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We believe it is important to use multiple therapies simultaneously to manage osteoarthritis (OA) effectively. We individualize our treatment plan for each patient, but, in general, our recommendations for beginning treatment include some combination of:
PAIN MANAGEMENT WITH MEDICATION
Whether a pet’s signs are obvious or subtle, if it has OA it has pain. It almost always is worthwhile to begin treatment for OA with a month-long course of a pain relieving medication. While the other treatments mentioned here are essential to use at the same time, the beneficial effects of these treatments are slower to occur and sometimes milder than those of medication. (The nsaids Metacam and Previcox are our most common first choices for pain control because they are the safest and most effective medications in this category.)
Excessive body fat increases the mechanical stress on joints - it requires more effort to move a heavier body than a lighter one. Excessive fat does more than this, though: it is an active organ in the same basic ways that other body organs are. When fat is present in appropriate amounts it performs the essential tasks of storing and providing energy. When a pet is overweight or obese, however, the excess fat provokes inflammation and degeneration of other body parts, including the joints.
The steps of a simplified weight loss plan, if you are happy with the features and performance of the diet you are feeding your pet, include:
- continue the same food and treats
- measure the amount you are currently feeding
- decrease this amount by 10 to 25%
- reweigh regularly
EXERCISE, THERAPEUTIC EXERCISES, AND REHABILITATION THERAPY
In addition to pain, OA also features reduced range of motion in affected joints and loss of strength due to decreased muscle mass and tone. Physical activity is the only sure way to manage these complications of OA. The exercise goal for osteoarthritic patients is frequent activities of short duration; the exercises should not last long enough or be intense enough to worsen the pet’s lameness. At the same time it is ideal to regularly exercise the pet to its maximum ability. Simple walking provides great benefits. It is relatively easy to do some therapeutic exercises and rehabilitation therapy at home too.
FATTY ACIDS (FISH OIL)
Fatty acids (aka omega-3 and fish oil) have significant anti-inflammatory effect throughout the body, including the joints. They only work when given as a daily supplement, and there is convincing evidence that using them at 2 to 3 times the commonly recommended dose improves their effectiveness when they are used to treat osteoarthritis. (We believe Prescription Diet J/D and the supplements Derma-3 and Welactin are the best sources of fatty acids for pets.)
JOINT PROTECTIVE COMPOUNDS
Joint protective compounds are supplements that maintain or improve the quality of the joint fluid, cartilage, and other joint tissues. Glucosamine/chondroitin sulfate daily oral supplements are the most well-known agents in this class, but we often use injectable psgags (polysulfated glycosaminoglycans) as well. (Dasuquin is the best oral supplement, and Ichon and Adequan are the most-commonly used injectable psgags.)
ADDITIONAL TREATMENT OPTIONS
It is our recommendation to begin OA therapy with a combination of treatments described above, but other options exist. Some that we have used and believe are worth considering for select patients are:
- LASER THERAPY
- INTRA-ARTICULAR INJECTIONS (injections into the arthritic joints)
- REGENERATIVE STEM CELL THERAPY
- REFERRAL TO A REHAB SPECIALIST
Some therapies that we have not seen good results with and that we do not believe are worth considering are:
- herbal therapy
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