Medications for arthritis pain
Although some pets can be kept comfortable without using traditional pain medication, many pets with arthritis need medications to keep them comfortable. Here is a brief discussion of the different pain medications that we may recommend using in your pet.
Non-steroidal Anti-inflammatory Drugs (NSAIDs)
NSAIDs are the mainstay of treatment for arthritis pain. NSAIDs block enzymes within your pet that are responsible for creating inflammation. Blocking these enzymes results in decreased inflammation and pain. There are currently 6 approved NSAIDs for use in dogs. The ones we use commonly are Metacam® (meloxicam), Deramaxx® (deracoxib), and Previcox® (firocoxib). Prior to starting your pet on an NSAID, we recommend bloodwork to establish baseline liver and kidney values. Bloodwork is then repeated 2 weeks later, and every 6 months thereafter. The most common side effect of NSAIDs is gastrointestinal upset. NSAIDs should never be given with prednisone or over the counter pain relievers. Many human OTC pain relievers are toxic to pets.
Tramadol is an opioid-like medication that is used in the treatment of arthritis pain. It is used 2 to 4 times per day. It is safe to use with other medications, and is often used in combination with an NSAID. Sedation is the most common side effect that is reported.
Amantadine is an anti-viral medication that is also useful in the treatment of “wind up” pain. “Wind up” occurs when there is chronic pain present. The receptors are then hyperactive, causing exacerbation of the pain response even in mild pain. Amantadine resets these receptors, allowing the other medications and supplements to achieve greater pain relief. Amantadine is used in pets that have been in chronic pain, or very severe acute pain.
Gabapentin was originally used as an anticonvulsant medication. We do not currently know its mechanism of action, but it has been used for neuropathic pain (pain related to damaged nerves) with good results. Clinical experience among veterinarians suggests that it is effective for arthritis pain as well.