Choosing a Diet for a Dog with Arthritis

There are many different factors that go into choosing a diet for a dog with arthritis or joint disease – from the right types of fats to fight inflammation, to the amount of protein to support lean muscle mass. Learn about the key nutritional factors that go into making the best dog foods for joint disease.

But first, it’s important to understand what arthritis is… and how to know if your dog might be affected by this condition.

Degenerative joint disease (also called osteoarthritis) is a progressive condition that happens due to wear and tear on the joints. About 20% of dogs by the age of one have arthritic changes, and about 80% of dogs by age 8 have joint disease. Many dogs will display infrequent or no symptoms outward symptoms at first, but as inflammation and breakdown of the joint increases, dogs will start to show signs of joint pain.

Clinical Signs

The first clinical signs might be as simple as an abnormal gait, an abnormal stance, abnormal nail wear, or muscle wasting on a particular area of the body. These small signs can show a dog who is compensating for a painful area so that they can still maintain normal activity. As the disease progresses you may notice shifting lameness, limping, exercise intolerance, panting, reluctance to sit or stand, inability to stand for long periods of time, slipping on floors, and very rarely – whining.

Predisposition

Certain breeds of dogs are more predisposed to joint-related conditions and arthritis than other breeds. Large breed dogs and our low-riders like Daschunds and Corgis can be particularly prone to joint issues like Hip Dysplasia, Elbow Dysplasia, Intervertebral Disc Disease, Cruciate Ligament Tears, and more. Some small breed dogs may also have conditions called Patella Luxation or Elbow Luxation. Whenever there is a joint that is abnormal – trauma within the joint is more likely to occur, thus it may cause earlier onset of disease.

Purpose of a Diet Optimized for Joint Health

Once joint disease occurs you cannot “reverse” damage without surgical intervention, however, you can provide support to the joint and surrounding tissues to slow the progression of the disease. The goal of this article is to give you an overview of the research associated with joint disease in relation to diet and show you ways you can optimize different areas of your dog’s diet to help with this condition.

As many dogs with joint disease are older – the overall composition of diets can vary greatly depending on con-current conditions. Always discuss any diet change with your veterinary team prior to the transition to make sure it’s the right choice for your pup.

An important note here as well – keeping your pup at a healthy weight is probably one of the biggest things you can do to help your pup if they suffer from joint disease. Research has shown improvement in pain and movement for dogs who undergo weight loss in conjunction with physical therapy. And multiple research studies have been done that show that obesity can cause chronic inflammation within the body, which could exacerbate this disease. Make sure to speak to your vet to know if your dog could benefit from weight loss.

• Need more resources on weight loss? Check out these blog posts for more information.

Fats and Essential Fatty Acids and Canine Arthritis

Probably the most well-researched area of the dietary management of arthritis in dogs comes down to the types and amounts of essential fatty acids within the diet. We know that when it comes to joint disease – inflammation is a big problem. Depending on the type of essential fatty acids within the diet we can either promote or inhibit inflammation within the body.

Generally speaking – omega 6 fatty acids such as linoleic acid, and arachidonic acid are considered pro-inflammatory, and by contrast, omega 3 fatty acids such as eicosapentaenoic acid, docosahexaenoic acid, and alpha-linolenic acid are considered more anti-inflammatory. 

Now, this doesn’t mean that omega 6 fatty acids are bad – they are still essential fatty acids and are required to maintain balance within the body, they help with fat-soluble vitamin/mineral transport, lipid metabolism, support organ function, and are mediators in a variety of hormonal and immune responses. So we don’t want “no” omega 6 fatty acids – we just want to keep them in a specific ratio to omega 3 fatty acids to have more of that “anti-inflammatory” effect.

• Research has shown that diets formulated to contain high doses of fish oil (combined EPA and DHA) can reduce the production of inflammatory cytokines, reduce pain, improve movement, and overall quality of life for dogs with arthritis over a three month time-period.
• In particular, researchers have found that the ideal diet for dogs with arthritis has a low omega 6 to omega 3 ratio ( less than 1:1 ), a total dosing per day of combined EPA and DHA of around 75-100 mg/kg with at least half that dosing from EPA (may also be written at 3.5-4% omega 3 with 0.5-1% EPA on a dry matter basis).

Overall there is no general recommendation on how much fat on a dry matter or caloric basis is “ideal” for dogs with joint disease - it matters more the type and dosing of fats used and the ratio of those types of fats to each other.

A Note About Supplementation of Fish Oil for Arthritis in Dogs:

There are three main issues with supplementing these large mega-doses of fish oil on top of a complete and balanced diet, rather than having these large doses formulated into the diet itself.

• First – many dogs are sensitive to high amounts of fat – the most common side-effect of giving large doses of fish is loose stools or diarrhea. And for dogs with pancreatitis – some dogs may not be able to tolerate these larger doses of fish oil on top of their regular diet without having flares.
• Second – a large portion of dogs with joint disease are overweight or obese – and fish oil – like most oils/fats are calorically dense. Adding on fish oil to an already balanced diet will add additional calories, and may be weight loss/maintenance difficult for some dogs. We know that excess weight is one of the biggest contributors to pain from arthritis and patient outcomes.
• Third – it may be extremely difficult to achieve the ideal ratio of omega 6 to 3 by just adding on fish oil. For example, a poultry-based diet that has a 20:1 ratio of omega 6 to 3 – adding the correct dosing of fish oil would still not achieve that 1:1 ratio we are looking for.

This is why it can be better to use a diet that contains these large doses of omega 3 fatty acids rather than adding or supplementing these on top of their regular food. Diets containing these larger doses have adjusted the cuts of meat, types of protein sources, the types of carbohydrates or fiber sources, etc to help offset issues such as loose stools and weight gain while achieving idea amounts of ratios of fats within the diets.

Choosing A Omega 3 Supplement for Canine Arthritis

If you are going to choose an omega 3 supplement for your dog it’s important to realize that not all sources of omega 3 are created equal. At the beginning of this section, I spoke a bit about three types of omega 3s: ALA, EPA and DHA.

EPA and DHA are highly bioavailable for dogs and are found in marine sources, this includes oily fish like sardines, mackerel, and herring, along with other marine animals like krill and phytoplankton.

ALA however is not a good source of omega 3 fatty acids for dogs with joint disease, this is because in order to be utilized it must be converted from ALA to DHA, then to EPA. The overall conversion rate is between 1-10% depending on other foods within the diet. Sources of ALA are seed or nut oils – things like flaxseed oil, walnut oil, etc. Many of these nut oils will also provide LA to the diet (an omega 6) which though necessary for body function we do not need large doses of.

Thus when choosing a Fish Oil (or other Marine-based Oil) look for products that:

1. Do third-party testing for heavy metals
2. Have a higher EPA to DHA ratio (as EPA is the final product we need to help with inflammation)
3. Have third-party testing for purity

Protein Content and Arthritis in Dogs

Many dogs who suffer from arthritis also suffer from something called muscle atrophy (or a decrease in muscle mass & body condition). Basically what happens is the dog will start shifting their movements to use the painful or unstable joint less and less, and as muscles are used less they will start to lose their size and strength. This loss of muscle mass can exacerbate joint-related problems because muscles and ligaments can provide needed stability and support to the joint (or joints) affected by arthritis.

There are several ways that we can help our dogs maintain their muscle mass. One way is by providing our dogs with adequate and highly digestible protein sources through their diet. And the question becomes – how much protein, and how do we know it’s high quality?

When we look at research on this topic we see that dogs maintain lean body mass and muscle condition scoring better both mid-life and later-in-life with diets composed of higher amounts of protein.

• One study done in 2017 showed that dogs who received diets containing 94g protein per 1000kcals maintained lean body mass better than dogs eating a diet of 60g protein per 1000kcals.
• A further commentary presented by board-certified veterinary nutritionist Dottie Laflamme in 2018 suggests that dogs that struggle with muscle wasting, or maintaining lean body mass benefit from 30-50% more protein than the typical healthy dog.

Though AAFCO’s minimum protein requirement is 18% on a dry matter basis for adult dogs, most do well with a diet composed of at least 25% protein for a healthy, minimally active adult dog. If we assume need 30-50% more protein - that places protein needs between 27-37% on a dry matter basis for dogs with muscle wasting that need to build muscle.

Knowing if a protein is of good quality is actually much more difficult. Protein digestibility or quality is affected by many other factors – from other ingredients within the recipe, to the processing method used within the dog food (aka extrusion, canning, freeze-drying, dehydration, cooking). The only true way to know the quality of (or how nutritious) the protein is by doing digestibility trials on the food. You can obtain digestibility information on a particular pet food by contacting the company directly for this information.

Ideally you want to look for a Crude Protein Digestibility of around 85%, but 80-85% is good.

Other Ways to Support and Prevent Muscle Wasting

You cannot just supply your dog with enough protein and expect that will by itself help with the maintenance of their physical condition. You also have to do the physical movement that utilizes that food to rebuild and maintain muscle. The best way to know which forms of movement would be best for your pup is to speak to your veterinarian or rehabilitation specialist.

Veterinary Rehabilitation Specialists can create a physical therapy routine for your pup based on their personal needs and condition to help build and strengthen muscles to support joints that are damaged. This can help improve mobility and overall quality of life.

Another way to help prevent muscle wasting is using supplements that slow the breakdown of muscles from disuse. This can be extremely helpful for dogs who are not using certain muscles for periods of time due to pain (or surgical intervention). One such supplement is called Myos (also called Fortetropin), which has been clinically proven to prevent muscle wasting and improve recovery time in dogs who have canine cruciate ligament surgery.

In summary - we need to supply adequate high-quality protein, then utilize that protein in a way that builds and strengthens muscles that support our dog’s joints. Then use supplementation to help prevent the breakdown of muscle mass we have gained. All these together can prevent muscle wasting, and help our dogs maintain their quality of life longer with arthritis.

The Role of Carbohydrates in Joint Disease

If you have done any research regarding carbohydrates and joint disease you have probably been assaulted by statements linking blood sugar, inflammation, and inflammatory markers to carbohydrates like the following:

“By spiking blood sugar, you prompt the body to produce pro-inflammatory chemicals called cytokines, increasing inflammation in the body and this can worsen the symptoms of inflammatory heart disease, joint inflammation and is strongly linked to depression.”

Feeding Dogs, page 81 – discussing Carbohydrates in Dog Food

Do we have any evidence to support this claim?

Sugar and Joint Disease

First, let’s break down the cited research given with the above quote… support for this statement was a paper from 2014 – where they looked at sugar-sweetened soda consumption and how that affects humans developing rheumatoid arthritis.

There are a couple of issues with the application of this paper to dogs. First – rheumatoid arthritis – a type of erosive Canine Immune-Mediated Polyarthritis (IMPA) is an extremely rare condition in dogs and should not be confused with the popular Osteoarthritis that we see in a large portion of the canine population.

Rheumatoid Arthritis is an immune condition – where the immune system basically attacks the joints causing inflammation. Osteoarthritis is a degenerative condition that occurs with aging (wear and tear over time), and can be related to genetic conditions like hip dysplasia, intervertebral disc disease, elbow dysplasia, cranial cruciate ligament injury, patella luxation, and more.

Second – this paper looked at “added sugar” consumption, not whole foods, and their effects. Though some dog treats do have added sugar, it is very rare for dog foods to contain added sugars. The typical dog food contains between 40-55% carbohydrates and 2-4% fiber – which is not the same as a 100% added sugar soft drink. Assuming they work or affect metabolism, blood glucose, or health in the same way, doesn’t make sense.

More research would be needed in order to make this claim.

Inflammatory Cytokines and Joint Disease in Dogs

We do have research that shows that pro-inflammatory cytokines may have a role in joint inflammation in dogs – in particular IL-6. And though we do have a research study that shows a low carbohydrate, fresh food diet can reduce skin-inflammatory markers in dogs – the particular inflammatory cytokines associated with joint disease in dogs have not been evaluated in relation to diet composition.

We also know that from research from the human side – whole grains – and other complex carbohydrates have actually been shown to have anti-inflammatory effects. Further research done in dogs looking at the addition of certain types of carbohydrates (soluble fiber) in combination with omega 3 fatty acids has been found to reduce inflammatory markers (AGEs), and positively affect the microbiome.

The evaluation of carbohydrates and their role within joint disease (and health) may be more complicated than just “good” or “bad” based on generalized “rules”.

Carbohydrates and Canine Arthritis

There are currently no general recommendations for the amount of carbohydrates within diets for dogs with arthritis. No comparative research has been done looking at low vs. high carbohydrate diets in relation to joint disease. There is also no research in dogs that suggests a higher carbohydrate diet would be harmful to dogs with joint disease or would predispose them to joint disease.

So let’s go over some facts:

Carbohydrates are not necessary for dogs however they may be useful. In particular, carbohydrates can be utilized to provide energy while sparing protein for other metabolic functions. They can also be used as a source of dietary fiber (soluble & insoluble), along with vitamins and minerals.

Dogs with joint disease can see potential benefits from higher amounts of protein (27-40%*) so they can maintain muscle mass and high amounts of omega 3 fatty acids (up to 8%*) to reduce inflammation, and dogs require at least 10.5%* fat in their diet according to AAFCO, but unless there is an underlying medical condition (like obesity or pancreatitis), most dogs do well with between 30-40%* fat within their diet. By doing some simple math – we would be looking at around 20-40%* carbohydrates on a caloric basis – though you could do less if you wanted and your dog tolerated it. (*all values on a caloric basis – not dry matter)

It is important to note that carbohydrate content may be modulated up or down depending on other concurrent medical conditions such as pancreatitis, obesity, kidney disease, or heart disease, especially as our dogs age.

Certain types of carbohydrates (fiber) may be beneficial for dogs with joint disease. New research published in 2020 has come out speaking about the changes to the microbiome that occur when pets have joint disease. As fiber provides the food for beneficial probiotics within the gut – it is possible that certain fiber sources may be beneficial for the management of arthritis in dogs. However, more research is needed to investigate this connection and it’s impact.

It’s likely that recommendations for carbohydrates, fiber, prebiotics, and probiotic complexes will change as we know more. Type of diet or processing may also influence disease processes – but we just don’t have the research to make these claims at this time in relation to joint disease.

Recommended Diets for Joint Disease in Dogs

Hill’s j/d: this diet contains high levels of omega 3 fatty acids (with a 1:1 omega 6 to 3 ratio), along with antioxidant compounds which has been clinically proven to help with joint disease in dogs. It is also relatively moderate in fat, and not calorically dense – making it a good option for obese-prone dogs, or dogs with GI sensitivities that cannot tolerate higher fat diets.

Just Food For Dogs Joint & Skin: A high protein, moderate fat fresh food recipe that contains a blend of nutraceuticals (collagen, hyaluronic acid, glucosamine, chondroitin, fish oil) to reduce inflammation. Omega 6 to 3 ratio of 3:1. 

Homemade Diet For Joint Disease: Another option is a homemade diet that contains a low omega 6 to 3 ratio. You can do this through a program like BalanceIT with veterinary approval. Simply select “joint disease” as an option and enter your veterinarian’s information and it will send a prescription diet approval form to your veterinarian. If you need help putting together a diet for your pup – feel free to reach out to discuss your options.

Personally, I’ve found my pup Ranger (who has moderate-severe hip dysplasia with osteoarthritis - diagnosed at age 7) has done extremely well on a homemade diet for his joint disease. His diet is around 40% protein, 40% fat, and 20% carbohydrates on a caloric basis, with a 1:1 omega 6 to 3 ratio, along with added green-lipped mussel, collagen, and hyaluronic acid. But it’s important to note that every dog is different and your pup may find success with a different diet/option.

Supplements for Dogs with Joint Pain

Though diet is the foundation to build on, supplements and nutraceuticals can also be very helpful adjunctive therapies. Especially for dogs with concurrent medical conditions or advanced stages of the disease. However… Like most areas of the supplement world – there is a lot of misinformation out there.

So if you’d like more information about the good, bad, and ugly of the joint supplement industry watch out for next week’s blog post where I discuss which supplements have science behind them, and which don’t.

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