I initially posted this in the Lavender Room, but now posting here for any info.
ALSO, any personal experience from non-specialists would be appreciated as well.
My irish setter girl has been diagnosed with degenerative arthritis on her knee (right front paw - first joint). We are heartbroken about this - she has been my constant running partner over the last six years. We started her on Metacam (anti-inflammatory), Adequan as well as Cosequin. We are also going to get her started on a weekly acupuncture regime. A couple of questions:
(1) Are these the most effective treatments we can pursue? What do you think about Cortisone injection? Our vet says that one does not inject cortisone into the joints of small animals. My husband thinks that this is going to be the most effective treatment.
(2) Will she be able to run again?
(3) How effective are Adequan and glucosamine/ chondroitin?
(4) What do you think about adding green lipped mussel?
(5) Is acupuncture really effective?
(6) Is surgery possible for dogs?
(6) Any recommendation for a good vet (in West Los Angeles or Valley areas) that specialize in canine arthritis?
Any help would be appreciated.
I had a samoyed who took glucosamine chondrotin for about 6 years. When we first started giving it to her, I was very skeptical. But, she went from walking with a limp all the time and not running, to running every day with only the occaissional limp after a longer run. There were a couple of times when we ran out, so she didn’t get it for a few weeks and the limp would always come back.
I was convinced that the glucosamine really helped her, and from then on we made sure she got it everyday. The anti-inflamatory was not necessary after she got started with the glucosamine.
EDIT - Oops! just re-read the subject and realized you asked for the opinion of specialists, which I am not. But I did have a dog I loved very much, and the glucosamine did help her.
My Labrador retriever came down with the same thing in both his elbow joints at about age 6. He had been a very active runner up until that time. Our vet advised me to stop running with him right away and to limit land retrieving and rough-housing with other dogs. We made the lifestyle changes and got him on Metacam. He’s now 11 and he has slowed down considerably. He can obny take short 5 - 10 minute walks. Still swims quite a bit and we have been encouraged to get him in swimming as much as we can. Other than the elbow problems he is in great health.
We were told that he may have had the degenerative condition for some time and when it was formally diagnosed was quite advanced - but he had shown no signs, symptoms or problems to that point. The breed is rather stoic and does not show discomfort or pain very well.
"EDIT - Oops! just re-read the subject and realized you asked for the opinion of specialists, which I am not. But I did have a dog I loved very much, and the glucosamine did help her. "
Paul
That is fine. Any personal history is appreciated as well. I am also trying to understand what other STers have experienced.
Just to add to Paul’s reply…I have pretty severe degenerative arthritis in my hips. The docs wanted to do hip replacements on me back in '04. I started taking glucosamine (and riding a bike) and it really helped me. If you do go the glucosamine route I would definitely do the liquid (I use Syn-flex). The pills/powders did nothing for me.
I’m not a vet but I own a pet supply store. Glucosamine does help. Green lipped mussle is just another source of Glucosamine. Whether you get glucosamine from green lipped mussles, bovine cartiledge, or shrimp shells doesn’t really matter. As long as it’s a quality product that has in it what it says you should be OK. Oral steroids will eventually damage your dog’s organs, especially the liver. Things like deramax and rimadyl will also cause liver damage. They are last ditch efforts. Non-buffered aspirin helps a lot too but, it’s hard on your dog’s stomach. Probably the best thing to do for your dog is to decrease running volume and use dietary supplements like Glucosamine/condroitin. Glycoflex is an excellent brand with great quality control. That 's what I gave my old running partner for several years. I hope your dog feels better.
I think, from your description, that you are describing your dog’s carpus, or wrist, instead of the knee. Dogs do have knees but they are in the hind legs. Some of the treatments for arthritis that may be possible for the knee are not commonly performed in the carpus, so I just wanted to clarify which joint is affected.
The treatments you have begun are about our entire arsenal for canine arthritis. Metacam is a great anti-inflammatory and I prescribe it a lot. Possible side effects of nonsteroidal antiinflammatories such as Metacam, Rimadyl, aspirin, etc are vomiting, diarrhea, gastric ulceration, and liver and kidney failure. HOWEVER, these are rare side effects, and you have to weigh the risk/benefit ratio for your setter. Personally, I would rather see a dog feel better and have less pain than not give the drug for fear of a side effect that very well may not happen. Adequan and glucosamine are also excellent treatments. Cosequin was the first glucosamine approved for dogs and seems to work better than others. Your vet is correct; cortisone is not injected into the joints of small animals.
Don’t push her on the running - let her decide if she wants to. If she enjoys running and doesn’t seem more painful afterwards then let her run, but I wouldn’t take her on long ones, and try to keep her on soft surfaces rather than pavement.
See #1
Green lipped mussel is a new one to me
Some clients (and veterinarians) believe that acupuncture works; some don’t. I have an open mind but no personal or clinical experience. There’s no harm in trying, but I would find a certified veterinary acupuncturist. That should be easy in California! =)
Your veterinarian can refer you to an orthopedic specialist, but I don’t know any specific names in California. UC Davis is great but that may be too far of a drive for you. Sometimes orthopedists can use arthroscopy to enter a joint and “smooth” the arthritic changes within, but that varies from joint to joint and case to case.
Hope this helps! Feel free to pm me if you have any more questions.
Thank you. I have been walking her around the block to keep her joints flexible. It is somewhat sad for her and her brother because she cannot run with her brother. Hopefully, she will be able to join us running eventually.
You are correct - it looked more like her wrist to me, but someone else insisted that it was her knee.
I will continue with this treatment and see where it goes. Meanwhile, she is still very lively and tries to be involved in everything around the house.
Thanks. I was asking about green lipped mussel because apparently Glycoflex has this as an ingredient, but cosequin does not. I have read that Cosequin was one of the best pet glucosamine/choindroitin (low molecular weight) product out there, but our vet was recommending Glycoflex.
I’ve had both my knees reconstructed (no, I’m not a dog:) and my first dog had her knee reconstructed. Back in '04 I thought my running days were over, but I did some research and started taking glucosamine. The more research I did, the more I learned that the liquid form is much better, because the body doesn’t get a lot from the pill form. So I started taking flexicose, here’s the website: http://www.flexicose.com/ When my first dog had knee surgery, they told me she already had arthritis, and it was most likely going to get worse. At the time, I didn’t know about the liquid glucosamine, so I had her on the Trader Joe’s dog glucosamine (tablets). It worked really well for her. After about a year and a half after surgery, she was back to her normal self and running and playing and everything she used to do. And, I had her off all of the anti inflamatory medications, and only taking glucosamine.
As for me…I swear by flexicose, and they have a pet version too (I think it’s the same as the people version, just different doses, but I’m not positive about that). The doctor’s told me I had arthritis and the pain I was experiencing was from too much pounding on my knees throughout my life and I should just stop running/triathlon/soccer/pretty much stop living is what I heard. Since I’ve started the flexicose (in 2004) I’ve been able to resume my running and I run 1/2 marathons and have done a 1/2 Ironman, and I can get back to thinking about doing the Ironman that I’ve always wanted to do. Unfortunately, my first dog passed away, so I never had the chance to give her flexicose, but with my new dog, if she ever has joint issues, I’d use flexicose for sure.
If you use glucosamine for your dog, take whatever brand you use to your vet and have him/her tell you the dose to use. When I was using the Trader Joe brand, my vet doubled what the bottle said. Good luck and I wish you the best!
A couple of general things to keep in mind. First, arthritis is progressive, degenerative, and irreversible. Use of anti-inflamatories and pain killers only slows the course of osteo arthritis and does not reverse damage that is already present. Cortisone shots can provide temporary relief in humans, I have no idea of their veterinary use. Cortisone shots also do not reverse existing joint damage. They are simply a highly potent and localized, though temporary, anti-inflamatory treatment. Next, there is no surgical procedure that can reverse the effects of arthritis.
Second, glucoseamine/chondroitin is very effective at helping lubricate the joints, can slow the progression of arthritis, and has mild anti-inflamatory properties. Acupuncture may or may not help with pain relief. I would strongly recommend glucosamine/chondroitin and I would be careful of the supplier. Not all glucosamine/chondroitin is created equal. Stick with major labels such as Cosequin or other label recommended by your vet, using the dosage recommended by your vet based on your dog’s body weight.
I would not recommend any more pavement runs with your dog, of any distance at all. However, if you continue to keep her on glucoseamine and a pain killer, there is no reason she cannot go for walks, play in the yard, run around in the park on soft surfaces. Constant pounding of distance running would not be advised.
One of my golden retrievers is nine years old; she’s had blown ACL in both rear legs, reconstructive surgery in both rear legs, arthritis in both hips and knees. She’s on glucoseamine/chondroitin and several other supplements (fish oil, vitamin C, vitamin E). She’s still really active and you would not know that she has such compromised joints. She doesn’t need any other painkillers yet (such as buffered aspirin or rimadyl or dermax).
I think the sad fact is that for the health of your dog, you should not take her out running anymore. You can keep her comfortable but there is no cure for arthritis and you cannot reverse the existing degeneration in her joints. Definitely start her on glucosamine/chondroitin and possibly fish oil and vitamin C.
I don’t know if Ventura is too far for you to go, but there is an exceptional veterinary clinic there called Veterinary Medical and Surgical Group (VMSG). They are affiliated with UC Davis vet school–most of the vets are UC Davis grads and they run an intern program in conjunction with UC Davis. Their website is here. They prefer you to have a referral from a general practice vet, but I doubt that they would turn you away if you can’t get one. We saw Dr. Ortega when our dog was diagnosed with cancer and she was extremely knowledgeable and wonderful to work with, although I don’t think she’s the orthopedic specialist among the group. You can look through their website for info about the docs. Just be prepared to spend the big bucks; that kind of specialty practice comes with a significant price tag. Dr. Ortega did put our dog on Previcox, which is an NSAID (cox 2 inhibitor), for it’s possible tumor fighting properties, which seemed to also help our dog’s arthritis and was very well-tolerated.
Another option is Dr. Alan Schulman at Animal Medical Center on Sepulveda in West L.A. Dr. Schulman is a well-respected veterinary surgeon and was the doctor who removed the avocado-sized tumor from our dog, at about half the price of what we were quoted at VMSG. The dog went on to live 3 years with metastasized cancer, which I’m sure was at least partly related to his skilled tumor removal. I believe his specialty is orthopedic surgery. Dr. Ortega told us he has come up to VMSG to lecture on orthopedic surgery in dogs. If you think surgery is necessary, this might be the place to go.
No, you don’t need a referral for Dr. Schulman. I’m sure we didn’t have one and I think we got in pretty quickly. I’m just not sure if he does general practice (i.e., non-surgical) stuff, and I don’t know anything about any of their other vets. I think I would probably try to get in to see him specifically, even if surgery is his main specialty, because I would think that he would be able to give you non-surgical alternatives. But, I don’t know that for sure, since my only interactions with him were related to surgery.
You might also want to ask about Previcox vs. Metacam. It seems like I heard Previcox has a better safety profile, although txvet clearly knows far more about that than I do. Do they have you taking Misoprostol with the Metacam to try to protect your dog’s stomach lining? If so, order it from Canada, it’s much cheaper.
I have no real advice but wanted to add that my parents have a lab that was diagnosed with arthritis in his “elbows” (maybe wrists?) back when he was TWO. It was devestating to be diagnosed with arthritis at such a young age.
They took him out of agility (a lot of pounding on those front legs) and don’t encourage jumping (but don’t NOT let him play either) and it doesn’t seem to have gotten any worse - and he’s TEN now!
They keep the dogs on a very high-quality diet, give glucosamine supplements, and take the pooches for LOTS of walks. On days when he seems a little extra stiff he gets a baby aspirin.
I think the vet said that there was surgery they could do to fuse the elbows if it got to be too bad? This seemed pretty dramatic tho and was never really something they looked into.
You may have to limit running but your dog can still have a great quality of life for a long time to come.
Thanks. I have been taking her on short 15 minute walks. After two injections of Adequan and a week of Metacam, she must have felt a bit better this morning. She was jumping around trying to get me to play and also even jumped upon on the sofa. It was hard to get her to stop running or jumping around the house. She was very energetic and led her brother on a 20-30 minute walk on the trail. I came back the minute she started showing any sign of limping. I usually take my dogs on a single track trail behind my house (we rarely see anyone there). They are walked off leash, so she can walk at her own pace - usually stops to sniff at something or look at rabbits / squirrels.
My 13 year old English Shepherd has arthritis. We have found a few things that work well for her:
Swimming. Swimming is a miracle therapy for her. We take her to a lagoon once a week and let her fetch in it if for 45 minutes or so. It has by far been the best treatment. My brother in law is a vet and when I mentioned this to him, he told me that some vet practices are having special hydrotherapy pools installed for the dogs— It sounded like they were dog-sized endless pools. The pools let the animals fully extend their legs and work hard with no joint stresses.
Flax-seed oil. Omega threes are great for inflammation. We pour a shot on her dog food each morning.
Bench & Field Holistic natural canine formula dog food. She is more energetic now that we’ve switched to this brand. There are significant differences between brands.
Garlic tablets. Not sure why these help but they are part of her program so I had to list them.
We tried a lot of different things over the past three years— My wife is a holistic health practitioner. These four things in combination have been the ticket for our pooch.
Thanks. I have heard that Omega 3s are good for arthritis - Flaxseed as well as fish oil. I will add these to her diet. We currently feed her Canidae - which claims to be natural and holistic. I agree that many of the premium dog food brands are not all equal. I have always favored non-mainstream brands such as Innova, California Natural and Canidae vs. Iams, Science Diet, etc. I will do some research into the brand you are mentioning.
I will try to find where I can get her to swim more. It is certainly low impact exercise that gets her to maintain her flexibility. She used to swim a lot when we lived in Chicago, but since moving to LA, she has not done much swimming. She got slammed by a big wave once, and since then, she got somewhat afraid of the ocean water.
