By Dr. Laura Carpenter, Veterinarian
One of the most common old age ailments is arthritis. It is an inﬂammation of one or more joints: commonly hips, elbows, spine, and knees, though it can affect any joint in the body. Arthritis can cause anything from mild, intermittent discomfort to complete inability to use a limb or stand up.
Dogs most commonly exhibit arthritis pain by limping, reduced activity, or difﬁculty rising. This is sometimes worse after resting or in cold or wet weather. Cats most commonly exhibit arthritis pain by reduced ability to jump, reduced activity, reduced grooming, defecating in inappropriate locations, or becoming withdrawn or aggressive. In one study, 90% of cats over the age of 12 had signs of arthritis on x-rays (JAVMA, 2002). Your lazy, quiet older cat may actually be painful! If your older dog or cat is showing any of these symptoms, it’s time to have them checked by your veterinarian. Your veterinarian can examine the joints to determine which joints are most likely involved. X-rays and blood tests can help conﬁrm the presence of arthritis and rule out other ailments that may have similar symptoms. Once a diagnosis of arthritis is made, there are several types of treatments available. Typically, a multi-modal approach (i.e. several different types of treatment combined) is needed to provide the best comfort. The following is a list of possible treatments.
Non-steroidal Anti-inﬂammatory Drugs (NSAIDs) – perhaps the most commonly prescribed and most effective class of medication for arthritis pain and inﬂammation in dogs. You may already be familiar with several common brands: Rimadyl, Deramaxx, Previcox. Though the canine and feline formulations are in the same class of drug as many human anti-inﬂammatories (Ibuprofen, Aleve, etc.), the human formulations should NEVER be used without speciﬁc instruction from your veterinarian as some human NSAIDs can be extremely toxic; this is especially true in cats. Before starting long term NSAID therapy, your veterinarian will perform baseline blood work to detect any problems where NSAIDs are contraindicated and so we know what “normal” is for your dog. Two to four weeks after starting therapy, a second round of blood work is done to determine if the medication is having any ill effects. If all is well, blood work should be done every 6-12 months thereafter. These medications require a prescription from your veterinarian. NSAIDs are not typically used as a ﬁrst line of defense in cats due to the higher incidence of side effects with long term use, however, in a few select cases where other treatments have failed, an NSAID such as Onsior may be recommended.
Glucosamine/Chondroitin Supplements – these are cartilage components that aid in cartilage health. Some products will also contain MSM, avocado, soybean, or other anti-inﬂammatory supplements. Several months of administration is required to see an effect, so these supplements should be combined with a quicker acting medication for a pet who is in pain. There is a wide variety in quality between brands of glucosamine and chondroitin supplements. Please ask your veterinarian for a brand recommendation. The higher quality brands will be more expensive, but they are worth it.
Omega-3 Fatty Acid Supplements – these oils, typically derived from ﬁsh, have antiinﬂammatory properties and can be quite helpful for a variety of ailments, including arthritis. This treatment may also take several months to be effective and quality can vary greatly between brands so please ask your veterinarian for a brand recommendation. Adjunctive Pain Medications – this is a broad group of medications intended to stop pain, but they do nothing for inﬂammation. They are commonly used in addition to an NSAID (in dogs) when NSAIDs aren’t quite enough. Some common choices are codeine, tramadol, buprenorphine, hydrocodone, and gabapentin. These require a prescription from your veterinarian. Prescription Mobility Diets – a complete diet with a controlled calorie content that contains omega-3 fatty acids, glucosamine, and chondroitin. This food requires a prescription from your veterinarian.
Adequan – this product is a cartilage component which is given by injection by your veterinarian. It can be very helpful in many pets, but the effects can take several weeks to be seen. It acts to decrease joint inﬂammation and protect cartilage. This is often a good choice when standard therapies don’t seem to be enough.
Diet and Exercise – in some pets who are overweight or obese, this can be your most effective weapon against arthritis pain. Even a modest reduction in weight in an overweight pet can sometimes yield dramatic results. As we all know, the older we get, the harder it is to lose weight and the more likely we are to injure ourselves with exercise. Please seek the guidance of your veterinarian for help with a plan! This is especially important with cats, as they can become extremely ill if they are too calorie restricted.
Physical Therapy – for those pets with extreme situations (severe disease or injury, obesity, muscle wasting, recent surgery), working with a veterinary physical therapist can help get them back on their feet. Muscle strengthening exercises tailored to your pet can increase muscle mass and help protect and support arthritic joints.
Acupuncture – yes, acupuncture is available for pets! It may provide some adjunctive pain relief. Please choose an acupuncturist certiﬁed in veterinary acupuncture.
Laser Therapy – As discussed in Dr. Goldman’s Laser Therapy Blog back in September, therapeutic lasers may be helpful to reduce arthritis discomfort by stimulating the existing cells to help reduce inﬂammation and increase blood ﬂow.
Stem Cell Therapy – stem cells are cells that have yet to decide what they want to be when they grow up. When injected into areas of unhealthy tissue, they have the potential to grow up and replace the damaged cells. To be clear, we are talking about adult stem cells taken from the fat of the very same pet they are meant to help, not fetal stem cells whose use is controversial.
Surgery – for advanced cases with uncontrollable pain, joint replacement, joint fusion, removal of bone fragments, or other surgical procedures may help return the pet to a good quality of life.
Arthritis can be tough for you and your pet, but we are here to help. Click here to schedule an appointment online to discuss arthritis with your veterinarian, or call us at 410.768.3620 anytime.