Thursday, August 26, 2010

Them Bones, Them Bones

So, I was out for a long run on Monday. Actually, I didn't have access to a car, my daughter having absconded with it and I had no other way to go home. Now a more sane person might have called someone for a ride, or at least picked the most direct route home. But nooo, I mapped out a 12 mile route, including a little turn around the high school track for good measure and trotted off. The thing about long runs is that there is a period of time where there is nothing to do other than to let one's mind drift, and drift mine did. As various things started to ache, I focused on a bunch of things that I wanted to write about, most of which I have forgotton, but I'll try to stick with the free association that I went through over the two hours it took me to get home to dinner.

First, I was thinking how I should think of things to write about. Seems to make sense. Then I realized that no one, not even one person, ventured a guess about the film references. I'm not going to assume that there are no readers out there (my ego couldn't take it) so I'll assume there are no Italian film fans. The references were to Amarcord, a 1973 coming of age film with everything a guy could want in a movie with subtitles except there was no karate.

Then I realized that no one knew that in our practice, Bichons, are the master stone formers. They just pop back and forth between struvite and oxylate, frustrating the heck out of their owners and their doctors alike.

By the second mile, I was all warmed up and feeling pretty good. I looked down at my feet and realized that I will need new running shoes after this race in September. (I never race in new shoes) Then I was thinking about the shoe drive that we are running at our hospital, collecting used but wearable shoes to be distributed by souls4soles, a non profit outfit that is actually in Hati right now as we speak, delivering shoes to those who are bare foot.

That kept me distracted for a while, until I started thinking about my pace and heart rate and all of those mundane things that I need to keep track of if I am to finish this run in any kind of shape and still be able to get the rest of my work outs in over the week. I was trying to juggle my schedule so that I didn't have runs on back to back days because that is really hard on my legs. Which led me to think how lucky I am that my knees are good. My mind quickly did some trick to ward of the evil eye and then I thought I should talk about arthritis in pets. There was one brief digression as I ran on a bit of roadside path that made me worry about ticks and lyme disease, but that topic doesn't really fit the trend of nutritional posts I wanted to write and maybe I could put that off for a week or so, even though we are getting into the second peak season for deer ticks that spread the disease, even tho we don't have a lot of deer in my area and then I notiticed that I hadn't taken a breath and the run on thought had become a run on sentence and I was going to pass out if I didn't slow down.

So miles 4 - 8 were mostly on joint disease. Now, both dogs and cats are subject to degenerative joint disease. I am talking about the type of arthritis that is caused by wear and tear on the joints. There may be underlying instability in the joint as in hip dysplasia. Sometimes it is a genetic predisposition such as the abnormal looking joints in Basset Hounds. And sometimes, it is just part of the aging process. We think of dogs as being arthritic, but there was actually a retrospective study that looked at the x ray films of cats admitted to hospitals for other reasons. 22% of the cats over a year old in this study showed radiographic evidence of osteo arthritis.

So what are we to do? There are plenty of medications out there to treat arthritis in dogs, not so many in cats. Some are non-steroidal anti-inflamatory medications (not in cats please). There are nutriceuticals such as glucosamine, chondroitin, green lipped muscles (who knew they had lips). There are surgical treatments (not so good). New research shows promise using stem cells. And we have had some very good success using our laser to treat painful joints in both dogs and cats. But what if you could do one thing to prevent, or at least mitigate, the degenerative changes in the joints.

Well, if you are a regular reader, you know that weight control is very important in preventing arthritis in pets. Purina did a great study in labs showing a correlation between arthritis and increased (excessive) body weight. (Leaner dogs also lived longer) So, work with your veterinarian to get the weight off of your heavy furry friends. Or, better yet, don't let them get fat to begin with.

What if they are thin and have arthritis anyway? It does happen you know. There was a series of three articles published in the past year in the Journal of the American Veterinary Medical Association (JAVMA) showing that there was an excellent response to a diet made by the folks at Hills. Dogs fed J/D (Hills cleverly uses initials to make it easier for veterinarians to remember what the food is for. Joint Diet - get it?) had a good resolution of clinical signs related to arthritis. In fact, there were all sorts of things that were measured and showed improvement over the initial 30 day period that the food was fed. I know, these diets are expensive. Not really when you consider that one of the articles demonstrated that dogs could reduce the amount of NSAID that they took when they ate this food. Add that savings in (not to mention that there are no side effects to feeding J/D and there can be with medications) and then the food is not that expensive after all. Oh, what about cats you ask? Well, they just came out with a diet for cats (Feline J/D, so clever those folks at Hills) and it works great too.

Now stop your whining before you start. "My cat won't eat that food" I can hear it already. They have a money back guarantee, my rep told me so today. If your cat won't eat the stuff, you can return it to your vet and get your money back.

So, here it is, you can actually decrease your pet's chances of getting a debilitating disease by feeding it optimally to prevent obesity. And if your pet is unlucky enough to develop osteo arthritis, you can "treat" the condition with food. Hey we all have to eat anyway, why not feed something that will make your pet's legs get better.

I'm not going to go into what I ws thinking about for the last couple of miles of the run. It wasn't pretty, and the thoughts were not all that pleasant. Just leave it to I finished, I was happy with the time it took, my legs felt OK and I had a cold beer waiting for me. My idea of optimal, post workout re hydration and recovery.


Dog Mama said...

I have to say I am not a big fan of prescription diets. And my dog want nothing to do with them.

But I do agree that a diet can help with arthritis. Good diet helps manage the weight and also provide nutrients that help joint health.

I would like to read more detailed article on how exactly nutrition affects development of arthritis (there was a study with moose) and also how exactly it helps manage it.

Of course, I have to say that if diet alone is not enough, there is always acupuncture to help out, and--since we are big advocates of the therapy--stem cell regenerative therapy!

Keith Niesenbaum, VMD said...

The original publications on the joint diets is in the past year's JAVMA. There were three articles over a one month period or so in the spring. I don't have the specific citations for you but thy should be easy enough to find. The mechanism is related to fatty acids, so supplementation with fatty acids (omega 3 such as in fish oil) will decrease the inflamation in the joints. It is important to make sure that the source of the omega 3's is free of mercury (not all fish oils are) and that they are fresh and stored correctly so they don't become rancid.

The moose story seems to indicate that a poor nutritional plane will increase the risk of arthritis. makes sense, lack of building blocks make for a weak structure.

As a veterinarian, I have to work in the real world, not the ideal one. Of course, in an ideal world fast food would be a piece of fruit and a half dozen almonds, not a Big Mac or a bag of chips. The same holds true for my patients. I encourge (and practice what I preach for my pet) feeding a premium, animal protein based diet with natural preservatives rather than chemical ones. It is not easy to overcome the marketing power of Madison Ave. and many owners feed an inferiour diet, not always aware that their choice is not the best.

As far as the theraputic diets, there have been great strides as far as the science behind the nutrition as well as the art of palatability. It is also sometimes easier to get compliance from the owner with a food, rather than with individual supplements. Although, we do it both ways here.

As far as stem cell, it is a promising modality and we are currently in talks with a company that will set us up to process the cells here in our hospital. This will elimate one anesthetic procedure and cut the costs to the client significantly. I'll keep everyone posted on the progress here.

Dog Mama said...

Stem cell procedure that eliminates one anesthetic procedure? I am all ears!

Yes, totally agree about the omega fatty acids, we do use omega 3 to supplement our home-cooked diet. We use pharmaceutical grade fish oil, Aller G-3 to be specific.

We have a custom recipe designed by a nutritionist based around Hilary's Blend (

Keith Niesenbaum, VMD said...

We also use the Aller G3 fatty acid supplements in our practice. For those that prefer the convience of home delivery, we recommend a human product, Sealogix fish oil which can be ordered from:

Links aren't active on comments so you'll have to cut and paste into your browser to see the web page.
We prescribe it for our arthritic dogs as well as our allergic dogs with skin disease. Unfortunately, people really want the quick fix so it is difficult sometimes to communicate the importance of the supplements in reducing the amount of other medications we need to give.

More to come on the stem cells, but I can tell you that we will essentially have the equipment in our hospital to isolate and activate the cells so that we can collect and inject in the same day.