Controlling your dog or cat's arthritis pain

2 Comments | Oakland Tribune, Jun 4, 2006

DEAR Dr. Utchen:

"I think my cat has arthritis. She is 13 years old and just takes tiny steps with her front legs, and acts stiff. She also hesitates to jump down. Is this arthritis? Is there anything I can do for her?"

Yes. Most likely you are describing arthritis. Arthritis in older cats is common in their elbows, and they move as you describe. Arthritis is common in dogs as well, although in dogs the problem can happen in all the major joints.

And, yes, there are a number of things that can be done for arthritis and pain in general. In fact, virtually anything that can be done for humans in pain has a counterpart in veterinary medicine.

First, for arthritis or other causes of pain, anti-inflammatory painkiller medications can be used. These block pain and inflammation in the body.

For cats, a medication called "Metacam" is often used by veterinarians, although the drug has only been approved by the FDA for use as a one-time injection in cats. However, it comes formulated as a liquid that can be given to cats by mouth and so far appears safe and effective for cats as a painkiller.

Generally as little as one drop of Metacam given every other day is effective for pain control in cats.

For dogs there are a variety of medications like this. Collectively, this new class of medications is referred to as "COX- 2 Inhibitors. We have been using this type of medication in dogs for almost a decade now, with excellent results. These drugs (Rimadyl, Deramaxx, Metacam, and Zuprin) are far safer for dogs than over-the- counter medications like aspirin and ibuprofen, and their efficacy can return many if not most dogs with arthritis to excellent mobility.

Second, compounds called "Glucosamine" and "Chondroitin" can be given to help with arthritis pain. To understand the use of these medications, a brief explanation of normal joint anatomy is necessary.

Inside a joint wherever two bones contact each other, the ends of the bones are coated with a smooth layer of cartilage. This is the shock-absorbing surface that makes normal movement of the joints smooth and comfortable.

However, if the cartilage begins wearing out and becoming rough due to injury, infection, age or because the joint never fit perfectly to begin with (this is called "dysplasia), movement of the joint becomes painful.

This is referred to as "Osteoarthritis" although many doctors simply refer to it by the colloquialism "arthritis."

Glucosamine and chondroitin are the building blocks for new cartilage.

When taken daily, over time these compounds insert themselves into the damaged cartilage coating inside the joints, thereby restoring more smooth functioning and better shock absorption to the joint.

Because the way glucosamine and chondroitin work to help an arthritic joint is by continually inserting themselves into damaged areas of the cartilage, these must be given daily to avoid the deterioration of the cartilage once again into the painful state of arthritis.

As opposed to the anti-inflammatory painkillers mentioned above, which are often used on an as-needed basis with people and pets, glucosamine and chondroitin products should be given every day. It may take 1 to 2 months to see benefits after supplementation with these products has begun.

In dogs, the glucosamine product I routinely recommend is "Synovi- G3" chews.

In cats, Cosequin sprinkles work well and are easy to administer.

One caveat: as these compounds are not regulated by the FDA, there is no assurance that over-the-counter products actually contain the amount of glucosamine and chondroitin stated on the label. Always purchase glucosamine from a reliable source, and use a product with a reliable track record.

And, of course, in all cases where you are administering medication to your pet, please call your veterinary office for recommendations or warnings.

Third, in addition to anti-inflammatory painkillers and glucosamine/chondroitin products, there are a number of other painkiller medications used for different reasons.

For example, a potent morphine-like drug called "Fentanyl" can be given to dogs and cats using a transdermal patch. What's that, you ask? Same thing as a nicotine patch, but with a painkiller in it instead of nicotine.

This is commonly used as a means of pain control for the first few days after surgery.

Other methods of pain control, ranging from local anesthetics all the way to epidural injections that effectively numb the back half of a pet's body, are used at our office.

For pets that are critically injured and require 24-hour pain control, several painkilling medications can be administered as continuous IV drips.

By adjusting the rate at which the IV is administered, we can easily increase or decrease the amount of medication delivered to a pet.

In veterinary practice we have to be proactive about controlling pain in our patients (yes, we call the dogs and cats patients!). They can't tell us when they're in pain, and generally their response to pain is to become quiet and motionless, rather than to announce it as people do.