Developmental Orthopedic Disorders and Arthritis

By: Holly MozdinVT236-PL6

Developmental Orthopedic Disorders

Developmental Orthopedic Disorders aka “DOD” involves a diverse group of musculoskeletal disorders that occur in growing animals, most commonly fast-growing large-and-giant breed dogs.

DOD can be attributed to genetic make-up, nutritional and stress-related etiologies.

Developmental Orthopedic Disorders

Examples of DOD:› Canine Hip Dysplasia (CHD)› Dyschondroplasia (DCP)› Physitis (Physeal Dysplasia or Epiphysitis)› Angular Limb Deformities› Vertebral Abnormalities (Wobbler

Syndrome)

Developmental Orthopedic Disorders and Nutrition

The skeletal system is most susceptible to physical and metabolic insult during the first 12 months of life because of heightened metabolic activities

Problems associated with dietary excesses are more likely especially in dogs fed a high-quality growth food that is further supplemented with minerals, vitamins and energy.

Developmental Orthopedic Disorders and Nutrition

Nutritional aims are as follows:› Feed a complete/balanced diet that does

not precipitate any predisposition to DOD› When DOD do occur, the diet needs to

limit any further damage that could be induced through poor or inadequate nutrition

Developmental Orthopedic Disorders and Nutrition

Fats› Excessive dietary energy intake may support a

growth rate that is too fast for correct skeletal development

› Dietary fat is the primary contributor to excess energy intake Levels should be monitored in large-breed diets, due

to fats having twice the calorific density of proteins and carbohydrates

Excessive energy intake can occur easily in diets with higher fat levels

Developmental Orthopedic Disorders and Nutrition

Fats continued› Dietary energy in excess of the animal’s

needs will be stored as body fat› The role of body condition score (BCS) is

important to monitor energy intake› Diets aimed at large and giant breeds have

a decreased energy density in comparison to small-and-medium breed puppy diets.

Developmental Orthopedic Disorders and Nutrition

Protein› Diets aimed at fast-growing animals have higher

protein levels Should be of high quality and easily digestible

› In dogs, protein excess has not shown to negatively affect calcium metabolism or skeletal development

› A growth diet for dogs should contain >22% protein (dry matter base (DMB) of a high biological value

Developmental Orthopedic Disorders and Nutrition

Carbohydrates› Carbohydrate content of the diet needs to be

balanced Levels need to be sufficient to provide adequate

calories to the animal, but not excessive to encourage excess weight gain

› The type of carbohydrate within the diet is important In cats and dogs, the carbohydrate content needs to

be of highly digestible nature, especially in small breeds of dogs and kittens

Developmental Orthopedic Disorders and Nutrition

Carbohydrates continued› Carbohydrates need to be low in fiber

In kittens and small-breed puppies high levels of fiber would decrease digestibility of the diet, and due to limited stomach size, they would not be able to consume the quantities of calories required for growth

Developmental Orthopedic Disorders and Nutrition

Vitamins and Minerals› The level of calcium within the diet is vitally

important in the development of orthopedic disorders in large-breed dogs

› Equally so is the ratio of calcium to phosphorus present within the diet

› Vitamin A is an essential factor in bone metabolism, especially orthoclastic activity

› Vitamin D’s metabolites aid in the regulation of calcium metabolism and skeletal development

Feeding Animals with DOD

The feeding of an animal with or predisposed to DOD must be done on an individual basis, as growth rates and requirements differ greatly› Physical evaluation or BCS should be performed at least

every 2 weeks› Care must be given when trying to avoid developmental

problems by changing to an adult maintenance diet from a puppy diet, in order to avoid excess calcium and energy levels Maintenance foods have a lower energy density than

growth diets, so the puppy must consume greater amounts of the diet to reach its energy requirements

Arthritis

Osteoarthritis (OA) can be an exceptionally painful and crippling disease

OA is a chronic progressive disease characterized by pathological changes of the movable joints

Dietary manipulation can aid in the management of arthritis, and help improve an animal’s mobility

Arthritis can be divided into two types:› 1. Degenerative types of arthritis, in which the degradation of

the articular cartilage is the prominent feature› 2. Inflammatory arthropathies, were synovitis is the main

pathological feature

Arthritis

OA is the most common form of arthritis experienced in both animals and man

Management of OA includes:› Weight control› Appropriate exercise management› Anti-inflammatory medications

OA is characterized by degeneration of the articular cartilage and proliferation of new bone

Arthritis and Obesity

Obesity is a major risk factor of OA› Weight loss must be initiated ASAP› Exercising and consequently weight loss

can be difficult due to restrictions in mobility

When deciding on a diet for an animal with OA, it needs to meet the requirements for the animal’s life stage and body condition score (BCS)

Arthritis and Supplements

The use of chondroprotectants and other nutraceuticals has become commonplace for cats and dogs with OA

Chondroprotective agents are reported to have three primary effects:› 1. Anabolic, by supporting or enhancing metabolism of

chondrocytes and synoviocytes› 2. Catabolic, inhibiting degradative enzymes within the

synovial fluid and cartilage matrix› 3. Antithrombolic, inhibiting the formation of thrombi in

small vessels supplying the joint

Arthritis and Supplements

Nutraceuticals are a category of chondroprotective agents and are defined as non-drug substances that are produced in a purified or extracted form and administered orally to provide compounds required for normal body structure and function, with the intent of improving health and well-being

Examples of Nutraceuticals used in the management of OA are:› Eicosapentaenoic Acid (EPA), a Omega-3 (n-3) fatty acid

that can help soothe the inflammation associated with OA › Glucosamine, when damage occurs to chondrocytes there is

a decreased ability to synthesize glucosamine; supplementing the diet stimulates the production of preteoglycans and collagen by these cells

Diets

Purina Veterinary Diets› JM Joint Mobility® Canine Formula

Formulated to help improve mobility in arthritic dogs long chain omega-3 fatty acids (including EPA and

DHA (Docosahexaenoic Acids)), help with inflammation

Glucosamine, building block for cartilage repair Antioxidants, that reduce enzymes involved in

cartilage breakdown.

Diets

Iams Veterinary Diets› Joint/Canine

Nutritionally manages adult dogs with: OA, hip dysplasia, joint health concerns, and senior dogs

Glucosamine and Chondrotin Sulfate to provide building blocks for cartilage

Omega-6:Omega-3 fatty acid ratio targeting 5:1 to help nutritionally manage inflammation at the cellular level

L-Carnitine to burn fat to help maintain a healthy weight, which minimizes stress on joints

Optimal protein and fat levels to help maintain muscle mass and body condition

Diets

Royal Canin Veterinary Diet®› Canine Mobility Support

JS™ 23 Used for the nutritional

treatment of OA Green-Lipped Mussel (GLM)

extract reduces the clinical signs of joint inflammation in dogs

EPA/DHA omega-3 fatty acids that modulate inflammation reactions

Supplemental levels of glucosamine and Chondrotin to help promote joint heath

Royal Canin Veterinary Diet®› Canine Mobility Support

JS™ 24 Large Breed Used for the nutritional

treatment of OA in large breed dogs

Green-Lipped Mussel (GLM) extract reduces the clinical signs of joint inflammation in dogs

Supplemental levels of glucosamine and Chondrotin to help promote joint heath

Diets

Hills Prescription Diet®› j/d® Canine-Canned, j/d® Canine Mobility-Dry,

j/d® Small Bites Canine- Dry Recommended for OA High levels of omega-3 fatty acids (EPA, ALA(Alpha-

linolenic Acid)) to reduce inflammation and help inhibit the degradation of cartilage

Addition of Glucosamine and Chondrotin to provide building blocks for cartilage repair

Carnitine to help dogs burn fat while maintaining lean muscle mass

Clinically tested to reduce NSAID dosage by 25%

Diets

Hills Prescription Diet®› Recommendation

For obese dogs with Arthritis, feed Prescription Diet® r/d® Canine until ideal weight is achieved, then begin feeding j/d® Canine

› Options Up to 10% of the daily energy needs can be met by feeding

Prescription Diet® Canine Treats while still maintaining appropriate nutrient profile to aid in the management of the underlying disease

Key Points

DOD› Ensure a correct

calcium to phosphorus ratio

› Feed a controlled energy level, suitable for the individual

› Regularly assess weight and BCS

› Use of a growth chart is advisable in the monitoring of growth rates

OA› Maintain optimal weight› Increase the use of

antioxidants in order to reduce the amount of free radicals

› Encourage the use of nutraceuticals as supplement or as part of dietary therapy

› Ensure mobility is maintained, and the pain levels are under control

The End… Resources:

› Companion Animal Nutrition: A manual for Vet Nurses and Technicians

› Purinavets.com› Us.iams.com› Royalcanin.us› Hillsvet.com