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How we can help our aging furry friends
How we can help our aging furry friends Osteoarthritis affects one of every five adult dogs. It is more difficult to give a number for cats because they hide their pain reactions well.

Have you noticed your canine companion experiencing more difficulty in rising? Is your feline friend less inclined to jump onto high ledges? If so, your pet may be suffering from osteoarthritis, or OA, just as we people do. Osteoarthritis affects one of every five adult dogs. It is more difficult to give a number for cats because they hide their pain reactions well, but it is assumed more prevalent than previously thought. Other symptoms that may indicate your pet has OA include limping or abnormal movement, decreased flexibility, loss of appetite, atypical aggression, reclusive behavior, obvious pain, inactivity, hesitancy to play/jump, or decreased grooming.

Fortunately, there have been many advances in the management of OA and the chronic pain that comes with it. Today, the treatment for OA usually involves multimodal therapy, which is the use of multiple treatments at the same time in an attempt to mitigate pain at several levels. The mainstay treatment for chronic pain is non-steroidal anti-inflammatory drugs (NSAIDs). However, other types of therapy that may be used are other pharmaceuticals, nutraceuticals, EPA-rich diets, physical rehabilitation, weight loss, and life-style changes. It is important to remember that chronic pain is an individual issue, and the treatment methods that work for your friendís pet may very well not work for your own. Therefore, treatment plans must be tailored to meet the individual needs of the patient. Several trial periods of different regimens may be required to see which works best for your pet. It is also important to remember that OA is a progressive disease that will most likely require changes in therapy as your pet ages.

Physical rehabilitation is as important for our pets as it is for us in the battle against OA. Many veterinarians/technicians are becoming certified in this area. Some goals of rehab are to rebuild lost muscle mass, increase range of motion/ flexibility, and improve balance. Controlled leash walking, water treadmills, obstacle courses, heat/cold therapy, and passive range of motion exercises are just a few examples of what is involved with rehabilitation. You can do many of these exercises with your pet at home.
In this article, it is assumed your veterinarian has already diagnosed your pet with OA; therefore, only treatment options will be discussed. As mentioned above, Non-steroidal anti-inflammatory drugs (NSAIDs) have been the mainstay treatment for OA, and they are typically the first medications that are tried. NSAIDs are very good at treating the inflammatory component of OA, which causes much of the pain. There are several prescription brands on the market for your dog. Cats, however, are severely limited with their choices of NSAIDS due to their unique physiology. Donít get discouraged if the NSAID your pet is on does not seem to help. As with people, one NSAID may work great in one patient and not in the next, so your pet may need to try different NSAIDs to achieve the desired results. However, do not switch medications without speaking with your veterinarian first. Many people and pets take NSAIDs with few problems, but there are some serious side effects of which one should be aware. These include but are not limited to, gastrointestinal (GI) ulceration, vomiting/diarrhea, kidney disease and liver toxicity (dose-dependent or idiosyncratic). GI side effects are the most prevalent, with kidney disease and liver toxicity the second and third respectively. It is important to have screening blood work done before starting any long-term NSAID use to check for any underlying organ disease. The blood is usually rechecked after a couple of weeks of therapy and then periodically after that to ensure no adverse affects from the NSAID have developed. It is important to stop NSAID use and notify your veterinarian if your pet has any vomiting, diarrhea, or dark, tarry stools. In addition, DO NOT give aspirin (which is an NSAID) or any other human pain medications concurrently with your petís medication because it can cause life-threatening illness for your pet.

Other pharmaceuticals that may be used for OA are tramadol, amantadine, gabapentin and polysulfated glycosaminoglycans. Tramadol is a synthetic opiate, which is used commonly in veterinary medicine for both acute and chronic pain. It appears to have few side effects and is generally well tolerated. It can be used in both cats and dogs. It is generally best used in conjunction with an NSAID as part of a multimodal protocol. However, there are patients whose OA is controlled well on tramadol alone, and it may be one of the few options for those patients who cannot take an NSAID. One downside is its bitter tasteÖand giving distasteful medications to cats is especially problematic.

Thankfully, we now have more options to provide our cherished kitty and pampered pooch relief from the pain that comes from OA.
Amantidine is an antiviral drug that has been shown to give relief to some pain syndromes. For OA in cats and dogs, it is usually reserved for situations where NSAIDs no longer seem to be effective at controlling the pain or when ďwind-upĒ may be occurring. Wind-up is a condition where the spinal cord becomes hypersensitive to pain signals and thus amplifies the pain sensation the patient feels. Amantadine helps reduce wind-up in patients and is typically used in conjunction with an NSAID for OA.

Gabapentin is an anti-seizure medication that has also been effective in treating some types of pain, specifically, neuropathic pain or pain arising from the nervous system. If your veterinarian suspects there may be a neuropathic component to your dog or catís OA, he/she may add gabapentin to the regimen. The main side effect is sedation and it must be withdrawn gradually after prolonged use to avoid rebound hyperalgesia, a heightened sense of pain. Polyslfated glycosaminoglycans (PSGAG) have anti-inflammatory effects, help restore joint fluid, inhibit destruction of cartilage, and promote synthesis of cartilage, which are all needed for a healthy joint. It is an injectable medication that is started on a once or twice weekly basis and then gradually tapered down to an as-needed basis. It has been used in both dogs and cats for non-infectious arthritis. It should not be administered to animals with hypersensitivity to the drug and those with bleeding disorders.

Nutraceuticals are non-FDA regulated dietary ingredients with various claims for the use in OA. Examples of these include Glucosamine, Chondroitin, MSM, Avocado/soybean unsaponifiables (ASUís), green-lipped mussel, Cetyl myristoleate, hyperimmune milk, phytochemicals, plant extracts, and various vitamins. There is much debate on the efficacy of these products, but there are some that have shown promise. It is beyond the scope of this discussion to talk in-depth on each one. Because these are unregulated products and their purity/composition are extremely variable, it would be advisable to purchase these products only from reputable companies .

EPA-rich diets are a fairly recent development. The n-3 fatty acids in these diets provide some anti-inflammatory effects for the joint, thus helping to alleviate pain. Currently, these are only available for dogs; however, cats could be supplemented with salmon or some other type fish oil. Note that there are very high levels of n-3 fatty acids in these diets, so it takes many fish oil capsules to match the levels in the food. There are dogs with OA that have responded very well to these diets.

Lastly, letís discuss life-style changes. One of the foremost issues to address is weight loss if your pet is overweight. As with people, weight loss in an overweight pet with OA can drastically decrease or even discontinue the need for medications. Your veterinarian can help devise a weight loss plan for your pet and prescribe weight loss medications (dogs only) if necessary. For those pets having difficulty jumping, ramps or steps can be built for easier access. You can elevate the food and water bowls for big dogs or those with neck pain. Throw rugs and mats can be placed on slippery tile and wood floors for improved traction. A pet with OA may also appreciate a heated bed for those achy bones to rest upon. Lastly, donít forget exercise. Stick with less stressful activities such as controlled leash walks and swimming (if an option). There are interactive activities you can do with your cat also. Controlled exercise is important because it helps keep body weight regulated and improves overall joint function and mobility.

Our pets are living longer than ever and with that longevity comes an increased risk of developing osteoarthritis. Thankfully, we now have more options to provide our cherished kitty and pampered pooch relief from the pain that comes from OA. With a few changes in their home environment, we can also provide them with a better quality of life.

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"How we can help our aging furry friends"
   authored by:
VETERINARY SCIENCE
Susan Nelson, DVM is an Assistant Professor in the Department of Clinical Sciences at the College of Veterinary Medicine-Veterinary Medical Teaching Hospital of Kansas State University. In 1985, Dr. Nelson received her BA of Biology from Hastings Col...



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