Conventional and Complementary Therapies for Pet Arthritis
by Shawn Messonnier, DVM
Holistic Veterinarian and Director of Paws & Claws Animal Hospital
Article used with permission.
Dr. Shawn Messonnier is the author of The Arthritis Solution for Dogs, The Allergy Solution for Dogs, the award-winning The Natural Health Bible for Dogs & Cats and 8 Weeks to a Healthy Dog (Rodale.) Check out Dr. Shawn’s Holistic Pet column each week in your local newspaper, distributed by Knight Ridder News Service.
There are many conventional treatments for arthritis including corticosteroids and non-steroidal anti-inflammatory medications (NSAIDS.) Is any one treatment preferred or better for the pet with arthritis? There is no perfect treatment. However, the “most perfect” treatment for arthritis should meet the following criteria:
1. The therapy should be cost-effective.
2. The therapy should be easy for the owner to administer.
3. The therapy must be safe for the pet.
4. The therapy must have minimal or no short and long term side effects.
5. The therapy should help the joint heal itself, as well as relieve inflammation and pain.
No matter what treatment is chosen for the pet with arthritis, it should meet as many of these conditions as possible to be of most benefit to the pet.
Conventional Treatments
There are numerous conventional treatments for pets with degenerative joint disease (arthritis). Unfortunately, some of these treatments have sought to relieve the effects of the arthritis without actually doing anything to help the pet’s joints heal.
Remember that arthritis is an inflammatory, painful condition. While the treatment selected must relieve the inflammation and pain, it is important to keep in mind that long term therapy with conventional medications are actually harmful to the joint cartilage. Most of these drugs actually prevent healing of the cartilage, further destroying the cartilage and joint components. So even though a pet will feel better for a while, we’re actually making their condition worse. And because many pets taking corticosteroids for prolonged periods of time gain weight as a side effect of this class of medication, this excess weight puts further stress on already damaged joints, adding more insult to injury.
Since most therapies for pets with arthritis seek to relieve inflammation, it’s important to understand just what inflammation is and how our therapies help relieve this side effect of arthritis.
Inflammation is caused by damage to the tissues and cells of the affected body part. When a tissue is inflamed it exhibits any or all of the following signs: redness, pain, tenderness, swelling, and loss of function.
Cell membranes contain chemicals called phospholipids. When the cell membrane is injured, as in the arthritic pet, an enzyme acts on the phospholipids to produce fatty acids including arachidonic acid (an omega-6 fatty acid) and eicosapentanoic acid (an omega-3 fatty acid). Further metabolism of the arachidonic acid and eicosapentanoic acid by additional enzymes yields the production of chemicals called eicosanoids. The eicosanoids produced by metabolism of arachidonic acid (the omega-6 fatty acids) are pro-inflammatory and cause inflammation, suppress the immune system, and cause platelets to aggregate and clot; the eicosanoids produced by metabolism of eicosapentanoic acid (the omega-3 fatty acids) are non-inflammatory, not immunosuppressive, and help inhibit platelets from clotting.
Various drugs work at different stages to help decrease the production of the pro- inflammatory compounds. For example, corticosteroids such as prednisone work at 2 places in this biochemical pathway: they help inhibit the enzyme which is responsible for metabolizing the membrane phospholipids into arachidonic and eicosapentanoic acids, and they inhibit the enzyme responsible for breaking down arachidonic acid into pro- inflammatory compounds. Non-steroidal anti-inflammatory medications such as aspirin and ibuprofen work at another step in the pathway called the COX pathway, discussed below, that is responsible for metabolizing arachidonic acid into pro-inflammatory compounds.
Corticosteroids
Corticosteroids (“steroids”) are commonly used for treating the arthritic dog. Steroids are one of the most frequently used and abused drugs in veterinary and probably human medicine. It’s just too easy for doctors to reach for the magic “steroid shot” to treat symptoms without really diagnosing and treating the disease.
Many of my holistic clients think that corticosteroids are horrible drugs that are to be avoided at all costs. However, that is far from the truth. Corticosteroids are actually wonderful drugs that can be life-saving when used correctly at the right dose, for the proper length of time, and in the right patient. So often though, they are often not used at the right dose, for the proper length of time, and in the right patient. Because they can aggravate existing arthritis by inhibiting the synthesis of proteoglycans and collagen, the molecules that make up cartilage, there is rarely if ever a need for their long-term use in the treatment of patients with arthritis.
I believe the best use of corticosteroids is for short term, infrequent use to control pain in pets with mild arthritis. I prefer an initial short-acting injection followed by a 5-7 daily oral dosing. Unless absolutely necessary, depot injections of methylprednisolone which can last in the pet’s body for 30-60 days should be avoided.
The negative side effects of long-term use of steroids is that they can decrease the ability of wounds to heal, they increase the chance of infection, they may also actually contribute to further destruction of arthritic joints by decreasing collagen and proteoglycan synthesis, and they can suppress the body’s immune system.
Milder short-term side effects seen in most dogs treated with corticosteroids include an increase in appetite, an increase in water intake, and an increase in urine output.
