Arthritis in dogs: what really helps beyond painkillers

He no longer jumps into the car, needs a few steps in the morning before he moves freely, and stops more often on walks. “He is just getting old.” Usually that is not true — he is in pain. And the most effective lever against it is on no package insert.

I have heard this sentence a thousand times in thirty years: “He is just getting old.” Usually it comes from people who love their dog dearly and watch him closely. And usually it is not true.

Growing old means: slower, greyer, more sleep. Growing old does not mean: no longer being able to get up, avoiding stairs, having to stretch before standing. Those are signs of pain. And in about one dog in five over the age of one they come from the same thing — arthritis.

What arthritis actually is

Arthritis is not pure wear and tear, even if the word suggests it. It is a cycle: the joint cartilage is damaged, the body responds with inflammation, the inflammation damages the cartilage further. Pain comes on top, pain leads to protecting the limb, protecting it loses muscle — and without muscle the joint carries even worse.

Two things to take from this. First: arthritis cannot be cured. Cartilage does not grow back, and anyone promising otherwise is selling you something. Second: it can certainly be treated — in several places at once, not just with a tablet.

The signs almost everyone misses

Dogs do not complain. They leave things out. That is why the early signs look less like pain and more like character:

• He needs a few minutes in the morning before he moves freely — and then he is fine again.
• He hesitates briefly before jumping into the car or onto the sofa. Only for the blink of an eye.
• The walks get shorter, he stops and sniffs more often.
• He no longer wants to play and withdraws.
• He has become more irritable and does not want to be touched in certain places.
• He licks one joint, always the same one.

By the time a dog limps, the arthritis is usually years old. Stiffness after getting up that “goes away again” is the most reliable early sign there is — and at the same time the one most often dismissed as normal.

The most effective lever is on no package insert

If your dog weighs too much, losing weight is the single most effective measure there is for arthritis. That is not an opinion, it is well researched.

In a study of overweight dogs with confirmed arthritis, lameness improved measurably as soon as the animals had lost just over six per cent of their body weight — with no medication at all, through weight loss alone. In objective gait analysis the effect showed from just under nine per cent, and by the end of the study 82 per cent of the dogs had improved (Marshall et al., Veterinary Research Communications, 2010). An older study of dogs with hip arthritis reached the same result at eleven to eighteen per cent weight loss.

Work that out for your own dog. Six per cent of 30 kilos is 1.8 kilos. That is no crash diet; it is a few weeks of consistently weighing the daily ration and of treats being subtracted from the daily allowance instead of added on top.

I know this paragraph is uncomfortable. Overweight in dogs is a subject that makes people feel guilty immediately, and guilt helps nobody. So let me put it differently: here you hold the biggest lever in your own hands. Free of charge. Without side effects.

Painkillers are not the second choice

I am a veterinarian, and I will be blunt: a dog in arthritic pain needs treatment. Not “let’s try something natural first”. Pain that persists changes the nervous system — the body learns the pain and at some point reports it even without a trigger. Waiting for months makes it harder, not easier.

Anti-inflammatory painkillers are the basis. They need supervision: regular checks of liver and kidney values, the lowest effective dose, and an honest conversation about how the dog is really doing on them.

One current point you should know about: For the antibody preparation bedinvetmab, injected against arthritic pain for some years now, the European and the British medicines agencies revised their assessment in 2025 and 2026. The product information was extended to include very rare side effects affecting the musculoskeletal system; an international expert panel reviewed severe individual cases and considered a connection possible. Both agencies still conclude that the benefit outweighs the risk for most treated dogs.

What that means for you: if your dog is on this medication, do not stop it on your own. Talk to your vet about it. That is exactly what such updates are for — an informed conversation, not panic on the internet.

What the evidence says about joint supplements

Here it gets uncomfortable for an entire market. The most extensive review to date of supplements in arthritis summarised 57 papers with 72 studies (Barbeau-Grégoire et al., International Journal of Molecular Sciences, 2022). The result:

• Omega-3 fatty acids — enriched foods as well as supplements — showed the clearest pain-relieving effect.
• Collagen performed weakly.
• Glucosamine and chondroitin showed what the authors call a “very pronounced non-effect”. They expressly recommend that these products no longer be recommended for pain.

Glucosamine and chondroitin are, of all things, what nearly every joint supplement on the shelf contains. I do not say this to run anyone down — but because every month people tell me they spend forty euros on a powder and wonder why nothing changes.

What belongs in your dog’s food and in what amount is your vet’s decision. But you are entitled to ask, next time you buy: “does this actually contain what was studied?”

Exercise: not less, but different

The most common mistake after diagnosis is rest. It is well meant and makes things worse, because the muscle that ought to guide the joint wastes away.

What is right: regular, moderate, even. Three quiet twenty-minute walks a day are better than one big Sunday outing. No abrupt stops, no ball throwing, no wild romping with emergency braking. Soft ground rather than tarmac.

Then there is what happens at home: take the danger out of slippery floors with runners, a ramp for the car, the bed away from draughts, bowls raised if bending down is hard. Physiotherapy and an underwater treadmill help many dogs considerably — ask your practice for a referral.

Where my perspective comes in

Everything so far is conventional medicine, and I stand behind it fully. What occupies me in addition in my work is the question that rarely has room in a consultation: Why this joint? Why this dog? Why now?

Arthritis does not arise at the moment of diagnosis. It develops over years — from uneven loading, from an old injury that never properly healed, from a movement pattern the dog adopted to spare something else. So when I look at an animal, I look not only at the joint that hurts but at the side carrying more because of it. And at the supply: a body expected to do repair work for years needs building material for it.

This replaces no treatment. It is what runs alongside — the same logic as with itching, where many small strains add up into a whole; I described that in more detail in the article on dog allergies . What I mean by this double view is set out in holistic veterinary medicine.

What I would like to leave you with

When your dog slows down, the most important question is not “which medicine?” but “is this age or is this pain?”. Age makes a dog calm. Pain makes a dog careful — and from the outside, care looks like age.

The difference is enormous, because one cannot be changed and the other certainly can. If you are unsure which signals you are seeing in your dog, my article When your dog shakes may help you place them.