What Are the Options?
Written by Dr. Denise Melton, DVM • Tamberly Animal Hospital • Milton, GA
When we diagnose arthritis in an older pet, one of the first questions owners ask is, “What can we give them for pain?”
The answer depends on your pet’s arthritis, other health problems, and how much discomfort they’re having.
Osteoarthritis involves inflammation inside the joint, changes to cartilage and bone, altered movement, muscle loss, and eventually changes in the way the nervous system processes chronic pain. That's why a pet with significant arthritis may need more than one type of medication — and why the best medication plan can change over time.
At Tamberly Animal Hospital in Milton, we build arthritis pain-control plans around the individual dog or cat: how much pain they're experiencing, which joints are affected, their other medical conditions, and what we're trying to accomplish with the rest of their mobility plan.
NSAIDs: Often the Foundation of Arthritis Treatment
Non-steroidal anti-inflammatory drugs, or NSAIDs, are among the medications we use most often for osteoarthritis in dogs.
They relieve pain, but the anti-inflammatory part matters too.
Inflammation inside an arthritic joint isn't simply the body's response to damaged cartilage. Inflammatory substances within the joint can contribute to further cartilage breakdown and changes in the tissues surrounding the joint.
Meanwhile, pain changes the way an animal moves. A dog with a painful hip may shift more weight onto the other three legs. A pet who hurts when getting up may simply get up less often. Over time, that means muscle loss, altered movement, and additional stress on other parts of the body.
So when we prescribe an NSAID, we aren't simply covering up pain so a pet doesn't notice the arthritis. We're trying to reduce pain and inflammation so they can move more normally and comfortably.
“But Aren't NSAIDs Dangerous for Older Dogs and Cats?”
They can have adverse effects, which is why we don't prescribe them indiscriminately. But being old, by itself, isn't a reason a dog can't receive an NSAID.
What matters is the individual patient.
Before starting long-term treatment, we consider kidney and liver function, gastrointestinal health, hydration, other diseases, and other medications the pet is taking. Blood and urine testing help us make that decision, and periodic monitoring helps us continue to make it safely.
If something changes — kidney values, appetite, another illness, another medication — we reassess.
There are pets for whom NSAIDs aren't a good choice. There are also many senior dogs for whom appropriate anti-inflammatory treatment makes an enormous difference in comfort and quality of life. We have to have a more detailed discussion of the pros and cons in cats, but NSAIDs may be the right choice for cats as well.
Medication always involves balancing benefits and risks. Chronic untreated pain has consequences too.
Why We Sometimes Combine Medications
Arthritis pain becomes more complicated as the disease progresses.
Inflammation within the joint is one source of pain, but chronic pain can also change the way pain signals are processed by the nervous system. That's one reason simply increasing one medication isn't always the best answer.
Instead, we may combine medications that work in different ways.
Amantadine
Amantadine is one medication we may add when chronic pain isn't adequately controlled with an anti-inflammatory alone.
It acts on NMDA receptors, which are involved in making the nervous system more sensitive to ongoing pain. We may also add it we are unable to use an NSAID.
Gabapentin
Gabapentin is another medication frequently discussed for painful pets. It can be particularly useful when neuropathic pain is suspected or when another source of pain exists alongside arthritis.
It isn't an anti-inflammatory, and it doesn't replace an NSAID's role in treating joint inflammation.
Some pets also become sleepy or unsteady on gabapentin, particularly when first starting it or at higher doses. Whether it's useful therefore depends on what kind of pain we're trying to treat and how the individual pet responds.
What About Librela and Solensia?
Librela for dogs and Solensia for cats are injectable monoclonal antibodies that target nerve growth factor (NGF), a protein involved in pain signaling. They work very differently from NSAIDs and can give us another option for controlling osteoarthritis pain.
Librela isn't the right choice for every dog. Because of its potential risks, we generally try other appropriate treatments first and consider Librela when the potential benefits outweigh those risks. But in the right patient, the improvement can be remarkable. We've seen dogs regain enough comfort and mobility to enjoy meaningful additional time with a good quality of life.
We don't view Librela as something every arthritic dog should receive — or something that should automatically be avoided. Like every arthritis treatment, the question is whether it's the right choice for the individual patient. The same principle applies to Solensia in cats.
Cats Need Arthritis Treatment Too
Cats deserve a special mention because feline arthritis is both common and remarkably easy to miss.
An arthritic cat may never limp.
Instead, the cat stops jumping onto the counter. They sleep downstairs rather than climbing to a favorite spot. They hesitate before jumping down, groom their back or hindquarters less thoroughly, or stop climbing into a high-sided litter box.
Historically, medication options for long-term feline arthritis pain have been more limited than they are for dogs. That's one reason treatments such as Solensia have been important additions to the options available for cats.
But medication is still only one part of feline arthritis management. Weight, accessible litter boxes, steps or ramps to favorite locations, traction, and other environmental changes can make an enormous difference.
Joint Supplements Aren't Pain Medication — But They Can Help a Lot
Some are marketed as though they'll make an arthritic pet comfortable without medication. That's generally not a realistic expectation for a pet who is already experiencing significant pain.
On the other hand, dismissing every joint-support product because it isn't a powerful analgesic doesn't make much sense either.
We may incorporate selected joint-support products into a long-term arthritis plan while being realistic about what we expect them to accomplish.
Omega-3 Fatty Acids
Omega-3 fatty acids, particularly EPA and DHA from marine sources, are among the nutritional supplements we commonly consider for pets with osteoarthritis.
They can have anti-inflammatory effects and may be useful as part of long-term joint support. The amount of EPA and DHA matters, though. Simply adding an arbitrary “fish oil” capsule isn't necessarily the same as using an appropriate veterinary dose.
Other Joint-Support Products
Depending on the patient, we may also consider other products intended to support cartilage or joint health.
This is an area where there are a lot of products and a lot of marketing. Evidence isn't equally strong for every ingredient or every supplement, so we'd rather choose products intentionally than have an owner spend money on five different things simply because each bottle says “joint support.”
Feeling better comes before getting stronger
One of the most important things to understand about arthritis treatment is that pain relief doesn't immediately restore everything arthritis has taken away.
A dog who has avoided using a painful leg for months has also lost muscle. Once we make that joint more comfortable, the dog may feel dramatically better before they're physically strong enough to resume their old activity.
That's why pain control and rehabilitation work so well together.
Medication can make movement comfortable enough to happen. Controlled exercise and physical therapy then help rebuild the strength needed to support the joint.
It's also why we sometimes have to tell owners to slow an enthusiastic dog down once treatment starts working. Feeling better is wonderful. Going from barely walking to chasing squirrels for twenty minutes isn't rehabilitation.
Arthritis Medication Isn't a Set-It-and-Forget-It Prescription
Osteoarthritis is progressive, and the treatment plan we use today may not be the one a pet needs a year from now.
Sometimes we add another medication. Sometimes we reduce one. A flare may require temporary additional pain control. Changes in kidney or liver function may change which drugs we're comfortable using. Improvements in weight, muscle strength, or rehabilitation may change the equation in the other direction.
We also have options beyond medication. [Laser therapy], PRP with hyaluronic acid, physical rehabilitation, weight management, environmental changes, and other treatments can all become pieces of a larger mobility plan.
We keep checking what your pet needs to stay comfortable and keep moving as their arthritis changes.
If Your Dog or Cat Is Showing Signs of Arthritis
Stiffness after resting, difficulty getting up, slowing down on walks, reluctance to use stairs, hesitation before jumping, changes in grooming, or simply doing less than they used to can all be signs of joint pain.
You don't have to wait until your pet is limping badly or struggling to stand before we do something about it.
If you're concerned about arthritis or mobility changes in your dog or cat, give Tamberly Animal Hospital a call at (678) 459-6001 or [book an appointment online]. We can figure out what's hurting and build a plan around your pet.
Call (678) 459-6001