Arthritis is a painful condition and many dogs will need medication to improve their quality of life. As arthritis is a degenerative problem, the condition will get worse with age so pain killers will usually be required on a long-term basis and the dose may need to be increased with time, or new medications added in.
Before giving your dog any additional medications or supplements, always get your vet’s advice as many can be toxic to dogs.
Any medication can have unwanted side effects in the body so any dog on long-term medication will need to be monitored carefully by your vet and may need regular blood tests. If used sensibly, pain killers can be safe and hugely beneficial to your dog.
There are several different classes of pain killer available, some of which are licensed for use in dogs and others which may be used by your vet under the Prescribing Cascade.
By relieving your dog’s pain from arthritis, you may be surprised to find that he becomes much more lively and youthful. Often the only way to tell how much chronic pain a dog is in is to provide some pain relief and see the difference it makes! Old age doesn’t have to be bad.
Non-Steroidal Anti-inflammatory drugs (NSAIDS)
These are the most common first-line treatment for arthritis in dogs and humans. There are many different types of NSAID. The vast majority of human NSAIDS (e.g. ibuprofen, diclofenac) are highly toxic to dogs so you should never give these to your dog.
The most commonly used NSAIDS which are licensed for use in dogs include meloxicam (e.g. Metacam, Meloxidyl, etc.), carprofen (e.g. Rimadyl, Carprodyl, etc.), firocoxib (e.g. Previcox), robenacoxib (e.g. Onsior), mavacoxib (e.g. Trocoxil) and cimicoxib (e.g. Cimalgex).
The main side effects which are seen with this class of drug are gastrointestinal (e.g. vomiting and diarrhoea). Stomach ulcers are a potential risk so if any vomiting occurs on the medication, it should be immediately stopped and veterinary attention sought. Some dogs react to one of the drugs but are fine on a different one. These medications should always be administered with food, never on an empty stomach. If your dog is not eating for some reason, do not give the medication and seek your vet’s advice.
Longer-term concerns include kidney disease although there is still some debate as to how these drugs affect the kidney and whether it is as severe as previously thought. Nevertheless, if kidney disease is apparent before starting treatment, or becomes apparent during treatment it is sensible to consider other options, only using low doses of NSAIDS if absolutely necessary.
Overdosage of these drugs can be a big problem, particularly as many of the formulations are palatable to dogs so if they get hold of the packet, they may eat the whole thing! It is very important to keep the pot or packet of medication well out of reach of your dog, make sure that you give the correct dose (never double-up because your dog seems sore unless you have been specifically told to by your vet) and only ever give one type of NSAID at a time (a wash-out period of at least 5-7 days between giving different NSAIDS, or an NSAID and a steroid is recommended). If you think your dog may have had an overdose, seek immediate veterinary advice.
Some opioids are licensed for use in animals but these are mainly injectable preparations which are used for pain relief for operations, not for longer-term use such as is needed in arthritis.
One opioid which your dog may be prescribed is called Tramadol. In 2018 a new licensed formulation of this medication was launched. It seems to be effective in some dogs but less so in others. It can be used alongside an NSAID to provide additional pain relief or is sometimes used if an animal is unable to take NSAIDS for some reason.
Side effects which you may see with tramadol are drowsiness and slow breathing. If your dog is at all unwell when using tramadol you should stop the medication and speak to your vet as soon as possible.
Paracetamol can be used in dogs, NEVER in cats, but has a very low safety range so many human strength tablets are toxic. Ideally it should not be used alongside NSAIDS, however there is evidence in people that this can be safe and MAY be the same in animals. There is an licensed version of paracetamol and codeine for dogs.
Gabapentin has been used as an anti-epileptic drug as well as chronic pain problems. It may be particularly useful in cases of spinal arthritis as it has some direct effects on nerves. Side effects of gabapentin can include wobbliness. If your dog is on gabapentin, it is important not to stop it suddenly but to wean down the dose over a few days or weeks. This is a human drug so can only be used under the Prescribing Cascade.
Amantadine was developed as an antiviral but has effects on chronic pain as well. It is most commonly used alongside a different class of painkiller. This is a human drug so can only be used under the Prescribing Cascade.