A: There are almost as many answers to this question as there are pets with osteoarthritis. The best strategy is usually to employ a multi-modal protocol. In other words, combining multiple therapeutic options often produces the best results. This column will discuss available therapies in broad terms, but it is very important to consult with your pet’s veterinarian before attempting any treatment.
The foundation of arthritis therapy should always be targeted nutrition. A lean body condition will help slow the progression of arthritis and will reduce the burden on already inflamed joints. High levels of certain omega-3 fatty acids, in certain ratios with omega-6 fatty acids, have been shown to reduce inflammation in joints nearly as effectively as prescription medications. This is not as simple as throwing a fish oil capsule into your pet’s food bowl, so please consult with a knowledgeable veterinarian about the role of nutrition in managing joint inflammation.
Another popular early treatment option includes nutritional supplements. This is an area where pet owners should be very cautious. There is nearly no regulation of these products and many are simply ineffective. For example, perna mussel extracts are only effective if they contain the carbohydrate-fraction of the mussel. If the extract is not obtained within minutes of harvesting the mussel, all that is left is an expensive low-dose fish oil. Similarly, pets require low molecular weight chondroitin for the compound to ever make it to the joints. A low-quality product will simply end up passing straight through your pet into the yard or litter pan. Again, a candid discussion with your veterinarian should be the basis of selecting any supplement for your pet.
There are injectable non-drug treatment options for modifying the joint environment. Commercially available polysulfonated glycosaminoglycans (PSGAGs) have been used for decades. More recently, treatments have been developed that use substances harvested from a pet’s own body that are then injected into joints. Examples include platelet-rich plasma and stem cell therapies.
There are also physical therapies available to help pets with joint inflammation. Rehabilitation therapy involves a series of exercises and activities that build and strengthen muscles around problem joints. This mode of therapy also works to improve flexibility and balance. Other physical forms of therapy include therapeutic lasers, pulsed ultrasound, or acupuncture. These physical therapies all require a knowledgeable therapist, appropriate equipment, and repeated treatments.
Another important part of managing joint pain and inflammation is the use of prescription medications. Although we try to minimize their use by employing all of the previous therapies mentioned here, drug therapy is essential for successful arthritis management in many pets. If pain is not adequately controlled, pets will shift weight away from affected joints, which accelerates muscle loss and contributes to even more pain.
For dogs, the base medication is usually a non-steroidal anti-inflammatory drug (NSAID). These medications are both safe and effective, but must be monitored carefully for potential side effects. Just like in people, some pets seem to respond to a particular brand of NSAID better than others. Also, each of these drugs has slightly different ways that they work and side effects that they can cause. These medications are sold only by prescription for important reasons. Please follow your veterinarian’s instructions carefully, especially regarding follow-up monitoring. Since NSAIDs are not as well-tolerated in cats, it is especially important to stay in close communication with your veterinarian if one is prescribed for your feline friend.
Other medications are also available to reduce pain and/or inflammation in joints. These include opiods, gabapentin, local analgesics, and even steroids. Some are given by mouth, by injection, or even in topical forms. There are also ongoing studies looking into the usefulness of cannabinoids in reducing arthritis pain.
By combining multiple medications, physical therapies, supplements, and even injections, it is nearly always possible to improve the quality of life for pets with osteoarthritis. However, the best results will always come with early intervention and with regular consultations with your veterinarian.