Help, My Dog Has Arthritis: A Vet's Evidence-Based Guide to Pain Relief and Mobility

Have you ever seen an older dog walking around with that happy look in its eyes, the drive to want to play, only to watch it struggle with each step? Mobility issues in older dogs are both heartbreaking to watch and can be frustrating to treat, particularly if joint disease has progressed significantly (Roitner et al., 2024). Fortunately, there are some simple measures that can be taken to:

• Delay the onset of debilitating joint disease
• Improve mobility and reduce joint pain
• Improve overall quality of life

In this article we will provide evidence-based recommendations for comprehensive treatment strategies to aid in management of arthritis/joint disease in dogs (Cachon et al., 2023).

(Of note, younger dogs can also experience arthritis due to dysplasia or injury and the concepts presented here can also be applicable to some younger dogs. For younger dogs, we also recommend considering consultation with board certified veterinary surgeon as some causes of juvenile joint disease can respond favorably to surgery)

Arthritis is classified as a life long, progressive disease. The bad news for arthritis: there is no magic bullet. There is no quick fix. The good news: there are multiple ways for pet owners to improve mobility in older dogs. These include:

• Maintaining a lean body weight/avoiding obesity
• Providing consistent, low-impact exercise
• Optimize the home environment for mobility
• Providing select joint health supplements
• Following veterinary advice for prescription medications
• Considering a rehabilitation certified or integrative medicine veterinarian

We will briefly touch on each of these topics below to give a broad brush strokes approach to each of these important facets. Linked articles and learning resources for a more in-depth review of these topics can be found below. Finally, each individual dog is different and a management plan tailored to the individual in conjunction with their veterinarian is advised (Cachon et al., 2023).

Before we dive into the science-backed strategies of arthritis management, it is important to first properly identify the warning signs of arthritis in dogs. Arthritis is a diagnosis made by a veterinarian, though knowing what to look for in the early stages can lead to earlier diagnosis and, thus, appropriate intervention. As with most conditions, earlier treatment/management is much more preferable compared to late stage intervention.  Some of the more subtle signs of arthritis include: 

• Mobility Changes: Reluctance to stand or being slower to rise from laying down
• Stair and Furniture Hesitations: Being hesitant or slow to go up/down stairs, no longer jumping into the car or on the couch
• Activity Level: Reduced ability or desire to exercise, including lagging behind on walks
• Gait Changes: Occasional limping, stiff walking after a period of rest, or “bunny-hopping” gait in the hind limbs (Roitner et al., 2024).
• Behavioral Shifts: Reduced interaction with family, appearing irritable/uncomfortable when touched in certain areas, or licking of joint areas

Many owners may see these signs as “typical aging,” though we now know that arthritis is a complex disease process with multiple treatment options that can be implemented early on. So, if you think a dog is simply getting older, it may be worth considering if it could have early stage arthritis. An appointment with a veterinarian is advised to make the diagnosis and stage the degree of arthritis, as well as provide a comprehensive evaluation of your pet’s health (Cachon et al., 2023). The recent AAHA guidelines recommend veterinary check ups every 6 months for senior dogs, part of which is to identify arthritis and other chronic conditions, in their early stages (AAHA, 2023). 

Perhaps the most important aspect of joint health and arthritis management is body weight, specifically body condition score (BCS). As our understanding of arthritis grows, we have developed a deeper understanding of the relationship between weight and arthritis: it is  complex physiology that is more than just simple physics (Cachon et al., 2023).

Extra adipose tissue (fat) and additional weight affects the joints through two primary mechanisms:

• Increased Inflammation: fat is not inert, rather, it is biologically active and produces pro-inflammatory cytokines, resulting in additional inflammation within the joints themselves (Marshall et al., 2009). 
• Mechanical Strain: a higher body weight will place additional strain on joints and result in increased pain to arthritic joints (Marshall et al., 2009),

The combination of increased mechanical strain and increased inflammation created by additional body weight (specifically fat) is clearly detrimental to already inflamed joints (Anderson et al., 2020). The good news? This aspect can be reversible and have a major positive impact on joint health and subsequently the comfort of your pet.

A healthy body is a crucial part of general pet health, and the importance of this is amplified in the setting of arthritis/joint disease (Cachon et al., 2023). Dogs should maintain a lean body weight throughout life, which is achieved through a combination of feeding a nutritionally complete diet (AAFCO standards for life stages) and regular exercise (Kealy et al., 2002).

Deciding on diet is a particularly important topic and one that can be a difficult decision for pet owners given the abundance of advertising in the pet food world. We can make it simple (or possibly complex): no single diet has been shown to be superior to others as long as AAFCO standards are met (link to the “dog food section”). We can’t tell you which is the “best” as each dog may have different health conditions or taste preferences. With that in mind, for overweight pets, weight loss diets are a very reasonable consideration. These are generally prescription diets that require veterinary approval, though some non-prescription diets for weight loss exist. These can be labeled as “moderate calorie,” so consider these options in conjunction with veterinary advice (Herzig et al., 2025).

Finally, quantity is important. Be sure to not overfeed, not only at mealtime, but also with treats. Table scraps and human food tend to be high calorie and can quickly add up. Food packages generally have feeding guides to help give a ballpark starting point regarding quantity.

For a more in-depth look into diet selection, you can read our article here

As the saying goes, “an ounce of prevention is worth a pound of cure.” It is much easier to maintain a dog at their ideal body weight rather than have an overweight pet try to lose weight (Lawler et al., 2008). Getting your pup on the right track with appropriate weight management from an early age is strongly recommended, though if you find yourself with a pup that has a bit of extra mass to love, the above steps can help to shed those extra pounds.

For more information on diet and weight management, here some other useful sites: 

https://caninearthritis.org/average-dog-weight-overweight/ https://www.avma.org/resources-tools/pet-owners/petcare/your-pets-healthy-weight

Lastly, some prescription diets formulated for joint health are available, and there is some evidence of efficacy associated with use of these diets (Barbeau-Grégoire et al., 2022).

Each dog will have different exercise requirements as well as tolerance. Dogs with earlier or more mild forms of arthritis will likely be able to exercise longer and potentially perform slightly higher impact activities such as hiking, whereas dogs with more advanced joint disease may be limited to more leisurely strolls. The important point is providing some exercise for each and every dog (Anderson et al., 2020).

This can be as simple as a 10 minute walk each day and increasing as tolerated, through to multi-mile hikes (if that’s what they/you are into). If the primary caretaker is unable to perform exercise to meet the needs of the dog, there are dog walkers and friends that can be called on to provide the regular exercise needed. Establishing a routine is extremely helpful to ensure the exercise stays consistent. Habit building has been shown to be successful when linked to another regular routine, so we recommend trying it out. Whether it be a walk first thing in the morning after coffee or breakfast, in the evening right after dinner, or linked to another activity you perform regularly, incorporating daily exercise into your pups routine can become second nature.

Dogs with mobility issues can have a difficult time navigating what was once a simple environment. A slip or fall on slippery stairs or even level ground can be quite painful. Assessment of the home environment to make it more “joint health friendly” can make a big difference in quality of life (Cachon et al., 2023). To do this, identify problem areas, such as slippery floors, stairs, or other common household obstacles. In these areas, provide methods for increased grip - place secured rugs over slippery floors, provide a ramp instead of stairs (if just a few stairs) or place treads on stairways; block off stairwells with dog gates to prevent inadvertent wandering, to name a few examples. Elevating food and water bowls to minimize downward neck movement may also be of benefit.

There are also dog factors that can reduce the incidence of falls. Long nails can impair grip, so ensure your dog’s nails are appropriately trimmed. Commercially available products to increase paw grip can also be of benefit to some dogs.

There are many supplements on the market advertised to improve joint health. Some of these have evidence of efficacy, while others do not. The supplements with reasonable evidence supporting an improvement in joint health include: omega-3’s from marine source (fish oil, krill oil) and green lipped mussel (GLM); and to a lesser degree, undenatured type II collagen and CBD/cannabidiol (Barbeau-Grégoire et al., 2022). It is important to note that these supplements each had a mild improvement noted in mobility/joint pain and that beneficial effects took up to 8 weeks to be observed. So, while supplements may play a role in the overall management of joint disease, their use is as an adjunctive therapy rather than a single agent (Cachon et al., 2023).

It is also important to note that other supplements, including glucosamine and chondroitin, did not demonstrate a consistent clinical benefit (Barbeau-Grégoire et al., 2022). Many products combine glucosamine and chondroitin with some of the aforementioned ingredients that have a demonstrated clinical benefit. Observed improvements related to these combination products are likely due to the beneficial effects of other ingredients (if present), or possibly placebo effect.

To read up on individual supplement types, you can access our page on joint health supplements here.

Your primary care veterinarian is your main advisor for comprehensive arthritis care. Older dogs can have concurrent health conditions and your veterinarian can help to navigate arthritis care in the midst of these other factors. Often, bloodwork and imaging such as x-rays can be helpful to gain a complete clinical picture and set your pet up for the best chance of success.

Prescription medications can help immensely in the symptomatic management of arthritis, with recent drug classes offering multi-modal therapy options (Cachon et al., 2023). Examples of prescription medications include monoclonal antibody treatments (e.g. Librela), non-steroidal anti-inflammatory drugs (NSAIDs), priprants, and other analgesics such as gabapentin or NMDA antagonist therapy (Pye et al., 2022). Such medications should only be used under veterinary prescription and guidance. Please consult with your veterinarian to determine if any of these medications may be suitable for your dog.

Every dog will have different requirements throughout its life, and your primary care veterinarian can help to guide you through each life stage and the associated preventative health recommendations. With their guidance, you can be the best advocate for your pet.

The last facet to discuss is incorporation of a veterinarian with additional training in rehabilitation and/or integrative medicine. Though these are different “categories” of veterinarians, significant overlap certainly exists. Certified rehabilitation veterinarians earn the letters CCRT (certified canine rehabilitation therapist) and are trained in physical therapy techniques along some eastern medicine techniques (Cachon et al., 2023). Integrative medicine practitioners also undergo training at an institute, though specific letters may not be conferred. These veterinarians may offer additional therapies including acupuncture, underwater treadmill, laser therapy, and manual physical therapy, to name a few (Cachon et al., 2023). Less common therapies, such as intra-articular injections of PRP (platelet rich plasma), stem cells, or newer veterinary medical devices can also be considered. These veterinarians can work in conjunction with your primary care veterinarian to provide a holistic approach to arthritis management, as well as potentially provide at-home exercises for pet owners to perform.

Surgical referral often is associated with an impression that surgery could or should be performed; however, the reality is that veterinary surgical specialists (DACVS) are also trained in the medical treatment of canine joint disease. Their expertise can provide insights to other non-surgical therapeutics or minimally invasive techniques not available to most general practice veterinarians. Such techniques may include:

• Intra-articular joint injections: platelet rich plasma, hyaluronic acid/glycosaminoglycan products, among others
• Arthroscopic evaluation of the joint: placing a small camera inside the joint and potentially removing small fragments that may be causing a problem
• Advanced imaging such as CT or MRI of joints/soft tissues to get an exceptionally detailed diagnosis that may help to tailor treatment

Referral to a surgical specialist can be considered for cases that are either refractory to initial management, classified as moderate-severe, or primarily affecting certain individual joints. Young dogs with congenital joint disease should be referred early to determine if surgical options are available before a potential therapeutic window closes. While not a staple of routine arthritis management, select cases with severe arthritis resulting in major impacts to quality of life may benefit from surgery, including certain joint replacements or joint fusion (Cachon et al., 2023). The type of surgery will depend on the affected joint(s) and the individual dog, though it is worth mentioning as it can be a beneficial management tool for select animals. These surgeries are often complex, and consultation with a board certified surgeon is often recommended.

As a bonus feature, some specialty hospitals will also have board certified veterinary anesthesiologists on staff (DACVAA) who may be able to help formulate a long-term pain relief plan for patients with chronic joint disease and pain. The combined expertise of multiple specialists advocating for the same patient can yield impressive results. It is worth noting that specialist referral is intended to complement the medicine of primary care veterinarians and the trio - specialist, primary care veterinarian, and owner - work together to optimize care for the individual patient.

By conquering each of these pillars of arthritis care, we have the opportunity to improve the quality and quantity of life of our senior friends. Management of arthritis takes work, though by making small, yet gradual improvements provided in this framework, your arthritis management journey can get off on the right paw. We hope you found this article helpful and as always, thank you for visiting our site.