Jun 01 2015

Aching Bones … Better!

So, where was I?

Oh, yes … Arthritis.  You may remember that I told you all about the over-the-counter things that the doctors tried making me eat in order to get me feeling better.  Well, those things helped.  I wasn’t so achy, but I still couldn’t make it to the top of the microwave in one leap.  Let’s be honest – I likely will never be as spry as I once was, but I wanted to feel better.

Just like for older people, there are a plethora of prescription medications for older pets that are suffering, like me.  Luckily, dogs  have it a lot easier than us cats.  There are many medications for arthritis in dogs, including Carprofen (Carpaquin, Rimadyl, or Novox), Derramaxx, Etodolac, and Previcox, among others.  These are all called Non-Steroidal Anti-Inflammatory medications, or NSAIDS.  They are the “work-horse” of arthritis pain control as they help to decrease the inflammatory response at the site of the arthritis.  Like I said, dogs have it lucky – they have lots of options for NSAIDS

Cats, however, don’t have a lot of choices for long term pain control.  There is the Aspirin every 3 days (1/2 of an 81mg, but no more), but that gave me a belly ache.  My only other option for a long-term NSAID is Metacam (meloxicam).  BUT…even that can cause problems.  At too high of a dose, it will cause my kidneys to shut down…and I need my kidneys.  The good news is that some research has found that at a low dose, it will help my pain and may even PROTECT my kidneys.  Weird, huh?  However, the jury is still out on Metacam’s safety.  In the EU, veterinarians can use it long term, according to the label.  But, in the US, there is a “black box” warning about the possibility of kidney failure with long-term use.  My veterinarians are concerned about my pain and they monitor my kidneys frequently, so I get to take the Metacam daily at a low dose.  It tastes good too!

Sometimes, NSAIDs aren’t enough to control pain, so sometimes steroids have to be considered.  Steroids, like prenisolone, prednisone, and medrol, are really potent anti-inflammatories, but they have a lot of side effects.  These can include increased thirst, increased appetite, having to go to the litterbox more often, and sometimes even aggression.  Not to mention the fact that steroids can make the liver work too hard and cause it to wear out early.  Steroids can even lead to other diseases, like Cushing’s disease and infections.  That’s why the doctors like to use NSAIDs first.  However, steroids are the only thing that works.

Anti-inflammories are good, but they are just a starting point.  Sometimes, more pain control is needed.  Central pain relievers like Tramadol, Codine, Oxymorphone, or other opiates are sometimes needed to stop the perception of pain in the brain.  They are really good medications but they are controlled substances because they can be used and abused by our owners.  That makes the doctors hesitant to prescribe them unless they are absolutely necessary.

There are also other medications, neuromodulators, like Gabapentin, Pregabalin, and Amantadine, that affect the way that nerves conduct pain signals.  These medications help to slow down the pain signals so that it is not as intense.  They can even help to “deregulate” nerves.  With chronic pain, like arthritis, nerves that normally carry other sensations can be “recruited” to carry pain.  Neuromodulators help to return these nerves to normal sensation.

Phew!  Lots of information, huh?  Just one more thing:

There is a prescription medication, called Adequan, that contains polysulfated glycosaminoglycan or PSGAG, a replacement joint fluid.  This injection has to be done on a regular basis (every 4 days at first, then monthly), but it can replace the old, worn out joint fluid with slipperier, slidier joint fluid.  It doesn’t even have to be injected into the joint directly!  Just given in a muscle, it will help to give joints an “lube job”!

So, ole Waldo here is feeling good and living large on my medications.  I’ll take them forever, but they make me feel so good!  If YOU have any questions about any of the medicines I mentioned, you should call your veterinarian.  Mine are very helpful.  Well, until next time…


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