Arthritis is a very common condition in pets, but the pain arthritis can cause is often overlooked by families or misinterpreted as their pet “just slowing down” as they age. The underlying disease process is slightly different in dogs (Osteoarthritis) and cats (Degenerative Joint Disease), but both species very commonly show clinical signs related to the pain of arthritis as they age. These signs are often subtle since pets very rarely cry or groan in pain. Many families expect that they will easily recognize pain, but animals are instinctively very good at masking their discomfort. Often pain could manifest as simple behavior changes such as refusing to go up the stairs, declining to jump on a couch or countertop, unwillingness to groom themselves, or staying seated instead of following family members around the house.

Luckily there are many therapies we can use to control the pain associated with arthritis. Sometimes, though, the multitude of treatment options and wealth of information available on the internet can be overwhelming for families. With that in mind, we have created this worksheet to help guide pet families as they approach their pet’s arthritis pain management plan. Utilizing the difference approaches allows families to utilize multi-modal pain management strategies to keep their pet as pain-free as possible for as long as possible.

Weight Management: One of the most beneficial things pet families can do to guard against the pain of arthritis is to keep their pets lean throughout their life. Studies have shown that 80% of labrador retrievers develop osteoarthritis when fed generous calorie meals. However, when their study counterparts were fed a reduced-calorie diet, only 50% of those labrador retrievers developed osteoarthritis. This highlights the difference monitoring weight and calorie intake can have on a pet’s longterm health and comfort. The labs in these studies who were fed the restricted calorie diets also lived 1 to 1.5 years longer than the free fed labs. Ask your veterinarian to discuss your pet’s ideal weight and make sure to monitor their body condition score throughout their lives.  An ideal body condition based on the chart below would be 4-5/9 or 2.5-3/5 depending on the point system being used.

EPA Rich Diet: Diets high in Omega-3 fatty acids supply the body with building blocks that help regulate the amount of inflammatory mediators in the body. The most helpful building block is Eicosapentaenoic acid ( or EPA), which is a type of Omega-3 fatty acid.  EPA can be incorporated into the diet by adding a high quality fish oil (our preference) or by switching to a diet that has higher levels of EPA.  We recommend both Grizzly and Kronch salmon oil at Napa Holistic Vet.  The dose of EPA will be appropriate for your pet's arthritis if you follow the dose on the label.

If changing to an EPA rich diet be somewhat wary of general “fish oil” or “fatty acid” claims as you want the diet to contain >2% Omega-3 Fatty Acids and specifically mention EPA to be most beneficial. Omega-6 fatty acids do not provide the same type of joint inflammation protection. These increased EPA levels can be found in prescription diets as well as some over the counter diets. Examples of EPA rich diets include: Hills J/D, Purina Pro Plan JM, Iams Joint Plus, Royal Canin Mobility Support, Orijen Senior, Dogswell Happy Hips. Victor Performance/Joint, Now Fresh, Merrick Grain Free Healthy Weight, Fromm Gold Weigh Management, Earthborn Weight Control, Earthborn Coastal Catch, Annamaet Grain Free Lean, and Nature’s Variety Instinct Healthy Weight.  Make sure to evaluate your pet’s food for the AAFCO label and review the Guaranteed Analysis section to ensure it contains these ingredients.

Chondroprotectants: Chondroprotectants include Glucosamine, Chondroitin, and Avocado Soybean Unsoponafiables (ASUs). Some of the products we recommend include Dasuquin, which provides all three chondroprotectants listed above, Adequan, ArthriEase Gold and Standard Process’ Flex Support. Dasuquin is one of the only products including ASUs, which makes it one of the most beneficial chondroprotectants available to pets. Dasuquin Advanced is a newer product which also includes boswellia (frankincense) and curcumin extracts in addition to ASUs. Many other glucosamine/chondroitin products are available, but please keep in mind these products are not regulated by the FDA and in many cases you do get what you pay for. Studies evaluating glucosamine products have shown that when products cost under $1 per day, that less than 10%actually contained the amount of glucosamine that their label claimed. Using products that your veterinarian trusts will ensure you are not using products with no benefit to your pet. The good news is that often after being on chondroprotectants for 4-6 weeks, you may be able to decrease your pet’s medication dose by 25% – saving you money on their medication costs instead of their chondroprotectant cost.

nSAIDs: Non steroidal anti inflammatories are the mainstay of medical treatment for arthritis pain in dogs.  These medications treat the inflammation that is at the root of arthritis pain. Commonly prescribed nSAIDs include carprofen (Rimadyl, Truprofen, etc), deracoxib (Deramaxx), meloxicam (Metacam), and firocoxib (Previcox), among others. These medications are often invaluable in breaking the pain cycle for pets with arthritis and while we attempt to use the minimum effective dose, many pet families are reluctant to give these medications for fear of liver or kidney damage or GI upset. While these concerns are valid, simple monitoring with routine blood work and treatment with anti-oxidants to support the liver can alleviate many of these concerns, while allowing us to keep a pet comfortable.  There is also a new NSAID on the market for dogs called Galliprant that is safer for the kidneys and liver if your pet has a pre-existing condition with these organs.  Cats are much more sensitive to NSAIDs.  Meloxicam is often used off-label in cats at low doses and like any NSAID, should always be done so under the supervision of your veterinarian.

Nutraceuticals/Supplements: Other dietary supplements are available that support joint and general muscle-skeletal strength. We often use Standard Process’ Musculoskeletal Support with good results. Standard Process’ Whole Body Support is another that we will commonly use in our geriatric patients as a foundation for good overall health. Many people have reported improvement by using Golden Paste a tumeric formulation that can have anti-inflammatory benefits.  Another product we recommend is CurcuVET-SA50, which uses the active component of turmeric called curcumin.  This often is more simple for pet owners who do not wish to make their own golden paste.  Essential oils can also be extremely helpful for pain and discomfort!  We recommend both individual oils and blends from Young Living® And DoTerra® that include but are not limited to copaiba, frankincense, helichrysm, wintergreen and peppermint.  Please always consult with your holistic veterinarian prior to starting an essential oil regimen for your pet!

Adjunctive Therapies: There are several other therapies that can be utilized for pets with arthritis and degenerative joint disease. Cold laser therapy can be very beneficial in reducing inflammation. At Napa Holistic Vet we offer both in-home cold laser treatments as well as cold laser rental for clients who wish to treat their pets themselves in the comfort of their own home.  Stem/Regenerative Cell Therapy is a process which involves harvesting a small amount of adipose (fat) tissue from a dog, using a laboratory to process and localize the stem cells present in that tissue, and then injecting the processed solution back into the dog (usually via an IV or directly into the affected joints).  We do not currently offer this therapy, however make sure to check with your regular veterinarian because more and more clinics are starting to offer this service. Environmental modification such as using ramps, using yoga mats or “puzzle pieces” for traction control, and using Toe Grips and PawFriction can also help older pets have more control of their footing and minimize sliding or falling on slick floors. Acupuncture is a very beneficial treatment for pets with arthritis pain and can make a significant difference in the comfort and mobility of geriatric pets. Learn even more about acupuncture for pets on our website!

Adjunctive Medications: Many times as the pain from arthritis progresses, the nSAID being utilized is not enough to control the pet’s pain. Utilizing multiple medications that each have different ways of interrupting the body’s inflammatory and pain responses can make a big difference in your pet’s overall comfort. Commonly used adjunctive medications for arthritis pain control can include Chinese Herbal medications, Gabapentin, Amantadine, and Tramadol. Occasionally Acetaminophen (Tylenol®) can be used for painful conditions in dogs but is not recommend with pre-existing liver disease.  It is important to note that Tylenol® is high toxic (deadly) to cats so careful discussion with your veterinarian prior to administering this medication is required!

Physical Therapy: Physical Therapy is often considered for people with joint and mobility concerns, but is not as often prescribed for pets, although it can be just as beneficial. There are several very simple exercises that families can do with their pets to encourage muscle use and flexibility. Massage is also beneficial to pets and can be a nice bonding experience for the pet and their caretakers. Speak with your veterinarian about which exercises they recommend for your pets.

If your pet is showing clinical signs related to arthritis changes, please contact Napa Valley Holistic Veterinary Services at 707-535-9979 to schedule an evaluation to discuss which recommendations might be best for your pet.