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ORTHOPEDICS: ARTHRITIS: OA 3. MEDICAL TREATMENTS: PAIN MANAGEMENT WITH MEDICATIONS

YVCipedia ORTHOPEDICS

OA -  MEDICAL TREATMENTS: PAIN MANAGEMENT WITH MEDICATIONS

Part of the disease process of OA is pain; our patients with OA invariably have some degree of discomfort. Pets usually do not show evidence of pain in obvious ways like crying out, whimpering, or limping badly. Their pain is demonstrated in subtler ways: a dog might be slow to rise from lying down or reluctant to jump in the car; a cat might soil the floor next to the litter box instead of stepping in and out of the box. Sometimes the first evidence of OA is discovered when we examine a patient and find that they have muscle atrophy of one or more limbs, due to favoring it for an extended time.

It is our goal at YVC to manage pain using as little medication as possible; the other treatments discussed in our OA articles (weight management, supplements, exercise, etc.) can all help dramatically to manage this problem. But pain control medication is almost always needed:

- Unlike pain medication, which works almost immediately, these other treatments require weeks to months to exert their positive effects.

- Patients with OA need pain control to be able to exercise effectively.

- An attempt to medicate “as needed” often does not work because it is often not obvious when a pet needs help.

We create our treatment protocols specifically for each OA patient. When we first diagnose a patient with OA we will usually prescribe pain control medication for a minimum of one month. This allows sufficient time for other treatments, started at the same time as the pain medication, to begin to take effect. The medication may then be tapered off, discontinued, or continued indefinitely based on the individual pet’s needs.

There are many analgesics from which to choose and, again, we believe it is essential to tailor treatment for each patient. The class of medication that is most useful is nsaids (non-steroidal anti-inflammatory drugs). It is our opinion that the two best oral nsaids are Meloxicam and Previcox.  

Some patients need multiple and/or changing drug therapy to get significant relief. When we use multiple drugs, we choose medications that work in different ways and might therefore complement each other.

Every medication has potential side effects and we do not take this possibility of adverse drug reactions lightly. We carefully consider the risks and benefits of each medication we prescribe for every one of our patients.  In general: we prescribe these medications a lot, we infrequently see mild side effects, and we rarely see serious side effects.

Peter Smith, DVM

Yarmouth Veterinary Center

2014


 

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