What a Pain!

Just hearing the forecast of more snow makes my joints ache! I have been trudging through narrow corridors of self compressed snow up and down my lane to my nearly abandoned car. I have been shoveling for what seems like weeks. Gone are the days when my yellow lab Bosun and I could walk effortlessly to the mailbox. With the snow’s depth over my knees and virtually over his head, Bosun is like a porpoise plunging through white waves. Walking or porpoising through snow is hard work and taxing to our body’s joints. Whether trudging to the shed for more firewood, or attempting to take Bosun out for a walk, I wind up breathless and clutching my aching knees. Bosun puts up the good fight, but eventually gives up and lies down. Perched atop a snowy pillow, his eleven year old legs must rest. I’m quite sure he’s not the only dog whose legs are suffering. Of course there’s pain from misplacing a step and falling into a crevasse, or once paths are cleared splaying out on ice, but right now I’m referring to the pain from joints which suffer from chronic inflammation, now exacerbated by intense cold and challenging conditions.

Fortunately, there are several new modalities for addressing painful joints. Virtually everyone knows about glucosamine which helps to strengthen cartilage. It is often paired with chondroitin which also repairs damaged cartilage. These are oral supplements which are taken on a once or twice daily basis. When used prophylactically in young animals, these agents keep cartilage strong. Interestingly, a Maryland based company (Nutramax) was among the first to market a reliable and reputable glucosamine product. This is noteworthy as glucosamine and chondroitin fall under the category of nutraceuticals — naturally occurring compounds which have health benefits. Nutraceuticals are not supervised by the FDA, and therefore are unregulated. That means that unscrupulous manufacturers can take liberties with their products. What the label says and what’s in the bottle may not be the same thing. Always purchase glucosamine products from your vet. He or she is more likely to carry trustworthy supplements.

Another type of medication acts on joint fluid, the viscous liquid which bathes all joints and which delivers nutrients to cartilage cells. This is administered as a series of injections given in the vet’s office or owners can be taught to do it at home. These shots, PSGAGs, increase the viscosity of joint fluid, providing pain relief for months.

The afore-mentioned treatments attempt to re-establish the building blocks of a healthy joint. Therefore, they take time to work — weeks to months. For immediate pain relief, there is a new class of medication called COX-2 inhibitors. These act by blocking essential pathways in the production of pain, inflammation and fever. As such, they modulate both pain and swelling. Since inflammation is an essential component to causing pain in the first place, by blocking inflammation, these drugs provide more effective pain relief. It is for this reason that the newer osteoarthritis pain meds are better than aspirin. Aspirin subdues pain, but does nothing for inflammation. Also, they have fewer side effects. They’re easier on the gut — less vomiting and diarrhea and generally have less tendency to cause bleeding. The COX-2 inhibitors are oral preps, mostly flavored chew tabs or easily administered liquids. Many dogs take them daily, even for years to alleviate joint pain.

With all these options available for better joint health, dogs like Bosun can walk with a spring in their step. Now if he could only see over the snow!