Osteoarthritis, often referred to simply as arthritis, is the most common musculoskeletal disorder in pets. While it can occur in any sized dog or cat, it is usually seen in large breed dogs. In clinical practice, almost all large breed dogs eight years of age and older are afflicted with arthritis. The joints usually affected are the hips (where the arthritis is usually secondary to hip dysplasia).
Conventional medicine involves the chronic administration of non-steroidal anti-inflammatory drugs (NSAIDs), most commonly etodolac (product name EtoGesic®) or carprofen (Rimadyl®). Unfortunately, as is the case with people, pets can experience side effects from this class of medication. These side effects can be mild (vomiting, anorexia, lethargy) or severe and potentially fatal (acute liver disease, gastrointestinal ulceration or perforation, renal failure). This article uses an actual case to demonstrate possible side effects, and then explores the cautions that must be followed when using NSAIDs or therapies that can be used in place of NSAIDs.
Pele is a 12-year-old neutered male Shetland Sheepdog that had been diagnosed with arthritis. This diagnosis was based on clinical signs and the age of the pet; no radiographs were made to confirm the diagnosis. Pele was started on Rimadyl (25 mg given twice daily). He responded well within several days, and no follow-up examination or blood testing was done.
But though his joint problems had improved, Pele was suffering renal failure and gastrointestinal disease. About a year after being diagnosed with arthritis, he saw an internal medicine specialist for the evaluation of melena (black and tarry bowel movements). The diagnosis of gastrointestinal ulceration, resulting after Pele started taking Rimadyl, was made. Moderate renal failure was also diagnosed, based on blood and urine testing. Like the gastrointestinal ulceration, Pele's renal failure was felt to have come about after NSAID administration.
Pele's owner sought my advice for an integrative approach to his three problems: arthritis, renal failure and gastrointestinal ulceration. Since Pele had experienced side effects related to taking NSAIDs, it was decided not to use this class of medication to help control the mild pain and inflammation associated with his joint disease. Instead, a canine joint supplement containing glucosamine, chondroitin and boswellia was given to Pele. He responded well within several weeks. To control his gastrointestinal ulceration, sucralfate was administered, along with a canine supplement containing probiotics and glutamine. To manage his chronic renal failure, his owner was taught how to administer fluids subcutaneously (under the skin), and fluid therapy was prescribed on a daily basis. A diet formulated for renal failure was prescribed, as were supplements (including a fish oil supplement) that have been reported to assist pets with renal failure.
