- NSAIDs (Nonsteroidal Anti-Inflammatory Drugs):
- Pros: NSAIDs are generally very effective in managing pain and inflammation associated with arthritis. Common NSAIDs include carprofen (Rimadyl), meloxicam (Metacam), and deracoxib (Deremaxx).
- Cons: While NSAIDs can be very effective, they can sometimes have side effects such as nausea, stomach ulcers, and kidney damage. It is important to give them with good and bloodwork monitoring is generally recommended to monitor for signs of kidney damage.
- Pain Relievers: Drugs like gabapentin or amantadine may be added for dogs needing more support.
- Pros: They may be a helpful adjunct to NSAIDs and have minimal dangerous side effects, other than gabapentin may be mildly sedating.
- Cons: There is very little good evidence these medications are effective, although some pet parents find them helpful. In some dogs gabapentin can be sedating and cause worsening of symptoms due to the sedation and wobbliness it can occasionally cause.
- Joint Supplements: Glucosamine, chondroitin, and omega-3 fatty acids may support joint health and reduce inflammation over time.
- Pros: These are generally very safe.
- Cons: They may not be particularly effective, especially when used alone.
- Disease-Modifying Osteoarthritis Drugs (DMOADs): Injectable options like Adequan® can slow cartilage deterioration.
- Pros: Generally safe and there is some evidence Adequan can help slow the progression of arthritis and reduce pain and inflammation.
- Cons: Adequan must be given injectably. Pet parents can have a veterinarian or veterinary technician do this or can learn to do this themselves. Can also be on the pricey side.
2. Adjunctive therapies
- Weight Management: Extra weight increases strain on joints and worsens pain.
- Pros: Can be one of the most effective things you can do to help an overweight dog with arthritis.
- Cons: Can be very difficult to achieve weight loss in dogs with very little muscle mass and limited mobility, because they can’t exercise much. Physical therapy can help improve outcomes.
- Low-Impact Exercise: Gentle walks and swimming can preserve muscle mass without overloading joints.
- Pros: can be helpful to maintain and improve muscle mass
- Cons: Even gentle exercise can sometimes become too much for severely affected dogs. In cases where even low-impact exercise is difficult, physical therapy under professional guidance can help.
- Acupuncture and Laser Therapy: Acupuncture and laser are safe and effective therapies for reducing pain and inflammation associated with arthritis.
- Pros: Helpful for many dogs, often dogs enjoy their acupuncture/laser sessions, and often can be performed in the home (in NYC we recommend New York Veterinary Acupuncture: https://www.nyvetacupuncture.com/)
- Cons: some dogs may not tolerate, can be expensive, repeated sessions necessary.
- Physical Therapy: Rehabilitation programs guided by certified veterinary professionals, often involving exercises and treadmills partially submerged in water.
- Pros: can be extremely effective in helping dogs maintain muscle mass, improving mobility and pain scores.
- Cons: Can be time-consuming and expensive, not all dogs will tolerate the exercises or underwater treadmill.
3. Home and Lifestyle Modifications
- Comfortable Bedding: Orthopedic beds help reduce pressure on painful areas. Occasionally, dogs will choose to lie on the tile floor, however, even if you purchase them the best orthopedic bed on the market.
- Traction Aids: Dogs with arthritis often can have trouble, particularly on tile or hard wood floors. You can purchase traction booties, or traction paw pads that you can stick on the bottom of the paw pad, or you can use yoga mats and non-slip rugs in the areas of the home where your dog spends the most time to help them get around.
- Ramps: You can purchase ramps to help your dog get up onto couches or beds.
- Help-Em-Up Harness: Help-Em-Up harness is a brand of harness you can leave on your dog that has two handles that allow you to help them get up and to provide support while they are walking. What’s great about this harness is you can provide just a little support or a lot.
- Carts and strollers: Some dogs, especially smaller dogs, with advanced arthritis and difficulty walking may enjoy walks in carts or strollers when walking becomes a major challenge.
4. Advanced Therapies
- Stem Cell Therapy and PRP: Regenerative treatments with some evidence.
- Pros: May be effective in helping arthritis
- Cons: May not be effective in all dogs, very expensive.
- Synovetin: A newer treatment that can be injected directly into arthritic joints.
- Pros: Can be very effective for about a year
- Cons: May not be practical if more than one or two joints are affected, dogs must be put under heavy sedation/anesthesia to receive, can be very expensive, and not many veterinarians currently offer it.
5. Surgery
In severe or localized cases (such as hip dysplasia), surgical options like joint replacement, arthroscopy, or joint fusion may be considered.
When Arthritis becomes too much: When to consider euthanasia
Most people never have to consider euthanasia for their dogs with arthritis. But in some cases, the pain becomes so severe or mobility becomes so impaired that a dog’s quality of life is no longer good, and euthanasia may be the kindest decision.
If you have a dog whose arthritis is causing a great deal of pain or who is beginning to struggle to walk due to arthritis, I highly recommend making a comprehensive end of life care plan for your dog. Similar to an advanced directive in a human, you want to address important care questions like:
- If my dog gets to the point where they can no longer walk, what will I do?
- How can I modify the layout of my home to help my dog as the disease progresses?
- Do I have help should my dog be unable to walk and I need to bring him to the hospital?
- Would I pursue advanced treatments as the disease progresses?
- What plan do I have should my dog’s arthritis progress to the point where they cannot posture to urinate or defecate?
- Is it safe for me to manage my dog as they need more support? Do I have help from friends or family members if needed?
- Do I want to ensure my dog has a home euthanasia?
- Is everyone in my family comfortable with this plan?
I also recommend keeping a daily journal of your dog’s quality of life in a journal. I recommend simply putting a smile for a good day and a frown for a bad day. The journal can also be a place where you write new memories you made with your cat each day. It is important when facing the end of life to live in the moment and cherish every single day.
When you are starting to see more bad days than good days, it’s a good time to give them a beautiful send-off. When clients wait too long, they often regret allowing their dog to suffer at the end.
Our comprehensive quality of life scale (https://pawsatpeace.com/quality-of-life-scale/) can help you assess your dog’s quality of life. This quiz can be taken once to give you a snapshot of your dog’s quality of life, or taken multiple times to assess trends over time. You can also have the results sent to your veterinarian.
Signs that Euthanasia may be the kindest option in dogs with arthritis
This list is just an example of some criteria you may consider to determine if it may be time for euthanasia. This list is deeply personal and differs for each family depending on circumstances. For example:
- Euthanasia might need to be considered sooner in a 120 pound Rottweiler that cannot walk than in a 5 pound Chihuahua that cannot walk because the Chihuahua can be carried.
- Pets that live in single-story homes or apartments with elevators may be able to be supported longer than pets living in 4th floor apartments with no elevator.
- A frail 80 year old woman living alone may need to make a decision earlier than two strong 30 year olds caring for a dog together.
- A sedentary breed such as a bulldog might tolerate spending its days lying on the floor better than an active breed like a border collie.
Sample criteria for euthanasia
- Inability to stand, walk, or move without significant assistance
- Pain that cannot be controlled, especially if they are crying out or wincing frequently
- Falling frequently, difficulty getting up, collapsing
- Inability to control bladder or bowel movements due to mobility problems
- Soiling themselves regularly leading to skin infections or distress
- No longer showing interest in normal activities such as walks, play, or interacting with the family
- Seeming withdrawn, depressed, or frustrated with their situation
- Difficulty sleeping or restlessness at night due to pain and discomfort
- Unmanageable side effects from medications
- Safety concerns: risk of injury from falling or slipping, caregiver at risk of hurting themselves while caring for the dog
It should be noted that dogs with arthritis severe enough to consider euthanasia are often still eating very well. This can make the decision exceptionally difficult. But in many cases, despite still eating well, a dog’s quality of life can be poor enough to warrant euthanasia due to the pain, frustration, and other adverse effects of severe arthritis.
Final Thoughts
I hope this guide has helped you make the best decisions for your dog with arthritis. Remember: regardless of what treatments you pursue: if you focus on your dog’s quality of life, you will make the right decision. Dogs don’t care how long they live, they only care that they are happy every moment they are here.
If you are not sure what to do and would like more guidance and support, we offer comprehensive teleconsults with compassionate veterinarians. We will review all your dog’s medical records and history, discuss all your options, and help you formulate the most compassionate and loving plan for your family.