Friday, March 18, 2011

Pain Management and Your Senior Pet

I once read that pet owners are special people because they know that they will outlive their pets, and they accept the eventual sadness that will come with the loss of a pet, in exchange for the happiness and joy that they will give their pet and receive from their pet during the years they are together. If there was one thing I could change about my dogs, it would be that their lifespans could be lengthened. It is difficult to watch them grow old.

Probably one of the first signs that age is affecting your pet (besides the sweet grey whiskers that pop up on their chins), is the slowing of their movements. They are slow to get up from their beds, may avoid using the stairs, or may develop a limp. In early stages, they may seem more painful in the morning or late at night and behave relatively normal during the rest of the day. They may lack the same energy for a game of fetch, avoid jumping or choose to sleep rather than go for a walk. Chances are they are suffering from arthritis. Arthritis also known as degenerative joint disease, is a painful swelling and inflammation of the joints. This pain impacts the dog's mobility. If your dog has been diagnosed with a genetic orthopedic issue, or has injured himself in some way, he may show signs of arthritis at an earlier age. But by the age of 7, the number of cases of arthritis doubles.

What can you do to treat this condition? A trip to the veterinarian is a good place to start. A senior blood panel is a good idea to get a baseline of your pet's liver and kidney functions and overall health. Your vet will probably recommend xrays of some of your pet's suspect joints to determine if the degenerative process has begun. Once a diagnosis has been reached, your vet may recommend surgical, medicinal or physical therapy or a combination of all three. Fortunately, there are many types of drugs that act in a variety of ways, at a relatively low cost that will help you manage your pet's arthritis and allow him to remain active.

Cayman (pictured above) will be 13 at the end of May. He suffers from arthritis in his knees, hips and spine. Yet, every single day, around 4pm, he is at my desk asking to go out to play. He wants to chase his tennis ball and still feels well enough to tell me it's time to play. He is on some form of all the medications listed below. Although, at first, it may seem overwhelming, once you understand how each medication is relieving his suffering, and see the results of this treatment, then giving him his meds becomes as easy as feeding him his meals.

Glucosamine, Chondroitin, MSM - If your dog is suffering from mild or early stages of arthritis, your vet may simply recommend the natural supplements of glucosamine, chondroitin and MSM (methylsulfonylmethane). These supplements support joint health by acting to keep cartilage healthy as well as protecting cartilage from destructive enzymes. There are a number of products that your vet can recommend to ensure your dog gets the proper dosage of these supplements. It is important to keep in mind that these supplements are not pain relievers, but simply work to bolster joint health. I started all my pups on these treats around the age of 5. I use Joint Max Triple Strength Soft Chews. I follow the directions on the package based on my dog's weight and simply plop these treats into their dog bowls with their meals. Be sure to check with your veterinarian and go with the product that he/she recommends.

Non Steroidal Anti-Inflammatories (NSAIDs) - NSAIDs work by reducing the inflammation and swelling at the joint. Think of these drugs as your doggy's "ibuprofen". You may be familiar with NSAIDs already if your dog has had any surgery, as these are most often given as take home meds post-operatively. Theses drugs require a prescription from your vet and are specially formulated for dogs. Drugs in this class include Rimadyl, Deramaxx, Etogesic, Metacam and Zubrin. It is important to discuss these drugs with your veterinarian and their potential side effects, as they have been known to cause stomach upset and occasionally stomach ulcers. For these reasons, be sure to follow your veterinarians instructions carefully, discontinue if vomiting occurs, and do not give in conjunction with corticosteroids. It is not recommended to ever give your pets the human forms of aspirin, ibuprofen or acteminophen due to the same concerns stated above.

Tramadol - If your dog has had surgery recently, you may also be familiar with the drug tramadol. Tramadol is a human medication used for pain and acts similar to an opioid (such as morphine). It works by helping to block pain signals to the brain. It is used extensively in veterinary medicine to treat post operative pain and chronic pain (such as cancer pain and arthritis). It can be used in conjunction with NSAIDs, but also alone. It has a wide window of dosage and can be adjusted to fit the needs of the patient. It can be given every 6 - 8 hours alone or with food. Tramadol is bitter to the taste and may need to be well hidden in food to be given. It can also cause mild sedation. If you think that your pet is "too sedate" on the drug, speak to your veterinarian and consider lessening the dose before discontinuing its use.

Gabapentin - Gabapentin is another human drug that is also useful for animal patients. This drug works primarily for neurological pain and is used most often in cases of chronic pain such as that associated with cancer and arthritis. If your pet has been diagnosed with arthritis in the spine, or seems weak in his back end, then gabapentin may be a good choice. When used in combination with NSAIDs, gabapentin can be effective at lower doses. Similar to Tramadol, it also has a wide window of dosage and can be adjusted to fit your pet's individual pain level.

Adequan - Adequan is an injectable drug that slows the progression of arthritis in the joint. It is manufactured by the drug company Novartis and was originally developed for horses. It helps keep the cartilage in the joint healthy and intact thus keeping the bones in the joint from rubbing together. It is administered by your veterinarian. Treatment involves two injections per week for four weeks and then a monthly maintenance injection after the first month. For the drug to work properly, it is important to keep up with this schedule.

If you aren't afraid of needles, ask your veterinarian about the possibility of learning to give the injections at home. I currently use Adequan for all four of my Labs. I can give the injections by myself. I find the best opportunity is to slip in the shot while they eating their meals. They don't even flinch because they are so engrossed in their food.

Again, do not be overwhelmed by the recommendations above. Once you begin a drug protocol for your pet, give it some time to work. Start small and add other medications slowly until you feel like your pet has reached a reasonable level of comfort. Don't give up until the pain stops.

Both tramadol and gabapentin can be called into a local pharamacy for very reasonable prices. Joint supplements can be purchased over-the-counter in many different forms also at reasonable prices. NSAIDs and Adequan are a little more expensive. Save money on Adequan by learning to give the injections at home. Talk to your vet about purchasing NSAIDs in bulk to see if you can receive a price break that way.

Last, medicinal therapy is not the only choice for pain management in our elder pets. Here are a few other tips to make sure your pet feels good well into his senior years.

1)Weight management is equally important. A lean weight will lessen the pressure and stress his/her aging joints need to support.

2)Feeding your dog a healthy diet is also important. There are a variety of senior diets available at retail stores that specifically address senior pet health issues. Ask your vet for a recommendation.

3) Moderate exercise. Let your dog tell you how he feels and judge the amount of exercise accordingly. Exercise helps to keep the joints mobile and lubricated. Moderate walks and swimming are wonderful ways to exercise your aging pet.

4) Holistic pet therapies. Don't forget to consider canine massage, physical therapy, acupressure and acupuncture. Remember your last massage? Didn't you feel fabulous afterward? Give your senior pet the same gift. Physical therapy exercises can also help keep your pet flexible and mobile. Ask the physical therapist about exercises you can do at home. Check with your vet for a recommendation for a physical therapist near you. Acupressure and acupuncture are also holistic alternatives that can help your pet feel better.

Unfortunately, we can't stop our pets from aging. But we can help them live a long, comfortable life. Is it all worth it???? Look at the face above....doesn't that say it all???

2 comments:

  1. Thanks for this. Perfect timing, as my old chocolate lady is showing some signs of slowing down.

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  2. Moderate exercise. Let your dog tell you how he feels and judge the amount of exercise accordingly. Exercise helps to keep the joints mobile and lubricated. Moderate walks and swimming are wonderful ways to exercise your aging pet.
    Holistic pet therapies. Don't forget to consider canine massage, physical therapy, acupressure and acupuncture.
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