DEGENERATIVE JOINT DISEASE
By Cindy Exelby, D.V.M.
Osteoarthritis (another term for degenerative joint disease) is a chronic progressive disorder affecting joints. It is characterized by cartilage destruction and alterations in the subchondral (bone underlying the cartilage) and joint fluid. Clinically, degenerative joint disease (DJD) is characterized by decreased range of motion, pain on flexion and extension of joint, and joint swelling. Traditionally, treatment has focused on drugs that decrease pain. Currently treatment is divided into surgical and medical management of the disease. Our focus here will be on the medical treatment.
A new class of drugs called Disease-Modifying Osteoarthritis Drugs (DMOAD) has resulted from current technology. These drugs are directed toward decreasing further destruction of joint cartilage, inhibiting the release of inflammatory mediators and controlling the pain involved with inflammation. Among these new drugs are Adequan, recently approved for use in the canine. This drug, in my experience using it for the last 4 years, has given miraculous relief to hundreds of dogs (and a few cats) with debilitating DJD. It is an intramuscular injection that reaches all major joints within 2 hours and lasts up to 72 hours. Adequan not only relieves the pain, but works to limit further joint damage. It is a 4 week protocol initially, and thereafter given symptomatically.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are often used in medical therapy. The most commonly used is aspirin. Gastric ulceration is a toxic side-affect, so proper dosing is essential through your veterinarian. In cats, toxic side-affects are more serious, and therefore should never be used except under the direction of a veterinarian. Rimadyl has recently replaced the use of phenylbutazone and aspirin because of its lower toxicity, yet excellent pain relief.
Corticosteroids, when used long-term, inhibit cartilage synthesis and suppress joint fluid production. Their use is reserved for end-stage DJD, where the short-term anti-inflammatory benefits outweigh the long-term destructive effects.
Keep in mind that if your pet is overweight, the extra load carried by joints can be destructive in itself. High-impact exercise (off lease running and jumping) is discouraged in DJD patients, whereas low-impact exercise (swimming, leash walking) is encouraged to provide weight control.
Cindy Exelby is a Doctor of Veterinary Medicine
at Rodeo Plaza Animal Clinic in Santa Fe.
Note: This article first appeared in the Spring 1998 issue.
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