Slide presentation discusses the management of lamenessand chronic pain in dogs.

1.  Now What?
By Jacquelyn H. Burns, DVM
Copyright © Jacquelyn H. Burns
All rights reserved

2. Please, visit your vet.
That’s what they’re there
for.

3.  When we veterinarians say
osteoarthritis or arthritis, we mean
Degenerative Joint Disease or DJD
◦ In dogs and cats, degenerative joint disease
means bone, muscle, tendon, ligament
and/or joint changes have occurred as a
result of joint instability or structural
unsoundness
◦ The body attempts to rectify instability by
forming extra bone at/around affected
joints.
◦ There is also inflammation with a snowball
effect that tends to make itself worse over
time.

4.  Injury
◦ Blunt force trauma (hit by car)
◦ Athletic type injury (―football player‖ injury)
 Torn ACL ligaments
 Heredity
◦ Hip dysplasia
◦ Patellar luxation
◦ Elbow dysplasia
 Acquired/Developmental/Other
◦ OCD (osteochondritis dessicans)
◦ Angular limb deformity

5.  The results are the same
◦ Chronic pain
◦ Chronic lameness

6.  Animals are usually
rather stoic and do
not always show
outward signs of pain
 Many never cry out.
◦ In a pack atmosphere,
showing outward signs
of pain shows weakness
and vulnerability
 Dogs tend to ―Keep
calm and carry on.‖ ―If it didn’t hurt, he
wouldn’t be holding his
foot up.‖
Dr. Burns

7.  There are only two
reasons why a patient
might limp
◦ PAIN
◦ Structural instability
 Bones or ligaments that
support the
musculoskeletal system
are broken or torn

8. Gosh
darn, this
hurts.
How am I
going to tell
 Unusual or different the big
posture people?
 Decreased appetite
 Decreased play
 Decreased
interactiveness
 Becoming withdrawn
 Sleeping a lot more
than usual
 Irritability/snappy

9.  Structural instability
What is this here
thing you call
 PAIN
inflammation?  Inflammation

11. Inflammation
More pain Pain
More
inflammation

12.  NSAIDS= Non-  Cons
steroidal anti- ◦ Pets must have healthy
inflammatories kidneys and livers to
take these medicines
 Pros
◦ All senior pets (and
◦ Contain no cortisone some non-senior) must
◦ Very decent painkillers undergo regular blood
for all types of general testing in order to use
pain NSAIDS
◦ Block the ◦ Sometimes cause GI
inflammation-pain- upset
more inflammation – ◦ Cannot be used with
more pain cycle corticosteroids
(cortisone, prednisone)

13.  Pros  Cons
◦ Non-drowsy opiate- ◦ Short half-life means
like pain killer dosing three times a
◦ Very safe, including day for best results
senior dogs and cats ◦ VERY BAD TASTING
◦ Blood work not  Owners who depend on
necessary for food or treats for
prescribing these concealment of pills may
find that pets refuse
◦ Can be used at the them or eat around the
same time as tramadol
corticosteroids
(cortisone, prednisone)

14.  Nutraceuticals are food supplements that
promote healthy joints
 Nutraceuticals are not all created equal. In
other words, a cheap one may not work as
well as a higher end one.
 Generally in a pleasant flavored chewie.
 Most are given once daily.
 Note, these are not medicine and do not kill
pain. These are vitamins for joint health
 Ingredients vary but usually include
glucosamine, chondroitin, fish oil

15.  Gabapentin is a  Cons
seizure drug but ◦ Gabapentin is
used in cases of formatted for human
chronic pain has use, so sometimes
we have to get it
proven very helpful made to order in
in pain that is special smaller mg
refractory to other tablets or
drugs suspensions for very
 Convenient one to small dogs and cats
two times a day
dosing

16.  Adequan is a  Cons
chondroprotectant ◦ Expense
(cartilage protector) ◦ Necessitates bringing
 Give by injection pet for injection
every week for a
 Once weekly for month
four weeks, then
every three to four
weeks as
maintenance

17.  Acupuncture
 Cold Therapy Laser
 Physical therapy or
rehabilitation
◦ Underwater treadmill Wonder
where I can
find
somebody to
do that to
me?

18. Holistic
medicine? Might
as well go out
in the pasture
 Holistic and pull a
―medicines.‖ handful of
 Recently the weeds for him.
AVMA has
made a position
statement that
holistic medicines
are not proven to
be safe and
effective

19.  NSAIDS – carprofen
(Rimadyl/Novox, meloxicam
(Metacam), Previcox, Deramaxx
 Tramadol
 Joint Supplements (yummy Phycox soft chews
are Dr. Burns’ favorite)
 Gabapentin
 Adequan
 Physical Therapy
 Acupuncture
 Cold Therapy Laser

20. Man, I’m dying
 There have never been here. What is
satisfactory safe wrong with the
pharmaceutical
options for home pain
industry?
management—either
long term or short
term—in cats! While
we have a few things
now that we didn’t
have five or six years
ago, we still have
needs that are unfilled.

21.  Nutraceuticals
 Meloxicam  Cons are many!
 Onsior ◦ Meloxicam is often used in
cats, but it is not FDA-
 Gabapentin approved for long term use in
 Tramadol the USA.
◦ Meloxicam requires very
healthy kidneys and a good
hydration status. Even so, it
still can cause kidney failure in
some cats
◦ Onsior is only FDA-approved
for 3 consecutive days in the
USA
◦ Gabapentin and Tramadol
have to be compounded
(made to order) and are not
FDA-approved for cats in the
USA

22. Like I always
say, better
living through
chemistry!
 To make the pet
have the best
mobility and quality
of life that he/she
can have
 To make good days
outnumber bad
days

23.  Chronic pain is not curable; it
is a management condition
 It is not reasonable to expect
your pet with DJD never to
limp
 Your pet may not be able to do
the same amount of exercise
or play that he/she once did
 Like people, there will be good
days and bad

24. • People with DJD and chronic pain
often use mobility devices such as
walking canes, walkers and
wheelchairs. Unfortunately, most
dogs cannot use these.
Wonder where
I can get a
walking cane?

25. • People with chronic pain have I’m so
some days where they are blessed to
have Rascal
nearly normal and walk/move to love!
pretty well with a cane or
walker, some days where they
really feel good…and some
days when they don’t feel like
getting out of bed.
• Your dog is I’m so glad I
can still run
the same. and play!
And that
she loves
me!!!!

26. Material is not intended to
be construed as veterinary
medical advice and not
intended to be a substitute
for examination, diagnosis
and treatment of your pet
by your veterinarian.
Please, visit your vet.
That’s what they’re there
for.