Nutritional Management of Osteoarthritis

Nutritional Management of Osteoarthritis


Osteoarthritis or degenerative joint disease
occurs when the protective cartilage on the ends of bones wears down. This can occur in
any joint, but is more common in certain joints like the elbows, knees, and hips. When bone
becomes less protected, inflammation results with swelling, stiffness, and discomfort or
pain. The prefix of “osteo” is used to distinguish this disease from other arthritic conditions
that are due to an infection or an autoimmune disease like rheumatoid arthritis. Typically
osteoarthritis is a concern in older pets, but earlier onset can happen with improper
feeding early in life especially with large and giant breed dogs. Dogs with an ideal body
condition are typically considered large or giant breeds when they weigh more than 60
lb. or 27 kg as adults. Osteoarthritis is commonly diagnosed with
“x-ray” imaging or radiographs, but a strong suspicion may be raised based on clinical
signs and physical examination. Pets with arthritis may be less active or have a lameness
with joint discomfort that can be elicited by the veterinarian feeling and bending the
joint. It is not uncommon for osteoarthritis to be underdiagnosed in older cats even though
it can be common. Losing extra body weight can reduce the amount
of force being placed on inflamed joints. Thus, if a pet is overweight, losing weight
can provide a great deal of relief. For a more comprehensive discussion on how to nutritionally
manage weight, please see the weight management video in this series. Key strategies discussed
in that video include feeding less calories than are needed, nutrient enhancement, energy
density reduction, caloric distribution modifications, increased feeding frequency & treating, and
providing supplemental compounds especially L-carnitine. Lowering of the omega-6 to long-chain omega-3
fatty acid ratio can be helpful in the nutritional management of osteoarthritis. During any inflammatory
process, the body’s immune cells make eicosanoids, which are signalling molecules. Eicosanoids
can be made from omega-6 or long-chain omega-3 fatty acids. Eicosanoids made from omega-6
fatty acids are better at signalling. This means that eicosanoids made from omega-3 fatty
acids are not as effective at signalling and as a consequence consumption of foods rich
in long-chain omega-3 fatty acids can actually reduce inflammation. This reduction in inflammation
can potentially decrease the discomfort that is felt with osteoarthritis. Although shorter
chain omega-3 fatty acids, like alpha-linolenic acid that comes from terrestrial plants, can
be elongated to the long-chain omega-3 fatty acids, EPA and DHA, their conversion is poor.
Thus, the common use of marine oils and/or fish to enrich foods with these “less inflammatory”
fatty acids. At times, a concern is raised about the antigenicity of these oils, but
some products are distilled reducing the likelihood of this as can the use of oils or fatty acids
from fish species or algae that are not as commonly used in pet food. Ratios can be variable
depending on what specific fatty acids are included in the calculation, but one often
looks for Linoleic Acid + Arachidonic Acid : EPA + DHA ratios of less than 3. Glucosamine and chondroitin sulfate are natural
substances found in and around the cells of cartilage. Glucosamine is an amino sugar that
the body produces which is distributed in cartilage, as well as other connective tissues.
Glucosamine is suggested to strengthen cartilage and assist with glycosaminoglycan synthesis.
Glycosaminoglycans (aka GAG) are a major part of joint cartilage. There is a great deal
of debate regarding the effectiveness of glucosamine in the management of osteoarthritis, and there
are limits on its inclusion in pet food especially when from a synthesized or purified form and
not from a natural source like poultry or fish cartilage. Chondroitin sulfate is a natural
GAG that helps cartilage retain water which helps it to resist compression and act like
a shock absorber. Chondroitin sulfate also appears to have anti-inflammatory effects.
These effects are of significant debate and like glucosamine, there can be regulatory
limits to the chondroitin sulfate inclusion in pet food especially when added in a synthesized
or purified form. Fortunately, glucosamine and chondroitin sulfate are considered very
safe, so they often are tried to see if they will have any beneficial effects. Nutritional management of osteoarthritis is
often used in conjunction with anti-inflammatory drugs. Since these drugs do have side effects,
especially on the GI tract, but also on the kidney and liver, efforts to reduce the needed
dose and/or frequency of medication with concurrent dietary therapy are often made. As osteoarthritis
is a progressive disease, the main goal with any treatment is to increase comfort, and
thus, mobility and quality of life.

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