Arthritis & Pain Management Services
We offer a wide range of services and treatments to help our older dogs and cats better cope with arthritis pain and long term pain issues like back pain and degenerative joint disease (DJD).
In a famous veterinary study involving Labrador Retrievers, the lack of ability to walk because of an orthopedic problem like arthritis was found to be the most common cause of euthanasia. Because of the serious adverse impact that arthritis pain can have on dogs and cats, we tend to be aggressive in our treatment of this common condition.
Unfortunately, there is no one single arthritis or pain management approach that works with all pets every time. Every pet has unique pain management needs and unique responses to pain relief therapies, so each pet will likely need a personalized pain management protocol. The best way to do this is to work with your veterinarian to develop a plan that is right for you and your pet.
Knowing this, we at the Chastain Veterinary Medical Group use a multimodal approach to the treatment to osteoarthritis, back pain and other chronic pain issues. This means that for best results we generally apply more than one therapy and often more than one at a time. Here are some of the options:
Acupuncture and acupressure for dogs and cats are considered forms of Alternative Medicine and as such they are more difficult services to secure for the painful pet. Nevertheless, acupuncture has been shown to be beneficial for the treatment of the pain and inflammation associated with arthritis. We ourselves have had some good success working with a certified acupuncturist on several of our patients. If you want to look into this for your pet and we all agree this is a viable option for your pet, we can help you get connected with a certified provider.
Here I am talking about massage as a form of physical therapy. Beneficial effects of massage include relaxation of muscles, reduced muscle spasm and trigger points, increased flexibility, improved blood and lymphatic flow, and reduction of edema or fluid accumulation. Massage has been used to increase blood flow to muscles to “warm up” the area before activity, and to decrease stiffness after activity. You see this all the time in professional sports, and many dogs are said to respond favorably as well.
An experienced bodywork therapist, working with your veterinarian, will know what form of massage is right for your dog. It is important that massage therapy work be known to and approved by your veterinarian. You can start your search for a bodywork therapist by speaking with your veterinarian or searching the AAMB member directory.
Class IV therapeutic laser therapy is a newer form of treatment for arthritis and chronic pain. Used for decades in human sports medicine, it only recently became practical for our veterinary patients. Cold lasers are thought to help chronic pain in four ways: improved tissue regeneration, reduction of inflammation, pure pain relief (analgesia), and enhancement of normal immune function. At the Chastain Veterinary Medical Group, we have used a Class IV Therapy laser for over 5 years on a wide variety of pain problems with our patients and we have seen very impressive results from this drug-free alternative.
Oftentimes simple changes around the house can make a big difference for pets with chronic arthritis. Think about the simple things first: provide a comfortable well-padded dog bed. Position the bedding away from windows, doors and drafts. Consider carpeting or throw rugs to improve the pet’s traction when walking. Carpeted ramps or stairs can be a big help in getting dogs and cats up and down from the bed.
There are an almost infinite number of joint supplements available now for dogs and cats. Most of these contain some combination of glucosamine, chondroitin sulfate, MSM, ASU, green lipped mussel EPA, DHA and/or other proprietary ingredients.
Most of these kinds of products actually contain what they claim to contain, but not all. To be safe, stick with a recognized manufacturer like Nutramax. The science on these glucosamine products is subject to revision from time to time. Still, many pet owners and veterinarians have found certain types of these products to be very useful for arthritis and DJD. Oddly, just because a pet didn’t respond to one product doesn’t seem to mean they might not respond to another.
Recently, several companies have brought out pre-packaged Arthritis diets, such as Purina JM, that contain some of these same ingredients. In our hands these diets are about as likely to help as the individual joint supplements. In some cases we have had even better results by combining joint supplements with an arthritis diet.
Again, regardless of where you get these products, make sure to consult with your veterinarian first and let them know of your interest in trying these products.
Exercise in moderation is very important for the older dog. Short time duration, very low impact exercise sessions seem to yield the best results. We suggest keep the focus on passive range of motion. Passive range of motion is the process of using your hands to externally move a joint through its full range of travel, in both flexion and extension. Doing this regularly helps provide stress fairly evenly through the connective tissues of the joint and can thus strengthen scar tissue and connective tissues.
Pain Relievers / Anti-Inflammatories – when you see a number of different treatments available for the same condition that often means that no one treatment works consistently for all patients all the time. So it is with pharmaceuticals for osteoarthritis. Different pets are likely to respond positively to different drugs, or different combinations of drugs, and their responses may well change over time. Here are the main pharmaceutical options for this condition.
Adequan – from the manufacturer: Adequan® Canine (polysulfated glycosaminoglycan) is an injection, typically administered twice a week for four weeks. The drug is injected intramuscularly to ensure it reaches the critical parts of the joint. It goes to work in the joint in about two hours and stays in the joint for about three days. With Adequan® Canine you should see signs of improvement within four weeks.
Each injection provides the dog’s body with some of the building blocks needed to repair and maintain its joint cartilage.
In our hands, this has been a very effective treatment with few side effects and it is quite rare to see a dog that fails to respond positively to it. The downside is that Adequan must be given by injection and it can be a little expensive for some situations.
NSAIDS – for many dogs the mainstay of arthritis pain treatment is the non-steroidal anti-inflammatory class of drugs, referred to as NSAIDS for short. There are a number of brands available, again, in part because no single one is perfect for every dog. In our hands we have had very good results from Rimadyl, Previcox, and Metacam.
Of course, there are no effective medicines of any kind that are available with no side-effects. And so it is here: the possible side effects for the NSAID group are numerous. Vomiting, diarrhea, stomach ulcers and kidney problems are the main concerns. Happily, these side effects are uncommon and usually manageable. Still it is important that pets receive screening blood tests before starting on these kinds of medications and regularly thereafter. Discuss this with your veterinarian.
Also, please do not give your pet aspirin, Tylenol or other over-the counter human pain relievers without talking to your veterinarian first. The animal dosage window with these drugs is very narrow and they can cause serious problems if used incorrectly in a pet.
Tramadol – often used along with Adequan or NSAIDs, tramadol is potent pain adjunctive pain reliever. It is generally well tolerated and inexpensive with fewer side effects than many medications. Alas, as of now it is a considered a controlled substance, subject to government regulation. Still, in our hands, this medication has made an enormous difference in the lives of a number of pets.
Corticosteroids – in some cases, it is worth using glucocorticosteroids, or cortisone type products to reduce swelling and pain in arthritic pets. These medications are often very effective but they have their own down side side-effect profile as well. Increased drinking, increased urination, and increased appetite are often the first issues noted. If used long term corticosteroids can lead to a catabolic effect where in certain tissues of the body tend to break down over time. They can also be associated with diabetes mellitus, Cushing’s disease, liver disease, and suppression of the immune system.
Arthritis or osteoarthritis simply means inflammation of the joint. However, the real problem with arthritis is damage to the joint cartilage. Cartilage damage and erosion inside the joint capsule leads to irritation of raw nerve endings and this is what causes the joint pain of arthritis. There are some surgical treatments, particularly those involving arthroscopic surgery that can really make a big difference for the right patient, and in the right circumstances. Do keep in mind, however, that surgery is not a cure-all. Surgical methods must almost always be combined with medical management and weight loss for success.
Obesity is definitely associated with the development of arthritis in humans and weight management is an important part of the management of osteoarthritis in people. One study of humans found that overweight people were about three and a half times more likely to develop arthritis than light people. Our hunch is that these same patterns probably hold true for dogs and cats as well.
It just makes sense; if the internal structure is weakened, then overloading it with excess weight is just going increase the likelihood of failure. So let’s start by taking a little weight off our arthritic pets. Lets try to keep them on the slim side of normal. Obviously this will need to be done in close coordination with your veterinarian. Rapid weight loss is no better for a dog or cat than it is for a person.
The Chastain Veterinary Medical Group offers nutritional joint supplements, prescription pain medications, cold laser / LLLT therapy, and for those who really need it, we can facilitate surgical correction of some cases.
Our veterinarians would be happy to help you decide which drug, or combination of drugs, and therapies are most appropriate, safe and effective for your pet – all while keeping in mind the family’s insights and preferences.
Text reviewed for accuracy by Clint Chastain, DVM January 22, 2015.