We all want our pets to live long happy lives. Unfortunately, the majority of pets suffer from arthritic changes that cause them chronic pain by the time they are seniors. Fortunately, there have been many advances in the treatment and prevention of arthritis. But this means it can be confusing to navigate options. Generally, the best approach is what is called multimodal (combining several medications or therapies) to help with pain relief in multiple ways. Below is a brief overview of current therapies.
PRP (Platelet Rich Plasma)
PRP is a relatively new therapy that has come out of human medicine. The patient’s blood is collected and the red and white cells are removed, allowing the plasma and platelets to be concentrated and injected back into a damaged joint. These have growth and healing factors that help repair the damage that is occurring in the joint. This therapy has the potential to reduce or eliminate the need for NSAIDs in some patients long-term.
Cold Laser Therapy
Laser Therapy reduces inflammation in joints and soft tissues which dramatically reduces pain. More importantly, though, is that laser therapy is “biostimulatory”. This means it actually aids in repairing the damaged tissues and therefore improves strength and provides greater mobility. Most importantly, there are no side effects! Treatments last 3 to 8 minutes per site and require no anesthesia. Your pet will be very comfortable as this laser produces only a soothing warmth in the inflamed tissue. Laser Therapy for chronic conditions can require 5 or 6 treatments initially to get your pet to a very comfortable situation. Booster treatments are then required every 3 to 4 weeks to maintain reduced pain and improved mobility. This therapy may very well reduce the need for additional pain medication.
Weight loss and physical therapy
Weight loss and physical therapy are important factors in maintaining and prolonging joint health. Fat has pro-inflammatory factors that worsen arthritis. Excessive weight also contributes to joint wear-and-tear. Keeping joints moving is an important part of producing healthy joint fluid and maintaining muscle mass which will keep joints functioning.
Many products are available that help repair damaged cartilage and have some anti-inflammatory effects. Some of the most well-known are glucosamine and chondroitin. However, there are also many other nutraceuticals that have been found to hold additional benefits to the joints, many of which are already combined at appropriate amounts in joint supplements. Recommended joint supplements include Dasuquin Advanced, Phycox Max, and Cosequin. These products generally take at least 4-6 weeks to produce any noticeable changes, but they are well tolerated and have few side effects. They are also considered most beneficial when started early.
A mainstay of arthritis therapy for many years has been NSAIDs. They provide fast relief of arthritis pain and help reduce inflammation in the joint. These should only be given on the advice of a veterinarian and should not be combined with other NSAIDs or steroids. They can have undesired side effects like stomach upset and liver or kidney damage in some patients. Due to these side effects, human NSAIDs like aspirin and ibuprofen are NOT SAFE for dogs and cats.
When NSAIDs don’t seem to control pain enough drugs such as gabapentin, codeine and amantadine are sometimes added. These drugs will help control pain, but don’t help treat the underlying disease. These are generally not our first-line treatment, because they can occasionally cause sedation or altered mental states, but if the pain is severe, or a patient can’t tolerate NSAIDs, they can be helpful.
Adequan is an injectable drug that helps increase joint lubrication, stimulate cartilage repair, and inhibit enzymes that cause joint cartilage destruction. The drug seems to target damaged joints specifically. These injections work best when administered twice weekly for 4 weeks, and then on an as-needed basis, generally every 4-12 weeks.