Medications: Some medications have side effects (that while not common can occur) and most of the time your veterinarian will request lab work be run prior to starting these medications. The biggest category of medications for pain are the NSAIDs.
NSAIDs stands for Non-steroidal anti-inflammatories. These drugs are very good at controlling pain and inflammation associated with trauma, sprains, arthritis, and many other types of pain such as post- operative pain. These drugs absolutely cannot be mixed with aspirin or mixed within this class of drug. It is always advised that you consult your veterinarian BEFORE giving your dog aspirin due to the interference with these superior pain relievers.
Tramadol is a painkiller in the opioid class. This drug can be used for chronic pain but is used for situations where more pain control is required. The biggest side effect can be sedation. Dosing will vary and as a result can be slowly increased over time, however, at higher doses some animals will exhibit hyperexcitability.
Amantadine is an NMDA antagonist. It works better with other drugs for chronic pain. It is often used to treat “neuropathic” pain or for disk disease, cancer, and chronic arthritis.
Gabapentin was used as an anticonvulsant in people, however it is not used as such in pets. It helps alleviate nerve pain and chronic pain. It does not work as well for acute pain as it usually requires a build up to avoid side effects. Side effects can include dizziness and lethargy.
Supplements: There are many glucosamine and chondroitin products available. Some contain MSM, others will have Omega 3 and 6 fatty acids. Talk to your veterinarian about which one is right for your pet.
Herbal: Herbal therapy could be classified as supplements. Many of the joint supplements are now including herbs such as Boswelia and Devil’s Claw for their anti-inflammatory properties. Some veterinarians are also recommending Turmeric for its anti-inflammatory effects.
Acupuncture: Acupuncture is the process of inserting sterile, thin needles into specific locations on the body where muscles, nerves, and fascia converge. Treatments are usually painless and patients often fall asleep. Acupuncture helps the body heal itself by releasing natural pain relieving substances from the brain and nervous system.
Therapy Laser: Laser therapy reduces pain, and inflammation and accelerates healthy tissue healing through a process called photo-biomodulation. Photo-biomodulation involves low levels of heat, light and electromagnetic energy to stimulate individual cells to repair, regrow, and regenerate in a healthy manner. Laser therapy also affects nerve cells to release endorphins and decrease the perception of pain.
Physical Therapy: Often times, with severe pain, your pet will be reluctant to use a certain limb or certain side. The result over time is muscle loss. This loss of muscle makes it difficult to use the limb when it does feel better. Eventually more strain is placed on the unaffected limbs and soon they too are being damaged. Physical therapy helps to build muscle back or to keep muscle mass as even as possible. It strengthens both the affected limb and the unaffected limb to keep both as healthy as possible. Some physical therapy can be done in water to alleviate the effects of gravity on the joints. This can allow more rigorous exercise without causing as much pain and damage to the joints.
Support Braces: When a joint has been damaged enough to be unable to adequately support the needs of the pet, it will lead to a reluctance to walk or jump and difficulty in rising or climbing stairs. Companies like Ortho Pet and Hero will make a custom brace to fit your pet and provide stability to the joint. This stability will relieve some pain and allow your pet to regain strength.
Injections: Adequan is a Polysulfated Glycosaminoglycan than is given via an injection into the muscle twice a week. It will work at the level of the cartilage in the joint to try to help repair it. PRP (platelet rich plasma) is another injection that is harvested from a simple blood draw from your pet. The sample is prepared in a way that results in a concentration of growth factors and cytokines. These natural growth factors and cytokines can be injected into the affected joint to stimulate healing of the tissues within that joint. A joint injection is more invasive and does require sedation and sterile technique, but can provide months of relief for your pet.
CBD oil: CBD is a natural compound found in hemp. CBD hemp oil works by activating the endocannabinoid system that all mammals have. The endocannabinoid system is involved with almost every major system in the body and can help with anxiety, pain, seizures, appetite and much more. There are extremely low amounts of THC in the CBD oil. It is of great importance to make it very clear that this is NOT the same as marijuana which is toxic to pets. It is also important to find a product that has been extracted via the CO2 method and has third party lab testing to ensure there are no alcohols, hard minerals, pesticides, or minimal THC in the product. Limited research is being performed on its effects currently in pets. It is not approved by the FDA which means its use is off label.