Just like with people, pets are prone to aches and pains as
they get older. Many times the
underlying culprit is osteoarthritis.
With arthritis, the cartilage within the normal joint breaks down, leading
to abnormal rubbing of bone resulting in inflammation and pain. Sometimes this occurs early in life secondary
to an underlying conformational problem like hip or elbow dysplasia, but many
times it is a result of getting older.
In dogs, the common signs of arthritis are:
- · Stiffness after rest, which tends to improve after activity
- · Pain over a joint or “guarding” of a joint
- · Muscle atrophy (loss)
- · Crepitus (popping) of joints
Cats typically hide their pain better than dogs and you may
not notice a lot of changes at home besides a decrease in jumping, a hunched appearance,
or decreased grooming
A thorough physical examination can help pinpoint which
joints may be causing a problem for a pet and then x-rays can be taken to
confirm arthritis.
If your pet is diagnosed with arthritis, there are a wide variety
of treatments ranging from weight loss to medications to physical therapy.
Medications:
A wide variety of medications are available to help ease the
inflammation and pain associated with arthritis. There are numerous over the counter
supplements available that aid in arthritis relief. The two most common supplements are omega
fatty acids (fish oil) and glucosamine/chondroitin. However, the mainstay of treatment typically
revolves around non-steroidal anti-inflammatory medications (NSAIDS).
Fish Oil
Fish oil contains high amounts of omega fatty acids, which
are beneficial in reducing inflammation associated with arthritis. Specifically, the omega 3 fatty acids, EPA
and DHA, are the most helpful in arthritis.
Ideally, a pet should receive between 50-100 mg/kg of EPA to help with
arthritis.
Glucosamine/Chondrotin
and other Disease Modifying Osteoarthritis Drugs (DMOAD)
Supplementing with glucosamine can give relief to some pets. These medications help decrease the inflammation
within the synovial fluid of the joint and can help decrease cartilage
degradation. There are numerous oral
medications available like Cosequin and Dasqauin, along with an injectable form
called Adaquan. There are also
prescription foods that have added glucosamine and omega fatty acids, so
additional supplementation is not needed.
A couple examples of food are Science Diet J/D and Royal Canin Mobility
Support.
NSAIDS
Non-steroidal anti-inflammatory medications target an enzyme
called cyclooxygenase that creates prostaglandins in the body, which leads to
inflammation. There are numerous drugs
within this class including:
- · Carprofen (brand names Rimadyl and Quellin)
- · Meloxicam (brand names Metacam and Meloxidyl)
- · Firocoxib (brand name Previcox)
- · Deracoxib (brand name Deramaxx)
Which brand of NSAID that your pet is started on depends on
your veterinarian, how often you can medicate, and what your pet
tolerates. Every pet is different and
may respond to one NSAID over another. These
medications typically are tolerated well, but stomach upset or ulceration can
happen and kidney and liver values should be checked every 3-6 months if your
pet is taking them regularly.
NSAIDS are used very commonly with dogs, but the use in cats
can be controversial. In 2010, a
black-box warning was added to metacam in the U.S. stating that it can cause
acute kidney failure and death in cats. It is only labeled for one time use with post-operatively
pain in the U.S.; however, It can still be used off-label for chronic
pain. In the U.K. it is used very
frequently in cats suffering from osteoarthritis without major complications
and can be used successfully in cats by adjusting the dosage and monitoring
kidney values. Having a thorough
discussion with your veterinarian prior to starting your cat on meloxicam is
recommended.
Piprant Class
Recently, a new class of medications called the Piprant
medications have become available to help with arthritis. These medications target the receptors of prostaglandins
instead of production to control arthritis pain. Currently, only one medication (Grapiprant)
is available from this class.
Other Pain Drugs:
- · Gabapentin was originally used as an anti-seizure medication, but more recently has been found helpful in alleviating pain, specifically chronic neuropathic pain. It can be used in both dogs and cats
- · Tramadol is frequently added with an NSAID to help alleviate arthritis pain in dogs. It is less frequently used in cats since it can be bitter tasting
Stem Cell Therapy
This is a regenerative therapy that uses fat from a patient and
processes it to acquire stem cells. To
collect the fat, general anesthesia is required and the fat is then sent to a
laboratory for treatment. There are also
some in-hospital kits that are available and allow for processing without
sending the sample out. This is a newer therapy
and while it has been shown to benefit patients with arthritis, it hasn’t been
compared head to head with other therapies.
As noted above, there are numerous options to help control
arthritis pain in pets. Having a
discussion with your veterinarian about arthritis concerns in your pet is the
first step in the road to arthritis pain control.
