Pain Management for Canine Arthritis

According to experts from the University of Pennsylvania School of Veterinary Medicine (Penn Vet), 60 percent of dogs over seven suffer chronic discomfort from degenerative joint disease, more commonly known as arthritis. It often goes unnoticed by pet parents, however, because they are not familiar with the signs. Humans talk about pain and express it by crying or wincing. Dogs will rarely vocalise unless the pain is acute – a toenail cut too short, stomach distress or a broken bone.

Unfortunately, controlling the pain of arthritis is anything but simple. Researchers have found that arthritis pain follows several different pathways and creates changes in the dog’s central nervous system, which means that keeping an arthritic dog comfortable most often requires more than one type of pain relief. Learn more about the different forms of pain management available for dogs with arthritis.

Signs of arthritis in dogs

Signs of chronic discomfort are subtle and can come on so gradually that the dog’s person often doesn’t notice until a veterinarian points out the changes. A dog who’s uncomfortable may slow down, reluctant to run as fast or walk as far as they once did. They may be stiff after lying down, or take longer to get up and moving when it’s cold or damp outside. An uncomfortable arthritic dog may be grumpier, sleep more and decline to take part in games they used to love.

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Unsure if your dog is suffering from arthritis? One of the easiest ways to tell is with a trial of pain medication. Talk with your veterinarian about your concerns and request a week’s worth of anti-inflammatory medication. While your dog is on the medication, keep a diary and note changes in their behaviour. People are often amazed at how youthful their older dogs act once their discomfort is relieved.

Dog arthritis treatment

Penn Vet assistant professor of small animal surgery Kimberly A Agnello, one of the US’s foremost researchers in canine pain management, has some advice on how people can help their arthritic dogs feel better.

A healthy weight provides pain relief

According to Dr Agnello, one of the easiest, most cost-effective and beneficial ways to reduce pain associated with arthritis is to maintain dogs at their healthy weight. She described a recent patient with hip dysplasia who came to her overweight and in pain from arthritis. The dog was scheduled for hip surgery, but first, the dog’s parent was instructed to put the dog on a diet. Turns out that when the dog lost weight, they improved so much that they ended up not needing surgery. The dog felt better and their person saved money on food as well as on the procedure.

Rehabilitation to increase strength

Once the pain is controlled, strengthening in the form of rehabilitation exercises is vital to maintaining strength and mobility; even one visit to a canine rehab veterinarian for instruction on how to do these with your dog can be useful.

Strengthening exercises and activities like swimming or using an underwater treadmill build the muscles in and around the joint, making it easier for the dog to get around. This form of rehabilitation is done under controlled circumstances, with the dog wearing a safety vest, the water at optimum temperature and constant monitoring.

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Some dietary supplements can help

Dogs can also be helped by alternative therapies such as joint supplements (high-quality fish oil is an excellent choice; check with your vet for the appropriate dosage), acupuncture and cold laser. Other supplements include:

• Glucosamine and chondroitin sulfate: these substances provide the building blocks for polysulfated glycosaminoglycans, or PSGAGs, which are long-chain molecules that hold water and give cartilage its cushion.

• Methylsulfonylmethane (MSM): supplemental MSM appears to act as an analgesic (like aspirin). In a few small studies, it has improved pain and physical function in people with OA.

• DL-phenylalanine (DLPA): DLPA is a synthetic amino acid that seems to relieve pain. One component of DLPA, D-phenylalanine (DPA), has been shown to decrease chronic pain and boost the pain-relieving benefits of acupuncture in animals and humans.

• Avocado/Soybean Unsaponifiables (ASUs): ASUs act as anti-inflammatories and can inhibit the breakdown of cartilage and promote its repair.

• Perna canaliculus (Green-lipped Mussel): extracts from this New Zealand mollusk have been shown to reduce joint pain and swelling in arthritic dogs.

The supplements listed here can be combined with other remedies, but check with your vet before adding them to your dog’s diet. 

Long-term medication is available

When it comes to medication, non-steroidal anti-inflammatory drugs (NSAIDs) continue to be the mainstay of pharmaceutical treatment for canine arthritis. These drugs are relatively safe and generic forms are available. Dogs on NSAIDs long-term require annual blood tests to check liver and kidney function.

New arthritis medication for dogs

A new anti-inflammatory drug, Grapiprant, was launched in the UK in 2019 for chronic canine arthritis pain. A prostaglandin receptor antagonist, it specifically blocks the EP4 receptor, which is the primary receptor involved in arthritis pain. It is considered safer than many of the other NSAIDs available because its mechanism of action is so specific, meaning that it does not affect other systems in the body like other NSAIDS might. Grapiprant is labeled for use in dogs as young as nine months of age, which makes it a good drug for those with early-onset arthritis from hip or elbow dysplasia, but should not be used for dogs smaller than eight pounds.

Injectable PSGAGs, such as prescription Adequan, work like glucosamine and chondroitin, only faster. Hyaluronic acid, or HLA, is a natural source of PSGAGs (it’s found in connective tissue and synovial fluid).

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The future of arthritis pain management

For Dr Agnello, the most exciting and promising advances in the treatment of arthritis in dogs are likely to come from what are known as translational studies. Arthritic dogs are an almost perfect model for arthritic humans, which means that while researchers are developing new treatments for arthritis in humans, dogs also benefit (and vice versa). Treatments designed to resurface cartilage, partial joint replacements and transplanted ligaments are all being actively explored even as you read this article. Studies to improve blood supply to cartilage are also on the horizon, providing more options than ever before.

Dr Agnello believes that joint-specific treatments are also the future of pain management. One such possibility is a compound called resiniferatoxin (RTX), a naturally occurring chemical found in red-hot sap produced by a Moroccan cousin of the chili pepper plant. When the chemical – which is about 1,000 times more potent than capsaicin, the active ingredient that gives chili peppers their kick – makes contact with pain-transmitting nerve cells, it spurs a rush of calcium into the cells, destroying them and providing relief from pain.

Presently, RTX can only be delivered by spinal injection and patients must be anaesthetised. When RTX is injected into the spinal fluid, pain cells are permanently ablated, or destroyed, and pain is eliminated. This selective deletion of pain-receptor cells has been coined ‘molecular neurosurgery’ and has the advantage of sparing neurons that are in charge of other functions, such as gross motor movement and feeling. Consequently, the dog is pain-free, can maintain coordinated movement, perform activities of daily living and experience a good quality of life.

The Penn Vet research team also studied RTX’s ability to reduce pain in dogs with bone cancer. Anyone who has ever watched a dog suffer from this disease knows that the pain can be debilitating. After receiving injections of RTX, dogs who were virtually immobile were able to run and jump almost as though they felt no pain at all. Cancer persisted – and eventually proved fatal – but owners reported weeks to months of happy times with their dogs. RTX could eventually provide veterinarians with another tool in the ongoing fight to relieve pain associated with arthritis. Other exciting advancements in arthritis treatment and prevention include research into joint-specific stem cells and long-lasting intra-articular treatments.