What is the best pain reliever for arthritis in dogs?

When your dog can no longer jump onto their favorite chair and lying down is accompanied by a deep groan, it’s safe to say they’re entering their golden years. Indeed, as your dog ages, things that were once second nature become an effort.

The good news is, thanks to advances in veterinary medicine, many dogs are living to a ripe old age. The bad news? That longevity also increases the odds that they’ll suffer from some form of degenerative joint disease (DJD), or osteoarthritis. There are several types of dog arthritis, but the most common is the age-related degenerative form. Here’s everything you need to know — including how to ease your dog’s achy joints.

What is Dog Arthritis, Exactly?

As dogs get older, the cartilage surfaces of their joints begin to thin, and cartilage cells die. When the cells die, they release enzymes that cause inflammation of the joint capsule and release of excessive joint fluid. Extra bony growths (osteophytes) can develop. With severe cartilage thinning, the normal joint space narrows and the bone beneath the cartilage deteriorates.

All of these processes set in motion further changes in the normal functioning of the dog’s joint, and an ongoing spiral of pain, lameness, limb disuse/inactivity; plus, muscle atrophy sets in.

How is Dog Arthritis Diagnosed?

Many of these changes may be seen on X-rays. When it comes to a physical exam, veterinarians rely on a dog’s pain response to joint palpation, detection of crepitus (a crackling or grating sensation felt within the joint), observation of gait, and the presence of muscle atrophy to diagnose osteoarthritis.

Not all dogs — even those with significant DJD — vocalize when they’re in pain, but a dog whose muscles are atrophied and limbs are stiff, who requires assistance to rise, and does little more than teeter outside to go to the bathroom is, without question, in pain.

DJD isn’t the only reason for a decrease in a dog’s normal activity level, weakness, or reluctance to move, so other conditions that could be causing or contributing to this change need to be ruled out. Among the possibilities are: infectious and metabolic illnesses, cardiac conditions, cancer (particularly bone cancer), anemia, and endocrine conditions such as hypothyroidism or Cushing’s disease.

Can Dog Arthritis Be Prevented?

In an ideal world, all dogs would start life with genetically sound conformation and joints. For purebreds, the importance of responsible breeding and the use of OFA (Orthopedic Foundation for Animals) certification or other screening tests to evaluate hip and elbow conformation of prospective breeding animals cannot be overstated.

Regardless of a dog’s origins, feeding them a high-quality diet throughout life and helping them maintain an optimal body weight are also crucial. If your dog is overweight, a healthy weight reduction plan should be instituted immediately.

Sudden scratching? Finicky food eater? Loose poop? Whatever pet health question is on your mind, our veterinary pros are here to help.

10 Strategies to Ease Your Dog’s Arthritis Pain

When it comes to relief, reaching for a single “big gun” pharmaceutical is rarely the most effective approach. Rather, best results are achieved by working with your vet to develop a plan tailored to help with your dog’s specific issues.

An integrative, multimodal therapy regime can maximize your dog’s comfort and well-being and minimize the potential side effects of certain therapies. Here are a few strategies that have been found to be beneficial:

1. Orthopedic Beds, Steps & Ramps

Provide orthopedic bedding away from cold or damp drafts. (This will also help prevent the development of pressure-point calluses.) Carpeted or padded steps or a ramp to get on and off the bed or couch are advised. Non-slip flooring wherever surfaces are slippery is also very helpful. Outside, your dog may find a gently sloped ramp easier to negotiate than steps.

2. Massages & Body Work

Many arthritic dogs appreciate muscle massages, which stimulate blood flow to atrophying muscles. Certified canine massage therapists are available in most areas of the country; many are willing to show you their techniques. (Start your search at the IAAMB.) Warm compresses over sore joints can be soothing, but care must be used to avoid injury from excess heat.

3. Acupuncture & Eastern Medicine

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 benefits of acupuncture. (Click on “Find an Acupuncturist” at aava.org.)

4. Exercise & Water Therapy

Maintaining mobility through reasonable exercise is important regardless of a dog’s age and the extent of their 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 a senior dog with severe cartilage erosion.

Non-weight–bearing exercise — like swimming and hydrotherapy — is excellent if not contraindicated by other medical conditions. Look for a Certified Canine Rehabilitation Practitioner (CCRP) for help with designing an appropriate exercise program.

5. Therapeutic Laser Treatment

Class IV therapeutic laser is a form of low-level light energy treatment that can greatly improve arthritic conditions in dogs. The treatment stimulates blood flow to tissues, decreases inflammation, and increases muscle relaxation which promotes faster healing and reduced pain to targeted areas.

This non-invasive treatment is administered by the use of a handheld laser wand which is waved back and forth over the affected area. Depending on the pet’s specific needs, laser treatment may be applied weekly for several weeks.

6. Joint Supplements

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 pet parents 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 benefits 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.

7. Adequan Injections

These 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.

8. Tramadol

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.

9. Steroids

We can 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 stopped. That being said, many older dogs with advanced arthritis can get four to eight weeks of benefit from a long-lasting steroid injection.

10. NSAIDS

If none of the above provides sufficient relief, one of the veterinary NSAIDs (non-steroidal anti-inflammatory drugs) might be considered. Canine NSAIDs include Rimadyl, EtoGesic, Deramaxx, Previcox, Metacam, and Feldene. While these drugs are highly effective at reducing inflammation and pain, they should not be casually dispensed. I use them on a very limited basis with exceeding caution.

Few drugs are without possible side effects. The potential side effects of veterinary NSAIDs are numerous; they can be severe, and even fatal; their development can be completely unpredictable; and most importantly, they can be irreversible. I hold the “above all, do no harm” portion of our oath close to heart at all times. Unpredictable, irreversible side effects are scary.

For dogs whose systems tolerate an NSAID well, they can be wonderful. However, more than a few dogs, including healthy non-geriatrics, have succumbed to irreversible organ-system failure from sometimes no more than a few days’ worth of NSAID therapy. I have also heard of fatalities from perforating gastric ulcers, seizures, and other “adverse events.” The FDA has documented thousands of such deaths, which by their own estimation represent a fraction of total cases.

Blood work should be done before an NSAID is dispensed to confirm normal liver and kidney function, red blood cell count, and other parameters. These tests should be repeated at regular intervals to confirm that the NSAID is being tolerated. Ask your veterinarian for a copy of the pharmaceutical company’s Client Information Sheet; they should also advise you about symptoms to watch for, including, importantly, any increase in water consumption or urination. The medication should be stopped immediately if symptoms develop. NSAIDs must never be given with aspirin or any form of steroid; doing so can result in death.

A final word about drugs: Please do not give your dog over-the-counter pain medicines without consulting your veterinarian. Dogs have died tragic, unnecessary deaths from a variety of seemingly innocuous pills, including a healthy five-year-old dog whose human gave her several days’ worth of Ibuprofen, which is toxic to dogs (and cats).

The Bottom Line

Strive to keep your dog fit, healthy, and structurally sound. Provide them with excellent nutrition and age and breed appropriate exercise, and aim to keep them at an optimal body weight. Begin supplemental integrative therapies when they show symptoms of and are diagnosed with degenerative arthritis. Use “big gun” pharmaceuticals prudently and judiciously. Here’s to long, happy, comfortable lives for all our dogs!