Arthritis is an inflammation of the joints of the body. Typically seen in older dogs, it can become debilitating and significantly reduce a dog's mobility. Sometimes this can even lead to a dog avoiding going outside and a break in housetraining habits. Hip dysplasia often leads to degenerative joint disease and we will see old large breed dogs becoming crippled in their late years. Pain management is the primary treatment as there is no "cure" except joint replacement surgery.
Some of the therapeutics used in veterinary medicine for arthritis are nutritional supplements, injectable non-steroidals and joint fluid enhancers, oral non-steroidal drugs and catabolic steroids.
Nutritional Supplements:
These work on the theory that increasing some of
the chemical components of joint fluid will prevent cartilage deterioration
and may be anti-inflammatory, thereby reducing pain. Clinical impressions
support their effectiveness but they are best used early in the course
of arthritis, before significant cartilage destruction has occurred.
At Oakland Veterinary Hospital we use Glycoflex, an extract of geen-lipped
mussels that has a high concentration of glycosominoglycans and are chewable
tablets that dogs seem to like. We have also used Glycoflex in cats.
Injectables:
Adequan is an injectable medication that is purported
to enhance joint fluid viscosity and reduce inflammation. First developed
for use in race horses, it was tested in dogs to see if, when injected
into muscle, would it "find" its way to joints. Studies showed that
it did this in the dog model and then use in clinical applications for
dogs was begun. Usually monthly injections are required.
Non-steroidals:
The most common is aspirin. Given with
food to reduce irritation to the stomach, aspirin is safe for most dogs.
Problems with increased bleeding can occur as aspirin affects platelet
activity. We have seen serious bleeding problems and ulceration in
some dogs that were either susceptible or had other medical problems such
as Cushings Syndrome. Aspirin in cats is sometimes used but cats
cannot metabolize aspirin readily and therefore usage is restricted to
every 48 hours. TYLENOL IS NOT ASPIRIN AND WILL KILL CATS!!!
Newer non-steroidal drugs have been developed for
use in dogs with a reduced effect on the protective prostaglandins in the
stomach. Carpofen, marketed in the U.S. as Rimadyl, is a drug that
has been in use for many years, initially in Europe and now cleared for
use in the U.S. It is much more potent than aspirin and therefore
more effective at relieving pain associated with joints and sometimes with
spinal problems. There are some cautions with the drug as some dogs
have had liver problems and very rare reports of an autoimmune reaction,
Sweet's Syndrome.
Another less extensively used drug is Etogesic.
These newer non-steroidal drugs are not to be used
in cats. Cats do not possess the proper enzymes in their livers to
detoxify the drugs and thereforeserious side effects can occur. Very
short term usage of these drugs are used with careful monitoring in cats.
Steroids:
The steroid used for inflammation is prednisone.
It is extremely effective but has significant side effects which limits
its use in our hospital as a drug of last resort. Prednisone relieves
the pain of inflammation by interfering with the body's imflammatory process.
This eventually can lead to increased cartiliage destruction. Prolonged
use of prednisone in dogs can also result in Cushing's Syndrome and immunosuppression.
In cats, prednisone is used much more chronically without the significant
side effects.