DrNan’s Arthritis Treatment Plan  because getting old is not a disease

First, consider that arthritis is an inflammation of the joints.  So it makes sense to reduce inflammatory things in the food and in the environment.  The big inflammatories in dog food are wheat, corn, soy and dyes. You need to find a dog food and some treats that are grain-free.  Most dog foods on the market are full of these inflammatories.  Search for a grain-free high fat food and gradually change over, mixing your current food and the new one over a week or so.  A good food will pay for itself many times over. Look for a food with high fat (the closer to 20% the better), low carbs (less than 50%), with no corn, wheat, soy, dye or by-products.   An excellent website for impartial analysis of dog foods is www.DogFoodAdvisor.com.  You can have this site on your phone while you shop in the dog food isle.  The link between grain free food and cardiomyopthy is vague at best. UCDavis vets say it’s a thing. NCState says not. I go with State until proven otherwise. 

Second, try buffered aspirin.  Give baby aspirin (one 81mg size for every 20 pounds of dog) every night at bedtime with some food.  (NOT for CATS).  Arthritic dogs will sleep better, feel less stiff when they get up, and thus will feel better all day.  Some arthritic dogs sleep so uncomfortably that they start sleeping a lot during the day.  The aspirin helps.  There is controversy between vets about using aspirin in dogs.  It is a stomach irritant. It must be used carefully. At the University of Tennessee, Dr Mills’ studies support using aspirin for osteoarthritis. Use it as a test: if aspirin makes a difference that you can notice, then arthritis is probably present.

Third, fix a thick foam bed, with a heating pad under it during the winter.  (and also in the summer when air conditioners are running.) Chewey.com  has heated indoor and outdoor beds and solid chew-proof wafers which can be placed underneath a thick memory foam square.  Here is one from Amazon. 

Fourth, add Fish Oils to the food every day.  For a 30-pound dog or greater, give one human generic fish oil caplet (usually they are 1000 or more milligrams each).  I usually snip off the end of the caplet and squeeze the oil onto the food.    The high quality grain-free dog foods often have lots of fish oils already added. (I like Victor and 4Health Grain-Free dog foods.)

Fifth,  add a joint health supplement like JointFlex (Walgreens brand).  There are lots of these on the market.  Pick a generic brand and then double the human dose.  You are looking for Chondroitin, Glucosamine, MSM,  EPA, shark cartilage, kelp, mussel, yada, yada, yada. 

Sixth,  start a round of Adequan.  This comes in injectable form.  It was developed to treat knee injuries in racehorses.  It is powerful.  It is injected under the skin and it travels selectively to any hot, red, inflamed joint anywhere.  There it calms down the inflammation and reduces the pain and heat.  Even better, it serves to stimulate a smooth lubricant on the joint surfaces themselves, so it doesn’t just cover up pain, it actually addresses the disease itself.  I give one injection every 3 days for 4 treatments.  It makes a remarkable difference in many dogs.  Boosters can be given every few months to get some real long-term relief.

Seventh,  if the above treatments don’t seem to give enough relief, you can stop the aspirin and start on a stronger NSAID (a non-steroidal antiinflammatory drug).  Rimadyl, Deramaxx, Prevacox, Metacam are all in this category.  They are wonder drugs.  Some of these are expensive, but some can be found in generic form (at nearly every local and chain pharmacy).  These have the same dangers as aspirin:  they can irritate the stomach and stress the liver.  NSAIDS can eat ulcers into the stomach lining.  Easily.  So you use them at the lowest doses possible, taken with food, and with Pepsid AD 10 mg per day.  You watch closely for vomiting, loss of appetite or dark sticky tar-like stools indicating GI bleeding.  I like to do some simple blood tests before starting these drugs, and every few months thereafter.  

Eighth,  do some very gentle exercise and range-of-motion stretches.  I would prescribe a walk to the mailbox for the first two weeks after starting all these therapies.  Then perhaps a walk around the block every other day, as the supplements start to work.  Never walk enough to get sore.  Swimming is the best exercise of all, with the least impact and the most range-of-motion benefit.  So, it would be best if you would buy a walk-in Jacuzzi or a nice heated swimming pool.  When you do that, let me know.  I’ll be over.  

Nineth,  see if you can get him to lose some weight.  The thinner you are, the less stress on your joints.  And, news to me, it appears that fat cells themselves create inflammatory cytokines that flood the tissues, including the joints.   Also, lots of older dogs have a low thyroid hormone level and therefore have trouble staying trim.  We should test his thyroid before blaming him for being piggy. Thyroid meds are very inexpensive and might offer a new lease on life.

Tenth, acupuncture.   This is not voodoo.  It works.  If you like drug-free therapies, you should perhaps try this first.

Go over these ten things often.  You may be able to tell when or whether to repeat or increase these drugs and supplements.  In general, increase your supplements and your exercises first and then check with me to increase your NSAIDS only if the other things stop working.  Repeat the Adequan injections at any time.  There are great benefits to Adequan, and very few consequences.

Is that enough information??  Sorry you asked??