Dog Arthritis Cure on the Horizon

As a senior emergency clinician at New York City Veterinary Specialists, Trisha Joyce, DVM, has seen her share of doggie trauma. But she says some of the saddest cases are the least dramatic: dogs suffering from severe arthritis.

“One family brought in their Labrador that was so arthritic he couldn’t even get up to go to the bathroom,” Dr. Joyce says. “His overall health was OK, but he was just too big and too arthritic. The owners came in to euthanize, which was a really hard decision because it’s not like he had a life-threatening disease. But there was no practical way to manage it at home.”

Dog Arthritis Is Common
Scientific studies indicate that 20 percent of middle-aged dogs and 90 percent of older dogs have osteoarthritis in at least one joint. it’s hard to stop the disease once it has set in, according to James Cook, DVM, at the University of Missouri-Columbia.

“There are two problems we see in osteoarthritis,” explains Dr. Cook. “One is we don’t have a cure, and the other is that we still see progression of arthritis even after the best treatments. Both of those problems come from the fact that we diagnose it too late.”

A Research Breakthrough
Dr. Cook and his research team, however, may have found the key to early diagnosis. It’s what he calls “the Holy Grail” in the fluid that surrounds and lubricates the joints of both dogs and people. Dr. Cook sampled this fluid from dogs known to have osteoarthritis and from others without the disease. As he wrote in the American Journal of Veterinary Research, when he analyzed the proteins in the fluid, a pattern became evident.

The scientists noticed that quality and quantity of this fluid were altered in arthritic dogs. Examining the fluid even more closely, they identified seven proteins that appear to be linked to arthritis. The proteins increase and decrease in patterns that “are consistently different than [patterns] found in normal patients with no arthritis at all,” notes Dr. Cook.

The Next Steps
Dr. Cook and his team plan to follow healthy dogs over time to see if the pattern can correctly predict which dogs end up getting arthritis. If everything happens as theorized and according to schedule, he hopes that a screening test will be available for young dogs in three to four years.

Until then, here is some practical advice for dog owners worried about, or already dealing with, canine arthritis:

  • Warning signs Watch for decreased activity and signs of pain. These may be overt (e.g., limping, lameness, whimpering) or subtle, like a typically pleasant dog becoming snippy. Some arthritic dogs may consistently stop doing only specific activities, such as jumping on the bed or into a car.
  • Diagnosis If you think your dog has arthritis, schedule a visit with your veterinarian for a comprehensive diagnosis of the problem. Knowing which joints are affected, and how severely, can greatly help determine which treatment options to consider.
  • Treatment Dr. Joyce says that while arthritis is forever and can’t be undone, certain medications can alleviate pain and symptoms. Other considerations include alternative treatments like acupuncture and hydrotherapy. Surgical procedures are an option for extreme cases. Most dogs will achieve a higher quality of life with any of these treatments.
  • Activity The best way to treat and prevent arthritis is to help your dog stay in good shape. Maintain its weight in the low end of the normal range and keep your pet active just enough to sustain muscle tone and strength. Start with moderate levels of activity -- a brisk walk, limited periods of playing in the park -- and work your way up. Through trial and error with careful monitoring, you can find your dog’s “sweet spot” of exercise for optimal joint health.
  • Diet A healthy diet is a big part of staying in shape. Dr. Cook recommends going with name brands that commit to putting science into dog food, offer well-balanced nutrition and are tailored to specific breed sizes. He says that while supplements cannot prevent the disease, they can help alleviate pain. “Pet foods with glucosamine and chondroitin or fish oil can help manage the disease because they reduce inflammation and degradation,” he adds.

A Cure on the Horizon
Is the ultimate solution -- a cure for arthritis -- within reach? Dr. Cook says he hopes his research is starting to point in the direction of a cure. If his pattern of biomarkers can truly predict arthritis, scientists will be closer to determining the root causes of the disease.

“Now we know earlier steps in the process,” he says. “If we can address those steps, we could potentially have a cure. We are getting to the foundation steps, or the critical cogs in the wheel, of what becomes arthritis.”

New Hope for Canine Cancer

Two years ago, Buddy the golden retriever hobbled into his veterinarian’s office, barely able to walk. Tests revealed a tumor on the 8-year-old dog’s spine. Buddy’s doctors gave him little hope.

Yet when the plucky dog’s owner, Marti Johnson of Akron, Ohio, learned about an experimental new drug treatment for dogs with cancer, she signed Buddy up. Within six months of daily treatment with nitrosylcobalamin (NO-Cbl), Buddy's tumor had shrunk by 40 percent, and the most recent test revealed that his tumor has shrunk by 70 percent.

Buddy isn't alone. Numerous other dogs have experienced similar results from NO-Cbl without any side effects. In fact, the treatment is so effective that its creator hopes the innovative drug can someday help people, too.

How NO-Cbl Works
The name “NO-Cbl” doesn’t exactly roll off the tongue, but it contains just two key components. These are nitric oxide and cobalamin, which is the chemical term for vitamin B12.

For decades, researchers have known that cells, especially cancer cells, have an affinity for vitamin B12. “All cells need B12 to divide and proliferate or they'll die," says Joseph A. Bauer, Ph.D., NO-Cbl's creator and director of scientific research with Bauer Research Foundation in Akron, Ohio. He adds that cancer cells are particularly fond of B12. Studies show that when mice are given B12, their tumors are 400 percent larger than afflicted mice that don't receive B12.

Nitric oxide, on the other hand, does the opposite, encouraging cell death, which is why Dr. Bauer decided to combine the two. He explains that this is the perfect combination because vitamin B12 would lead the nitric oxide to the cancer cells, and once there, the nitric oxide would kill the cells.

How to Get Your Dog on This Drug
Dogs with cancers of all kinds could be candidates for NO-Cbl. “Because of the biochemistry of B12, this drug is effective against all types of tumors,” Dr. Bauer says, adding that cats too are now on NO-Cbl. The one stipulation? Tumors can't be bigger than 7 centimeters by 7 centimeters.

To get your pet involved, contact Bauer through his research foundation online. You'll receive a consent form that you and your veterinarian will need to fill out. Your veterinarian must agree to oversee the treatment.

While there is often a waiting list of dozens of dogs, once you’re in the program, your veterinarian will teach you how to administer the drug through injections. Once a month, your dog will also need to undergo a full exam and complete blood work, and every six months, it will also require an MRI scan to check the drug's efficacy. This data then goes to Dr. Bauer for analysis.

Cancer-free With a Freebie
Although the treatment costs about $24 per day for an average-size dog, owners pay nothing for the drug itself. "The goal my family and I had when starting the foundation was to offer this drug free to pet owners," Dr. Bauer says. He's currently working with organizations to help fund this research so he can make the drug more widely available.

Because dogs and humans share similar genes, Dr. Bauer hopes that once he collects enough data from dogs, he'll be able to convince the FDA to run human trials.

As for Buddy, he's back to enjoying his daily walks and playing with toys. “Buddy is a miracle dog,” Johnson says. “Even our vet has never seen anything like this.”

The Health Clues in Your Dog's Behavior

The Chappell family was puzzled: Why was their house-trained mixed poodle, Molly, now wetting her bed during the night? Ten-year-old Molly had never done this before, making it seem like the once well-mannered canine suddenly decided to misbehave.

“We couldn’t understand why Molly was forgetting her house-training,” recalls Stan Chappell, who lives in Vienna, Va. “It was frustrating -- especially for my wife, who ended up having to launder Molly’s wet bedding every morning.”

What the Chappells didn’t realize was that Molly’s bed-wetting wasn’t a house-training issue at all. “Many cases of behavioral problems have a medical origin,” says Dr. Andrew Luescher, a veterinary behaviorist and director of Purdue University’s Animal Behavior Clinic in West Lafayette, Ind.

Here are some common apparent canine behavioral problems and their possible medical causes:

Aggression Pain or discomfort can prompt a dog to become grumpy toward people or other pets. For example, an older dog that develops arthritis may snap when touched in a newly-painful area. “This happens in people, too -- you’re much more likely to snap at your spouse or co-worker if you have a headache or feel crummy,” points out Dr. Karen Sueda, a veterinary behaviorist who practices at West Los Angeles Animal Hospital.

Pain isn’t the only physical trigger of aggression. Experts also cite seizures, low levels of thyroid production, brain tumors and liver disease as possible causes of aggression. Another cause of aggressive behavior could be the loss of sight or hearing. For example, a dog that becomes deaf may snap or bite if surprised by a person or animal approaching it from behind.

Compulsive behavior A dog whose behavior appears to be compulsive and/or harmful, such as excessively licking one spot, biting their fur or other forms of self-mutilation, or constant head shaking, may simply be trying to deal with discomfort on the skin or in the ears. “Many of the behaviors that are directed to the self…are due to dermatological disease,” notes Dr. Luescher. “And repetitive behavior may be caused by neurological disease.”

House soiling “Of all the cases that I see, house-soiling is probably the most common problem that has a primary medical origin,” says Dr. Sueda. Endocrine [hormonal] and kidney disease may increase a dog’s need to eliminate. Additionally, older dogs that develop arthritis or spinal cord disease may suddenly find it more difficult to use stairs or the dog door to go outside and eliminate.

Other causes of house soiling can be as simple as a urinary tract infection, or as complicated as an older dog developing a condition called canine cognitive dysfunction syndrome, which is very similar to Alzheimer’s disease in humans.

Because behavior problems -- particularly behavioral changes -- in dogs often have physical causes, it’s important for any pet exhibiting unwanted behavior to be examined by a veterinarian, says Dr. Sueda. Generally, if the causes of the behavior are eliminated, the behavior itself will cease.

That’s what happened with the Chappells’ bed-wetting dog. When the behavior persisted, the family took Molly to her veterinarian for an examination. The veterinarian explained that as spayed female dogs like Molly grow older, they lose estrogen. The lower supply of estrogen then leads to a loss of muscle tone in the urinary tracts in these dogs. The result, all too often, is that such dogs wet their beds during the night.

Molly’s veterinarian prescribed a short course of a synthetic hormone called diethylstilbestrol (DES) to replace her lost estrogen. The medicine did the trick. Chappell reports, “After that, Molly never wet her bed again.” In this case, as for many others, the good dog seemingly gone bad was really just a sick puppy needing appropriate medical treatment.

Dog Cancer Survivors

In the three years that Allie’s been working at Bryan Middle School in Bryan, Ohio, she’s been diagnosed with cancer four times. But hearing the “C” word doesn’t get her down. In fact, each time she’s diagnosed, she takes only a few days off for treatment.  

What’s Allie’s secret to cancer survival? No one can say for sure -- but one possibility may be the fact that Allie is a golden retriever. “Allie is a trooper,” says the 9-year-old therapy dog’s handler, guidance counselor Jackie Boyd. “She always bounces back to her old self! She is a fighter.”

The ability of Allie and other dogs to live with cancer is becoming less and less unusual. “In many cases, cancer in dogs is not a death sentence at all,” says Deborah Knapp, DVM, professor of veterinary clinical sciences at Purdue University. “There are many forms of cancer that are curable.”

And even when cancer can’t be cured, some dogs, like Allie, can live with the disease for quite awhile. “As the practice of veterinary oncology has evolved, so has the philosophy of cancer care,” explains Carolyn Henry, DVM, associate professor of veterinary oncology at the University of Missouri. “We now realize that even for patients that cannot be cured of their cancer, we can often provide treatments that will control symptoms and slow disease progression so that they can live a good quality of life with cancer.”

Some of those treatments include:

For all but systemic cancers, such as lymphoma, surgery to remove a tumor is still usually the initial step in treatment. For example, Allie has surgery to remove her skin tumors whenever they arise. Such surgery causes her to miss a few days of school while she recovers. Meanwhile, though, “minimally invasive surgical techniques are being developed to reduce the morbidity associated with cancer surgery,” says Dr. Henry.

Chemotherapy is simply the administration of drugs designed to kill cancer cells, but such therapy often affects normal cells as well. However, “therapies are currently being developed and evaluated that selectively target cancer cells while not harming normal cells,” says Dr. Knapp. 

Radiation therapy delivers very strong X-ray beams to a tumor in an effort to kill the tumor cells, but like chemotherapy, it can also harm healthy tissue near the tumor. Radiation oncology researchers continue to develop new ways to target those beams much more precisely so that normal tissue is spared. Even when radiation doesn’t totally kill a tumor, it can keep the tumor from growing, which can prolong the dog’s life and also improve its quality of life.

Diet, Vaccines and Research
In addition to these traditional therapies, researchers are developing and employing completely new anticancer techniques. For example, scientists are learning more about how low-carbohydrate/high-fat diets can effectively starve certain types of cancerous tumors while still feeding the patient. Other researchers are exploring areas such as injecting genes into the body to increase a canine cancer patient’s strength and prolong its life. Antitumor vaccines that hope to use old drugs, such as one currently given to malaria patients, to combat bone cancer are also in the works. At the same time, still other scientists are learning more and more about the ways cancers develop and grow. Such knowledge could well lead to even more innovative treatments that could lengthen lives or even cure canine cancers. 

Meanwhile, dogs like Allie are living proof that it’s possible for dogs to enjoy happy, productive lives even though they have cancer. Boyd says that thanks to Allie, “the students have learned that although cancer is scary, it isn’t always fatal.”

Canine Heart Disease: A Silent Killer

On a percentage basis, more dogs than people suffer from heart disease. According to Novartis Animal Health, a Switzerland-based healthcare company, 25 percent of dogs over the age of seven have the most extreme form of heart disease -- heart failure. By contrast, the National Institutes of Health estimates that only 6.4 percent of men and 2.5 percent of women between the ages of 65 and 74 suffered from the same condition between 1998 and 2002 (the most recent period for which such data is available).

While both dogs and people can get heart disease, the reasons they acquire these conditions differ. "With human beings, it's a matter of lifestyle -- putting on weight, not eating properly and not exercising," explains Dr. Deborah Fine, assistant professor of cardiology at the University of Missouri-Columbia College of Veterinary Medicine. "With dogs, what we see is mostly caused by genetics or breed susceptibility." 

Common Canine Heart Diseases and Their Symptoms
The two most prevalent canine heart diseases -- dilated cardiomyopathy (DCM) and mitral valve disease -- are believed to be at least partially hereditary.

DCM and mitral valve disease cripple the heart in different ways. DCM causes a swelling of one of the heart's lower chambers, which are called ventricles. The left ventricle is affected more often than the right. "The ventricle changes from a football shape to a basketball shape," explains Dr. Fine. "This weakens the ability of the heart to pump blood. The heart becomes large and flabby and beats weakly."

Mitral valve disease attacks the valves that serve as doorways between the heart's upper chambers, which are called atria, and the ventricles. The valves deteriorate to the point that they don't close completely. This failure to close allows some blood in the ventricle to flow back to the atrium instead of out from the heart to the rest of the body the way it's supposed to do. Consequently, the heart must work harder than normal to pump enough blood to meet the dog's needs.

With either condition, a dog may not show outward symptoms for years.  Eventually, though, the dog shows signs that all is not well. Those signs can include:

  • Lethargy
  • Appetite loss
  • Coughing, especially during exercise or excitement
  • Gasping for breath
  • Fainting or collapsing
  • Gradual abdominal swelling

Although these signs can signify the onset of heart failure, they also mimic other conditions. For example, if the left side of the heart fails, fluid backs up into the lungs, but other conditions can do that too. That's why a dog with these symptoms needs a thorough examination with appropriate testing. "You need a chest X-ray to confirm left-side heart failure," says Dr. Fine. "Fluid in the lungs could also be pneumonia, bronchitis or a fibrosis of the lungs."

At-Risk Breeds
Due to inherited genes and as a consequence of breeding, DCM usually affects large or giant breeds, especially:

  • Doberman Pinschers
  • Great Danes
  • German Shepherds
  • Irish Wolfhounds
  • Mastiffs

Mitral valve disease, again due to genetics and breeding, affects a disproportionate number of small breeds, including:

  • Cavalier King Charles Spaniels
  • Chihuahuas
  • Miniature Poodles
  • Toy Poodles
  • Maltese
  • Bichon Frises
  • Beagles
  • West Highland White Terriers

Both diseases generally strike dogs in mid-life or later, except for the Cavalier King Charles Spaniel, which can show signs of mitral valve disease at just 2 years of age.

Helping Your Dog
If your dog is one of the more susceptible breeds, expert monitoring from an early age is a good idea.  For example, some experts believe that every Doberman Pinscher over the age of one year should receive an annual electrocardiogram because DCM is especially prevalent in that breed. Similarly, other experts recommend that Cavalier King Charles Spaniels receive yearly screenings for mitral valve disease. Such monitoring won't prevent either condition, but it can lead to earlier, more aggressive treatment that can improve a dog's quality of life, and may even lengthen it. "With heart disease, it's not just about living longer, it's about living better," says Dr. Fine.

You can help your dog live better too. In addition to aggressive monitoring for early detection, good home care can keep a dog comfortable longer. If heart failure hasn't occurred, "Keep your dog active, maintain a healthy diet and a healthy weight," suggests Dr. Fine. "Excess weight makes the heart work harder." 

Treatment Options
Once a dog has been diagnosed with heart failure, treatment focuses on controlling symptoms and the condition's progression. A veterinarian may start treatment by prescribing a diuretic to reduce the dog's fluid level and an ACE inhibitor, which levels blood pressure, to help the diuretic work better. A dog with right-side heart failure may also undergo abdominocentisis, a procedure in which the veterinarian inserts a needle into the abdomen to withdraw excess fluid. A dog with DCM may be prescribed medications to help the heart contract more normally.

Because these conditions aren't curable, owners may question whether treatment is worthwhile. Dr. Fine responds, "I always encourage people to try therapy (treatment) because the medications can help their dogs return to their old selves. Give it a few weeks -- the vast majority of dogs do much better."