In this post, I wanted to look at the most common arthritis treatments prescribed by veterinarians. Even though I prefer holistic treatments, there is a time and a place for pharmaceuticals. I wrote this article because I think some pet owners may be interested in a holistic veterinarian’s thoughts and experience with these commonly prescribed medications and treatments.
If an animal is suffering, or in a lot of pain, it is sometimes appropriate to try a pharmaceutical medication.
The interesting thing I have found, however, is that just like with herbs, pharmaceuticals don’t work every single time.
I have had patients in extreme pain/ anxiety, who didn’t respond to any pharmaceuticals but immediately responded to a Chinese herb or a flower essence.
In the same way, some animals that aren’t responding to herbs may respond to a pharmaceutical.
For me, they are just another tool in the kit, although due to their higher risk of side effects, I tend to use them sparingly and only when necessary.
1) NSAIDs (Nonsteroidal Anti-inflammatories)
This is probably the most common pharmaceutical treatment prescribed by veterinarians for arthritis.
Medicines that fall into this category include:
-Carprofen (Rimadyl, Novox)
These medicines are the equivalent of doggy Advil (Do NOT give Advil, Tylenol or other human pain medicines to dogs. They can be highly toxic to animals). These medicines listed above were created as safer alternatives to human anti-inflammatories for pets.
NSAIDs tend to work pretty well to control pain and decrease inflammation in the short-term. Once animals are on them for a long time, however, their positive effects tend to plateau or wear off. I like to limit using these medications to short-term or as needed situations.
NSAIDs can be taxing for the kidneys, liver and digestive tract. There are many safer and equally effective alternatives available for arthritis management. In the same way that a person should not take Advil every day, it is likely not healthy for our pets to take these medicines every day.
The one exception to this rule is for end-of-life and hospice situations. When an animal is declining and our goals are more about keeping our pet comfortable rather than extending the health of their organs, than these medicines are great options.
This is an opioid medicine that is very commonly prescribed for pain in dogs.
Tramadol works by blocking the transmission and perception of pain. It doesn’t take away inflammation or help in healing, but it can make an animal more comfortable.
It is generally safe for both the liver and the kidneys, and rarely causes any digestive upset. Because it is a mild sedative and works on the brain, it can make a dog loopy, anxious, or seem disoriented. The bitter taste of Tramadol is difficult to conceal in food, and not all dogs will eat it.
My opinion: I don’t consider Tramadol a particularly effective or strong medicine for arthritis. There was one study I read that found that only 30% of dogs had any improvement in their arthritis symptoms after taking Tramadol, and I would agree with this statistic. It is uncommon to have a pet owner tell me that they saw a huge improvement in their pet’s energy or mobility after taking Tramadol.
This is a medicine that is also prescribed for people. People say that it works pretty well, so it may work better in people than in animals.
It does seem to help, however, with post-operative pain for animals that have undergone surgery. The mild sedative effect can be useful for these patients as well, keeping them from moving around too much after surgery.
Since it is fairly well tolerated in animals, and safe to use long-term, I do prescribe it in certain situations. I don’t see many long-term negative side effects associated with this medicine. The animals that don’t tolerate it or respond to it well, tend to have immediate negative effects (be more loopy or anxious).
Gabapentin is similar to Tramadol, in that it blocks the sensation of pain. It does not have anti-inflammatory benefits. It is still a relatively newer medicine in the veterinary community (unlike Tramadol), and so may not be a first choice for many veterinarians. So far, however, it seems to have a pretty good margin of safety. Side effects are similar to those seen with Tramadol.
My opinion: I don’t have a lot of experience with this medicine, but the animals I have seen on it, have done pretty well. It might have a slightly stronger pain blocking ability than Tramadol.
There was a recent lecture I attended on CBDs, where the researchers described that they are seeing a synergistic effect of CBDs when given with Gabapentin. What that means is that the two treatments worked better together than each did by themselves for pain. This may become an interesting treatment in the future when the legal issues surrounding CBDs change.
Adequan is a polysulfated glycosaminoglycan (try saying that one ten times fast), that is given as an injection to horses, dogs and sometimes (off-label) to cats.
Glycosaminoglycans, or GAGs, make up part of the cartilage in joints. Cartilage breaking down is part of what creates pain in arthritis. These injected GAGs are said to be taken up by the cartilage and prevent enzyme degradation of the joints.
My opinion: Adequan is safe and a relatively natural treatment option. I like that part.
I’ll be honest that I don’t use Adequan that often, so take my opinion with a grain of salt. It is relatively expensive and requires frequent injections initially. In the animals that I have used it in, I have seen slight improvements in mobility. There are other options that I personally prefer more as first line treatments for arthritis (because they are either cheaper or more effective), but I like having it as an option in the tool kit.
5) Glucosamine Chondroitin
Glucosamine is probably one of the most widely used supplements for arthritis and joint therapy. It is a precursor to glucosaminoglycans (GAGs), which are found predominantly in the joint cartilage. It is believed that by supplementing more of this precursor, the body is able to better maintain and preserve the joints.
It is often combined with another nutraceutical called Chondroitin.
My opinion: While studies in both animals and humans show mixed results with glucosamine, I have seen good results in my own pets and some patients. Studies have shown that glucosamine works the best in mild to moderate cases of arthritis.
Both of my personal dogs responded well to it. When I accidentally ran out of the supplement and stopped giving it to my dogs for a few days, I noticed a significant difference. I have talked to pet owners that have seen the same in their own dogs. For severe arthritis, it tends to be less effective.
This is a supplement where the brand you buy matters. Some dogs did not respond at all to human brand OTC glucosamine, but responded much better to Dasiquin or Cosequin. I am not sure why this is the case, but could have something to do with better absorption in the veterinary brands.
Glucosamine itself comes from various sources, including in some cases, shell fish. Some dogs can have a shell fish allergy and will develop diarrhea when taking this supplement. If this is the case, you can substitute for a non-shellfish variety to see if your pet responds to it better.
Talk to your veterinarian if you are interested in any of these treatments!
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