Pain can often go unnoticed in our pets, especially our older cats and dogs. Almost every day, I hear a client say, “He’s just slowing down with age.” Remember, age is NOT a disease. The “slowing down” is likely due to a problem, often arthritis. Arthritis, or osteoarthritis, is inflammation of a joint. Degenerative joint disease (DJD) forms when there is chronic inflammation that damages joint cartilage and results in pathologic, irregular bony growths (OUCH!).
I see many older dogs (and cats) with DJD. In fact, up to 90% of cats in all age groups have some degree of DJD. Younger animals can develop DJD after severe trauma. In general, signs of pain in dogs and cats include the following (from the International Veterinary Academy of Pain Management):
Common Signs of Pain in Dogs
- Decreased social interaction
- Anxious expression
- Submissive behavior
- Refusal to move
- Whimpering
- Howling
- Growling
- Guarding behavior
- Aggression/biting
- Decreased appetite
- Self-mutilation/chewing
- Changes in posture
Common Signs of Pain in Cats
- Reduced activity
- Loss of appetite
- Quiet/loss of curiosity
- Changes in urinary/defecation habits
- Hiding
- Hissing or spitting
- Lack of agility/jumping
- Excessive licking/grooming
- Stiff posture/gait
- Guarding behavior
- Stops grooming/matted fur
- Tail flicking
- Weight loss
The most common complaints that I hear are that that a dog is slow to rise or reluctant to jump into the car, and a cat is defecating (or urinating) outside the litter box for the first time ever. If you feel your dog or cat is in pain, the first step is to schedule a physical exam. Routine blood work may be necessary to rule out other illnesses. X-rays will definitively diagnose DJD. There is a vast array of options for pets with DJD, but each pet’s situation is unique. Together we will formulate a plan works best for both you and your pet. Here are some of my typical protocols for dogs and cats:
ADEQUAN® injections—this medication helps to “cushion” painful joints. I recommend clients try Adequan first because it’s very safe and effective. The downside is that this would require injections INTO THE MUSCLE given twice weekly to start, then weekly, then every 2–4 weeks as needed. I have one client whose dog with bad hips benefits from weekly shots (because he just hates taking oral pain medications).
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)—Metacam (meloxicam), Rimadyl (carprofen), Onisor (used in cats), etc. And there is a NEW drug called Galliprant, which is reportedly 10–15X safer than an NSAID. This is like humans taking Aleve…you need to give these every day. Occasional dosing is simply NOT effective.
A second daily pain medication is often indicated. I like amantadine for dogs and tramadol for cats. Tramadol is often prescribed for dogs, but it simply does NOT work well in dogs…any positive affect you may see is likely due to the serotonin-like affect it produces. Other medications I use include gabapentin, amitriptyline, and oxycodone (in severe cases). The truth is all pets are individuals, and you don’t know for sure what’s going to work well until you try.
Glucosamine-Chondroitin supplements can be tricky! There are so (too) many products out there to choose from. Products like Dasuquin® and Cosequin® are reliable and contain low molecular weight chondroitin, which is critical to proper metabolism.
Alternative therapies such as acupuncture, cold laser therapy or PEMT (pulsed electromagnetic field therapy) are all backed by science.
ADDITIONAL “EASY” RECOMMENDATIONS TO START TODAY:
- Weight Loss—A weight loss of 10% can provide the same pain relief as an NSAID.
- Controlled Excercise—Strong muscles lead to more stable joints and less pain. Long walks on leash are best.
- Omega 3 Fatty Acids—Dose about 50 mg/kg/day of EPA (that’s a specific type of fatty acid)
- Vitamin E—Dose about 10 IU/kg/day
I don’t have studies to back the next three, but they are extrapolated from human medicine:
- Niacinamide (form of Vitamin B3) seems to improve joint flexibility and reduce pain and swelling. It may reduce necessary pain medications.
- Turmeric is an anti-inflammatory.
- SAMe = S-Adenosyl l-Methionine: This nutraceutical is most commonly used to treat liver disease, but it also has antioxidant properties that may benefit DJD patients.
What about steroid shots? There are NO studies in dogs or cats with the effects of such joint injections. Patients must be screened for any underlying disease first. And, you must discontinue NSAIDs for 5 days prior to injection and for 5 days following. I only do this as a treatment of last resort.
What about cannabis? I just don’t have any dosing information on this, and it is illegal for me to prescribe.
THAT’S ALL FOLKS. I hope you found this useful. I would love to examine your dog or cat to assess his / her needs. All our pets deserve proper PAIN RELIEF so don’t delay (please).
Thank you LING LING (pictured)!