Mar 13 2012

Help for Dogs with Arthritis Pain

“Good morning Doc,” the 4’2” woman says as she attempt to haul, shove, carry and otherwise move her 120 pound Burmese Mountain dog, Ben, into my mobile veterinary clinic.

I raise my eyebrows and feel obligated to help her. As I try to help the massive dog take the two steps up, I can feel his body shake and his muscles tense. His lip curls up and his ears lay flat against his head.

The lady backs away and shakes her head. “This is why I called you. He has gotten so aggressive lately. I am concerned about my niece and nephew. I think he might bite them.”

Concerned he might bite me, I take a step back and evaluate him. Thankfully, he is in the clinic and the diminutive woman is standing behind him with the door shut.

His eyes look at me soulfully, and I get a sense of what is happening.

This is not an aggressive dog; this is a dog in pain.

Mark my words, he should be treated with caution because he will react aggressively to any threat to his body, and I will not tolerate any risk to household members, but in a previously wonderful pet, this sudden shift of attitude is a strong indicator that should not be ignored.

In fact, Ben was diagnosed with severe arthritis of hips and right elbow via examination and x-rays. On a pain scale of 1-10, where 1 is pain free and 10 is excruciating, his owner classified Ben as an 8 after I showed her how to recognize the signs of pain in a non-verbal animal. I agreed.

Arthritis is a common disease of all companion animals, dogs as well as cats, in large ones and small ones. Since I see it so often, and since the snow is towering above my windowsill and making even my bones ache, I figure it is time to discuss this prevalent and often debilitating disease.

First of all, arthritis is not a catch-all term that relates to aging, aching animals. It is a specific pathologic process that must be diagnosed by radiographs (otherwise known as x-rays). Although a veterinarian may suspect arthritis, I have personally had cases that shocked me once I viewed the x-ray. Bone cancer, fractures and neurologic processes are frequently misclassified as arthritis, and since they all require vastly different treatments, make sure your diagnosis is correct.

Second, once arthritis is verified, you will need to decide what type of treatments you and your pet are comfortable with (and what your insurance will cover if you have pet insurance). Traditional treatment involves daily administration of NSAIDS (non-steroidal anti-inflammatories). Common types are Rimadyl, Previcox, Deramaxx, and Metacam, although there are many more.

I personally do not advocate aspirin in animals, although some veterinarians do. Do not give Tylenol or any Ibuprofen products such as Advil. Many clients assume that if they can take it, their pet can also (which is why I steer clear of aspirin). This is definitely NOT true. The liver enzymes are different in each species, and the p450 enzyme that converts the NSAIDS into their active metabolites can make these medications deadly to dogs and cats.

Before starting any of these, your pet must get a blood chemistry evaluation to look for liver or kidney dysfunction. Although rare, any NSAID medication can cause organ damage and thus your veterinarian must verify if your pet is healthy enough to have these meds, or if one would be more appropriate than another. These medications are given once or twice daily, some are liquid and some are tablet or chewable. Depending upon your schedule and your pet’s attitude, one might be easier for you to give. Remember, that without you giving the meds to your pet, they won’t work! So get something that you will use. Medications in a bottle is like money down a drain.

NSAIDS are great lifesavers and I dispense them all the time. But some pets and pet-parents do not want to use them, thus they need alternative therapies.

There are several nutraceuticals that help joint health, including glycosaminoglycans (GAG’s), glucosamine and methylsulfonylmethane (MSM). Additionally, omega-3 fatty acids have received a lot of attention lately about their benefits to arthritic pets. I have one big caution flag to waive when it comes to these products. They are NOT ALL CREATED EQUAL.

The regulation from the EPA and the FDA is quite different between medications and nutraceuticals, and therefore the companies that make these products often do not have to prove that they do what they claim they do. My personal opinion is that you often get what you pay for, and cheap, unknown products seem to do less good than better known, higher priced ones. Cosequin is a well-known brand, but there are many out there. I hate to say it (being a veterinarian meself), but you might be better advised to speak to a nutritionist or a veterinarian before being swayed by persuasive on-line propaganda.

Injectable glycosaminoglycan (Adequan) is an absolute favorite of mine. With no specific metabolic side-effects it is safe for most any pet, it works incredibly well if dosed correctly and is a fantastic value for the money to the client. Especially for my more naturopathic clients, or my pets that cannot have NSAIDS, I love injectable glycosaminoglycan. I have seen old, debilitated Rottweilers turn into puppies again!

Chiropractic and acupuncture care is another one of my favorites, but make sure your veterinarian knows what he or she is doing, and ask if he or she is certified. Certification is not the same as competence, but it gives you an idea of their experience. Also, a human chiropractor is not the same as a dog/cat chiropractor. Just look at how a human walks compared to a dog/cat! As I always tell my mother, an MD, human doctors need to know about two species- man and woman. Veterinarians need to know every breed that walks through the door and what hereditary, congenital and acquired diseases are specific to that breed. Believe me, there are a LOT of breeds!

Lastly, I am a huge fan of laser therapy. This is an up-and-coming method of treatment that uses a laser beam to stimulate natural healing and reduce inflammation. It also is safe for most any pet, and my patients love it. Some of them get so relaxed during treatment that they lean against me while I administer the Joules, or some even fall asleep during treatment. Laser needs to be done frequently in the early stages, then less frequently as the body heals. From a cost perspective, it is one of the most affordable modalities you can give your pet, but it comes at the inconvenience of meeting up with your veterinarian on a regular basis.

There are also many Chinese herbs, western herbs and homeopathic remedies that can help, but each pet is so individual that these options can truly only be offered on a case by case basis, and I would be going against the philosophy of treatment to offer a single set of options. Suffice it to say that I employ many of these in my practice, and some work better than others in specific cases, and all attempt to work with the body instead of trying to work against it.

In summary- arthritis is common, often devastating and can lead to a decreased quality of life for the pet and a deterioration of the human-pet bond as in the case of Ben, the Burmese Mountain dog I described earlier.

There are many options for treatment once a definitive diagnosis has been made, which include NSAIDS, nutraceuticals and a variety of complementary therapies. I often employ a combination of treatments, and work hand in hand with my pet owners to decide what works best and when to modify our approach. Laser treatment and injectable glycosaminoglycan are my absolute favorites, but homeopathic treatments and herbals come a close second. Nutraceuticals are rarely sufficient alone, but also are very safe. Lastly, NSAIDS work great, and if you want quick results, and have good blood work, they can make a significant difference for your pet.

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