Canine Osteoarthritis Treatment

Last time we discussed osteoarthritis and its prevalence in older dogs. The good news is that there are many different approaches to treatment from traditional medication options to non-pharmacology options. Arthritis is a common and life limiting disease for many pets but now with all the options available, the story can be changed. It is important to identify arthritis in the early stages when management and therapies are most effective, adding many good quality years to your dog’s life.

Often the foundation of any arthritis management plan must focus on weight loss. Approximately 60% of all dogs are obese and keeping dogs at a leaner body weight can help to reduce both the development and severity of osteoarthritis (2). Exercise also maintains muscle mass, improves joint function, and reduces inflammation, providing many benefits in addition to weight loss. Low impact exercise such as underwater treadmill therapy, range of motion exercises performed at home, and therapist guided canine rehabilitation are some of the forms available. Weight loss and exercise can be used before or in conjunction with other therapies. A multimodal approach or using multiple therapies is often recommended to provide the best results and overall improvement in quality of life.

The most common and probably most familiar medication to most pet owners when discussing treatment for osteoarthritis are the anti-inflammatory options. Steroids (Prednisone) have been around for decades and were frequently used for soft tissue injuries, orthopedic disease, and arthritis pain. There has been a general shift away from steroids due to development of veterinary non-steroidal anti-inflammatories (NSAIDs) which have less side effects and are more commonly preferred. NSAIDs work by inhibiting enzymes that stop the release of prostaglandins, the cause of chronic inflammation associated with arthritis. This both reduces pain and is shown to slow the progression of arthritis. NSAIDs do have potential gastrointestinal side effects such as vomiting and diarrhea, although rare. It is important to ensure any pet on long term NSAID use is monitored through a veterinarian. Regular bloodwork once to twice a year is advised to monitor liver and kidney function. While NSAIDs do have side effects, the benefits in management of osteoarthritis can be significant. Often an additional pain medication such as Gabapentin is added with an NSAID to provide greater pain management.

Other therapies that can be provided by your veterinarian are injectable options. Adequan is a PSGAG or polysulfated glycosaminoglycan compound and is given on a preset schedule. It is approved by the FDA and works by inhibiting enzymes that degrade joint cartilage, slowing down or preventing the degeneration of joint and bone (1). Once arthritis advances, it is not possible to reverse the changes which is why it is most effective to start therapies like Adequan in the early stages of arthritis. There are also newer therapies which are showing promise including monoclonal antibody injections that target specific proteins that cause pain.

Nutraceuticals are over the counter supplements such as glucosamine, MSM, etc. Nutraceuticals are not as heavily regulated as human products, but veterinary supplement companies still are required to abide by FDA regulations that ensure good manufacturing practices as well as quality control. There are many joint supplements available and ongoing studies are constantly looking at the effectiveness of common ingredients, but results are limited and variable. It is important to use companies that are not only abiding by the FDA guidelines but also invest in research to produce high quality products. Joint supplements can provide many benefits to support joint health and are often included to support other therapies.

The last category are the non-pharmacology options. These include therapeutic laser which aids in pain relief, PEMF or pulsed electromagnetic therapy which stimulates healing in both bone and soft tissue, and acupuncture. All three look to add benefit by reducing pain and inflammation which are the common targets in the majority of arthritis treatments with acupuncture being well documented to provide both short and long term pain relief in orthopedic disease. Effectiveness and results can vary due to differences in equipment, experience/training of the person administering the therapy, frequency of the sessions etc.

Every pet is different, just like humans, and finding the right combination of these therapies may take a little work. Response will vary based on the individual animal, stage of osteoarthritis, and compliance amongst other factors. It is important to discuss any and all options with your established veterinarian to ensure that they are appropriate for your pet and to help monitor the response so that adjustments can be made. Remember, early intervention is key and something as simple as adding in a joint supplement before arthritis develops may provide significant benefit. 

Dr. Shannon Stephenson