Arthritis, also referred to a Degenerative Joint Disease, is one of the most common causes of chronic pain in dogs and cats.  It can affect almost any joint but is commonly found in the elbows, neck, back, knees and hips on both cats and dogs, especially as they age.   Some studies have shown that the majority of cats over 8 years of age have some arthritis present.   Signs of pain from arthritis can be subtle, often beginning with pets that are less than enthusiastic about climbing up or down steps, jumping into the car or onto their favorite piece of furniture.  They may be less interested in walks or quit earlier during play time.

I tell my clients that there are three main areas to focus on in order to help their pet get the best response to other therapies and to help slow the progression of arthritic changes.

1.  Achieve or maintain an ideal body weight and condition
2. Maintain appropriate activity level to keep joints and tissues mobile and sustain suitable muscle mass.
3. Feed a properly balanced diet that includes supplements with a focus on promoting lean body weight while providing a source of high quality protein, antioxidants, a therapeutic level of Omega 3 fatty acids as well as a source of glycosaminoglycans.

Without an emphasis on the above three factors, the results of any additional therapy will often be less than optimal.    For obese pets, weight reduction may have the most significant effect on chronic pain by reducing the level of inflammation as well as reducing the weight that each individual joint needs to support.

My Top 10 Recommendations for an Integrative Approach to Arthritis

1. Start with a clear expectation of what will likely be required including the importance of diet, exercise and appropriate supplementation.
2. Provide immediate pain relief to allow your pet to become more mobile so that appropriate activity can be maintained.  This may include acupuncture, laser therapy, initial short term use of anti-inflammatory drugs (called NSAIDs), or any combination of these or other therapies.
3. Herbal and homeopathic therapies can be individually tailored to each pet’s needs where appropriate.
4. Pharmaceutical drugs have a valuable role they can play when used appropriately.  NSAIDs (“aspirin” type drugs) should be used for the shortest required duration or when necessary maintained at the lowest dose needed.   At least twice yearly blood screening, particularly for kidney and liver function, should be monitored for animals on long term NSAIDs.  Narcotic and other adjunct pharmaceuticals such as Tramadol (a narcotic) and Gabapentin (used for chronic pain wind-up) can help improve overall response and reduce the require dose of NSAIDs.
5. Therapeutic Laser can offer a convenient and cost effective means for long term pain management as most sessions can be performed by a veterinary technician in less than 20 minutes.
6. Acupuncture can provide significant benefits for many pets and can be coupled with Laser Therapy for an even greater overall effect in some patients.
7. Chiropractic Therapy can significantly improve mobility and help manage pain in many patients.
8. Biotherapeutic, homeopathic drugs such as Traumeel® and Zeel® have good scientific evidence to support their use in veterinary patients.  Some patients may respond as well or in some cases better to these than conventional NSAIDs, particularly when administered by injections, IV, SQ, IM or into specific acupuncture points.
9. Injectable Disease Modifying Drugs such as Adequan® or Cosequin® (that help preserve the cartilage within the joints) can provide additional long term benefits and have a sparing effect on the need for NSAIDs or other pharmaceuticals.
10. The importance of daily activity/exercise cannot be overemphasised.  For those pets with more pronounce mobility issues, muscle wasting or neurologic deficits, rehabilitative therapies such as underwater treadmill, supported swimming, massage therapy or Chinese tui-na is recommended.

Stem Cell Therapy is a relatively new treatment that can provide long term relief for some pets with arthritis and may be even more effective when administered in the early stages of the disease.  After a short surgery is performed to collect fat tissue (usually from the abdomen), this tissue is sent to a laboratory where the stem cells are isolated.  These stem cells are then injection directly into the affected joints as well as given intravenously while the pet is under sedation.

Most pets will do best with a combination of some of the recommendations listed above as a single medication or supplement in and of itself may not be enough.  If you pet is suffering from arthritic pain, I recommend you schedule an assessment with one of our veterinarian to discuss the best options for your pet.

Rob Butler DVM, CVA, CVCH, CVFT