Friday, August 9, 2013

Avoiding NSAIDs in Dog Arthritis Treatment


Dog arthritis is a crippling disease that attacks the cartilage in the joints. As the joint loses more cartilage, bone spurs and scar tissue start to develop. These make the joint stiffer and cause chronic pain and inflammation in the joints. As a result, the arthritic dog experiences lameness. When the cartilage loss becomes too extensive, "bone to bone" contact occurs. This is when the bones on either side of the joint are exposed to higher levels of friction, without the cartilage's cushioning effect and smooth surface, so that using the joint becomes very difficult, resulting in severe pain.

Though veterinary science has yet to discover a cure for this debilitating disease, there are many ways to prevent it from progressing to a stage where the arthritis will greatly reduce a dog's quality of life. Treatments for dog arthritis must aim at stopping cartilage loss, as well as protecting and supporting chondrocytes (the cells in the cartilage matrix), reducing inflammation and relieving pain.

The basis for any dog arthritis treatment plan is the management of pain and inflammation. Anti-inflammatory drugs have been a common arthritis treatment for the second half of the twentieth century. There is no doubt that these drugs are effective and have contributed to the improvement and comfort of many arthritic dogs.

Nevertheless, there is now a growing concern over the safety of anti-inflammatory drugs, especially non-steroidal anti-inflammatory drugs (NSAIDs). This growing concern from veterinarians and informed dog owners is based on the mechanism of action of NSAIDs. These drugs reduce inflammation by inhibiting the pro-inflammatory properties of COX-enzymes. Unfortunately, COX-enzymes have several important functions in a dog's body such as the production of platelets, the maintenance of the protective lining of the stomach and upper intestines and maintaining sufficient blood flow in the kidneys. So there is a concern that some NSAIDs may cause the development of stomach ulcers and intestinal bleeding, excessive blood thinning or even renal failure. All of which have the potential to be fatal.

These side effects were far more common with the older NSAIDs, which had an effect on all of the COX-enzymes (for example, aspirin). With the development of newer non-steroidals and the requirement of thorough clinical trials prior to these newer NSAIDs being registered in the market, there has been a marked reduction in side effects. These newer NSAIDs are known as COX-2 selective drugs, which means they have less of an effect on the "good" functions of COX-enzymes and mainly focus on reducing inflammation, ie "bad" and debilitating functions. Despite these advances in research and development, there are still some dogs that do not tolerate NSAIDs regardless of whether they are COX-2 selective or not, so it is important to monitor all dogs closely for side effects while they are on the drugs and carry out a blood screening test to check the kidney function before and during treatment.

It is a good idea to formulate treatment plans that are less dependent solely on NSAIDs. The following are dog arthritis treatment options that can reduce dependency on NSAIDs or in some cases, may function as a complete substitute:

NMDA antagonists help reduce pain by "calming down" overactive neural pain pathways. Common NMDA antagonists include Gabapentin, Amantadine, Ketamine and Amitriptyline.

Opioids provide stronger pain relief than other prescription painkillers and have very few side effects. They contain substances that bind to the pain receptors found in the brain, spinal cord, and gastrointestinal tract to decrease the brain's awareness of pain. Examples of opioids are Tramadol, Morphine, Fentanyl, Buprenorphine, and Codeine. Unfortunately, these drugs are not available in all states and countries as some local laws identify opioids as controlled substances.

Stem cell therapy is considered by some as a controversial treatment option but has been showing good potential. Conversely, stem cell therapy for dogs does deserve the notoriety it has been given. With this method, stem cells are harvested from the dog's body fat, which are then injected to the arthritic joint. Stem cells are able to stop the cartilage damage, promote cartilage regrowth, and suppress inflammation.

Cortisone is a more potent anti-inflammatory than NSAIDs. It can help to settle "acute on chronic" pain. However, it should never be considered as first option and it should not be used for more than two to three times a year. Furthermore, Cortisone should not be used together with NSAIDs.

Joint health supplements are health products made from natural ingredients. They are believed to reverse some of the effects of the disease and provide the necessary building blocks for cartilage repair. When choosing the right supplement, make sure the product contains the following:

-D-Phenylalanine. An essential amino acid found in the breast milk of mammals. It is reputed to be a natural analgesic.

-SAM-e. Also known as S-Adenosyl methionine, SAM-e is a substance produced and consumed by the liver. Studies have shown that it has analgesic, anti-inflammatory and anti-oxidant properties.

-Low molecular weight Chondroitin. An important component of cartilage, it can suppress inflammation, inhibit cartilage-destroying agents, promote the growth of new cartilage and the production of synovial fluid.

-Glucosamine HCL. A structural component of cartilage responsible for the tissue's spongy texture.

-Fish Oil Omega-3 Fatty Acids. EPA (eicosapentaenoic acid) is an omega-3 fatty acid that can reduce inflammation. Studies have also revealed that omega-3 helps to protect the existing cartilage from further damage.

-Niacinamide. Also called Vitamin B3, this nutrient can improve cartilage production, prevent further cartilage damage, and improve joint mobility.

-Avocado and Soybean Unsaponifiables (ASU). This substance has anti-inflammatory and analgesic properties and can help improve chondrocyte metabolism.

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