Medications and Supplements for Dogs with Arthritis
Nonsteroidal Anti-Inflammatory Drugs
These are anti-inflammatory medications, but they do not repair or heal cartilage. Ideally, they would be used along with supplements and given with food. These do provide rapid relief from pain.
A few NSAIDs have chondroprotective characteristics, which means they protect against the breakdown of cartilage. Others, such as aspirin, actually destroy cartilage in the dosage required for pain relief. This is one reason why aspirin is used less frequently for treating osteoarthritis.
The NSAIDs most often recommended are prescription medications. Newer medications have been developed that offer significant advantages over aspirin and the older NSAIDs. Rimadyl (carprofen) is an excellent drug with a low incidence of gastrointestinal side effects that has proven itself over time. It must be given daily. Rimadyl provides good pain relief and seems to slow the arthritic process. There are no detrimental effects on cartilage. Labrador Retrievers, and possibly a few other breeds, may show a higher predisposition for liver toxicity with Rimadyl. Etogesic (etodolac) is another newer NSAID. It requires only one dose a day. This drug may prove as effective as Rimadyl. These drugs are available through your veterinarian by prescription. Note that many over-the-counter NSAIDs used for pain control in people are dangerous when given to dogs. Do not use any drugs without veterinary approval, and never use more than one NSAID at the same time.
Due to potential serious side effects, dogs on these drugs should have blood work first to assess liver and kidneys. The drugs may prolong bleeding times and interfere with clotting, and have the potential to cause life-threatening liver and kidney problems and gastrointestinal ulcerations. Nausea and vomiting may be the first indication of trouble. Blood work should be rechecked every six months, or sooner if there are problems. These drugs should not be combined or given with steroids.
The most common side effect is GI bleeding. This can be difficult to diagnose and quite extensive before signs become apparent. Misoprostol (Cytotec) is a drug that prevents ulceration and helps heal ulcers caused by NSAIDs. Sulcrafate (Carafate) is another drug that protects against mucosal damage. Your veterinarian may prescribe one of these stomach protectants if your dog is taking an NSAID for chronic arthritis.
Oral glucocorticoids (corticosteroids) are used for their anti-inflammatory effects. Low dosages appear to protect cartilage, while high dosages (those needed to relieve pain) destroy cartilage. Future formulations may have better protective effects and a wider margin of safety.
Unfortunately, dogs are unusually sensitive to the adverse effects of both the NSAIDs and glucocorticoids. Glucocorticoids are best used for short periods in dogs with osteoarthritis who have failed to respond to NSAIDs. Long-term therapy should be reserved for dogs with immune-mediated arthritis.
Steroids are regarded as highly dangerous medications with many side effects. These can range from interfering with cartilage repair to causing increased drinking and eating (with the associated increased elimination). Long-term use can lead to liver and adrenal problems. Still, steroids can provide quick relief for many conditions, and for immune problems they may be the drug of choice. They should not be combined with any of the NSAIDs.
These compounds appear to modify the progression of osteoarthritis by preventing further breakdown of cartilage. Breakdown of cartilage is the first step in the development of degenerative joint disease. Chondroprotectants are most effective when used early in the course of osteoarthritis.
Adequan (a polysulfated glycosaminoglycan similar to glucosamine) is a chondroprotective given by intramuscular injection twice a week for four or more weeks. It can be used as a preventive in dogs who are at high risk of developing degenerative joint disease, such as those with hip dysplasia.
Other chondroprotective agents are nutraceuticals-products that lie somewhere between a nutrient and a drug. Nutraceuticals are believed to have medical value based on subjective evidence of their effectiveness, although clinical evidence based on controlled studies is lacking for many of these. Unlike drugs, nutraceuticals do not undergo an approval process and are not regulated by a federal agency. Numerous controlled studies in humans, limited studies done on dogs, and canine anecdotal reports suggest these substances do have medical value for arthritic dogs.
Most nutraceuticals used to treat osteoarthritis contain glucosamine, polysulfated glycosaminoglycans, and chondroitin sulfates-compounds known to be involved in the synthesis and repair of joint cartilage. Examples include Cosequin and Glycoflex. These compounds are given orally and can be considered as follow-up therapy after Adequan, or in any condition in which joint damage is anticipated or expected, such as trauma, surgery, degenerative joint disease, or immune-mediated arthritis.
Chondroprotectives may be given along with an NSAID. The combination reduces pain and alleviates joint inflammation. The chondroprotectants can also be used to help prevent the development of osteoarthritis. There are now some prescription diets that include chondroprotectants in their formulation. Always check with your veterinarian before adding any supplements to avoid adverse interactions with medications your dog may be on.
This article is excerpted from “Dog Owner's Home Veterinary Handbook” with permission from Wiley Publishing, Inc
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