Last month, we talked about arthritis (the disease itself) but did not get into the treatment choices. I think it is important for pet-guardians to understand the basic workings of several pain medications we routinely use. This is not a scientific look at the topic but gives a broader and easily digestible view.
Blocking local source of pain: Here we address the inflammation in the joints. Some forms of anti-inflammatory medications like Rimadyl, Deramxx, Metacam are helpful. All anti-inflammatory meds are potentially harmful to the liver and the kidneys. It is advised to monitor the liver and the kidney values before the meds are started and follow up every 6 months to a year. I found that generic Rimadyl works fine for our practice, and it is cost-effective.
The choices for cats are limited. We have used Meloxicam in our practice. It is not approved for long-term use in cats in the U.S. However, there are published studies from Australia and Europe that show when Meloxicam is used cautiously in renal failure cats, it did not significantly alter the kidney damage markers.
There is a new class of drugs like Galliprant, which reduces the generation of the pain signal by an independent non-inflammatory pathway. The manufacturer claims that it can be used even in liver and kidney failure cases. However, for now, it is rather expensive!
Controlling signal conduction: Pain signals are carried by nerves to the brain. Drugs like Gabapentin reduce the nerve conduction of pain signals and can be a useful adjunctive therapy for pain control. Gabapentin is used extensively in humans for back pain. We found that for marked pain, anti-inflammatories don’t seem to be enough, and adding Gabapentin helps significantly.
Controlling pain by blocking brain-perception: Many opioids (like morphine) are used to reduce the brain’s perception of pain. We do not use drugs as strong as morphine routinely, but a much weaker cousin, Tramadol, works well when used along with other classes of pain meds. In cats, we use oral Buprenorphine routinely along with Meloxicam, if needed.
Reducing muscle spasms/tightness: Frequently, back pain results not only from nerve pain from pinched nerves but also pain from spasmed muscles. Muscle relaxants are used frequently in dogs for this purpose.
Anti-depressant: Tricyclic antidepressants like Amitriptyline (Elavil) are showing significant promise as another pathway to control pain. Its use for pain control is not yet popular in vet medicine.
Next time, we’ll discuss holistic treatments for pain.
Goutam Mukherjee, DVM, MS, Ph.D. (Dr. G) has been a veterinarian for more than 30 years. He works at his home as a holistic veterinarian and is a member of North Alabama Electric Cooperative. Send pet-related questions to drg.vet@gmail.com.
