Mountain View Animal Hospital

Mountain View Animal Hospital

129 Main Street, Essex Junction, VT 05452

(802)-879-6311

www.vtvet.com

Medications for the Treatment of Degenerative Arthritis

Degenerative joint disease is the number one cause of chronic pain in the dog and cat. The condition is the result of both long-term instability and stress on a joint due to previous injury, or simply an old-age change and natural development of arthritis. Most cases cannot be treated surgically and we are left with medical management. Our goals are three-fold: (1) Reduce the chronic pain and make your pet feel more comfortable, (2) give your pet a better quality of life as they get older, and (3) slow the progression of further joint damage. Numerous products are available. The following is a summary of your therapeutic options:

ASPIRIN

Aspirin is a “non-steroidal anti-inflammatory drug”, or NSAID. It is somewhat effective in relieving pain due to inflammation, such as an arthritic joint. Its advantages are that it is readily available and inexpensive. The disadvantage to using aspirin is that in some animals it is simply not strong enough and they remain uncomfortable due to their arthritis. Another side effect is that aspirin (and any NSAID to a certain degree) rarely can cause gastrointestinal ulcers and intestinal bleeding. If you use Aspirin for your dog’s arthritis, always be on the lookout for dark/tarry looking stools or vomiting (especially if it looks like coffee grounds or bright red blood). If you see any of this, discontinue the aspirin and call your veterinarian. Aspirin also decreases the body’s ability to produce a blood clot and thus can promote bleeding during surgery or after trauma.

·  Never guess the dose of aspirin for your pet. Always consult your veterinarian before instituting therapy.

The dose for your dog is ______tablet by mouth once or twice daily.

·  Cats metabolize aspirin VERY slowly and require a very low dose. They should therefore only receive it a maximum of twice a week.

·  If you use aspirin for your pet, always use an “enteric coated” or “buffered” brand. This eases the digestion and decreases the potential for stomach upset. We recommend using either Bufferin or Ascriptin.

RIMADYL – ETOGESIC - DERAMAXX

These medications are also NSAIDs. They were developed specifically for use in dogs and are an improvement upon aspirin and other NSAIDs for which side effects have been problematic. The incidence of GI upset and ulcers are significantly reduced by using these medications instead of aspirin. They are designed for indefinite use in dogs with minimal side effects and are significantly stronger pain relievers than aspirin. Rimadyl is given twice daily and Deramaxx and Etogesic are given once daily. Typically a trial period of about a month is prescribed to see if the effect is worth continuing. As with people, some individuals respond better to different NSAIDs. If the effect is good and your dog is comfortable again, then the medication can be continued.

·  Although rare, approximately one dog in 5000 will have a serious liver reaction to Rimadyl. Labrador retrievers are at increased risk for this reaction. Animals with historical elevations in liver enzymes, pre-existing liver disease, Cushing’s disease, or Phenobarbital use should probably not use this medication. (We generally use Etogesic/Deramaxx in these cases)

·  Unfortunately, none of these medications can be used in the cat.

GLUCOSAMINE AND CHONDROITIN SULFATE

Cartilage is made up of glucosamine and chondroitin sulfate. Most commercial supplements are harvested primarily from sea mollusks. By taking these products orally, the patient is able to have plenty of the necessary “building blocks” needed to repair damaged cartilage. It is also felt that these products may have some anti-inflammatory properties as well. Unlike NSAIDs, these products do not produce rapid results. One to two months of use is required for them to build up adequate amounts in the joint.

·  These substances are classified as “nutriceuticals” rather than “drugs” and are therefore available over the counter. We generally recommend buying in bulk at either Wal-Mart or Costco.

·  These products can be used in both dogs and cats and often complement treatment with NSAIDs.

MSM (Methylsulfonylmethane)

Sulfur is a crucial component of both plants and animals. The body synthesizes MSM from compounds which are normally found in unprocessed foods but are lost in processing and storage. Supplementing with MSM provides additional sulfur to help meet the body’s daily needs. MSM can help form bonds that hold together tiny strands of connective tissue. It helps to support healing and can reduce inflammation around wounds. Collagen is an important part of the tough, fibrous material in cartilage and MSM may provide nutritional support for collagen production to repair cartilage damaged by arthritis, in addition to its nutritional support for inflammation and pain. The dose is 0.5 mg/lb and is generally enough to replace the amount of MSM which is missing in a processed food diet.

** You can buy a human product called “Triple Flex” at Costco which has in it all three supplements (glucosamine, chondroitin and MSM). Cost is about $29 for a 250ct bottle. Dosage is 1 tablet twice daily. **

OMEGA FATTY ACIDS

The use of Omega Fatty Acids is a nutritional approach to helping many inflammatory diseases including arthritis. They work by modulating the immune response to that there is less inflammation. The role that they play in treating arthritis is to convert PGE2 (prostaglandin) to less inflammatory PGE1 or PGE3, thereby reducing inflammation and joint stiffness. Further research needs to be done to determine which type and which combinations are the most effective. The two most commonly used fatty acids are fish oil or flaxseed oil. Response to fatty acid supplementation could take weeks to months, so it is important to maintain a constant dosage of the supplement for at least 2 months.

ADEQUAN INJECTIONS

Adequan is a “polysulfated glycosaminoglycan” (PSGAG) and is a component of cartilage, similar to glucosamine/chondroitin. Instead of coming from sea mollusks, it is harvested from the windpipe of cattle. Adequan has numerous beneficial effects for the arthritic patient, including the inhibition of harmful enzymes involved in joint cartilage destruction, stimulation of cartilage repair, anti-inflammatory effects, and increasing joint fluid and lubrication. It is given as an injection and so is able to reach all joints, but it seems to have an affinity for damaged joints.

·  The typical schedule of injections would be one injection every 4 days for 6 injections and then as needed. The cost is $35 per injection. To save you money, we are happy to teach you how to give the injections and can sell you a bottle of Adequan instead of having you pay per injection.

·  Adequan should be avoided in patients with blood clotting abnormalities as a matter of caution. (At excessive doses tested in normal patients, abnormal clotting developed, so it is best not to take any chances with an abnormal patient.)

Weight control is as important as any of the above-mentioned medications, and probably more so. Having to carry around any extra weight at all is hard on your pet’s joints. Commit yourself to helping your pet lose any excess weight to aid in their therapy. Ask us to help you formulate a weight loss plan for your pet. We are happy to calculate out exactly how much food you should feed them per day to attain weight loss. Proper exercise is excellent physical therapy for the arthritic patient as it is crucial to maintain proper muscle tone to support the abnormal joint. So don’t forget to exercise them!