Pain Management for Canine Arthritis

Degenerative joint disease, more commonly known as arthritis affects 80 percent of dogs over 8 years old. It often goes unnoticed by pet parents, as the signs can be very subtle. Humans talk about pain and often communicate it easily. Dogs will rarely vocalise their pain unless it is acute, for example a torn claw, stomach ache or a broken bone. This means we have to clue into how dogs express their pain more closely.

Unfortunately, controlling the pain of arthritis is anything but simple. Researchers have found that arthritis pain follows several different pathways and creates changes in the dog’s central nervous system, which means that keeping an arthritic dog comfortable most often requires more than one type of pain relief. Learn more about the different forms of pain management available for dogs with arthritis.

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Signs of arthritis in dogs

Signs of chronic discomfort are subtle and can develop so gradually that a dog parent often doesn’t notice until a vet points out the changes. An uncomfortable dog may slow down, become reluctant to run as fast or to walk as far as they once did. They may be stiff after lying down, or take longer to get up and move around, especially in cold or damp conditions. An uncomfortable arthritic dog may be grumpier, sleep more and decline to participate in games they used to enjoy.

Unsure if your dog is suffering from arthritis? Talk with your vet. There are various options you can explore including X-rays for a more definitive diagnosis, or a  pain medication trial. While your dog is on any pain medication, keep a diary and note changes in their behaviour. Your vet is likely to recommend a blood test to monitor their internal organs (especially their liver and kidneys) before and during your pet receiving the medication, to ensure the medication is safe to give. People are often amazed at how youthful their older dogs feel once their discomfort is relieved.

Dog arthritis treatment

Penn Vet assistant professor of small animal surgery Kimberly A Agnello, one of the US’s foremost researchers in canine pain management, has handy advice on how people can help their arthritic dogs feel better.

A healthy weight provides pain relief

According to Dr Agnello, one of the easiest, most cost-effective and beneficial ways to reduce pain associated with arthritis is to maintain dogs at their healthy weight. This helps by relieving strain and stress on joints. She described a recent patient with hip dysplasia who came to her overweight and in pain from arthritis. Following a strict diet regime for weight loss, the dog greatly improved and hip surgery was not indicated.

Rehabilitation to increase strength

Once the pain is controlled, strengthening in the form of physiotherapy or rehabilitation exercises is vital to maintaining strength and mobility; even one visit to a qualified canine physiotherapist (registered with the APBC or ABTC) can help to formulate exercises tailored to your pet.

Speak to your vet for appropriate guidance or a physiotherapist referral. Strengthening exercises and activities like use of an underwater treadmill can help to build the muscles around affected joints, making it easier for your dog to get around. This form of hydrotherapy is done under controlled circumstances, with the dog wearing a safety vest, the water at optimum temperature and constant monitoring.

Some dietary supplements can help

Dogs can also be helped by alternative therapies such as joint supplements (high-quality fish oil is an excellent choice; check with your vet for the appropriate product and dosage), acupuncture and laser therapy, performed by a qualified professional. Other common supplements include:

• Glucosamine and chondroitin sulfate: these substances provide the building blocks for polysulfated glycosaminoglycans, or PSGAGs, which are long-chain molecules that hold water and give cartilage its cushion.

• Perna canaliculus (Green-lipped Mussel): extracts from this New Zealand mollusk have been shown to reduce joint pain and swelling in arthritic dogs.

• Avocado/Soybean Unsaponifiables (ASUs): ASUs act as anti-inflammatories and can inhibit the breakdown of cartilage and promote its repair.

The supplements listed here can be combined with other remedies, but check with your vet before adding them to your dog’s diet.

Long-term medication is available

When it comes to medication, non-steroidal anti-inflammatory drugs (NSAIDs) continue to be the mainstay of pharmaceutical pain relief for canine arthritis. In otherwise healthy dogs, these drugs are relatively safe when given as prescribed, with common tablet and liquid formulations available Dogs on NSAIDs long-term require regular blood testing every 3–6 months to check liver and kidney function.

New arthritis medication for dogs

A new anti-inflammatory drug, Grapiprant, was launched in the UK in 2019 for chronic canine arthritis pain. A prostaglandin receptor antagonist, it specifically blocks the EP4 receptor, which is the primary receptor involved in arthritis pain. It is considered safer than many of the other NSAIDs available because its mechanism of action is so specific, meaning that it is less likely to  affect other systems in the body that other NSAIDs might.

Injectable PSGAGs, such as prescription Cartrophen, can be beneficial to add in. Bedinvetmab and paracetamol are other prescription arthritis analgesic medications for dogs – do speak to your vet before considering these.

The future of arthritis pain management

For Dr Agnello, the most exciting and promising advances in the treatment of arthritis in dogs are likely to come from what are known as translational studies. Arthritic dogs are an almost perfect model for arthritic humans, which means that while researchers are developing new treatments for arthritis in humans, dogs also benefit (and vice versa). Treatments designed to resurface cartilage, partial joint replacements and transplanted ligaments are all being actively explored even as you read this article. Studies to improve blood supply to cartilage are also on the horizon, providing more options than ever before. 

Dr Agnello believes that joint-specific treatments are also the future of pain management. One such possibility is a compound called resiniferatoxin (RTX), a naturally occurring chemical found in red-hot sap produced by a Moroccan cousin of the chili pepper plant. The chemical  is about 1,000 times more potent than capsaicin, the active ingredient that gives chilli peppers their kick. When this chemical makes contact with pain-transmitting nerve cells, it spurs a rush of calcium into the cells, destroying them and providing relief from pain.

Presently, RTX is not widely available for canine patients in the UK. It is thought that when RTX is injected into the spinal fluid, pain cells are permanently ablated, or destroyed, and pain is eliminated. This selective deletion of pain-receptor cells has been coined ‘molecular neurosurgery’ and has the advantage of sparing neurons that are in charge of other functions, such as gross motor movement and feeling. Consequently, the patient is pain-free, can maintain coordinated movement, perform activities of daily living and experience a good quality of life.

The Penn Vet research team also studied RTX’s ability to reduce pain in dogs with bone cancer. Anyone who has ever watched a dog suffer from this disease knows that the pain can be debilitating. After receiving injections of RTX, dogs who were virtually immobile were able to run and jump. Cancer persisted and eventually proved fatal, but pet parents reported weeks to months of happy times with their dogs. RTX could eventually provide vets with another tool in the ongoing fight to relieve pain associated with arthritis. Other exciting advancements in arthritis treatment and prevention include research into joint-specific stem cells and long-lasting intra-articular treatments, with these already available at some centres in the UK.