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Add a paragraph introducing yourself or your subject. Include any material
you'd like to help create a webpage that is unique to you. Degenerative joint disease is the number one cause of chronic
pain in the dog and cat. The condition itself is the result of
long term stresses and instability of a joint either as a result
of old injury or of natural development of the joint in that
individual. While surgery may be able to help in some
situations, most of the time the degeneration of the joint
cannot be reversed and treatment focuses on preventing
progression of damage. Numerous products are available on the
market; some are best combined with others and some cannot be
combined. The following is a summary of options:
ASPIRIN
Aspirin is a non-steroidal anti-inflammatory drug or NSAID. It
is effective in relieving pain due to inflammation as is
occurring within the arthritic joint. It has the advantage of
being readily available and inexpensive. It also has a
relatively fast onset of action (other medications require at
least one month of use to build up adequate levels in the
joint). In some animals, however, it is simply not strong enough
or it causes unpleasant side effects such as upset stomach or
even intestinal bleeding. Aspirin also deactivates platelets
(the blood cell responsible for clotting) and thus can promote
bleeding should surgery or trauma occur.
* Cats metabolize aspirin extremely slowly and require a very
low dose and a typical dosing schedule of twice a week usage.
Dogs can use aspirin up to three times daily. * Because this
medication is available in almost every pet-owning household,
there may be a temptation to guess a dose based on the human
dose. Do not be tempted to do this. Do not use aspirin or any
other medication in your pet without veterinary guidance. *
Enteric coating of aspirin has become popular in human products.
This coating is a problem in animals and creates unpredictable
absorption. This becomes dangerous when enteric coated aspirin
tablets do not digest in the stomach and instead collect in the
stomach until a toxic dose is reached. To avoid this disaster,
use either aspirin made specifically for pets or aspirin with a
powdery covering rather than the "hard candy" type enteric
coating.
RIMADYL AND ETOGESIC
These medications are also NSAIDs. They were developed as an
improvement upon aspirin and other NSAIDs developed for humans
for which side effects have been problematic in animals. Rimadyl
and Etogesic are both designed for indefinite use in dogs with
minimal side effect potential. Rimadyl is given twice daily and
Etogesic is given once daily.
Typically a short trial of one of these is prescribed to see if
the effect is worth continuing; as with people, some individuals
respond better to different NSAIDs. If the effect is good, then
the medication can be continued. Some blood testing is
recommended prior to long term use and every 6 months thereafter.
* Approximately one dog in 5000 will have a serious liver
reaction to Rimadyl. Animals with histories of elevated liver
enzymes, pre-existing liver disease, Cushing's disease, or
phenobarbital use should probably not take this medication. *
Neither of these medications should be used in cats.
GLUCOSAMINE AND CHONDROITIN SULFATE
These products are cartilage components harvested chiefly from
sea mollusks (i.e., cartilage is made up of glucosamine and
chondroitin sulfate). By taking these components orally, the
patient is able to have plenty of the necessary building blocks
needed to repair damaged cartilage. It is also felt that these
products may have some anti-inflammatory properties separate
from their structural uses. Unlike NSAIDs, these products do not
produce rapid results; one to two months are needed for them to
build up to adequate amounts. There are numerous products
available combining glucosamine, chondroitin sulfate, assorted
vitamins, creatine (a muscle building block), omega 3 fatty
acids, and more.
* Because these substances are classified by the FDA as
nutriceuticals (i.e., nutrients with medicinal properties)
rather than as drugs. The usual rigorous testing for efficacy
has not been required. As a result, the optimal dosage has not
been determined and almost every product has a different dose
recommendation. Some experimentation may be necessary. * These
products are not likely to be helpful for spinal arthritis as
the joint composition of an intervertebral disc (the joint of
the spine) is totally different from those of other bones. *
These products can be used in both dogs and cats. * These
products often complement treatment with NSAIDs.
ADEQUAN® INJECTIONS Adequan
Adequan® is a polysulfated glycosaminoglycan, which is also a
cartilage component but instead of coming from sea mollusks,
adequan is derived from the windpipe cartilage of cattle.
Adequan has
numerous beneficial effects for the arthritis
patient including the inhibition of harmful enzymes involving
joint cartilage destruction, stimulation of cartilage repair,
and increasing joint lubrication.
* Adequan is given as an injection and so is able to reach all
joints but it seems to have a special affinity for damaged
joints. * Adequan should be avoided in patients with blood
clotting abnormalities as a matter of caution. (At excessive
doses tested in normal patients, abnormal clotting resulted so
it is best not to take a chance in an abnormal patient.) *
Adequan is best given as a series of injections, twice a week or
so until a response is seen but not exceeding eight injections.
After an effect is seen, Adequan injections are given on an as
needed basis. * Adequan is formally approved for use in dogs and
horses but may also be used in cats with good results. * Adequan
may be combined with NSAIDs and with glucosamine and chondroitin
sulfate.
OMEGA 3 FATTY ACIDS
Certain fats have been found to have anti-inflammatory
properties. While this finding has primarily been utilized in
the treatment of itchy skin, many arthritic dogs and cats have
also benefited from supplementation. While there are no toxic
issues to be concerned with, these products require at least one
month to build up to adequate amounts. Effects are not usually
dramatic but can be helpful.
* Omega 3 fatty acids can be used in dogs and cats. * Omega 3
fatty acids can be combined with any of the above treatments.
MSM MSM 250
MSM stands for methyl sulfonyl methane and represents another
nutriceutical anti-inflammatory agent. MSM is present in most
plant and animal tissues and is a natural source of sulfur;
however, for commercial sale MSM is derived from DMSO
(dimethylsulfoxide), a solvent that comes in both medical grade
or industrial grade. Because it is a nutriceutical and thus not
required by the FDA to be subjected to tests of safety or
efficacy, its effectiveness is still up in the air. There is a
tremendous human market for this product, thus little motivation
for manufacturers to finance expensive testing of this nature.
* MSM can be used in dogs and cats. * MSM can be combined with
any of the above products.
SUPEROXIDE DISMUTASE (SOD) Comfort Tabs
The usual veterinary product for SOD is called Comfort Tabs.
(There is also an injectable product called palosein.) This
product is what is called an anti-oxidant, or free radical
scavenger. Free radicals are molecule fragments that are
unstable due to the presence of an electron that should be
matched with electron as a pair. The free radical will attract
electrons from other molecules thus creating biochemical chain
reactions as free radical molecules steal electrons from one
another. This transfer of electrons, called oxidation, is very
damaging to cells and can increase the risk of cancer. The
inflammatory activity in an arthritic joint is one of many
sources of free radicals in the body. The body has natural
anti-oxidants to curtail free radical activity but there is a
great deal of thought that taking these agents as medication
could be helpful in an assortment of situations (from slowing
the aging process to the prevention of cancer). While proof is
somewhat lacking, SOD does not appear to be harmful and should
be able to combine with any of the other products listed above.
PREDNISONE AND OTHER STEROIDS
Predisone This discussion would not be complete without mention
of the steroid class of drugs. These agents are strong
anti-inflammatory agents but with chronic use, can lead to
suppression of the immune system, excessive weight gain, and
impaired cartilage healing. These are considered a last resort
in most cases. See more information on prednisone.
Proper exercise is excellent physical therapy for the arthritic
pet as it is crucial to maintain as much muscle mass as possible
to support the abnormal joint. Massage and gentle
flexion/extension of the joint may also help. Remember,
treatment for joint disease is likely to involve a combination
of medications in addition to physical activities.
The above is general veterinary information. Do not begin
any course of treatment without consulting your regular
veterinarian. All animals should be examined at least once every
12 months.
About the author:
Copyright 2002 - 2006 by the Veterinary Information Network,
Inc. All rights reserved.
Linda Mar Veterinary Hospital and its cat-only affiliate,
Coastal Cat Clinic, are small animal practices located in
Pacifica, California. To find a veterinarian or to learn more
about the vet clinic and our staff,
visit:[http://lindamarvet.com/]
Written by: Wendy C. Brooks, DVM, DipABVP
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