As my pets age, they seem to act more and more like their owner – me (Dr. Tenney). They get up slowly, they circle around when getting ready to lie down and whimper and whine a lot. Many of our clients can relate the feelings of being stiff and sore. Dogs and cats suffer from osteoarthritis just like their owners. Since this is one of the MOST COMMON conditions we treat, here is some general information for your review.
When a combination of various therapies are used to prevent or address pain, the benefits can be profound. First, more complete pain relief is possible. Second, the safety profile can improve as lower doses of each component are needed to get the desired result. Third, the cost of treatment may actually decrease as some of the more expensive medications may be given in smaller doses. This may sound too good to be true. But actually, just google “multimodal analgesia” and you will find that this is a very common topic in human as well as veterinary medicine. The list of approaches to the relief of osteoarthritis listed below is based on this philosophy.
The #1 action we owners can do to delay the onset of arthritis and to minimizes its effects is to control your pet’s weight. During a physical exam, we score (or judge) the body condition (BCS) with a number from 1-9. More than 50% of our patients are in the 5-9 BCS. It is not easy to get a pet to lose weight, but many times we are literally “killing them with kindness” when we overfeed. For more information on Body Condition Score, as well as some tips on losing weight, see the following page on Purina’s web site.
Starting in 2014, we began offering Therapeutic Laser treatments for painful and arthritic dogs. Please follow this link for more information.
NSAIDs (Non-steroidal anti-inflammatory drugs):
The bedrock of all drug related treatment for arthritic pain is non-steroidal anti-inflammatory drugs. We use different drugs according to the patient size, age, weight and drug sensitivities. We most commonly prescribe Rimadyl® (carprofen) and Metacam® (meloxacam).
Caution: Never combine two different prescription NSAID’s together nor combine a prescription such as Carprofen with any over the counter drug such as aspirin or ibuprofen. The combination can lead to serious side effects.
Dogs and cats that require long term therapy; like most arthritic pets; can benefit greatly from gabapentin. This drug is commonly used in people with chronic pain as well. There is a wide dosage range in pets. Gabapentin is well tolerated by both dogs and cats. Generally we start with a lower dose for a few weeks because if a pet is put on the full-strength right away, there is a tendency to become weak and wobbly. This is not what we want our painful patients to experience. For more information about gabapentin, click this link
Adequan is an injectable medication that is very useful in relieving pain and restoring damaged cartilage. It is given in a series of injections. It is far more effective than nutritional supplements such as glucosamine. We have had several cases that have responded very well to adequan injections even when the pet’s arthritis was quite advanced. If your pet is diagnosed with a chronic source of joint pain, we will discuss if this drug is likely to be effective in providing relief.
Omega 3 fatty acids:
There was a recent study published in one of our professional journals regarding the benefits of omega 3 fatty acids in dogs with OA. After 90 days, there were measurable and significant improvements in the pets fed the supplemental fatty acids. Not all Omega-3 fatty acids are the same. More information on the relative efficacy of Omega-3 formulation was the topic of a recent article on our website. There is an optimal balance or ratio of omega 3 to omega 6 fatty acids. There are diets formulated with the relief of arthritis in mind and have been shown to lower the need or dose of non-steroidal medications over time, reducing possible negative side effects and saving money as well.
Glucosamine (and chondroitin):
Many of us use these nutraceuticals for our own joint pain. Since they are not “drugs” but nutritional supplements, they are not regulated closely by the FDA. There can be a great variation in the actual quantity of the active ingredients in each pill, no matter what the label says. We carry a pet formula (chewable) for supplementing our patients. We feel the quality standards of this manufacturer are very good. In any case, the benefits of nutritional supplements will vary widely and will take time to manifest.
When pets are experiencing acute (sudden onset) pain, we often turn to tramadol for patient comfort. This is also a human pain drug that is a great aid for pets. Dogs react differently than people taking tramadol. It takes a higher dose and more frequent dosing (3-4 times per day) to be optimal.
Not all pain results from simple joint pain. In Arizona, Valley Fever is frequently involved in lameness and pain. We will usually need radiographs and may test for Valley Fever (Coccidiomycosis) prior to starting on pain medications.
There are many approaches to relieving arthritis pain. Unfortunately, none of them are usually sufficient alone. Most pets require a combination of treatments. The best thing we can do for our pets is to keep them at a healthy weight and provide them the best pain relieving drugs and use of other interventions when needed.