Diseases of the Joints

Diseases of the Joints

INCLUDED UNDER THIS heading are conditions which produce inflammatory changes, viz. arthritis, and those which cause

deposition of new bone- arthropathies. It is common practice, however, to use the term arthritis in the broad sense to

cover all joint inflammations and degenerative changes.

1. ARTHRITIS DUE TO INFECTION

This is brought about by the introduction to the joint of pyogenic bacteria chiefly by injury, the main organisms being

Streptococci and Staphylococci

CLINICAL SIGNS. There is an initial temperature rise and febrile signs develop. The affected joint becomes swollen, tense

and hot. Pain is obvious by the onset of severe lameness. Examination may reveal the presence of punctures on the skin

and the appearance of a purulent exudate. This latter must be differentiated from synovial fluid, escape of which can

occur if the wound has penetrated the joint capsule. This fluid has an oily feel and is less opaque than purulent exudate.

TREATMENT

1. ACONITUM 30c. This should be given as soon as possible in the early febrile stage if noticed in time.

2. FERRUM PHOS. 6c. This also is a good remedy for the initial feverish stage, more often indicated when throat symptoms

accompany the invasive process.

3. BELLADONNA 30c. Indicated when the patient presents an excitable picture with dilated pupils, throbbing arteries and a

hot skin

4. BRYONIA 6c. The indications for the use of this remedy are a deterioration of symptoms on movement, relief from pain

on pressure over the joint and a possible involvement of the respiratory tract. The joint is usually extremely hard and

tense.

5. APIS MEL. 6c. If the synovial sheath of the joint becomes oedematous, indicated by soft fluctuatory swellings, this rem-

edy may help. The patient is made worse by heat in any form, and is invariably thirstless.

6. LEDUM 6c. This is the remedy of choice if the arthritis has been caused by the initial penetration of a sharp object giving

rise to a punctured wound.

7. JODUM 6c. This is a remedy which sometimes gives good results in the less acute case, especially when joint pains are

worse at night. When this remedy is indicated the patient is often thin with a voracious appetite and the skin is dry and

withered-looking

8. RHUS TOX. 6c. The indications for this remedy are relief from movement, although there may be an initial stiffness on

rising. There may be accompanying skin symptoms of a vesicular, itchy nature.

9. SILICEA 30c. This remedy is indicated in the more chronic case. There may be involvement of neighbouring lymphatic

glands showing cold abscesses

The intercurrent use of Streptococcal and Staphylococcal nosodes is also indicated.

2. SIMPLE ARTHRITIS. So called Rheumatoid Arthritis

True rheumatoid arthritis as it occurs in man is thought not to occur in the dog and the syndrome in this species, which

goes by the popular description, is a polyarthritis of systemic origin affecting mainly older animals particularly of the

larger breeds

CLINICAL SIGNS. Lameness is first evident and there is increasing difficulty in rising as the condition progresses. The

joints are normal-looking in the early stages but become larger as the disease develops due mainly to deposition of new bone (osteoarthritis). Skin lesions accompanying these changes have also been noted. The animal may improve on exer-

cise and show a response to differing weather conditions.

TREATMENT. The following remedies may give some measure of relief in the early stages and have given encouraging

results:

1. RHUS TOX. 6c. One of the main indications for the use of this remedy is relief of symptoms on movement. The patient

may be stiff and disinclined to move but once exercise is taken symptoms appear to be less pronounced. A deterioration

is often seen in wet or damp weather and skin symptoms in the form of vesicular rashes sometimes accompany the

condition.

2. BRYONIA 6c. This remedy is indicated when the patient appears better at rest, exercise or movement tending to aggra-

vate. The joints appear tense and may be hot and swollen indicating an accompanying synovitis.

3. ACID. SALICYLICUM. 6c. Indicated especially when the smaller joints such as the carpus and metacarpal region are

involved. Movement aggravates, while the application of dry heat relieves the symptoms. All affected joints are tender on

touch.

4. 1ODUM 6c. This is a useful remedy in chronic states and may be indicated when the patient is lean with dry, staring coat

and a tendency to exhibit voracious appetite, and glandular swellings, which later ay tend towards atrophy. Joint pains

increase during the night, and are made worse by touch or pressure. Dropsical swellings of the joints may occur leading on

to suppuration

5. CALC. FLUOR 30c. When this remedy is indicated there are usually cracking noises in the joints and there is a tendency

to dislocations Synovial membranes are also involved, giving rise to swellings. Bony deposits (exostoses) may also arise.

6. ACTAEA RAC. 6c. There may be a generalised involvement of all joints when this remedy is needed, especially those of

the lower vertebrae and around the hip joint, associated muscles become involved.

7. CAULOPHYLLUM 6c. The smaller joints are chiefly affected, particularly those of the feet and cervical vertebrae. It could

be the remedy of choice in bitches which have a history of genital disturbances of one kind or another.

8. LITHIUM CARB. 6c. The joints of the hind limbs are more involved than the fore. There is difficulty in ascending stairs.

The hip joints may show alternate involvement.

9. OSTEOARTHRITIC NOSODE 30c. This nosode has been developed from joint-fluid in affected cases and has been used

with success either by itself or in conjunction with appropriate remedies.

3. ANKYLOSING SPONDYLITIS

This condition is not uncommon in the dog and is confined to the vertebral column. There is a breed disposition, promi-

nent among sufferers being representatives of the Dachshund, Great Dane and Boxer breeds.

ETIOLOGY. The exact cause has not been determined with accuracy but it appears to follow protrusion of an intervertebral

disc because of inflammatory degeneration of the ligaments supporting it. This is followed by ankylosing of the vertebral

joint.

CLINICAL SIGNS. Acute pain accompanies the early lesions. The animal's movements become unsteady and paraplegia or

paresis ensues, according to the severity of the condition. Arching of the back is a common feature. There may be urinary

incontinence. Doubtful cases can be confirmed or rejected by X-ray examination.

TREATMENT. The following remedies may all give good results if treatment is started early in the pathological process:

1. RUTA 6c. This remedy has a specific beneficial action on the periosteum of bone and will limit the early inflammatory

process, especially that surrounding the sacro-iliac region.

2. HYPERICUM 30c. This is one of the main remedies for the relief of pain because of its selective action on injured nerves.

It acts especially well in combination with the preceding remedy in the treatment of the condition under discussion. The

lower end of the back from the sacrum to the coccyx is particularly affected.

3. CALC. CARB. 30c. Indicated in fat subjects, e.g. mainly in the Boxer and similar types. Attacks may come on suddenly,

and give rise to cramping movements which precede joint involvement. It will help regulate the calcium metabolism and

reduce the tendency for calcium to be deposited in joints.

4. CALC. FLUOR. 30c. A tendency to dislocation is common and there may be other joints affected besides the vertebrae.

S. HECLA LAVA 12c. This remedy has a selective action on bone and used homoeopathically will aid those cases where

exostoses appear because of deposition of new bone.

4. OSTEOARTHRITIS

This is the term used to describe degenerative joint-disease where the articular cartilages become eroded and bony exos-

toses occur at the margin of the joints. The hip and stifle joints are the ones most commonly affected.

ETIOLOGY. Although age undoubtedly plays a large part in the onset of these changes, systemic or metabolic disturbances

are also involved. Progressive mild inflammation in the joint over a period of time is more likely to produce osteoarthritis

than any other predisposing factor. Obese and heavy animals may develop it more readily than lighter dogs. Poor confor-

mation also contributes. Once the cartilage degenerates the cushioning effect is lost within the joint and the joint capsule

then becomes progressively involved.

CLINICAL SIGNS. Lameness is the principal sign and may involve several joints. Unwillingness to use the affected limb

or limbs results in muscular wasting. Later signs include thickening of the joint. The worst affected limb may be held in a

flexed manner.

TREATMENT. This is not an easy condition to treat satisfactorily and the earlier it is started the more likely it is that deteri-

oration will be slowed down. Among the more useful remedies for the early inflammatory stages are the following

1. RHUS TOX. 6c. This remedy is indicated when the animal's symptoms are eased after movement progresses for a short

time. There may be initial stiffness on first moving

2. BRYONIA 6c. The indications for this remedy are the opposite of the preceding, viz. the animal prefers to remain still and

any movement causes distress and sometimes acute pain evidenced by the animal crying out.

3. ACTAEA RAC. 6c. This may be needed if accompanying muscles are involved as indicated by a heaviness in the limbs

and the animal appearing to be generally stiff and cumbersome when trying to move.

4. CAULOPHYLLUM 6c. This remedy could well be indicated if the condition is confined to the smaller joints, e.g. carpus,

tarsus and the joints of the toes.

5. LITHIUM CARB. 6c. With this remedy the smaller joints are also more prone to involvement. Application of warmth

eases the pain. Small nodular swellings may be felt in the joints.

6. CALC FLUOR. 30c. May be needed in the later stages once exostoses and joint swellings develop. The carpus is the main

joint affected when this remedy is indicated. There may be accompanying cystic tumours around the joint.

7. HECLA LAVA 12c. This is another useful remedy when exostoses have developed and will help limit the deposition of

new bone.

5. BURSITIS

By this term we mean the appearance of a swelling over the joint, those particularly affected being the points of the elbow

and the hock

ETIOLOGY. Damage to the bursa of the joint due to overweight is a common contributory factor as is also irritation of the

part by repeated contact with the ground if the animal is inclined to rest more than is usual.

CLINICAL SIGNS. The acute form shows swelling, heat and pain, evidenced by lameness. Effusion into the bursa occurs

and this accounts in part for the increase in size. When bursitis is chronic, fibrotic changes take place leading to the forma-

tion of a solid lump in the affected area. This may eventually ulcerate leading to secondary infection.

TREATMENT

1. APIS MEL. 30c. This is a useful remedy in the early inflammatory state where effusion is taking place and the joint is

extremely tender to the touch. The animal may lick and gnaw at the joint because of itching irritation. The patient shows

an intolerance of heat and touch.

2. BRYONIA 6c. Indicated when the joint is enlarged and pressure over the area brings relief as also does the application of

cold compresses. The animal resents movement and prefers to lie on the affected joint.

3. RHUS TOX. 6c. If surrounding ligaments and tendons are involved to any great extent, this remedy may be needed.

Movement limbers up' the animal which is in need of Rhus Tox.

4. 1ODUM. 6c. This remedy may be needed if the affected animal is lean with excessive appetite and dry, lustreless coat.

The joint capsule may be involved causing a general joint enlargement.

5. CALC. FLUOR. 30c. This is a good general tissue remedy and has a beneficial effect on the development of cysts, cystic

tumours and fibrous swellings.

6. SILICEA 30c. This is another good long term' remedy which will help dissolve any associated scar or fibrous tissue. It

will be beneficial if surface ulceration occurs leading to secondary infection.