Understanding Arthritis in Dogs: A Multimodal Approach to Managing Chronic Pain
Canine Arthritis Awareness Month is a perfect time to learn more about how we can support our dogs as they age — especially when joint pain and mobility issues arise. Arthritis is one of the most common chronic conditions affecting dogs, and it is more than just “slowing down.” It is a progressive, painful disease that deserves a thoughtful, science-backed treatment plan.
What Is Canine Arthritis?
Canine arthritis—also known as osteoarthritis (OA) or degenerative joint disease (DJD)—is a progressive condition that affects the joints, leading to chronic pain and mobility loss. Healthy joints are protected by smooth cartilage and lubricated with synovial fluid, allowing bones to glide comfortably over one another. In arthritic joints, cartilage deteriorates due to age, injury, poor conformation, or underlying conditions like hip or elbow dysplasia. As the cartilage breaks down, inflammation increases, bone surfaces rub together, and new bone formations (osteophytes) develop—leading to stiffness, pain, and reduced range of motion.
Over time, this chronic inflammation affects not only the joint but also the surrounding muscles, nerves, and soft tissues. Dogs may compensate by shifting their weight, altering their gait, or avoiding movement altogether, which leads to secondary muscle atrophy and worsening joint instability. Because the process is gradual, signs of arthritis are often dismissed as “normal aging,” but recognizing and treating it early can dramatically improve a dog’s comfort and long-term quality of life.
At Toronto Veterinary Rehabilitation Centre, we believe in a multimodal approach to arthritis management—combining therapies that address pain, inflammation, mobility, and overall health from multiple angles.
Managing Arthritis with a Multimodal Approach
Pharmaceutical Pain Management
Prescription medications are often the cornerstone of arthritis care, especially for dogs experiencing moderate to severe pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce inflammation and provide relief and should be considered as a first line treatment for the pain and inflammation associated with osteoarthritis. These include veterinary-approved drugs such as robenacoxib, meloxicam, or deracoxib, which block enzymes responsible for inflammation and pain in the joint.
For dogs who cannot tolerate NSAIDs due to gastrointestinal, kidney, or liver issues—or for those whose arthritis is not well controlled by NSAIDs alone—we incorporate additional adjunct medications to further support analgesia. These may include gabapentin, which targets neuropathic pain; amantadine or ketamine, NMDA receptor antagonists that minimizes hypersensitivity to pain; or acetaminophen, an analgesic which can be used safely in dogs under veterinary supervision.
A newer class of therapy, monoclonal antibodies, has also entered the arthritis space. Librela® is a once-monthly injectable that specifically targets nerve growth factor (NGF), a key mediator of pain in osteoarthritis. It offers a novel mechanism of action and can be used alone or alongside other treatments.
For localized joint pain, especially in situations where we are trying to limit the use of systemic medications, intra-articular injections may be recommended. These include Platelet-Rich Plasma (PRP), corticosteroids, and/or hyaluronic acid, which are injected directly into the joint to provide longer-lasting relief. These therapies reduce inflammation, enhance joint lubrication, and stimulate healing from within.
Pharmaceutical pain management is often the first step in restoring a dog’s comfort and serves as a critical foundation in multimodal care.
Chondroprotectants & Joint Support
Chondroprotective agents and nutraceuticals have long been used in the management of canine arthritis, but recent high-quality research is helping clarify which products actually offer clinical value. A 2022 systematic review and meta-analysis evaluating 72 clinical trials in dogs and cats with osteoarthritis found compelling evidence to support the use of omega-3 fatty acids, while also questioning the efficacy of other widely used joint supplements(1).
The study concluded that omega-3-enriched diets and omega-3-based nutraceuticals (such as fish oil or green-lipped mussel extracts) were consistently associated with measurable improvements in pain and mobility. These results were supported by both subjective and objective outcome measures, and omega-3 products also stood out for having higher-quality study designs and strong safety profiles. Omega-3s help reduce joint inflammation by modulating inflammatory mediators and slowing cartilage degradation, making them a reliable part of long-term joint care.
In contrast, the meta-analysis found that glucosamine and chondroitin supplements—despite their popularity—offered no clinical benefit over placebo in the majority of trials. These supplements were linked to poor study quality and had a high non-effect rate (nearly 89%), prompting the authors to recommend that glucosamine-chondroitin products should no longer be used to treat osteoarthritis in dogs or cats. While these compounds may still be promoted based on theoretical benefits or lab-based data, their real-world effectiveness when used alone in companion animals is unsupported by current evidence.
Other ingredients, such as undenatured type-II collagen, avocado unsaponifiables and eggshell membrane derivatives, have demonstrated efficacy in select trials, but however small sample sizes make it difficult to draw strong conclusions. Further high-quality research is needed so that we can better understand the long term benefits and best uses of these products.
In addition to nutritional support, we continue to utilize disease-modifying osteoarthritis drugs (DMOADs), including polysulfated glycosaminoglycans (PSGAGs) like Cartrophen and Adequan. These injectable therapies work by enhancing cartilage metabolism, reducing joint inflammation, improving synovial fluid production, and slowing structural degeneration. DMOADs have demonstrated measurable effects on joint health and are a core component of long-term arthritis management, especially when started early in the disease process.
In our practice, we tailor joint support recommendations to each dog’s specific needs and stage of disease. We continue to recommend omega-3 fatty acid supplementation—either through prescription diets or targeted supplements—as a proven, evidence-based foundation of arthritis care. Oral nutraceuticals and DMOADs are incorporated when appropriate to protect and preserve joint health, especially in active or aging dogs at risk of progression.
Non-Prescription Pain Management Modalities
Non-invasive, integrative therapies play a major role in long-term arthritis care—especially when dogs experience breakthrough pain or when we’re aiming to reduce reliance on pharmaceuticals. These modalities can stimulate healing, reduce inflammation, and improve circulation.
Shockwave Therapy
Extracorporeal Shockwave Therapy (ESWT) is one of our most effective tools. It uses high-energy sound waves to penetrate deep into tissues, where it stimulates cellular repair, increases blood flow, and promotes natural anti-inflammatory effects. Shockwave is especially useful for dogs with chronic pain affecting both the joint and surrounding muscles, tendons and ligaments, and often improves range of motion and reduces lameness.
Photobiomodulation (laser therapy) delivers specific wavelengths of light into affected tissues, which stimulates mitochondria, enhances cell repair, and reduces inflammation. It is safe, comfortable, and well tolerated even by sensitive patients.
Acupuncture supports pain relief by stimulating nerve pathways, improving blood flow, and triggering the release of endorphins. It is particularly effective for dogs with compensatory pain from altered gait, muscle tension, or spinal issues.
At-home technologies like PEMF (Pulsed Electromagnetic Field Therapy)—using devices such as loops, mats or beds—can reduce inflammation and pain between visits. TENS (Transcutaneous Electrical Nerve Stimulation) is another modality that can be used at home to help block pain signals and support muscle relaxation when used under guidance.
These therapies work best when used alongside pharmaceuticals and rehabilitation, contributing to a holistic and sustainable plan for managing chronic joint pain.
Weight Management & Body Condition Scoring
When it comes to managing arthritis, weight management is one of the most impactful and under-appreciated tools that we have. Excess weight places additional stress on joints, accelerating cartilage breakdown and amplifying inflammation. Several studies have shown that even modest weight loss—just 6–10% of total body weight—can significantly reduce clinical signs of arthritis, including pain, lameness, and stiffness. In many cases, reducing a dog’s weight along results in improved comfort without needing to increase medications or add new therapies.
Despite its importance, weight is often overlooked due to the normalization of overweight pets. Research consistently shows that over 50% of companion dogs are overweight or obese, and many pet owners don’t realize their dog falls into that category. That’s where Body Condition Scoring (BCS) becomes a vital tool.
Body Condition Scoring
BCS is a visual and tactile method of assessing a dog’s body fat, using a scale (typically from 1 to 9) where 4–5 is considered ideal. A dog at an ideal BCS should have:
A visible waist when viewed from above
A tucked-up abdomen when viewed from the side
Easily palpable ribs with a thin layer of fat over them—like feeling pencils under a towel
Dogs with a BCS of 6 or above are considered overweight, while 8–9 indicates obesity. Obese dogs not only suffer from greater joint stress but also face increased risks of metabolic disease, systemic inflammation, and reduced lifespan.
At Toronto Veterinary Rehabilitation Centre, we include BCS assessments in every evaluation and work with families to create sustainable, goal-based weight loss programs. These plans often include:
Therapeutic weight loss diets with controlled calorie content and balanced nutrition
Portion control guidance based on actual metabolic needs
Low-impact exercise routines, such as walking, hydrotherapy, or controlled play
Regular weigh-ins and re-evaluations to track progress and adjust the plan as needed
Weight management isn’t about perfection—it’s about supporting a dog’s functional movement, comfort, and longevity.
Exercise & Rehabilitation Therapy
Hydrotherapy
One of the most important—and often overlooked—tools in managing arthritis is targeted therapeutic exercise. While caregivers often assume their arthritic dog should “take it easy,” inactivity leads to muscle atrophy, reduced range of motion, and worsening pain. The key is moving with intention and strategy.
The key to any effective exercise program is specificity; there is no such thing as a cookie-cutter plan and individualized rehab programs should be tailored to each dog's specific condition, physical abilities, and lifestyle. These programs often include a combination of strengthening exercises, stretching routines, balance and coordination work, and movement retraining to restore proper gait. Building and maintaining strong muscles is essential, as muscle mass supports the joints and reduces stress on damaged cartilage.
Hydrotherapy, particularly in an underwater treadmill, allows dogs to exercise with buoyancy-assisted support. The water’s resistance builds strength without overloading the joints, and its warmth helps relax stiff muscles.
While ongoing activity is often critical in managing dogs with arthritis, exercise modification may also be part of the plan. Activities that involve sharp turns, jumping, or repetitive high-impact movement (such as playing fetch on hard surfaces) may be adjusted or replaced with low-impact alternatives like swimming, controlled leash walks, and puzzle-based enrichment.
Regular movement improves circulation, preserves mobility, and releases natural endorphins that reduce pain. Rehab exercise not only supports the joints—it helps dogs feel more confident, active, and engaged in daily life.
Environmental Modifications & Assistive Devices
Help Em Up harness
Making thoughtful changes to a dog’s environment can significantly improve their comfort, safety, and independence. Many dogs with arthritis struggle with slippery floors, stairs, or uneven terrain. We often recommend non-slip rugs, rubber-backed runners, or traction devices like Toe Treads to help prevent slips and falls.
Firm but supportive bedding—such as orthopedic foam mattresses—can ease joint stiffness overnight. Elevated food and water bowls help reduce strain on the neck and spine, and ramps or stairs allow dogs to access beds, cars, and couches without jumping.
Mobility aids such as the Help ‘Em Up harness can be invaluable for supporting dogs on stairs, bathroom breaks, or getting in and out of vehicles. For dogs with advanced arthritis, orthotics, prosthetics, carts, or wheelchairs can restore independence and allow continued participation in activities they enjoy.
Why Multimodal Care Matters
Managing arthritis isn’t about relying on a single treatment—it is about combining multiple therapies that work together to improve comfort and function. By addressing pain, inflammation, muscle strength, flexibility and mobility from different angles, we can help arthritic dogs move more freely, enjoy more activity, and maintain their quality of life for years to come.
If you suspect your dog may be showing signs of arthritis—such as stiffness, limping, difficulty rising, or reluctance to exercise—early intervention is key. There are many treatment options available, and the sooner we start, the better the long-term outcome. With the right combination of treatments, your dog can stay active, happy, and comfortable well into their senior years.
Arthritis is a lifelong condition, but it doesn’t have to mean a life of pain. 💙