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volgend artikel werd me toegestuurd, door een collega student. Dacht wel handig om hier te plaatsen. Het is wel in het engels...
Arthritis and Chronic Pain
Arthritis is one of the most common medical problems afflicting dogs today, and a growing number of cats are also affected by it. Arthritis can be secondary to an earlier injury or surgery, can be caused by genetic conditions such as hip dysplasia, or can be the result of a number of degenerative processes that are not fully understood. There can be infectious agents involved in some types of arthritis, as well as an autoimmune component. Do not diagnose arthritis in your pet yourself. Be absolutely sure that your veterinarian has ruled out other causes for stiffness, lameness, and pain on movement.
The most common first reaction to arthritis is to reach for a pain medication, but I'm going to suggest something else. There is some evidence, not definitive by any means, that NSAIDs may actually make arthritic conditions worse, while masking the pain. (Journal of Orthopaedic Research, November 2002.) They also have some pretty serious listed side effects. And yet those are often used as a first line treatment, even for mild pain in a fairly young animal.
A better option in my view is to explore the many effective and safe alternatives that are available for the treatment of arthritis symptoms in dogs first. These may also be helpful in the treatment of pain from similar conditions such as spondylosis (calcium deposits on the spine).
Suggestions for first line defense for arthritis and similar chronic pain:
Examination and diagnosis by your veterinarian
Grain free, low carbohydrate diet
Fish oil and vitamin E supplementation
MSM, SAM-e, Cetyl Myristoleate if the animal responds to them
Appropriate homeopathic remedies
Mild anti-inflammatory herbs or drugs as needed
Acupuncture as needed
Injectable glucosamine (Adequan)
While purely anecdotal, there are literally thousands of accounts of dogs and cats who were switched off of high-carb processed diets and put onto home prepared, low-carb diets, who experienced a great deal of relief from stiffness and pain. (You'll see similar stories about humans who did the same thing!) Decreasing carbohydrates in the diet can also contribute to weight loss, and it is essential that dogs with hip dysplasia, arthritis, or any form of pain on movement be kept as lean as possible. While some kibbles are lower in carbs than others, there is no such thing as a "low carb" kibble. Information on home-prepared diets is available from any number of excellent books on the subject, a few of which are listed in the Resources section at the end of this article.
Just as in humans, glucosamine/chondroiton supplements are effective in dogs and cats for the relief of arthritis symptoms. But they do more than just relieve symptoms; they actually lubricate the joint, reduce inflammation, and help cartilage rebuild in the affected areas. They don't just mask pain; they actually help heal the joint. Not all glucosamine supplements are created equal; be sure to use one that has undergone independent testing.
Fish oil has a number of important anti-inflammatory benefits and has been used with good results for arthritis. Be sure to give extra vitamin E, as increased levels of oil in the diet increase the body's need for that vitamin.
There are a number of other supplements that others have had tremendous luck with, including MSM, SAM-e, and Cetyl Myristoleate. If you try them, be sure to use them for a long enough period to make a fair judgment of their effectiveness. Supplements do not work like drugs, and you cannot expect overnight relief. A wonderful resource on the use of herbs and supplements in the treatment of arthritis can be found at http://www.bowchow.com/specific.html#arthritis.
Homeopathy can also work very well in the treatment of chronic pain from arthritis, but as with all chronic conditions, homeopathic treatment needs to be done by a professional. Chronic treatment is more complex and requires far greater levels of training than acute treatment or first aid. If you want to investigate homeopathy for the treatment of chronic pain, please find a good homeopathic veterinarian, preferably one who has been certified by the Academy of Veterinary Homeopathy (be sure to contact a practitioner who has been certified by the Academy, not just someone who has completed their training course) at http://www.theavh.org/, or PO Box 9280, Wilmington, Delaware, 19809.
If supplements do not work or become less effective over time, veterinary acupuncture is a promising next step, when it is available. Acupuncture has been proven to have a beneficial effect on pain and inflammation, and in my experience has produced miraculous results in as little as a single visit. You can find a veterinarian who has been trained in acupuncture through the International Veterinary Acupuncture Society at http://www.ivas.org or by calling 970-266-0666. In addition, in some states, a licensed human acupuncturists may treat animals under the supervision of a veterinarian, so you and your vet might want to explore this option.
I have observed especially great results with the combination of acupuncture and Adequan, an injectable form of glucosamine that must be obtained through your veterinarian. Adequan is a drug manufactured by Lupitold, a very small company, and it is expensive and not frequently used by veterinarians. I am absolutely convinced that if they could invest in the kind of marketing program that Rimadyl and other drugs have benefited from, Adequan would be one of the most widely used arthritis treatments for dogs in the US. Like oral glucosamine supplements, it has been proven to go to the affected joints and lubricate them, reduce inflammation, and help rebuild cartilage. However, it is much more effective than its oral version, and will provide much more dramatic and rapid benefits. ("Joint Disease - A New Approach?" Veterinary Forum, October 1987.) It is essential that the label directions be followed, including the loading dose. If you try to space the injections out too far, or give fewer than the recommended number of injections, you will not get the same result, and might abandon a treatment that could give your dog years of pain-free activity.
When those first-line therapies stop working, or if you cannot obtain the relief your animal needs to have a pain-free and fairly active life, you can investigate more powerful pain medications. In the next article in this series, I'll focus on dealing with severe acute and chronic pain, post-surgical pain, and pain management in terminally ill pets.
If you are looking for information on feeding a home-prepared diet to your pets or finding out more about dealing with pain in animals, there are any number of books and thousands of websites that will help. Here are a few resources to get you started.
Dr. Pitcairn's Complete Guide to Natural Health for Dogs and Cats by Richard Pitcairn DVM PhD and Susan Hubble Pitcairn
Home-prepared Cat and Dog Diets: The Healthful Alternative by Donald Strombeck DVM PhD
The K9Nutrition email list
K9 Kitchen by Monica Segal
Switching to Raw by Sue Johnson
Herbs for Pets by Mary Wulff-Tilford and Gregory L. Tilford
My weekly Holistic Pet Care online chat at http://www.doghobbyist.com/ (Sundays at 9 PM Eastern Time)
Copyright 2003 by Christie Keith
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