Degenerative joint disease (also called osteoarthritis) is the number one cause of chronic pain in the dog and cat. The condition itself is the result of long term stresses and instability of a joint, either as a result of old injury or of natural development of the joint in that individual. While surgery may be able to help in some situations, sometimes the degeneration of the joint cannot be reversed, and treatment focuses on preventing progression of damage.

At Friendship Hospital for Animals, we make improving your dog's comfort a top priority!

Our doctors and staff are trained in the latest methods for pain relief and arthritis management. Many times, medications from different classes are combined for an enhanced effect, and further combination with non-drug therapies can also help to alleviate symptoms and slow disease progression.

Some of the methods that may be employed alone or in combination to treat degenerative joint disease include:
 

Lifestyle Changes

Weight Control

As joints age, they become less and less able to handle the load of the body. This is also true in diseased joints of any age. It is crucial for your dog to maintain a lean physique to help to decrease the strain on their joints. We can help make a plan for your dog's weight loss, which may include controlled exercise, decreased food ration, prescription weight loss food, or changing normal treats to healthy low-calorie alternatives like carrots, green beans and no-salt/no-butter popcorn.

Controlled Exercise

Gentle, controlled exercise is good for dogs with arthritis! Exercise helps to keep dogs lean, maintain supportive muscle structure, and help lubricate joint cartilage with healthy joint fluid. Keep things slow and easy to make sure your friend stays comfortable. Short, frequent walks at a normal pace are a great start. Gentle swimming is also a great choice. Try to keep a consistent regimen to avoid making your dog a “weekend warrior”. High impact exercise like running, or exercise that involves sudden, jerky movements like fetch or wrestling can make damaged joints more sore.
 

Nutritional Supplementation

Diet

Several pet food companies have formulated prescription diets for joint health. These diets are supplemented with high amounts of omega-3 fatty acids, carnitine, and glucosamine chondroitin (much more than can be accomplished with supplementation alone). We most commonly prescribe Hill's j/d, but Eukanuba Joint Plus and Purina JM are also available. All of these diets are nutritionally complete for adult and senior dogs.

Glucosamine/Chondroitin Sulfate

These products are cartilage components that are taken orally to provide the necessary building blocks needed to repair damaged cartilage. These products may have some anti-inflammatory properties separate from their structural uses.

These products take time to build up in your dog's system, and so one to two months may be needed to see a positive effect. New products are also becoming available that introduce MSM and ASU, ingredients thought to further help slow progression of disease and contribute to overall joint health. Most of these products are available as a tasty chewable treat.

Because these substances are classified by the FDA as nutraceuticals (i.e., nutrients with medicinal properties) rather than as drugs, the usual rigorous testing needed for drug approval has not been required. At Friendship, we carry products like Chondroflex, Cosequin, and Dasuquin from companies who have undergone voluntary testing for consistency in formulation and feel very confident in their effectiveness compared to over-the-counter products.

Omega-3 Fatty Acids

Certain fatty acids found naturally in some foods (like fish) have been found to have anti-inflammatory properties. Previously, the benefits of these fatty acids have been noted in skin disease, but new research has shown that they can be beneficial in reducing inflammation and improving comfort in joint disease as well. Fatty acid supplements in capsule or liquid form (3V Caps) may be utilized for dogs who cannot eat joint diets due to food allergies or other underlying disease. Side effects are very rare and may include stomach upset or weight gain.
 

Drug Therapy

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are often one of the main treatments utilized in the treatment of arthritis and other chronic pain. Some examples include Rimadyl (carprofen), Deramaxx (deracoxib), Previcox (firocoxib) and Metacam (meloxicam). They are fast acting and often very effective drugs, but can come with serious side effects, and so they are always used with caution and monitored vigilantly.

Simple screening blood tests are needed to make sure that your dog's liver and kidneys are healthy before beginning non-steroidal drugs. Follow-up tests are recommended 2-4 weeks later to make sure that your dog is tolerating the drug well. If all looks well, these tests are repeated every 6-12 months.

Side effects of NSAIDs can be seen any time during therapy, even after many years. The most common side effects seen are stomach upset, lack of appetite, or dark, tarry stool/diarrhea. Any of these signs should be reported to us immediately. Other more serious side effects include stomach or intestinal ulcers, liver or kidney failure, or blood clotting abnormalities.

NSAIDs should not be used in dogs with liver or kidney disease, or gastrointestinal ulcers. NSAIDS cannot be used in pets who are taking aspirin or steroids such as Prednisone. Make sure your veterinarian knows all of the medications and supplements that your dog is taking before beginning NSAIDs.
 

What about human NSAIDs?

It used to be much more common that veterinarians would prescribe aspirin or buffered aspirin for pets. While aspirin is an effective pain reliever in dogs, concern for toxic side effects makes it less favorable now in comparison to newer veterinary NSAIDs. Furthermore, use of drugs like aspirin can amplify the toxicity of veterinary-specific NSAIDs if used within days or weeks of each other. Other over-the-counter pain relievers like Tylenol (acetaminophen), Advil (ibuprofen), and Aleve (naproxen) can be harmful or even fatal if used in pets without veterinary advisement.

Tramadol

Tramadol is a medication that has morphine-like effects on pain without some of the undesirable side effects of morphine. It serves only as a pain killer and does not affect inflammation or underlying disease. It has a wide dosage range of effectiveness and safety and can be used up to three times a day. Side effects are minimal, most commonly sedation or grogginess. It has a great synergistic effect when used with NSAIDs, but can also be used as a sole medication, especially for those dogs who cannot take NSAIDs. It should not be used with certain behavior drugs, so make sure your veterinarian knows about all the medications and supplements your dog is taking.

Adequan

Adequan is a polysulfated glycosaminoglycan, which is also a cartilage component. Adequan has numerous beneficial effects for the arthritis patient including the inhibition of harmful enzymes involving joint cartilage destruction, stimulation of cartilage repair, and increase in joint lubrication and mobility.

Adequan is given as an injection and therefore is able to reach all joints, but it seems to have a special affinity for damaged joints. The injection may be given here at Friendship, or we can also teach you how to give it at home. Adequan is given in an initial series of one injection twice weekly for four weeks, then tapered to the longest effective dosage interval. Adequan should be avoided in patients with blood clotting abnormalities.

Gabapentin

Gabapentin has previously been used as an anti-seizure medication, but has now been recognized as an effective medication in chronic pain. Gabapentin is thought to help decrease the “wind-up” phenomenon noted in chronic pain, where the presence of pain amplifies the pain sensation pathways, leading to excessive perception of pain (hyperaesthesia) and pain in areas that are normally non-painful (allodynia).

Gabapentin can be used along with NSAIDs, as well as Tramadol and nutriceuticals. It should not be used in dogs with kidney failure. Sedation is the most common side effect noted.

Amantadine

Amantadine is another drug that has been recognized to decrease the “wind-up” phenomenon. It is available as a capsule or a liquid that is taken once daily. Side effects are uncommon, but may include stomach upset, gassiness or diarrhea. It should be used with caution in pets with kidney disease.

Adjunctive Non-Drug Therapy

Acupuncture

Friendship offers acupuncture therapy through Certified Veterinary Acupuncturist Dr. Meghann Berglund. Acupuncture has been recognized for many centuries to be an effective and safe means of controlling pain and decreasing inflammation. Acupuncture can be used to speed healing and recovery in almost any disease condition, but shows particular benefit in degenerative joint disease. Acupuncture will not be able to reverse the bony changes within the joint, but can help to decrease muscle spasm, improve circulation to joints, and provide comfort by the release of endorphins, the body's natural morphine. Therapy is usually initiated weekly for 3-6 weeks, then tapered as needed for each individual pet. Click here to learn more.

Massage and physical therapy

These are two other ways to help relieve the pain of arthritis, improve muscle strength and comfort, and optimize joint function. Please ask a team member for referral information to certified providers of these services.

The Bottom Line:

Pain doesn't have to be a way of life for your dog!

There have been many advances in medicine and non-drug therapy that can help your pet regain some of their youthful comfort and playfulness. Ask how we can help your dog get on the road to wellness today!