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Arthritis
Painful arthritis limits your pet's mobility and interferes with your relationship with your pet.

Old DogThe dog doesn't want to walk, or growls when touched; the cat can no longer jump up on the bed or climb stairs. When your pet hurts, you want to help. You know that medications are available, but are so many different products that you just don't know where to begin. Learning about these different products will help you choose the best for your pet.

Let's start by looking at the two most common classes of products used to help reduce the pain associated with arthritis in our pets. These are a group of pain medications, called nonsteroidal anti-inflammatory drugs (NSAIDS) and a group of joint supplements, often called nutraceuticals (nutraceuticals are food components that provide health benefits). These two classes of products are entirely different and should not be confused with each other.

Let's start with the joint supplements. Joint supplements are nutrients. They are added into the diet to replace crucial nutrients that may be depleted due to inadequate diet, poor absorption, trauma, or aging. They do not work by controlling pain and are not considered anti-inflammatory or pain medications. Instead, they help by increasing the health of the joint, which in turn, can reduce the amount of pain which your pet feels. Some supply joints with the nutrients needed to maintain healthy cells, replace damaged cells, or make lubricants; others act as antioxidants, and some are substances that bind damaging free radicals. These nutrients are called 'chondroprotective' because they work to protect the joints. Different mixtures and strengths of ingredients are combined into nonprescription products. Cosequin, Glyco-Flex, Arthramine, and Synovi G-3 are just a few of the many joint supplements available for cats and dogs.

It can take several weeks to see the results of joint supplements. Because they provide nutrients needed to build new, healthy cartilage and stimulate joint fluid production, their effects occur gradually, over time. Although some animals may feel better within days of starting a joint supplement, most products are given for a minimum of four to six weeks before gauging a pet's response. Because many supplements contain different combinations of ingredients, it is often necessary to try one or more supplements before picking the one that works best for each pet.

Most pets can take oral joint supplements without restrictions. They generally have a wide margin of safety and are well-tolerated. They can be taken with pain medications. They can be given to both old and young pets, either as a treatment for degenerative joint disease, or as a means to help promote joint health and prevent deterioration. Those owning pets that eat special diets, are taking medications, or have food allergies should always check with their veterinarians before starting any supplements. Many owners prefer to give chewable joint supplements, although pills, liquids, powders, and granules, are available. Some nutraceuticals are available by prescription in an injectable form.

The next class of products includes drugs that help limit pain. Medications designed to primarily combat pain and inflammation are very different from nutraceuticals. The most commonly used pain medications for our dogs are the nonsteroidal anti-inflammatory drugs (NSAIDS). These medications work by blocking enzymes that help create chemical messengers called prostaglandins. Prostaglandins mediate immune reactions and inflammation. When the enzymes are blocked, the prostaglandins cannot be produced. If the prostaglandin messengers are not produced, inflammation and the pain caused by inflammation are reduced. The most-often targeted enzymes are called cyclooxygenases (abbreviated COX-1 and COX-2), so most of the NSAIDS are called COX inhibitors. Medications that are included in this class include non-prescription products such as aspirin and prescription products such as Rimadyl, Deramaxx, and Metacam.

Each medication works to inhibit varying amounts of the COX enzymes. Some inhibit both COX-1 and COX-2. Some inhibit more COX-2 than COX-1. Some only inhibit COX-2. There has been much discussion regarding the efficacy and safety of the different COX inhibitors. This is because the prostaglandins that mediate pain and inflammation are also needed for healthy blood cells, kidneys, nerves, bones, and platelets, as well as the immune system and the gastrointestinal tract. For example, prostaglandins help keep the stomach lining intact and the proper amount of blood flowing through the kidneys. So a drug that stops prostaglandin synthesis will reduce pain and inflammation, but may also reduce the prostaglandins in needed areas of the body, such as the kidneys and stomach. This can lead to unwanted side effects.

Since these protective prostaglandins are primarily made in a COX-1 pathway, drugs that inhibit COX-1 may have more unwanted side effects than those that inhibit only COX-2. However, the COX-2 inhibitors may not control pain as well and also have side effects. The bottom line is that both types of NSAIDS may help your dog and both can cause unwanted side effects. Interfering with the prostaglandins can result in gastric irritation, bleeding, and ulceration, along with liver, kidney, intestinal, and cardiovascular problems. Unwanted side effects can occur with any brands of the drugs in an individual animal. It is not possible to say that one product will always work better or always cause fewer side effects. It is necessary to try the product in an individual animal and watch for unwanted effects.

It is also not possible to predict which NSAID will be most helpful in reducing your dog's pain. Depending on the cause of the pain and type of prostaglandins produced, your dog may respond better to one of the NSAIDS than another. Typically, one drug is prescribed by your veterinarian after considering the dog's age, health, activity level, and pain level. Then the dog is monitored. When using these pain medications, make sure you keep track of the exact dose, the timing of the doses, and the dog's responses to the medication. It may be necessary to alter the dose, the timing, or even the brand of medication to achieve the best results for your dog. Good record keeping will help you achieve this goal in a minimum of time.

If the dog does not get adequate pain relief from one brand, it is logical to try another brand, in that each medication works slightly differently. Do not combine different brands and always consult with your veterinarian before switching brands. Typically, the dog is taken off all NSAIDS for several days between brands. Misuse of the drugs, either by using too much, administering too frequently, or combining them with other NSAIDS or medications, can dramatically increase unwanted side effects.

Although NSAIDS can cause side effects, they are the best medications available for dogs for long-term control of pain and inflammation associated with arthritis. The vast majority of dogs that are placed on NSAIDS get relief of pain without unwanted side effects. Those that experience side effects can often be helped by reducing the amount of NSAID given. NSAIDS can be used in conjunction with joint supplements and other therapies, such as massage, physical therapy, acupuncture, swimming, and moderate activity. Reduction of pain can be the start of a positive cycle that reduces signs of arthritis. Exercise is crucial to help arthritic dogs, but many dogs avoid it because they are just too sore. The use of NSAIDS may allow these dogs to actually feel well enough to get up and start moving. This in turn, allows you to gently increase the dog's exercise, which in turn, will help with weight loss, joint lubrication, and an over-all feeling of well-being. This all starts with the proper use of NSAIDS.

Always consult your veterinarian before using NSAIDS for your dog and do not use them for cats without direct advice from your veterinarian. Because most NSAIDS are not licensed for cats and can cause severe side effects, there use in cats is limited to only a few, specific circumstances and must be monitored by an attending veterinarian. Joint supplements are safe for the majority of cats and most owners choose to help arthritic cats with nutraceuticals. Joint supplements are also safe for the majority of dogs, and can be combined with NSAIDS. The combined use of joint supplements and NSAIDS may be the best method to control the pain of arthritis in your dog.

None of us want to see our pets in pain. Years ago, we lacked proper pain medications for our pets. Recent medical advances have provided us with supplements and drugs that can help reduce our pet's pain. We simply need to understand that pain control is not simple. It is not an all or none proposition and no one drug is necessarily the best for your pet. It may take time and energy to find the right NSAID for your dog, or the best nutraceutical for your cat, or even the best combination of therapies. The only way to find the best is to try. The sooner you start, the sooner the results will be apparent, and the sooner your pet will get relief.

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