Arthritis Treatment Options
The most common form of arthritis affecting our domestic animals is osteoarthritis. It can
also be called degenerative joint disease (DJD). This type of arthritis results from an imperfectly
functioning joint that allows for some joint instability and therefore extra wear on the joint.
Normal limb joints are protected by cartilage and lubricated by synovial fluid. A joint with DJD
will have worn down cartilage, increased synovial fluid, and often the joint will have irregular
bone formation due to the constant irritation.
Treatment involves one or more of the following:
1) Nutraceuticals to help protect, and improve the function of the joint,
2) Anti-inflammatory medications to reduce the pain, and/ or
3) Surgery to repair a bad joint.
Nutraceuticals
These are products that are produced naturally by the body that have both nutrient
and drug effects. These medications do not block pain. Instead, they reduce joint
stiffness and slow the progression of arthritis by lubricating the joint. They are
considered “cartilage protectants” because they work by preventing friction between the
bones in a joint. Friction erodes the cartilage that protecs your bones, and is the direct
cause for arthritis pain. They are not regulated by the FDA, must be used on a long-term
basis because they do not work immediately, and are generally considered very safe.
Effectiveness can be difficult to determine in some cases. The nutrients in the joint fluid
are called glycosaminoglycans (GAG’s) and include:
Glucosamine- stimulates production of the supportive tissue in joint cartilage.
Chondrotin Sulfate (CS)- inhibits the formation of inflammatory chemicals within
the joint; therefore, it decreases inflammation, decreases pain and decreases the
destruction of joint tissues.
Manganese & Ascorbate- necessary components for Glucosamine and CS to work.
PRODUCTS
Cosequin- combination of Glucosamines, CS, Manganese and Ascorbate. Highest
quality and purist ingredients of any joint nutraceutical. Same as human product
Cosamin. Comes in capsule, powder, and chewable tablet. Has safely been used in
people, horses, dogs, cats, rabbits, and other species.
Find out more at http://www.cosamin.com/html/cosesmall.html
Glyco-Flex- freeze-dried Perna Canaliculus (type of shell fish) that is an excellent
source of Glucosamines, CS, and other GAG’s. Comes in chewable tablets.
Multi-Source Glucosamine- includes several forms of Glucosamine. Also has
Manganese, Ascorbate, and Calcium but no CS. Comes in capsules.
Adequan- injectable form of CS. This form of CS may be better used by the body
and therefore more potent. Initially given two times a week, and then as needed.
Shark Cartilage- raw cartilage collected from the fins of sharks. Contains all the
GAG’s, but not likely in a form that can be used effectively by the body.
NOTE
* Many other products containing Glucosamines, CS, and other GAG’s are available.
They vary greatly in purity and source. Many of lesser quality may not be very
effective, and worse, may have impurities that can be harmful.
* The main purpose of the GAG’s is to decrease the progression of the arthritis and
to a much lesser extent decrease pain.
* Glucosamine and CS are more effective if used together.
* After initial response, most products can be reduced in quantity given.
* The Veterinary Approved products are recommended because of the known safety
and purity of these products.
* Loading dose of Glucosamines and CS are approximately 44mg/kg each.
* Average onset of effect is usually 4-6 weeks
* Mild side effects of intestinal gas, and soft stools are dose dependent. Monitor
glucose regulation changes if used in diabetics.
PAIN RELIVING MEDICATIONS
ANTI-INFLAMMATORY DRUGS
These are drugs regulated by the FDA. They have great potential for harmful side
effects if not used properly. They should only be used as prescribed by a veterinarian.
Most can be used as needed for pain or inflammation, and effectiveness can be noted
within several hours. All anti-inflammatory medications work by interfering with the
chemicals that trigger nerves to “feel” pain and that trigger inflammation. Unfortunately,
these same chemicals also protect the linings of the stomach, intestine, and kidneys from
damage, so vomiting and diarrhea are common side effects, and kidney failure is a
potential rare side effect. Routine blood tests should be done to ensure your pet’s
treatment is not causing any harmful side effects.
Only one of these drugs should be used at a time; however, these medications
can be used in conjunction with the nutraceuticals.
1. Non-Steroidal Anti-Inflammatories:
Aspirin- over-the-counter medication that can be useful in reducing the inflammation
associated with arthritis. Best if used in buffered form (i.e. Ascriptin or Ecotrin) and
given with food. Side effects can include stomach upset and bleeding problems. Should
be used with extreme care in cats. Other products are better if pain relief is needed
frequently. Consult a veterinarian before using Aspirin or any other medication for proper
usage and dose.
Rimadyl- veterinary prescription drug. Similar to Aspirin but seems to be more potent
in dogs with less stomach upset. Safe in bleeding disorders. Shouldn’t be used if
underlying liver disease. Any vomiting, diarrhea, or loss of appetite please stop
medications and call the office immediately.
Metacam- prescription drug with once daily dosage. Also easier on stomach and more
potent than Aspirin. Metacam is metabolized more through the kidneys than the liver, so
it is safer to use in pets with mild liver disease, but should be avoided in pets with any
kidney issues.
Deramaxx 2. Steroidal Anti-Inflammatories:
Corticosteroids- drugs like Prednisone and Dexamethasone have very strong antiinflammatory effects. They not only block the chemicals that trigger pain receptor nerves,
but also interfere with the white blood cells that cause inflammation. They can be used to
reduce the swelling, irritation, and pain associated with severe arthritis, but eventually
can contribute to cartilage destruction. Often they are prescribed for acute flare ups, or
for short-term relief, but side effects make it undesirable for long-term use in most cases.
3. Cell Mediated Blockers:
Tramadol is a pain medication that works by interfering with the white blood cells that
cause inflammation. It stops inflammation at the tissue site instead of blocking the
body’s ability to ‘feel” pain. Unlike other anti-inflammatory medications, it rarely
causes stomach upset, and is relatively safe to use in patient’s with other medical
conditions. It can be used in conjunction with other anti-inflammatory medications and
morphine based pain medications for more severe or chronic pain.
4. Pain Receptor Blockers:
Morphine based products. Medications like Torbugesic, Hycodan, Codeine and
Fentanyl can be used separately or with anti-inflammatories to help treat acute severe
pain, or chronic debilitating pain. Common side effects include sedation, constipation,
and nausea. The liver and kidneys tolerate these medications well, but they should be
used with caution in patients with heart or respiratory disease.
NEVER USE IBUPROFEN (Advil, Motrin, etc.) in dogs or in cats. NEVER USE
ACETAMINOPHEN (Tylenol) in cats. NEVER use any drugs not previously okayed by
a veterinarian!
All long term use of pain medications has the potential to disrupt liver or kidney function,
so routine blood tests are recommended twice yearly if your pet needs dialy treatment. If
you ever notice any lack of appetite or other signs of illness while your pet is on pain
medications, please call us right away. If you have any questions or concerns about
treatment and its potential side effects, please ask your veterinarian.