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DJD. WTF?

Degenerative Joint Disease is a condition that develops when there's injury or inflammation within a joint. Commonly referred to as arthritis, it is concerningly becoming more and more common amongst our pets.

So how can we help them without creating more damage in the long run?!?

I find that having an understanding of the processes that are occurring can be helpful when it comes to identifying treatments and therapies that may be of most help to the patient. So lets take a little look at inflammation.



INFLAMMATION

Inflammation is part of the body's natural immune defense system. It signals the need to heal and repair tissue, and protect from foreign pathogenic invasion. This process only becomes problematic if it goes on for too long, or in places that it is not required.  During an acute injury or illness, the inflammatory cascade causes blood vessels to dilate, blood flow to increase, and white blood cells to flood the area to promote healing. This is what creates the signs we see such as swelling, redness and heat.

The body also produces chemicals to assist the process; cytokines (are like the paramedics) who rush in hormones, nutrients and immune cells to fix the problem, and prostaglandins (more like hospital doctors), create blood clots to heal damaged tissues, but they can also cause pain and fever as part of the healing process. 


This is why signs and symptoms of injuries are; redness, pain, swelling, and stiffness. Inflammation is doing its best to help the body to heal quickly. 



INFLAMMATION IN A JOINT


In a joint, this increased number of cells and inflammatory substances can cause lots of irritation. It creates swelling of the joint lining, and over time this can wear away cartilage. 

Inflammation in a joint also affects synovial fluid, think of synovial fluid like a gel type lubricant that keeps your joints hydrated and slippery allowing them to move freely as you do. Inflammation makes this fluid less slippery and gel-like and unfortunately that lack of lubrication can create friction within the joint when it moves, and that friction can create pain. This reduction in slipperiness means that cartilage may also be damaged, instead of smooth sliding joints that glide over one another, they become more sticky and can almost get 'caught' sometimes, this then compounds friction and pain and can further result in bone spurs, loss of ROM (range of motion), muscle loss and even more pain. Doesn't sound like much fun does it?!?



IS THIS DIFFERENT TO DYSPLASIA?

Dysplasia on the other hand is when a body part or organ doesn't form properly, it's usually a congenital or developmental abnormality, and is a common cause of DJD, however DJD can also be caused by factors such as injury, trauma, wear and tear, and occasionally infection or autoimmune conditions. 



CONVENTIONAL TREATMENT

Unfortunately conventional treatment is usually either pain killers, steroids, surgery or NSAIDs. All of which have pretty unpleasant side effects, and should never be used long term.

There is one particular veterinary medication however that has shown some pretty impressive benefits, PSGAGs, polysulfated glycosaminoglycans (a disease modifying agent that slows cartilage destruction). The most common of which is labelled Adequan. 

Adequan is a PSGAG, that is injected (& can be administered by you to your pets at home) that decreases the enzymes that breakdown cartilage, it also soothes and lubricates the inflamed joint and can help stimulate repair. It can be given in the muscle or under the skin, anywhere really and the animals own physiology will put it where it needs to go. From what I've read it essentially doesn't have any of the negative side-effects that accompany the other veterinary options for treating DJD. 

For more information on whether this medication may be right for your pet please speak to your vet. (And if your vet ever tells you there's nothing they can do except give pain killers, steroids or NSAIDS for your pets arthritis, please for the love of your pet, find another vet!)


NATURAL TREATMENT OPTIONS

Naturally speaking though, holy crap, we have an absolute bucketload of remedies that may help. Sometimes however it is about trialling various things to see what works for your pet. We're all individual at the end of the day, right?!?



FOOD & DIET

I ALWAYS start with food and diet, obviously removing anything that is processed, commercially manufactured, rendered, or contains artificial colours, flavours, preservatives, and introducing or including a diverse range of anti-inflammatory wholefoods.

These days there are some truly incredible businesses that are geared towards supporting your pets best health. In every major city and many regional ones there are now a multitude of options for done-for-you fresh, frozen, raw, whole-food based meals that can even literally be delivered to your doorstep. Some will custom make meals specifically for your pet so you don't have to do a thing, others package up blends of various whole-foods, vegetables, antioxidant rich fruits, seeds and good oils that can be easily mixed together with fresh meat to supply an abundance of nutrients to your pet without too much fuss on your part too. 

So in terms of a good, healthy, whole-food diet there really is no excuse not to being feeding your pet (especially if they have signs of joint pain or inflammation) the best you can afford. 



SUPPLEMENTS

Glucosamine and Chondroiton -  many people think of these for treating human arthritis and the same can be said for our dogs. Glucosamine sulphate is found in the body and used as a building block for making ligaments, tendons, cartilage and synovial fluid. Chondroitin is one of the building blocks of cartilage. Being structural components of cartilage taking these supplements may help to reduce the breakdown of cartilage, support repair and prevent further damage from occurring. 

MSM - a biologically active form of sulphur, MSM is necessary for collagen and keratin production and can improve joint flexibility too! MSM also functions by making cells more 'permeable' so to speak; allowing cells to release toxic waste products more easily. MSM dissolves calcium phosphate, the 'bad' calcium that builds up causing degenerative illnesses, and detoxyfies 'bad' estrogens too. Allowing wastes to flush out of cells means less lactic acid buildup, less pain, better detoxification of cells, glowing hair & skin, and better absorption of nutrients from food. MSM has many wonderful benefits, long term the benefits are numerous however used alone in the short term it may not reduce the symptoms of pain and stiffness enough to be your only port of call.

Omega fatty acids - EPA and DHA have been shown to have anti-inflammatory effects in the body, and given that we have established DJD as an inflammatory disorder it makes sense that these good oils would prove beneficial. Studies have reported benefits such as; decreased lameness, improved weight-bearing ability, improved ability to rise, walk and play, and a reduced need for NSAIDs.

Antioxidants - through food intake is fantastic but adding additional supplements may be of benefit during times of increased need to speed healing and support recovery. Antioxidants such as CoEnzymeQ10, glutathione, alpha-lipoic-acid, vitamins A, C, E, D, rosehips, and resveratrol can all be helpful and are safe for animals.

Medicinal mushrooms - tone the immune system, organs and glands to support overall health and resilience. There are a multitude of medicinal mushrooms available with each species conferring general and specific health benefits. It is definitely worth seeking out those mushrooms that are of the most benefit to your animal and ensuring you are purchasing from clean, tested and reputable sources only.


Natural anti-inflammatories - such as curcumin (tumeric), boswellia, ginger, bromelains, quercetin, spirulina, vitamins A, C, D, E can be easily added to foods to support a reduction in the inflammation that causes pain and discomfort.

Chinese Medicine - has a long and valued tradition of use and can be extremely helpful in some cases. Unfortunately I am not personally trained in this system of medicine so cannot provide you with specific recommendations, however highly recommend consulting with a Chinese medicine practitioner if this appeals to you.

Homeopathy - AMAZING!!! I cannot speak highly enough of homeopathic medicine and animals. The results are nothing short of incredible, particularly for acute conditions & first aid. For chronic conditions I do recommend consulting with an experienced homeopath, preferably one with experience with animal treatments. The obvious rememdies that come to mind for arthritic conditions are arnica, rhus tox and ruta grav. The combination of these 3 is commonly referred to as RAR, or RRA. In acute injuries I've personally seen this address pain, loss of motion, cramps, and limping in a day(!!), and resultingly a low potency combination of these three remedies is included in Joint Juice to aid more chronic conditions. 

Medical Cannabis - I get asked about this fairly regularly, so I'll have to write a post dedicated to the topic soon. As for the basics, yes cannabis has incredible results when used for pain, and healing. BUT you NEED to know exactly what you're giving your pets with respect to doses, quantities, and ratios of cannabinoids. THC toxicity is a real risk in dogs and is not to be taken lightly, that said going for a product that is completely THC free is not necessarily the best option either. There is a synergistic effect that is recognised with plant medicines, the effect of the whole is often greater than the sum of the parts. THC is also a really important cannabinoid when it comes to pain relief. So yes, I highly recommend cannabis use when warranted, but again, this options requires a much more in depth and personal conversation than just giving out recommendations.


Physical therapies - chiropractic, physiotherapy, rehab style water training, there's also laser and ultrasound based treatments available these days. Myotherapy, or dog massage can also be helpful to promote blood flow, blood flow promotes better waste removal and increased flow of healing nutrients to body parts. It's also very relaxing, soothing and therapeutic for an animal that may be concealing or dealing with more pain than they outwardly show. (Which is part of their survival instincts, don't show that you're injured or hurt as that makes you a liability to the pack!)

Stem cell therapy - this is a much more involved route of treatment. Stem cells can be used to treat arthritis and can be directly injected or given via IV. The only major down side to this is the initial surgical procedure required to harvest stem cells from fat deposits in the body. The surgeons collect fat from the patient from which stem cells are concentrated and prepared. Extras can be banked for future use thankfully and there is exciting ongoing research into the production of "allogenic" stem cells, which are essentially universal donor cells that would remove the need for surgery and anaesthesia to individually collect them. Stem cell research is very exciting and is currently used both for treating arthritis and facilitating the healing of joints that have undergone surgery of some kind eg. knees.

Platelet rich plasma - works similarly to stem cells however the collection procedure is a little different. Blood is taken from the patient and platelets and plasma are separated from the red and white cells, concentrating their healing factors. Although mostly water plasma also contains proteins, electrolytes, antibodies, enzymes and clotting factors. Platelet rich plasma is often injected directly into the affected site of injury or pain to provide concentrated healing, and is used in both human and animal medicine particularly with athletes after injuries. It has a side-benefit of not requiring surgery but works very well alongside stem-cell treatment providing even greater results. 

PEFT - Pulsed Electric Field Therapy I have no personal or professional experience with, but understand that it is similar to PST (pulsed signal therapy) used in humans to stimulate cartilage regrowth and to repair damaged joints. Apparently it stimulates chondrocytes to become more metabolically active and repair damaged cartilage. It's painless, works by stimulating the body's own healing capacities, and a US vet that I follow advises that most animals in his experience require 9 x 30min session, with full effects seen in 1-3months (cartilage growth takes time!).

Joint Juice - Here we go, onto the good stuff!! HA! Joint Juice is a combination of herbs and homeopathics, with some added flower essences, to address the issues of inflammation, particularly the signs and symptoms such as pain, loss of movement, stiffness, soreness and lameness. It contains some of the herbs listed above, namely Withania, Devils Claw and Boswellia. These are anti-inflammatory herbs that also help to rebalance the immune system, reduce inflammatory chemicals that create pain and discomfort, and support healthy joints. The homeopathics used are arnica, ruta grav and rhus tox, the combination of which helps to support free movement, reducing stiffness, soreness, pain on moving, and increase blood flow and oxygenation to the joints. 


Probiotics for Pets - almost can't believe I left this one for last, but you know what they say about that....!! Now why on earth would I recommend a probiotic for an inflammatory joint condition? Well this isn't just any other probiotic for a start. Being a naturally fermented whole food product there is an absolute abundance of easily and readily absorbed nutrition in every serve. That means more vitamins and minerals more readily accessible for your pets body to use. And all of that goodness translates into antioxidant and anti-inflammatory potential, as well as healing building blocks. You may also have noticed that our ingredients include fermented shark cartilage (great source of GAGs such as chondroitin), and glucosamine! So on this one, we really do have you covered.


Wooaaahhhh....

Now by no means is this an exhaustive list of supplements, therapies or treatments for animals with DJD, arthritis, lameness, pain, soreness or stiffness. But you've got to admit its a pretty good start. If there's anything you'd like me to expand upon further please just ask, and with all great advice found online please share and discuss this with your pets primary care provider, and please do your own due diligence before taking anything I say as gospel! 

If you don't have a primary care provider for your pet that you trust with their life (coz lets face it they are the one who may one day make that call....) PLEASE get in touch and allow me to recommend you to one of the many incredible veterinarians I've come to know that also offer distance, Skype, telephone and online consultations. Frankly your pets health is too important not to have an amazing vet on your team, and I know this from experience. 


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