Osteoarthritis and Cortisone

Question
I have a 4 yr old Bernese Mt Dog.  She has shown signs of stiffness on her front legs for years.  Recently she became lame on both of those limbs and now been diagnosed with Osteoarthritis.  My Vet put her on Rymidal but it did not appear to ease her discomfort.  Are Cortisone injections an option for her condition.  X-Rays did not show any 'floating' fragments that would cause discomfort.

Answer

Hi Julie,

Have you spoken to your vet and told him or her that the Rimadyl doesn't seem to be effective? A dose adjustment might be needed. Other prescription medications that might help are Deramaxx, Metacam, Zubrin, or  Etogesic.  You shouldn't use Rimadyl with these other medications.

There are injectable cortisone products for dogs. However, their use is controversial. Corticosteroids act as a potent anti-inflammatory, but unfortunately, have many undesirable short- and long-term side effects. Because of these side effects and the advent of newer, more specific drugs,  (such as Rimadyl) corticosteroids are generally only used in older animals with flare-ups where all other pain control products have failed. Since your dog is only 4 years old, you should talk to your vet regarding the use of cortisone, and learn about it's side effects.

Talk to your vet about Adequan. This is an injectable form of Glucosamine that your vet would administer as an injection. A series of shots are given over weeks and very often have favorable results. The cost and the inconvenience of weekly injections are a deterrent to some owners, especially since the oral glucosamine products are so effective. This product helps prevent the breakdown of cartilage and may help with the synthesis of new cartilage.

Another injectable treatment to consider is Hyaluronic acid. Including it in the management of osteoarthritis may protect the joint by increasing the viscosity of the joint fluid, reducing inflammation and scavenging free radicals. Most of the research on hyaluronic acid has been done in people and horses, but it may also be effective in dogs.

Glucosamine and chondroitin are two supplements that have become widely used in treating both animals and humans for osteoarthritis.  Glucosamine and chondroitin will not cure arthritis, but it can slow the progression of the disease.  A dog needs to receive these diet supplements daily for 6-8 weeks, before the therapeutic effects may be seen. Some dogs really show marked improvement on Glucosamine and chondroitin supplements, while others do not. There's no way to guess at how any particular dog will do on these supplements, but it's worth trying.  
Glucosamine and chondroitin do not control pain, they need to be given along with whatever pain medication you have.  After your dog has been receiving the supplements for a few months, you can try to cut back on the pain medication to see if there is any improvement. Brands to look for are:  Cosequin, Arthroflex, Gluco-Tabs, Glyco-Flex (amongst others). You can also use a supplement made for human consumption, the dose for glucosamine is 500mg/25 lbs of body weight (or 20mg/lb) and the dosage of chondroitin is about 400mg/25 lbs of body weight, or about (16mg/lb) per day. In most cases it is recommended that the dosage be split and given half in the morning and half at night.

Acupuncture is something else to try, on top of the pain medication and using a Glucosamine and chondroitin supplement.  You can locate a veterinary acupuncturist here:

http://www.aava.org/php/aava_blog/aava-directory/

http://www.ivas.org/Members/VetSearch/tabid/124/Default.aspx


Best of luck,

Patti