Home Care for the Veterinary Dental Patient

As we all know, pet dental health goesbeyond bad breath. Plaque and tartarbuildup can lead to more serious healthconcerns ranging from tooth loss toorgan failure.1 Studies have shown dentalproblems to be the most common problemin dogs and cats.2 Dental problems can bevery painful, although our patients usuallymask their pain. When our pets receivegood dental care, they undoubtedly livelonger and better lives.

In the vast majority of cases, the causeof periodontal disease can be traced tothe colonization of plaque bacteria on thetooth surface. There are several factorsthat can influence the tendency toaccumulate plaque:

• Size. Smaller dogs are more at risk.• Age. Older pets are more at risk.• Masticatory habits. Pets that chew

and/or consume hard food are less at risk.

• Breed. Certain breeds are more proneto developing periodontal disease.

IN THIS ISSUE:Home Care for the Veterinary Dental Patient ............................ 1Senior Pets and Joint Health ..... 4Ask the Vet ................................ 7Animal Health Institute Selects Hartz for Membership ............... 8

Professional dental treatment,performed when needed and under general(inhalant) anesthesia, is the cornerstone ofpreventive dental health. On average, dogsand cats benefit from an annualprophylaxis starting at the age of 3, buteach patient needs to have its dentalprogram individualized. For example, somefeline patients will present at 8 months ofage with severe gingivitis and early signs ofperiodontitis (gingival recession, furcationexposure). These cats, with their juvenile-onset gingivitis/ periodontitis,3 are alreadycandidates for dental prophylaxis. Dogs(especially Maltese) with ulcerative

D E C E M B E R 2 0 0 3 V O L U M E 1 , N U M B E R 2

A NEWSLETTER OF PRACTICAL MEDICINE FOR VETERINARY PROFESSIONALS

• Systemic health.• Preexisting advanced periodontitis.

The goal of dental home care is tocontrol the accumulation of plaque andcalculus. Plaque bacteria can colonize onteeth in a period of 24 to 36 hours—within a few days following yourprofessional dental cleaning, the teeth arealready starting to accumulate thebacteria that will again cause periodontalinflammation and disease. If nothing isdone to prevent or retard the accumula-tion of plaque, the periodontal diseaseprocess will continue.

Home Care: Where to StartDental home care for the veterinary

patient starts at the veterinary office.Patients must be evaluated for thepresence of dental disease and treated,if necessary, prior to beginning a homecare program. The fact is that 85% ofdogs over the age of 3 and at least 50% ofcats have significant periodontal diseasethat requires professional treatment.

Daniel T. Carmichael DVM, FAVD, DAVDCColumbia University School of Dental and Oral SurgeryThe Center for Specialized Veterinary CareWestbury, New York

2 HARTZ® COMPANION ANIMALSM • DECEMBER 2003 • VOL. 1, NO. 2

Consulting EditorsAlbert Ahn, DVM

Corporate Vice PresidentChief Scientific OfficerThe Hartz Mountain Corporation

Bruce TrumanDivisional Vice President Animal Health and NutritionThe Hartz Mountain Corporation

HARTZ® COMPANION ANIMALSM

is produced for The Hartz Mountain Corporation by Veterinary Learning Systems, 780 Township Line Rd.,Yardley, PA 19067.

Copyright © 2003 The Hartz Mountain Corporation. All rights reserved.

Hartz® and other marks are owned by The HartzMountain Corporation.

Printed in U.S.A. No part of this publication may be reproduced in any form without the expresswritten permission of the publisher.

Inset photo on page 1 © Daniel T. Carmichael,DVM. Used with permission.

For more information on The Hartz MountainCorporation, visit www.hartz.com.

D E C E M B E R 2 0 0 3 V O L U M E 1 , N U M B E R 2

A NEWSLETTER OF PRACTICAL MEDICINE FOR VETERINARY PROFESSIONALSstomatitis require frequent prophylaxis;they have an exaggerated inflammatoryresponse to minimal amounts of dentalplaque and require professional cleaningsevery 3 to 4 months.

Annual (or as-needed) dental cleaningsunder anesthesia offer opportunities toperform a good oral examination. Makesure you and your clients are prepared forthe advanced treatments or extractionsthat may be required.

When patients are dischargedfollowing professional dental cleanings,a home care program needs to be part ofthe take-home instruction sheet.

Ideally, dental home care programsshould be started with the puppy orkitten. If your patient is already at an agewhere dental pathology has set in, it stillis “never too late to start.”

Home Care: What to DoAntibiotics and Analgesics

Antibiotics are used for systemicprophylaxis from bacteremia and/or asprimary treatment for oral infections.Every animal that receives professionaldental care does not automatically needantibiotics. Antibiotics can be used forsystemic protection from oral-inducedbacteremia. Patients with advancedperiodontal disease and concurrentdisease conditions or immunosuppressionare candidates for systemic prophylaxiswith a broad-spectrum antibiotic.Therapy depends on the route ofadministration, the goal being to achieveadequate blood concentrations at the timeof the procedure. Clavamox® (Pfizer) is agood choice as a broad-spectrumantibiotic that treats oral infections andprovide systemic prophylaxis.

When considering the treatment oforal infections, antibiotic therapy alone israrely successful. The antibiotics must becombined with appropriate dental therapy(extraction, root canal, surgery, etc.).Antibiotics can be used prior to oralsurgery to improve tissue quality andmake oral surgical procedures moresuccessful. Ideally, antibiotics should beinstituted 5 days prior to dental treatment

and continued for 5 days posttreatment.Antirobe® (Pfizer) is a good choice fortreatment of oral infections, especiallywhen bone involvement is suspected.

Another somewhat controversial use ofantibiotics is “pulse therapy,” where anantibiotic is administered intermittentlyon a chronic basis. Pulse therapy shouldnot be thought of as part of a routinehome care program but as a tool thatcan be used when treating advancedperiodontal disease or stomatitis cases. Acommon dosing schedule is Antirobe (5mg/lb) once a day for 5 days every month.

Analgesics can be administered before,during, and after dental procedures wherepain is an issue. Regional and localanesthesia can be administered and willafford the patient postoperative pain reliefas well as reduce the amount of inhalantnecessary to maintain a surgical plane ofanesthesia. It is best to use a long-actingagent such as bupivacaine HCl. Narcoticsand/or NSAIDs should also be routinelyprescribed for 2 to 3 days following oralsurgery or other potentially painfulprocedures. Patients that receive properpain management regain their appetitesmore rapidly and feel better faster.

ToothbrushingDaily toothbrushing is the best thing

pet owners can do to promote good oralhygiene. Owners should be taught how tobrush their pets’ teeth. The first thing tostress to a neophyte pet toothbrusher is togo slow and make it fun. Advise yourclient to start with canned food or babyfood on the finger. Let the pet smell itand then try rubbing it on the outsides ofthe teeth. They should concentrate on thebuccal (toward the lip) surfaces of theteeth. The lingual surfaces (toward thetongue) and palatal surfaces are keptclean for the most part by the tongue.Once the pet has accepted this, it is timeto introduce the toothpaste. Pettoothpastes are available in a variety offlavors such as chicken, beef, andmalt. They are made to be swallowedand do not foam up in the mouth.Always recommend pet toothpaste and

discourage the use of human toothpaste.To start, advise the client to place a

small amount of toothpaste on the fingerand let the pet sniff and then lick it. Next,they should gently rub the toothpaste onthe teeth. If things are not going well, tellthem to wait a few hours before tryingagain. When the pet has accepted thetoothpaste by finger, it is time for thebrush. A conventional toothbrush(children’s soft bristle) works well, orperhaps a finger brush. The toothbrushshould be held at a 45-degree angle to thetooth surface, with the bristles pointingtoward the gingival margin. This allowsthe cleaning of the gingival sulcus duringthe toothbrushing process. The tooth-brush should be worked in a circularmotion, concentrating around the caninetooth and upper fourth premolar tooth.Advise them to try for 30 seconds on eachside of the mouth.

DietThere are several commercial diets that

have been scientifically tested and shownto significantly reduce plaque and tartaras compared to “regular” dry food diets.This is not marketing hype—studiesdocument significant reduction in theplaque index for the foods tested.Specifically, these foods are Iams DailyDental Care™, Hill’s Prescription Diet®t/d™, Science Diet® Oral Care, and (onlyfor cats) Friskies® Dental Diet. With theincidence of periodontal disease so highin dogs and cats, there are few reasonswhy anyone would not want to providea diet that promotes good oral health.

Chew ToysRawhide treats for dogs are readily

available to pet owners and are effective inthe control and removal of plaque andtartar from dogs’ teeth.4 Rawhide is highlydigestible and has not been observedto cause the digestive problems thatconventional wisdom ascribes to them innumerous scientific studies. It has also beenshown that coating rawhide treats withcalcium-sequestering substances such assodium hexametaphosphate can furtherenhance plaque and tartar reduction.5

Various types and designs of compressedrawhide are also beneficial for promotinggood oral health.

There are chew toy-type products thatare not recommended due to theirtendency to cause tooth fracture. 100%nylon bones are too hard and often areassociated with slab fracture of thecarnassial teeth. It is recommended thatpets not chew on tennis balls manufac-tured for human sport, because they arenotorious for causing attrition (mechanicalwearing of the tooth surface).

Other ProductsOral rinses, sprays, and other such

products also have a role in home dentalcare. When pets refuse brushing, theseproducts may be the only kind of homecare possible.

Chlorhexidine gluconate is an excellentoral disinfectant. The chlorhexidine willactually bind to gingival tissue and can

exert its effects over a 24- to 48-hourperiod. Chlorhexidine kills the bacterialpathogens that contribute to periodontaldisease, halitosis, and plaque accumulation.Chlorhexidine is supplied as a liquid or gelthat can be rubbed on the gums or gentlybrushed onto the teeth. In chronic casesof gingivitis, instruct owners to usechlorhexidine twice a week and regulartoothbrushing on the other days.

Other oral rinses, containing zincascorbate or chlorine dioxide, work wellfor combating halitosis with theirneutralizing effect on malodorous sulfurcompounds. It is important to realize that

masking halitosis may not be addressingthe primary source of oral pathology.

References1. Wiggs RB, Lobprise HB: Veterinary Principles and

Practice. Philadelphia, Lippincott Raven, 1997, pp186–187.

2. Harvey CE, Emily PP: Small Animal Dentistry. St.Louis, Mosby, 1993, p 89.

3. Williams CA, Aller MS: Gingivitis/stomatitis incats, in Harvey CE (ed): The Veterinary Clinics ofNorth America Small Animal Practice. Philadelphia,WB Saunders, 1992, p 1371.

4. Lage A, Lausen N, Tracy R, Allred E: Effect ofchewing rawhide and cereal biscuits on removal ofdental calculus in dogs. JAVMA 197(2):213–219,1990.

5. Stookey G, Warrick J, Miler L: HMP significantlyreduced the rate of calculus formation in dogs. ProcVet Dent 94 World Vet Dent Congr:80, 1994.

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● Vitamin enriched.

● Specially formulated with Glucosamine to help support healthy joint function.

● Highly palatable.

● Available for both dogs and cats.

● Fluoride free.● Beef flavored.● Helps to remove tartar,

plaque and debris from your pets teeth and gums.

Hartz® Dental™ Brush 'n Clean™

Hartz® Advanced Care™

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Hartz® Dental™Breath-Strips™ For Dogs

Hartz® Pet Shoppe™ Dental™ Flavor Infused™ Chew-Dent™

● Sugar free, alcohol free.● Easy to use dispenser.● Dissolves quickly to

leave breath smelling fresh and clean.

● Reduces the accumulation of plaque and tartar up to 54%.

● Preferred over the leading competitor 3 to 1.

If you would like to receive a copy of the Hartz Veterinary Catalog, please call (800) 999-3000 x 5118.

AD-168

Osteoarthritis (OA) is a common,debilitating disease of older animals thatresults in discomfort, impairedambulation, and diminished quality of lifein some patients. OA is defined as aninsidious progressive, noninflammatorydegenerative joint disease characterizedby synovial membrane changes, peri-articular osteophyte production, anddegeneration of articular cartilage.1–2

Although the etiopathogenesis is notentirely understood, OA is a lifelongdisease. Clinical signs may surface atdifferent times depending on genetic andenvironmental factors. Despite theassumption that OA is an idiopathic,geriatric change, other hypotheses exist;manifestations of OA may be caused by ahumoral substance or systemic disease,3–6

which may explain the presence ofmultiple joint OA in mature dogs.3,6,7

OA is highly prevalent in dogs in thehip joint, representing 93% of the cases inone study, although the elbow, shoulder,stifle, and lumbar vertebral joints are alsoaffected.6,7 Hip dysplasia, elbow dysplasia,osteochondritis dissecans, and cruciateligament rupture are common predispos-ing conditions. Clinical signs in dogsinclude stiffness, reluctance or inability tojump or use stairs, and lameness,especially after inactivity or prolonged orhigh-impact activity.2 Despite the well-characterized clinical signs andmanifestations of OA in dogs, catsfrequently harbor OA and remainasymptomatic, contributing to infrequentdiagnosis.2,8 In one study of 100 cats, 90%had radiographic evidence of OA eventhough all cases were subclinical anddiagnosed as incidental findings.8 Clinicalsigns in cats include weight loss, anorexia,

Evidence-Based TreatmentIt is important to emphasize that the

radiographic severity of OA does notalways correlate to the degree of symp-toms and thus the need for treatment.15

Treatment of OA is palliative with thegoal of restoring comfortable functionand is classified as medical or surgical.16

Pharmacologic AgentsMedical treatment consists of a

combination of pharmacologic agents,weight management, and controlledexercise.16–18 Pharmacologic agents includeNSAIDs and glucocorticoids.16–19 Mostbut not all NSAIDs have analgesic andantiinflammatory properties, inhibitingthe cyclooxygenase (COX) pathway.17,18,20

The development of newer veterinaryNSAIDs (Rimadyl® [Pfizer], EtoGesic®[Fort Dodge], meloxicam, and Deramaxx™[Novartis]) that are more selective for theCOX-2 isoform has resulted in feweradverse effects.17,21 Zubrin™ (Schering-Plough) is another NSAID purported to inhibit both the COX andlipoxygenase pathways. The mostcommon adverse effects in dogs aregastrointestinal signs,17,20 although renaland hepatic abnormalities can developinfrequently.20,22 In vitro studies havedemonstrated that NSAIDs are capableof decreasing cartilage metabolism.20

Steroids are potent antiinflammatoryagents that prevent prostaglandin andleukotriene synthesis.20 Due to the highfrequency of adverse systemic effects andthe potential for promoting cartilagedamage with long-term use,20 somesurgeons have reserved oral steroids forshort-term use in dogs exhibiting acute,severe exacerbations of discomfort.23

depression, lameness, poor groominghabits, and inappropriate eliminationoutside the litter box.9

Evidence-Based DiagnosisDiagnosis of OA is primarily based on

clinical features, physical examination,and radiographic evidence.2 Synovialfluid analysis and synovial biopsy mayrule out other causes of joint disease.2,9

Specific radiographic methodologies arerecommended to screen for predisposingconditions such as hip dysplasia. ThePennHIP methodology has beenscientifically proven to predict suscepti-bility to hip dysplasia at 16 weeks of ageby measurement of passive hip laxity (thegreatest risk factor for the developmentof OA)10 as compared to othermethods.3,11,12 This is supported by alifelong study of 48 Labrador retrieversthat revealed a 55% false-negative resultwhen using OFA-type scoring todiagnose hip dysplasia and thus predictthe development of OA.3 The PennHIPmethod was accurate in predicting thatthese 48 dogs were susceptible todeveloping degenerative joint disease.Radiographic evaluation of elbows by anorthopedic surgeon or radiologist isrecommended to examine for elbowdysplasia and requires specific views forobservation of evidence of osteochon-dritis dissecans, fragmented coronoidprocess, or ununited anconeal process.However, unless there are radiographicsigns of OA, only about 9% of elbowdysplasia conditions will be evident onradiographs.13 Both CT and MRI scansare significantly better at identifyingthese conditions, even in joints lackingradiographic evidence.13,14

Erin Paster, DVMAmy Kapatkin, DVM, DACVSSchool of Veterinary MedicineUniversity of PennsylvaniaPhiladelphia, Pennsylvania

Senior Pets and Joint Health

4 HARTZ® COMPANION ANIMALSM • DECEMBER 2003 • VOL. 1, NO. 2

NutraceuticalsNutraceuticals, such as glucosamine

and chondroitin, have grown inpopularity despite the lack of scientificevidence to support their use. Glucosa-mine and chondroitin are purported to bechondroprotective by providing cartilageprecursors, increasing cartilagemetabolism, and depressing collagenolyticenzymes.24,25 Although Cochrane reviewsof randomized, placebo-controlled,double-blind studies have shownglucosamine and chondroitin to relievediscomfort and improve function inhuman OA patients,26,27 none exist indogs. Anecdotal evidence in companionanimals appears promising, but furtherstudies are needed to prove efficacy. Italso remains undetermined in humanstudies whether different preparationsaffect efficacy or if glucosamine is safe forlong-term use.27 Clients should beadvised that individual patients willrespond differently to an agent, and trialand error may be necessary to find theproduct best suited for symptom control.

Weight Reduction and Controlled Exercise

Weight control and exercisemodification are imperative to thesuccess of medical managementand must be continuedthroughout life.18 Obesityhas been shown to be arisk factor in OAdevelopment in dogs,most likely due to theincreased biomechanicalforces sustained by thejoints.3,7,28 This is evidenced by a5-year longitudinal study of Labradorretrievers, revealing a significant increasein prevalence and severity, and earlieronset of coxofemoral OA in free-fed dogsas compared to paired littermates fed 25%less.3,28 Weight reduction alone can resultin clinical improvement of lameness andgait as evidenced by studies using obesedogs clinical for coxofemoral OA.29,30

Effective weight reduction should resultin the loss of 1% to 2% body weight

weekly.31 Reduced-calorie treats can besubstituted for table scraps, and calorieintake can be reduced with prescriptiondiets or limiting the regular foodoffered.17 Unsuccessful attempts at weightreduction may be confounded byendocrinopathies such as hyperadreno-corticism or hypothyroidism, thusnecessitating further diagnosticevaluation.17 A controlled exerciseregimen of regular, low-impact activitiescan be a benefit by maintaining muscletone, joint structural integrity, and rangeof motion while contributing to weightcontrol.17,18,23 Trial and error is necessaryto arrive at an exercise schedule thatallows comfortable function withoutexacerbation of lameness.17,18 A studyusing force-plate analysis in dogs withouta cranial cruciate ligament in one limbshowed improved weight-bearing inthose with exercise instituted daily ascompared to dogs with limited activity.32

The regularly exercised dogs also had lessgross and radiographic evidence of OA.32

Alternative TherapiesScientific evidence regarding alterna-

tive therapies, including acupuncture,massage, hot and cold therapy, electro-therapy, and ultrasonography for OA, is

limited. A double-blind, controlledstudy involving force-plate

analysis of dogs with cox-ofemoral OA treated withgold bead implantationacupuncture failed to showsignificant clinical improve-

ment over the placebo group.33

Additional studies are needed.

Therapeutic/Preventive ProceduresThere are currently no surgical

treatment modalities in animals scienti-fically proven to reverse or prevent OAdevelopment. Many procedures involvingthe coxofemoral joint are the focus ofconsiderable debate, and evidence-basedstudies are needed to support theseclaims.34 With long-term studies reportingthat >75% of dogs treated with medicalmanagement will retain pet-quality

function,35,36 it is difficult to determine ifpurported therapeutic procedures wouldhave resulted in a better outcome. Surgicalcorrections of predisposing causes of OAsuch as cranial cruciate rupture, however,are recommended.

Salvage ProceduresSurgical treatments in older animals

with OA are primarily salvage proceduresand should be recommended whenmedical therapy is unsuccessful or if thedog’s lifestyle is severely limited.23 Thefemoral head and neck osteotomy (FHO)and total hip replacement (THR) arestandard orthopedic treatment optionsfor end-stage hip OA.16 Pain relief isachieved by the creation of a false jointand the replacement of diseased tissueswith synthetic implants. Arthrodesis isalso an option for eliminating discomfortof some joints, such as the carpus andtarsus, although gait is compromised.23

Elbow replacement surgery is currentlyunder investigation for clinicalapplication in veterinary medicine.23 Kneereplacement has not been clinicallydeveloped for dogs.

Treatment for FelinesLimited information is available for

management of feline OA. Bufferedaspirin administration every 72 hours,butorphanol, meloxicam, and nutritionalsupplements have been used for chronicOA in cats.9 Alternatively, cats appear tomaintain comfortable function and betterlong-term outcomes with surgicaltreatments such as FHO, probably dueto their small size.37

Osteoarthritis PreventionManagement of OA is best achieved

through prevention.34 It is theveterinarian’s responsibility to educateclients about OA prevention as early asthe puppy stage. Purchasing puppies fromreputable breeders that can verify theparents’ history is important. As the pupmatures, appropriate evidence-basedscreening tests should be instituted fordetection of elbow and hip dysplasia.

HARTZ® COMPANION ANIMALSM • DECEMBER 2003 • VOL. 1, NO. 2 5

Weight management in dogs is theonly proven method, surgical or non-surgical, to slow or even prevent OA.This evidence comes from the previouslymentioned studies comparing free-fed(mean body condition score of 6) andlimit-fed (mean body condition score of4) Labrador retrievers.3,7,28,38 Thesestudies revealed significant reduction in prevalence and severity of OA inmultiple joints at 8 years of age,7 and hip coxofemoral joint alone at 5 years ofage,28 in limit-fed dogs as compared tothose that were free-fed. Additionally,the thinner (limit-fed) dogs alsorequired NSAIDs for symptom controlsignificantly less frequently and later than the obese (free-fed) ones.38 It isrecommended to maintain dogs at abody condition score at or below 5 (on ascale of 1 to 9).38

SummaryOA is a disease that is well described

in dogs and underdiagnosed in cats.Evidence-based treatment optionsinclude medical management consistingof pharmacologic agents, controlledexercise and weight reduction, andsurgical management, which mainlyconsists of salvage procedures. Usingevidence-based diagnostic tests to screenfor disease risk and keeping dogs thin arethe best preventive measures.

References1. Lepine AJ: A morphologic and physiologic

review of articular cartilage. Vet Orthop SocAnnu Meet:6–13, 2000.

2. Taylor SM: Disorders of the joints,noninflammatory joint diseases, in NelsonRW, Couto CG (eds): Small Animal InternalMedicine, 2nd ed. St. Louis, Mosby, 1998, pp1076–1078.

3. Smith GK, Biery DN, Kealy RD, et al: Effectsof restricted feeding on onset, incidence andseverity of hip dysplasia and osteoarthritis indogs: Diagnostic, therapeutic and geneticramifications. Purina Pet Institute Symp:Advancing Life Through Diet Restriction:21–26,2002.

4. Sokoloff L: The Pathology of Osteoarthritis andthe Role of Aging. Tunbridge Wells, UK,

Pitman Medical Publishing, 1980.5. Westacott CI, Webb GR, Warnock MG, et

al: Alteration of cartilage metabolism by cellsfrom osteoarthritic bone. Arthritis Rheum40(7):1282–1291, 1997.

6. Olsewski JM, Lust G, Rendano VT, SummersBA: Degenerative joint disease: Multiple jointinvolvement in young and mature dogs. Am JVet Res 44(7):1300–1308, 1983.

7. Kealy RD, Lawler DF, Ballam JM, et al:Evaluation of the effect of limited foodconsumption on radiographic evidence ofosteoarthritis in dogs. JAVMA 217(11):1678–1680, 2000.

8. Hardie EM, Roe SC, Martin FR:Radiographic evidence of degenerative jointdisease in geriatric cats: 100 cases (1994–1997). JAVMA 220(2):628–632, 2002.

9. Hardie EM: Management of osteoarthritis incats. Vet Clin North Am Small Anim Pract27(4):945–953, 1997.

10. Smith GK, Popovitch CA, Gregor TP, ShoferFS: Evaluation of risk factors for degenerativejoint disease associated with hip dysplasia indogs. JAVMA 206(5):642–647, 1995.

11. Fordyce HH, Gregor TP, Smith GK:Correlation of OFA hip scoring to passive hiplaxity derived from the hip extended anddistraction radiographs. Vet Orthop Soc AnnuMeet:2000.

12. Smith GK, Gregor TP, Rhodes H, Biery DN:Coxofemoral joint laxity from distractionradiography and its contemporaneous andprospective correlation with laxity, subjectivescore, and evidence of degenerative jointdisease from conventional hip-extendedradiography in dogs. Am J Vet Res 54(7):1021–1042, 1993.

13. Snaps FR, Balligand MH, Saunders JH, et al:Comparison of radiography, magneticresonance imaging, and surgical findings indogs with elbow dysplasia. Am J Vet Res58(12):1367–1370, 1997.

14. Reichle JK, Snaps F: The elbow. Clin TechSmall Anim Pract 14(3):177–186, 1999.

15. Whittick WG: Canine Orthopedics. Philadelphia,Lea & Febiger, 1974, pp 348–368.

16. Clark DM: Current concepts in the treatmentof degenerative joint disease. Compend ContinEduc Pract Vet 13(9):1439–1446, 1991.

17. Martinez SA: Medical management ofosteoarthritis in companion animals. VetOrthop Soc Annu Meet:24–29, 2000.

18. Tomlinson J, McLaughlin Jr R: Medicallymanaging canine hip dysplasia. Vet Med6:48–53, 1996.

19. Fox SM, Burns J, Burt J: Treating the dysplastichip: The first steps to follow. Vet Med :701–708, 1987.

20. Johnston SA, Fox SM: Mechanisms of actionof anti-inflammatory medications used for thetreatment of osteoarthritis. JAVMA 210(10):1486–1492, 1997.

21. Kay-Mugford P, Benn SJ, LaMarre J, ConlonP: In vitro effects of nonsteroidal anti-inflammatory drugs on cyclooxygenase activity

in dogs. Am J Vet Res 61(7):802–810, 2000.22. MacPhail CM, Lappin MR, Meyer DJ, et al:

Hepatocellular toxicosis associated withadministration of carprofen in 21 dogs.JAVMA 212(12):1895–1901, 1998.

23. Medical therapy of osteoarthritis in dogs. VetExchange:5–7, 9–11, 16–19, 1995.

24. Anderson M: Glucosamine and chondroitinsulfate in the prevention and management ofosteoarthritis. Purina Nutr Forum:36–41, 2001.

25. Anderson MA: Management of osteoarthritiswith nutraceuticals. Purina Nutr Forum:79–86,2001.

26. McAlindon TE, LaValley MP, Gulin JP,Felson DT: Glucosamine and chondroitin fortreatment of osteoarthritis: A systematicquality assessment and meta-analysis. JAMA283(11):1469–1475, 2000.

27. Towheed TE, Anastassiades TP, Shea B, etal: Glucosamine therapy for treatingosteoarthritis [review]. The Cochrane Library;The Cochrane Database of Systematic Reviews:1,2003.

28. Kealy RD, Lawler DF, Ballam JM, et al: Five-year longitudinal study on limited foodconsumption and development of osteoarthritisin coxofemoral joints of dogs. JAVMA210(2):222–225, 1997.

29. Impellizeri JA, Tetrick MA, Muir P: Effect ofweight reduction on clinical signs of lamenessin dogs with hip osteoarthritis. JAVMA216(7):1089–1091, 2000.

30. Burkholder WJ, Taylor L, Hulse DA: Weightloss to optimal body condition increasesground reactive force in dogs withosteoarthritis. Purina Nutr Forum:74, 2000.

31. LaFlamme DP, Kuhlman G, Lawler DF, etal: Obesity management in dogs. Vet Clin Nutr1:59–65, 1994.

32. Baird DK, Kincaid SA, Rumph PF:Unpublished data.

33. Bolliger C, DeCamp CE, Stajich M, et al:Gait analysis of dogs with hip dysplasia treatedwith gold bead implantation acupuncture. VetComp Orthop Traumatol 15:116–122, 2002.

34. Smith C: Treatments for hip dysplasia sparkcontroversy. JAVMA 201(2):205–209, 1992.

35. Barr ARS, Denny HR, Gibbs C: Clinical hipdysplasia in growing dogs: The long-termresults of conservative management. J SmallAnim Pract 28:243–252, 1987.

36. Smith GK, Fordyce HH, Gregor TP:Nonsurgical management of severe hipdysplasia: Long-term results. Vet Orthop SocAnnu Meet:1999.

37. Tacke S, Schimke E, Kramer M, et al:Excision arthroplasty of the hip joint in dogsand cats. Long-term results of the veterinarysurgery clinic at the Justus Liebig University ofGiessen. Tierarztl Prax 25:373–378, 1997.

38. Smith GK, Biery DN, Kealy RD, et al:Clinical significance of osteoarthritis and hipdysplasia findings in the restricted feedingtrial. Purina Pet Institute Symp: Advancing LifeThrough Diet Restriction:27–28, 2002.

6 HARTZ® COMPANION ANIMALSM • DECEMBER 2003 • VOL. 1, NO. 2

Albert Ahn, DVM, is a veterinarian, Chief Scientific Officer and Corporate Vice President at The Hartz Mountain Corporation.

ASK THE VET

HARTZ® COMPANION ANIMALSM • DECEMBER 2003 • VOL. 1, NO. 2 7

QA

AQ

Which Hartz® products can be helpful formedical management of osteoarthritis?

Osteoarthritis is defined as chronicinflammation of the joint that is usuallyaccompanied by pain and discomfort.Osteoarthritis may develop from skeletaldiseases such as hip dysplasia or can besecondary to immune joint diseases ortrauma. This condition usually involvespathologic changes of both the articularcartilage and periarticular soft tissues. Painassociated with osteoarthritis is often due toirritation of exposed nerves that is a result ofcartilage and tissue damage.

The following products manufactured by Hartz may help in reducing your pet’sdiscomfort associated with osteoarthritis:

• Aspirin is commonly used to treat osteoarthritisin dogs. Aspirin is an NSAID with analgesic,antiinflammatory, and antiplatelet properties. Itinhibits cyclooxygenase, which in turn reducesthe production of prostaglandins andthromboxanes. It is relatively inexpensive andreadily available. The use of buffered or enteric-coated aspirin is recommended as it decreases thelikelihood of gastrointestinal irritation. Therecommended dose of aspirin for treatment ofosteoarthritis in dogs is 10 to 25 mg/kg. Inaddition, aspirin is used therapeutically in thetreatment of disseminated intravascular

We want to hear from you!• Have questions or comments? Call our Consumer Relations Department at 800-275-1414 and ask to speak to a Hartz staff

veterinarian or email us at feedback@hartz.com.• To obtain a Hartz Veterinary Catalog of products, please call 800-999-3000 x5118 or email us at feedback@hartz.com.

coagulation and pulmonary artery diseasesecondary to heartworm infestation in dogs. Also,low doses of aspirin have been shown to be helpfulas an adjunctive treatment of glomerular disease.

• Glucosamine is an amino-monosaccharide nutrientand is classified as a chondroprotective agent.Chondroprotective agents are thought to aid inthe healing of cartilage, may stimulate cartilagematrix synthesis, and may reduce enzymaticdegradation of cartilage. Glucosamine is aprecursor to the disaccharide unit ofglycoaminoglycans, which comprise theproteoglycan ground substance of articularcartilage. Glucosamine acts by providing theregulatory stimulus and raw materials forsynthesis of glycosaminoglycans in cartilage.

What are the dental benefits of rawhide?

Rawhide dog treats have been used for manyyears to satisfy dog’s natural chewing needs.Rawhide is high in protein and low in fat andcan provide the chewing satisfaction that dogscrave. Studies show that when rawhide is useddaily, it can effectively remove plaque. Theabrasive action of rawhide chewing helpsreduce plaque, calculus, and gingivitis.Rawhide also provides the necessary chewingexercise to strengthen gums and is a great wayto relieve boredom, frustration, or anxiety.

Veterinary Learning Systems780 Township Line RoadYardley, PA 19067

PRESORTED STANDARDU.S. POSTAGE

PAIDBENSALEM, PAPERMIT #118

400045

Animal Health Institute Selects Hartz for Membership

The Hartz Mountain Corporation has a long history ofprotecting and caring for America’s pets. They have beeninnovators in animal health, particularly in the area of flea andtick protection, and manufacture scientifically proven products.Hartz was recently selected as the newest member of theAnimal Health Institute (AHI).

The Animal Health Institute is the U.S. trade associationthat represents manufacturers of animal health care products—pharmaceuticals, vaccines, and veterinary medicines. AHI

interacts with the U.S. Food and Drug Administration, theU.S. Department of Agriculture, and the EnvironmentalProtection Agency, the federal agencies responsible forregulating animal health products.

Hartz, along with all AHI member companies, shares adeep commitment to providing high-quality products aimed athelping pets lead longer, healthier lives. For more informationon the Animal Health Institute, and for a complete list ofmember companies, visit www.ahi.org.

Come Visit Hartz at These Upcoming Conferences!

North American Veterinary Conference Western Veterinary ConferenceOrlando, Florida Las Vegas, NevadaJanuary 17–21, 2004 February 16–19, 2004Booth 511 Booth 249