Supplementation: Countless joint supplements are available to promote healthy cartilage and joint health. These contain varying combinations of glucosamine, chondroitin, MSM, green-lipped mussel and other chondroprotective substances. Many veterinarians and owners have found that a small number of these products seem to be helpful. We don’t yet know whether beginning supplementation at a young age benefi ts every dog. This decision is best made with your veterinarian, taking into consideration factors such as diet and genetics/conformation (e.g., has a dog been diagnosed early on with hip or other joint abnormalities?). The anti-inflammatory effects of omega-3 fatty acids (EPA, DHA) have also been documented to be of help in dogs with arthritis. These are included in some canine arthritis diets, but to be effective, higher levels via separate supplements may be needed.
Exercise: Maintaining mobility through reasonable exercise is important regardless of a dog’s age and the extent of her arthritis. (I’m convinced that what kept a certain red Dober-gal of mine going to 15-plus was her daily quarter-mile walk down the driveway, albeit at her own pace.) A dog with mild, early arthritis can and should get more exercise than an ancient pooch with severe cartilage erosion. Non-weight–bearing exercise— swimming, for example—is excellent if not contraindicated by other medical conditions. Look for a Certifi ed Canine Rehabilitation Practitioner (CCRP) for help with designing an appropriate exercise program. (Visit canineequinerehab. com/practitioners.asp to see if there’s one in your area.)
Complementar y therapy: Many arthritic dogs can be made more comfortable and more mobile by acupuncture. Alternative veterinary practitioners sometimes prescribe formulations of Chinese herbs to support the benefi ts of acupuncture. (Click on “Find an Acupuncturist” at aava.org.)
Laser: Class IV therapeutic laser is a newer form of treatment that stimulates blood f low to tissues and can greatly improve arthritic conditions.
Pharmaceuticals: When it comes to drugs, there are several options. Adequan injections have long been considered the gold standard for treating arthritis and other degenerative joint diseases in dogs. A potent chondroprotective agent, Adequan (polysulfated glycosaminoglycan, or PSGAG) provides the body with the building blocks of cartilage it needs to assist in repairing its own tissues. Unfortunately, it is often not employed because the initial treatment consists of six injections over three weeks, and it is somewhat expensive. However, rarely have I seen an arthritis patient it did not help, and in my own senior dogs, I get clear reminders if I forget one of their maintenance injections (every three to six weeks, depending on the dog). Adequan is largely without side effects; the main reported side effect is the potential for increased bleeding, but in 20 years of use in dozens of patients (including von Willebrand disease-affected dogs), I have never encountered this problem.
We can add an analgesic such as tramadol, a synthetic opioid. While not an anti-inflammatory, tramadol is a fairly potent pain medication, as well as being inexpensive and reasonably safe. Sedation and constipation are possible side effects, but in my experience, dogs tolerate tramadol wonderfully within the proper dose range. Gabapentin and amantadine also target the nervous system, altering the transmission and strength of pain signals.
We can elect to try a steroid for its anti-inflammatory effect. The caveat with steroids, of course, is that over time, they have a “breakdown” effect on body tissues, including joints. Also, if used for any length of time, they may contribute to the development of diabetes, medically caused Cushing’s disease, liver inflammation, immune suppression or other problems. In order to prevent gastric erosion or ulceration, vets will often prescribe medications such as histamine blockers (famotidine, cimetidine), proton-pump inhibitors (omeprazole) or gastrointestinal protectants (sucralfate). If ulcer symptoms develop, steroids should be discontinued. All this having been said, many ancient dogs with advanced arthritis can get four to eight weeks of benefit from a long-lasting steroid injection.