Management of Pain and Arthritis in Older Pets
Jonit Barsky, DVM, CCRT- Vermont Integrative Veterinary Associates, Waterbury Center, VT
“Buffy won’t do the stairs anymore.” “Fred can’t jump onto the counter to get to his food bowl.” “I have to help Oscar get into the car.” None of us enjoy witnessing the signs that our pets are getting older and not able to do things that once came easily. With advances in modern medicine, dogs and cats are living longer, but with that longevity comes arthritis and other chronic pain disorders. Osteoarthritis is the most common cause of chronic pain in our older pets, and is thought to involve around 20% of the canine population and around 10% of the feline population.
As our pets get older, the cartilage that lines the surfaces of their joints begins to deteriorate. When cells die, they release enzymes that cause inflammation of the joint capsule and production of excessive joint fluid. Extra bony spurs (osteophytes) develop, the joint space narrows, and the bones themselves begin to change, adding to the pain and lameness. Many of these changes may be seen on X-rays. This discomfort will lead to reduced usage of the limb and overall inactivity, which causes muscle atrophy.
Unfortunately, when less motion occurs at the joint, the more degeneration and pain will occur, creating a self-perpetuating cycle of disuse, stiffness, weakness, and pain. The most effective way to combat the cycle of osteoarthritis is to target the pain. Less pain leads to more mobility and comfort, which then slows the progression of the disease.
Conformation (body shape, symmetry, and composition) can play a major role in the development of degenerative joint disease in younger animals. Responsible breeding and the use of Orthopedic Foundation for Animals (OFA) certification to evaluate joints of prospective breeding animals are critical in minimizing the risk of hip and elbow dysplasia, which leads to arthritis. Secondly, feeding a high-quality diet throughout life and maintaining optimal lean body weight are also crucial. If your cat or dog is overweight, a healthy weight reduction plan is often the MOST important step you can take to increase joint comfort and prevent further disease.
The best results are achieved by working with your veterinarian to develop a customized plan to target your pet’s specific issues. An integrative, multimodal therapy regime can maximize your pets comfort and minimize side effects. Many of the most useful pain management techniques are based in non-pharmaceutical methods.Not only can use of non-pharmacologic techniques help to manage pain, but they can also allow lower doses of traditional medications to be used, which is safer on the pet’s body (and your wallet) in the long term.
Around the house: Provide well-padded bedding away from drafty areas. Carpeted steps or ramps to get on and off of furniture can help. Ramps can also be used outside instead of steps. Nonskid flooring (yoga mats are easily cleanable and movable) wherever surfaces are slippery is also very helpful.
Massage: Many arthritic pets appreciate massages, which stimulate blood flow to atrophying muscles. Certified veterinary massage therapists are available in most areas of the country; many are willing to demonstrate techniques to owners. Warm compresses over sore joints can also be soothing, but always test the temperature first to avoid injury to your pet’s delicate skin.
Supplementation: Countless joint supplements are available to promote healthy cartilage and joint health. These contain varying combinations of glucosamine, chondroitin, MSM, green-lipped mussel, omega-3 fatty acids, and other cartilage boosting substances.
Exercise: Maintaining mobility with reasonable exercise is important regardless of a pet’s age and the extent of the arthritis. Non-weight–bearing exercise— swimming, for example—can be an excellent tool. Look for a Certified Canine Rehabilitation Practitioner or Therapist (CCRP or CCRT) for help with designing an appropriate exercise program.
Complementary therapies: Many arthritic pets can be made more comfortable and more mobile by acupuncture. It is important to note however, that the response to acupuncture is not as immediate as the response to drugs. We recommend three weekly sessions before assessing the response.
Laser: The therapeutic laser is a newer form of treatment that stimulates blood flow to tissues and can greatly improve arthritic conditions.
Pharmaceuticals: When it comes to drugs, there are several options. Adequan (polysulfated glycosaminoglycan) injections are considered the gold standard for treating arthritis and other degenerative joint diseases in dogs and cats. This compound provides the body with the building blocks of cartilage that it needs to assist in repairing its own tissues. Pain medications like Tramadol, Gabapentin, and Amantadine are very effective drugs at targeting the nervous system, altering the transmission and strength of pain signals, especially in the cases of nerve pain.
If none of the above provides sufficient relief, one of the veterinary NSAIDs (non-steroidal anti-inflammatory drugs) can also be effective. While these drugs are highly effective at reducing inflammation and pain, the potential side effects are numerous; and can be unpredictable and severe.
With these tools, we can support fit, structurally sound pets through their golden years. We can work towards long and comfortable lives for our beloved companions even in the face of chronic joint disease; getting Buffy to walk up the stairs, Fred jumping back onto the counter, and Oscar jumping into the car again.
Jonit Barsky, DVM, CCRT, a graduate of Tufts Cummings School of Veterinary Medicine has a special interest in surgery, sports medicine, and pain management. She is certified in canine rehabilitation therapy and pursuing advanced training in acupuncture. She enjoys kayaking, hiking, and winter sports with her husband and two Alaskan Malamutes; Kanu and Kayak.