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

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

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

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.

PAIN PAIN GO AWAY!!!

Osteoarthritis is the most common cause of pain in older pets.  Most pets do not show outright signs of pain; rather, their pain is more subtle.  If your pet is slow to rise or cannot go up and down stairs as easily as he used to then he is likely in pain.  If he is limping, he is in pain.  Other signs of osteoarthritis pain can include decreased activity, stiffness after exercising, withdrawal from family members, and aggression and pain when touched.

Several options are available for treating arthritis pain in our pets.  Our goal of treatment is to keep pets comfortable and pain free.  The first thing that must be done for arthritic pets is weight loss if they are overweight or obese.  Many pets will be much more comfortable simply by losing a few pounds.  This can be accomplished by reducing caloric intake by limiting treats and table scraps, as well as using a prescription diet designed to help lose weight.  If you have any questions regarding these diets, do not hesitate to contact our office.

Next, all pets that are prone to developing arthritis should be on a glucosamine supplement.  These often include chondroitin and/or MSM as well as manganese.  These products have been shown to protect cartilage and decrease inflammation within the joints.  Studies have shown that they are more effective when used as a preventative than as a treatment, but they can help in our pets that already have arthritis as well.  Any large breed dog should be started on a glucosamine supplement by one year of age.

Another option for arthritis pain is a non-steroidal anti-inflammatory drug (NSAID).  NSAIDs reduce pain and inflammation. There are currently six veterinary approved products that can be used in dogs.  Over the counter products, including aspirin, ibuprofen, acetaminophen, etc. should not be used unless specifically directed by your veterinarian.  One study showed that aspirin causes GI bleeding in dogs 100% of the time.  These over the counter medications, especially aspirin, should never be given to cats.  While on these medications, it is important to monitor for side effects as well as performing routine lab work to monitor liver and kidney function.  

Adequan^® is another product available that can significantly help arthritic pets.  Adequan^® is an injectable product that will help decrease inflammation and lubricate the joints, as well as protecting the cartilage.  More information about Adequan^® can be found here.

Other important treatment modalities for arthritis pain are physical therapy and fatty acids.  Physical therapy will help strengthen the muscles to help support the painful joints.  Physical therapy can also help increase the range of motion of these joints.  High levels of fatty acids have also been proven to help decrease inflammation within joints.  Hill’s Prescription Diet^® j/d^® is formulated to help protect our dogs’ joints.  More information about this diet can be found here.  We have seen excellent results with this diet.

A few newer treatments are available or will be available soon, including stem cell therapy, pulsed electro-magnetic field therapy, and laser therapy.  Acupuncture has been proven to help decrease pain. There are also a few other drugs that are available to use for pain as well.  For more information on how we can work together to help your pet with his pain, please contact us and we can discuss options for treatment.

The best treatment often involves a combination of modalities mentioned above.  As members of the International Veterinary Academy of Pain Management, our goal at Olathe Animal Hospital is to keep your pet pain free so he can be as happy and as healthy as possible.