Dogs with arthritis can lead a long, active life, but they will require a comprehensive management plan. Lifestyle modifications are considered as important as pain management, appropriate exercise and optimal nutrition.
We divide Lifestyle into 3 categories:
- Activity Modification
- Home Environment Modification
- Assistive Devices
In this section, you will learn about each aspect of Lifestyle recommendations for dogs with OA.
Activity Modification
Historically it was thought that dogs with OA should have limited activity, and “exercise restriction” was prescribed. It turns out this recommendation is incorrect, and if strictly followed, would perpetuate weight gain, joint stiffness, muscle loss, and decline in functional abilities.
In humans with OA of the knees and hips, exercises including progressive resistance training, quadriceps strengthening, aquatic exercise, land-based exercise, walking, and aerobics have all been found to decrease pain and facilitate weight loss. In fact, the benefit of land-based exercise was shown to be similar to that of NSAIDs.
The American College of Rheumatology recommends aerobic exercise, muscle strengthening and preservation of joint mobility as central components of non-pharmacologic management of OA. These recommendations hold true for canine patients with OA.
The best recommendation we can give for dogs with OA is “exercise modification.” This means dogs SHOULD exercise, in fact, they should ideally do something every single day rather than be weekend warriors.
Best exercises for OA
The ideal exercise program for dogs with OA is regular, low-impact, and controlled.
Regular exercise means that they are going for walks most days, rather than one big activity at the end of the week. A study by Greene LM, et al in 2013 found that dogs with hip OA that exercised for >60 minutes/ day had lower lameness scores than dogs that exercised <20 minutes/day.
Interestingly, in this same study, the administration of NSAIDs or chondroprotective agents was not associated with improved lameness scores. This supports the recommendation of an active lifestyle for dogs with hip dysplasia and OA. Similar studies have not yet been published for other forms of canine OA.
Low-impact and controlled
The type of exercise the dog is participating is important. This is where “low impact” and “controlled” come in. To best describe this recommendation, we turn to physics (sorry, but it is easy physics).
A simple formula from physics states that Force = Mass x Acceleration. We want to reduce the Force on dogs’ arthritic joints, so we do that by decreasing Mass and Acceleration.
Decreasing Mass, or body weight, means weight loss or maintenance of a lean body condition. Another way to effectively decrease mass during exercise is by using water. The buoyancy of water decreases the amount of weight placed on the joints.
For example, if a dog is exercising in an underwater treadmill with the water at the level of the hip, the amount of body weight borne on the joints is 38% of that which it would be on land. In other words, the amount of body weight is effectively decreased by about 60%. (Ref: Levine D, et al, 2010). If the water level is lower, the effective reduction in body weight will be less. Swimming and underwater treadmill therapy are great, low-impact ways for dogs with OA to exercise since the amount of force on their joints will be lower, yet they will be able to gain muscular and cardiovascular strength and improve limb range of motion.
Slow exercise is good
The other important way to decrease Force on the joints is by decreasing Acceleration. Without getting into more physics, this is essentially how quickly the force is applied to a joint. Examples of high Acceleration (or quick force to the joint) are running and jumping (particularly jumping down or landing from a jump). The magnitude of force to the joints is increased exponentially with high-impact activities. Therefore, dogs with OA should ideally avoid running and jumping down.
What about off-leash play?
The 3rd recommendation for exercise is controlled. The best way to describe this is by saying that the dog park would be the opposite of controlled. When dogs play at the dog park, they are often running, jumping, twisting and turning quickly and placing abnormal forces on their joints. If they have abnormal joints, that is, developmental orthopedic disease or OA, these abnormal forces on their joints can be significant and often results in lameness. So, the ideal forms of exercise for dogs with OA are those that the owner can control, including leash walking and therapeutic exercise.
However, some dogs live for the dog park, to chase balls, or run in the snow. To take away their favorite form of activity may decrease their quality of life, even if it is the best medical recommendation for their OA. Therefore, it is important to discuss ideal activities and the implications of high-impact activity.
Helping dogs have a high quality of life
The goal of comprehensive treatment of OA is that all of the other methods described to manage pain, preserve cartilage, and strengthen the body are used so that dogs can enjoy the highest quality of life doing the activities they enjoy.
To summarize: The best medical recommendation for dogs with OA is that they should exercise regularly, ideally 30-60 minutes every day, and not engage in high impact activities such as running, jumping and rough play.
But, the practical recommendation must be tailored to the individual dog/ pet parent. In some instances, dogs with OA will be allowed to do activities that are not ideal for their joints but are necessary for their overall well-being. An example of this paradox is that puppies with a developmental orthopedic disease, such as hip or elbow dysplasia, must still be encouraged to socialize with other dogs and people in order for them to develop appropriate social skills.
Activities that should not be recommended for dogs with OA:
- Going for a jog/ run with the owner (Canicross)
- Flyball
- Agility
- Frisbee (Disc dog) or jumping up to catch a ball
There are numerous other canine sports that involve varying degrees of jumping, running and explosive activity. In general, these sports would put increased force on the joints of dogs and are not typically recommended, though there may be individual exceptions.
Activities that are GOOD for dogs with OA:
- Leash walks, ideally on varying terrain such as trails
- Swimming (though be careful with entry and exit from the water, especially if there are rocks or uneven terrain)
- Therapeutic exercise and underwater treadmill therapy
- Noseworks/ scent detection
- Going on outings to the store/ coffee shop, etc.
- Musical canine freestyle (dancing with your dog… YouTube it…)
Home Environment Modifications
I once had a client ask me how they should build their new house to best accommodate their dog with OA. Oh, if everyone had the opportunity, forethought, and desire to design their home around their dog’s needs! If we were designing the ideal OA friendly home, it would have the following:
- Carpet throughout
- A carpeted staircase of about 8 steps to walk up
- An elevator to use rather than going down steps
- A room set up for the dog’s gym
- Orthopedic dog beds throughout
- Excellent insulation to maintain a perfectly comfortable room temperature
- A pool and hot tub for the dog
- A fenced yard
- A loading dock for the dog to easily get in and out of the car rather than jumping down
Since most of the time we don’t get to build this dream house from scratch, we need to make recommendations for how clients can modify their current home to help their dog with OA.
Human occupational therapists will often visit their patient’s homes and make suggestions for modifications based on the individual’s injury or disability and particular home environment.
When working with clients of dogs with OA, it is important to ask questions about what the home is like (carpet? stairs?), what the dog needs to do in the home (stairs? Get on the owner’s bed?), and what they struggle with. Viewing pictures or videos of the home may also provide insight. For example, does the dog struggle to get out of their bed because the bed is positioned right next to a step or on a slick surface?
Easy ways to modify the home
Here are a few basic suggestions for home environment modifications. Each dog and client will be unique, so there may be other scenarios that will require modifications to improve the dog’s ability to function in their home environment.
FLOORING
The first and perhaps most important recommendation is to ensure the flooring provides traction for the dog to stand up. There are products such as booties or toe grips that are designed to help dogs stand on slick floors, but these do not work for many dogs and are certainly less helpful that providing a surface with adequate traction under their feet.
This will mean covering up tile, hardwood, vinyl, and other slick surfaces with rugs, runners, yoga mats or gym floor tiles. When carpet runners or area rugs are placed, it is important that a non-skid pad is placed beneath the rug. Any area where the dog is desired to be should have plenty of non-slick flooring, including directly under the dog bed.
STAIRS
The next discussion is regarding stairs. Sometimes stairs are unavoidable, particularly if they are needed to enter/ exit the house. The primary concern with stairs comes if they are slick (hardwood), narrow, steep, or circular (and worst- all of the above!).
I am actually a proponent of medium and large breed dogs with OA walking up stairs—this is a great form of active range of motion, strengthening and proprioception. I actually believe that my own dogs with OA have maintained their mobility because they must do stairs every day. But I don’t recommend stairs for small breed dogs- they are having to jump up each step, which could be hard on their back and joints. Small breed dogs should be carried up and down the stairs.
Walking down stairs does not provide the same advantages as going up stairs—forces on the front limbs are increased and it takes a lot of control to walk down slowly. Dogs with elbow and carpal OA have a particularly difficult time going downstairs.
If stairs are part of a dog’s activity of daily living (ie, they must do as part of their home life), the stairs should be carpeted or traction pads added and the dog may need assistance walking down, such as using a harness or sling to help support and slow the descent.
BEDDING
All dogs deserve a warm, comfortable, safe place to rest. Many dogs will sleep on the human bed, others will sleep in their crate, and some will rest on the floor despite multiple bedding options.
The recommendations for dogs with OA are the following:
- Supportive bedding, such as memory foam mattresses, should be provided. Here is one we like.
- Bedding should be placed in a warm/ non-drafty area of the house, and non-slick flooring should be under/ around the bed.
- If the dog is crate trained, the crate should be large enough for them to stand up, move around and stretch out; and the crate should have supportive bedding.
- If dogs are sleeping on the human bed, ideally they should not be jumping off the bed but should use stairs or a ramp, particularly if the bed is high.
NAILS and FOOT CARE
It is very important to keep toenails trimmed short. Over-grown nails will change the biomechanics of the digits and could lead to arthritis in the toes. Long nails will also prevent dogs from getting traction on slick floors.
Ideally, pet parents are able to trim their dog’s nails at home regularly (at least once a month). A Dremel tool may be more tolerated by the dog and is less likely to “quick” the nail. Dogs should be trained to the Dremel tool (or any nail cutting tool) from a young age ideally, though older dogs can be conditioned to the task using a lot of high-value rewards and patience. It may take months to train the dog to allow nail trimming, but in the end, it will be worth it. For pet parents that are unable to trim the nails, regular toe nail trim appointments should be made.
Dogs with long hair, or feathers, between their pads should have this hair trimmed regularly to improve foot traction.
FEEDING STATION
Raising the food and water bowl can help dogs with OA. When eating from a bowl on the floor, dogs shift more weight to the front limbs. Dogs with carpal, elbow, shoulder and neck OA may have a difficult time reaching down to eat or drink. Dogs with pelvic limb OA already shift more weight to their front limbs, and then when eating they would further overload the front legs, potentially leading to compensatory muscle issues in the shoulder and neck.
Raising the bowl to the level that allows a neutral spine and minimal neck flexion will shift weight back on the pelvic limbs, which is actually a good form of exercise for dogs with pelvic limb OA (isometric strengthening). The ideal level of the food bowl is typically at about the dog’s shoulders. There are many commercially available elevated feeders such as this.
Assistive Devices
The time will come for most dogs with osteoarthritis (OA) to need some form of assistive device to help with their activities of daily living (ADLs).
We have divided assistive devices into 7 categories:
- Stairs and ramps
- Slings and harnesses
- Support wraps and orthotics
- Strollers and wheelchairs
- Non-slip support
STAIRS AND RAMPS
Jumping down from a bed or out of an SUV puts a lot of force on the joints of the thoracic limbs and is not recommended for any dog—with or without OA. Stairs or ramps should ideally be used to help dogs, particularly when getting down/out. Many dogs will also benefit from assistance with getting up or jumping in.
Indoor “ladders”
There are many commercially available stairs and ramps designed to assist dogs in getting on and off the couch or bed. These come in all shapes, sizes, and décor. We have even seen very effective home-made ramps, such as using a cornhole lawn game with a yoga mat as a ramp!
When choosing couch and bed ladders, it is important to pick a product that has a non-slip surface and is wide enough for the dog to feel secure that they won’t fall off, and sturdy enough for the size of the dog. There is currently not a single product that CARE endorses, but we will be testing several different products in the future and will provide an update with recommended products.
Until then, if you have a favorite pet stairs/ ramp, please let us know!
Car “ladders”
There are a variety of products designed to help dogs get in and out of the car. These range from foldable plastic ramps to swivel steps that attach to a toe hitch, and many versions of steps and ramps in between. Unfortunately, we have not found any of these that work particularly well for all dogs.
As with the indoor ladders, car ramps or stairs must be wide enough for the dogs to feel secure walking up and down. They must also not be too steep. It seems that wide, gently-inclined, sturdy, slip-resistant ramps or stairs are difficult to produce without being too heavy or expensive.
Some of the most effective ramps we have seen are custom or home-made. Even though the perfect ramp does not yet exist, we still do believe that using some form of ramp or step, potentially with the help of a harness or sling (see below), is very important for assisting dogs when getting out of an SUV or truck.
Typically the biggest challenge with indoor or outdoor stairs or ramps is getting the dog to use them. This will take some training, just like any new behavior.
SLINGS AND HARNESSES
There are two brands that we hands-down recommend, depending on the need.
Sling: If a dog is recovering from surgery, there are several commercially available slings that can help act as a safety net as the dog is regaining stability on their legs (most surgical practices will carry these and send them home after surgery if requested). But if a support sling will be needed for more than a few days, we hands-down recommend the Help ’em Up Harness.
Support Harness: There is no other way to say it, the Help ‘Em Up Harness is the best tool out there for dogs that well, need help getting up.
This is a two piece harness that dogs can wear for extended periods of time. It is ergonomically designed with 2 handles for the handler to help the dog stand, walk, navigate stairs, or get in the car. The product is great quality and is designed to allow male and female dogs to urinate and defecate while wearing the harness.
Pet parents can purchase the harness online from the manufacturer: Help ‘Em Up Harness or many veterinary practices and rehabilitation clinics will carry the device and help clients with the fitting.
SUPPORT WRAPS AND ORTHOTICS
Wraps
Providing compression or support to an arthritic joint can potentially help ease pain and reduce swelling. This is particularly true for arthritis of the carpus and tarsus. Neoprene carpal and tarsal wraps can be ordered from several manufacturers, including OrthoPets, Thera-Paw, and DogLeggs.
It is important to measure the dog in order to order the correct size; each manufacturer will have their own measurement guidelines. In some cases, a custom wrap may be indicated for the correct size or to provide the appropriate amount of support. In these cases, we have worked with Thera-Paw for many years and have found their products and service to be excellent.
We do not recommend supportive wraps for treatment of OA in any other joints as these would be unlikely to stay in place (leading to rubbing sores), unlikely to provide adequate compression, and would inappropriately restrict the range of motion.
However, Caldera makes wraps that are designed specifically to hold ice or heat packs over different body regions of dogs. This is a great tool for assisting with ice/compression therapy, but the wraps should not be worn when not used for applying ice or heat.
Orthotics (braces)
Orthotics are devices that include hard, plastic material to provide support beyond that of a neoprene wrap. Orthotics are typically used to restrict the range of motion or provide support to hyper-mobile joints. We have used orthotics to manage carpal hyperextension injury, Achilles tendon injuries, and cranial cruciate ligament ruptures (though bracing is not typically our first recommendation for treating CCL rupture).
While there are some “off-the-shelf” braces commercially available, we do not recommend these as they are unlikely to fit the dog appropriately and unlikely to provide adequate support.
We recommend using custom-made orthotics and partnering with a veterinary orthotics professional. It is important to note that even the best custom made orthotic will eventually cause rub sores and modifications of the device are often necessary.
STROLLERS AND WHEELCHAIRS
Strollers
A few years ago, it may have looked strange to see someone pushing their dog around in what appeared to be a baby carriage. But these days, this is perfectly acceptable! Dogs that cannot go for long walks, due to OA or other medical conditions, can still enjoy outings with their owners in a pet stroller or wagon. This can be a very important part of OA management through mental and emotional enrichment.
Ideally, the dog would get out and go for short bursts of walks and then rest in the stroller if the outing is longer than they can handle.
Carts/Wheelchairs
Wheelchairs are typically used for dogs with neurologic conditions resulting in paralysis or severe weakness. However, there may be cases in which dogs with OA would benefit from a wheelchair in order to allow them to go for walks without putting stress on their arthritic joints.
We do not recommend this unless it is a last resort, as we ideally want dogs to use their limbs in order to retain the joint range of motion and muscle strength.
NON-SLIP SUPPORT
Dogs with OA can really struggle to stand up on slick floors such as hardwood or tile. It is imperative to provide non-slip support for these dogs in their home environment. Our preferred method of providing non-slip surface is using carpet or rugs (with non-slip pad) and/or yoga mats or gym floor tiles.
There are several commercial products designed to be placed on the foot, pad, or toe of dogs to assist in traction. These include booties with treads, spray or pads applied to the paw pads to increase friction and bands placed around the toe-nails to help grip the floor.
Most dogs do not tolerate wearing booties or socks, so we do not recommend these products.
If carpets, rugs, and yoga mats are not an option, we recommend trying Dr. Buzby’s ToeGrips. However, our experience with these has been mixed; they have worked for some dogs while others did not tolerate the bands and/or improvement was not seen.
For dogs that do not tolerate their feet and nails being touched, these can be challenging to impossible to apply. Adhesive spray with granules, such as Paw Friction may have merit, though once the sprayed material is on the pads and a dog walks on a carpet, it will collect carpet fuzz and lead to further slipping on the hardwood floors. This product will also be challenging to apply to dogs with sensitive feet, and it requires reapplication about once a week (vs. ToeGrips that last 1-3 months).
Written by: Dr. Kristin Shaw 6/2019
Reviewed/updated: 12/2024
References
Greene LM, Marcellin-Little DJ, Lascelles BD. Association among exercise duration, lameness severity, and hip joint range of motion in Labrador Retrievers with hip dysplasia. J Am Vet Med Assoc 20213;242:1528-1533.
Levine D, Tragauer V, Millis DL. Percentage of normal weight bearing during partial immersion at various depths in dogs. 2002; Proceedings of the 2nd International Symposium on Rehabilitation and Physical Therapy in Veterinary Medicine, Knoxville, Tenn.
Levine D, Marcellin-Little DJ, Millis DL, et al. Effects of partial immersion in water on vertical ground reaction forces and weight distribution in dogs. Am J Vet Res 2010; 71:1413-1416.