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My Dog has Arthritis! Now What?


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Slide presentation discusses the management of lamenessand chronic pain in dogs.

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My Dog has Arthritis! Now What?

  1. 1.  Now What?By Jacquelyn H. Burns, DVMCopyright © Jacquelyn H. BurnsAll rights reserved
  2. 2. Please, visit your vet.That’s what they’re there for.
  3. 3.  When we veterinarians say osteoarthritis or arthritis, we mean Degenerative Joint Disease or DJD ◦ In dogs and cats, degenerative joint disease means bone, muscle, tendon, ligament and/or joint changes have occurred as a result of joint instability or structural unsoundness ◦ The body attempts to rectify instability by forming extra bone at/around affected joints. ◦ There is also inflammation with a snowball effect that tends to make itself worse over time.
  4. 4.  Injury ◦ Blunt force trauma (hit by car) ◦ Athletic type injury (―football player‖ injury)  Torn ACL ligaments Heredity ◦ Hip dysplasia ◦ Patellar luxation ◦ Elbow dysplasia Acquired/Developmental/Other ◦ OCD (osteochondritis dessicans) ◦ Angular limb deformity
  5. 5.  The results are the same ◦ Chronic pain ◦ Chronic lameness
  6. 6.  Animals are usually rather stoic and do not always show outward signs of pain Many never cry out. ◦ In a pack atmosphere, showing outward signs of pain shows weakness and vulnerability Dogs tend to ―Keep calm and carry on.‖ ―If it didn’t hurt, he wouldn’t be holding his foot up.‖ Dr. Burns
  7. 7.  There are only two reasons why a patient might limp ◦ PAIN ◦ Structural instability  Bones or ligaments that support the musculoskeletal system are broken or torn
  8. 8. Gosh darn, this hurts. How am I going to tell Unusual or different the big posture people? Decreased appetite Decreased play Decreased interactiveness Becoming withdrawn Sleeping a lot more than usual Irritability/snappy
  9. 9.  Structural instabilityWhat is this here thing you call  PAIN inflammation?  Inflammation
  10. 10. InflammationMore pain Pain More inflammation
  11. 11.  NSAIDS= Non-  Cons steroidal anti- ◦ Pets must have healthy inflammatories kidneys and livers to take these medicines Pros ◦ All senior pets (and ◦ Contain no cortisone some non-senior) must ◦ Very decent painkillers undergo regular blood for all types of general testing in order to use pain NSAIDS ◦ Block the ◦ Sometimes cause GI inflammation-pain- upset more inflammation – ◦ Cannot be used with more pain cycle corticosteroids (cortisone, prednisone)
  12. 12.  Pros  Cons ◦ Non-drowsy opiate- ◦ Short half-life means like pain killer dosing three times a ◦ Very safe, including day for best results senior dogs and cats ◦ VERY BAD TASTING ◦ Blood work not  Owners who depend on necessary for food or treats for prescribing these concealment of pills may find that pets refuse ◦ Can be used at the them or eat around the same time as tramadol corticosteroids (cortisone, prednisone)
  13. 13.  Nutraceuticals are food supplements that promote healthy joints Nutraceuticals are not all created equal. In other words, a cheap one may not work as well as a higher end one. Generally in a pleasant flavored chewie. Most are given once daily. Note, these are not medicine and do not kill pain. These are vitamins for joint health Ingredients vary but usually include glucosamine, chondroitin, fish oil
  14. 14.  Gabapentin is a  Cons seizure drug but ◦ Gabapentin is used in cases of formatted for human chronic pain has use, so sometimes we have to get it proven very helpful made to order in in pain that is special smaller mg refractory to other tablets or drugs suspensions for very Convenient one to small dogs and cats two times a day dosing
  15. 15.  Adequan is a  Cons chondroprotectant ◦ Expense (cartilage protector) ◦ Necessitates bringing Give by injection pet for injection every week for a Once weekly for month four weeks, then every three to four weeks as maintenance
  16. 16.  Acupuncture Cold Therapy Laser Physical therapy or rehabilitation ◦ Underwater treadmill Wonder where I can find somebody to do that to me?
  17. 17. Holistic medicine? Might as well go out in the pasture Holistic and pull a ―medicines.‖ handful of Recently the weeds for him.AVMA hasmade a positionstatement thatholistic medicinesare not proven tobe safe andeffective
  18. 18.  NSAIDS – carprofen (Rimadyl/Novox, meloxicam (Metacam), Previcox, Deramaxx Tramadol Joint Supplements (yummy Phycox soft chews are Dr. Burns’ favorite) Gabapentin Adequan Physical Therapy Acupuncture Cold Therapy Laser
  19. 19. Man, I’m dying There have never been here. What is satisfactory safe wrong with the pharmaceutical options for home pain industry? management—either long term or short term—in cats! While we have a few things now that we didn’t have five or six years ago, we still have needs that are unfilled.
  20. 20.  Nutraceuticals Meloxicam  Cons are many! Onsior ◦ Meloxicam is often used in cats, but it is not FDA- Gabapentin approved for long term use in Tramadol the USA. ◦ Meloxicam requires very healthy kidneys and a good hydration status. Even so, it still can cause kidney failure in some cats ◦ Onsior is only FDA-approved for 3 consecutive days in the USA ◦ Gabapentin and Tramadol have to be compounded (made to order) and are not FDA-approved for cats in the USA
  21. 21. Like I always say, better living through chemistry! To make the pet have the best mobility and quality of life that he/she can have To make good days outnumber bad days
  22. 22.  Chronic pain is not curable; it is a management condition It is not reasonable to expect your pet with DJD never to limp Your pet may not be able to do the same amount of exercise or play that he/she once did Like people, there will be good days and bad
  23. 23. • People with DJD and chronic pain often use mobility devices such as walking canes, walkers and wheelchairs. Unfortunately, most dogs cannot use these. Wonder where I can get a walking cane?
  24. 24. • People with chronic pain have I’m so some days where they are blessed to have Rascal nearly normal and walk/move to love! pretty well with a cane or walker, some days where they really feel good…and some days when they don’t feel like getting out of bed.• Your dog is I’m so glad I can still runthe same. and play! And that she loves me!!!!
  25. 25. Material is not intended tobe construed as veterinary medical advice and notintended to be a substitutefor examination, diagnosis and treatment of your pet by your veterinarian. Please, visit your vet. That’s what they’re there for.