Osteoarthritis: How to deal with chronic pain
Chronic pain due to osteoarthritis is a very common problem in many of our older patients. Hip dysplasia, cruciate ligament ruptures and patella luxations are common genetic and traumatic disorders that lead to joint instability. Over time, cartilage is degraded and pain and inflammation will occur. Signs of arthritis include: slowing down, difficulty with stairs, pain upon rising, stiffness after resting, and resistance to being touched in certain areas. Osteoarthritis is a progressive condition and often will wax and wane, with flare-ups becoming more common with time. Arthritis is very treatable and our approach often involves multiple modalities from environmental management to drug therapy to nutritional applications.
One of the most important and often the most difficult part of treating osteoarthritis is keeping the pet lean. Obesity is a huge problem for these patients, taxing the joints, decreasing mobility and preventing moderate exercise to keep muscles in condition. Weight reduction diets are imperative if the pet is overweight. We can help design a weight loss plan for your pet.
Environmental modification can really help many pets maintain a good quality of life in their home. Limiting the amount of stairs, using ramps, providing good footing with rugs and rough textured surfaces, offering comfortable orthopedic bedding and elevating food and water bowls are all common sense adaptations that will help. A good website to check out is www.handicappedpets.com.
Dietary management of arthritis involves providing joint supplements or diets such as J/d to provide building blocks for cartilage. Cosequin, a glucosamine and chondrotin sulfate nutraceutical, has been shown to help repair cartilage and improve mobility in many patients. J/d diet has very high levels of Omega-3 fatty acids as well as glucosamine to help prevent cartilage degradation. J/d is also limited in calories to help with weight control.
Drug therapy is a mainstay of arthritis treatment. We utilize non-steroidal anti-inflammatory drugs (NSAIDs) such as Vetprofen and Metacam for relief of pain and inflammation. Most dogs will tolerate these well. It is important to screen for metabolic diseases that involve the liver and kidneys prior to starting drug therapy to be sure there are no existing problems that will complicate treatment. The most common side effects of these drugs are vomiting or diarrhea and stomach ulceration. Continued blood monitoring will ensure the safety of long-term drug therapy. Other drugs such as gabapentin used in combination with NSAIDs can be very effective in relieving pain.
Other options for treatment include Adequan (a cartilage protecting drug) given by injection twice weekly and tapering to monthly administration, acupuncture, physical therapy and underwater treadmill work-outs. These treatments are individualized for each patient depending on the level of pain.
Chronic pain is “the gift that keeps on giving”. We can help you keep your pet as comfortable as possible despite the ongoing disease processes.