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CONTROLLING OSTEOARTHRITIS
Osteoarthritis is an inflammation of a joint or joints and the surrounding bones and soft tissue. Inflammation leads to pain, joint fluid destruction (especially hyaluronic acid), decreased joint space, and brittle cartilage and eventually bone on bone contact. These changes make the joint biomechanically unstable causing the body to make new bone and soft tissue in abnormal places attempting to stabilize the joint. The changes cause a decreased range of motion, more inflammation, more pain and eventually disuse atrophy of the surrounding muscles. Less muscle tissue leads to further destabilization of the joint and the inflammation pain cycle continues. To successfully treat this arthritis we need to reestablish cartilage, joint fluid, muscle mass and range of motion while we decrease the level of pain and inflammation.
First we must control the pain short term to make your pet more comfortable. We currently recommend Rimadyl tablets once or twice a day or Metacam or Etodolac tablets once a day. These products are nonsteroidal anti-inflammatory agent that works like aspirin, acetaminophen, ibuprofen, ketoprophen, etc. without as many of the tragic side effects common in these products. If these products are not successful we recommend a narcotic pain reliever tramadol.
Second, we start on oral nutritional supplement called Cosequin, twice daily on the food for life. Cosequin is a combination of glycosaminoglycans (joint fluid and cartilage building blocks) and chondrotin sulfates (cartilage building blocks). These products work in the joint itself to decrease inflammation and rebuild both joint fluid and cartilage.
Third we start on Hill’s J/D with high levels of EFA’S that have been clinically proven to increase weight bearing in arthritic dogs. Feed at 1 cup per 15 - 20 pounds of pet.
Fourth, we start with a weekly injection of Adequan for four weeks. Adequan is a glycosaminoglycan also that has been shown to be present in joint fluid within a few hours of injection. It also reduces inflammation while it helps rebuild joint fluid and cartilage.
After four weeks of Adequan injections a product called Legend is given intravenously. Legend is hyaluronic acid, the final component of joint fluid that needs to be replaced. It is not used earlier because the inflammatory process would destroy it before it could be of benefit to your pet.
Next we need to restore some range of motion to the affected joints. This is done by passive-extension exercises at home with chiropractic manipulations and adjustments as needed. (This can be very helpful especially with some spinal arthritis patients and also reduces the pain level for your pet).
Now that we have restored joint fluid, joint cartilage, some range of motion and decreased pain and inflammation we need to increase muscle mass. This can be done with exercise alone or in combination with anabolic steroids like Winstrol-V. Gradually increase your pet’s exercise level over a 3-4 week period if he or she will tolerate it. Swimming is preferred to work all the muscles without the shock and joint trauma that running will cause. As the muscle mass is reestablished, it is important to continue with the exercise to maintain the range of motion and muscle mass. (What you don’t use you lose!) We will now try to reduce the Rimadyl level to once a day for 30 days. If your pet is still doing well we then go to every other day Rimadyl for 30 days and then stop if possible. The Cosequin should be continued for life.
Each animal is different and we will have to work back and forth with products and dosages to find the maximum level of comfort and activity with the lowest level of medication of your pet. Not all pets will be 100%, but you should notice a gradual improvement over the first 30-60 days of therapy.
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