Saiki Veterinary Mobile Care

 

Glucosamine and chondroitin sulfate are natural substances found in healthy cartilage. Glucosamine is an amino sugar while Chondroitin sulfate is a complex carbohydrate that helps cartilage retain water.

Many people do not know that there is a controversy over the effectiveness of these products for use in arthritis.  There are many products in the market place for both companion animals and humans promoting this nutraceutical.

 

Initially studies where based on anecdotal evidence. This is evidence based on personal anecdotes and testimonials. The difficulty with this type of evidence, is that is can be influenced by a placebo effect.

 

Laboratory studies suggest that glucosamine may stimulate production of cartilage-building proteins. Other research suggests that chondroitin may inhibit production of cartilage-destroying enzymes and fight inflammation.

The results of one of the largest and best-designed clinical trial, the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) have been recently released. This clinical trial funded by the National Institutes of Health concluded that these products:

 

“[Based on this study], it seems prudent to prudent to tell our patients with symptomatic osteoarthritis of the knee that neither glucosamine hydrochloride nor chondroitin sulfate alone has been shown to be more efficacious than placebo for the treatment of knee pain.” …..Three months of treatment is a sufficient period for the evaluation of efficacy; if there is no clinically significant decrease in symptoms by this time, the supplements should be discontinued. “

 

 

Lastly, before purchasing these products it is advisable to consult either Consumer Reports, or ConsumerLab.com to select products noted to meet the standards set up by U.S. Pharmacopeia.

 

For an evaluation of you dogs needs for arthritis pain management call my mobile veterinary house call practice located in San Jose, Ca. at 408-399-5353

GABAPENTIN

 

Gabapentin was originally developed as an anticonvulsant drug but it too can be an effective component of chronic pain management. It has been shown to be particularly effective in neuropathic pain management (pain from direct nerve injury) and cancer related pain.

Gabapentin is useful for both dogs and cats. It is generally free of adverse effects or adverse drug interactions although some patients will show some drowsiness usually limited to a few days. Dogs are typically dosed at 5 to 10 mg/kg BID to QID PO although doses as low as 2 mg/kg BID have been reported to be effective in some cases while doses as high as 120 mg/kg/day have been required in other cases. Cats are typically dosed at 2 to 10 mg/kg BID PO.

Gabapentin may potentiate the sedative influence of other medications. Withdrawal of this drug should be done gradually to avoid rebound pain.

Call Saiki Veterinary Mobile Care at 408-399-5353 for a Veterinary house call to see if your dog will benefit from this medication.

Series: Chronic Arthritis Pain in Dogs

 

TRAMADOL

 

The second medication that I use in my mobile practice in San Jose in treating older dogs with chronic arthritis is a drug called Tramadol. It can be used alone but more importantly in conjunction with NSAIDS. Tramadol is an excellent choice for canine patients inadequately controlled on NSAIDs alone and for those intolerant to NSAIDs.  Tramadol is a short acting opiod derivative, which exerts its effects on several different pain pathways. Best of all, it has relatively few side effects and compatible with most medications.

 

Initial dosing usually starts at 3 to 5 mg/kg TID to QID for dogs. The dose can be increased up to 5 to 10 mg/kg QID for more difficult to manage canine cases. At these higher doses some sedation may be evident and constipation may occur with long-term use.

Tramadol may decrease seizure threshold. It should be used with caution in patients with a history of seizure activity. Tramadol may potentiate the sedative influence of other medications.

 

Pain control of chronic arthritis pain can significantly and safely improve the quality of life of your older dog. For an evaluation if these medications can help please contact our house call practice. 

Series: Chronic Arthritis Pain in Dogs: Metacam

 

 

The first line of medication I use in my mobile veterinary practice for chronic pain associated with arthritis is Metacam (Meloxicam). Metacam  is a NSAID (Non Steroidal Anti-Inflammatory Drugs). NSAIDs play an important role in the pain management pyramid for dogs. They are used provided the patient does not have other disease processes that would preclude their use. This is why a monitoring blood work is essential when Metacam is used on a chronic basis.

Metacam is a liquid that is easily given orally only once a day and can be mixed in food. My experience with compliance is excellent for Dogs don’t seem to object to the taste. Moreover because it is a liquid the dosage can be reduced incrementally in order to find the lowest dose needed to provide pain relief. This helps decrease the potential for side effects.

Nancy……Dr. Saiki helped us get at least one more year of good life with our dog. We took our dog to other vets and they said she would not function with such bad arthritis and have to be put down. Dr. Saiki prescribed METACAM which is an oral medication for the treatment of osteoarthritis and it worked like magic, over night! It is easy to administer and gave our dog her mobility back and no pain. Thank You Dr. Saiki. Not to mention as others have said about her compassion, knowledge and her mobile service can't be beat.

 

The NSAIDs work by way of blocking prostaglandin activity. Prostaglandins are mediators produced by the cells of the body which are then involved in inflammation, pain, fever and the protection from ulcers in the stomach from gastric acids. Prostaglandins are produced by the enzyme called cyclooxygenase (COX). There are two COX enzymes, COX-1 and COX-2 both of which produce prostaglandins which have differing functions.

Non-steroidal anti-inflammatory drugs (NSAIDs) block the COX enzymes and reduce prostaglandins throughout the body. As a consequence, ongoing inflammation, pain, and fever are reduced. Since the prostaglandins that protect the stomach and support platelets and blood clotting also are reduced, NSAIDs can cause ulcers in the stomach and promote bleeding. Only COX-1 produces prostaglandins that support platelets and protect the stomach. How strongly they inhibit COX-1 and their tendency to cause ulcers and promote bleeding. Selective COX-2 inhibitors cause less bleeding and fewer ulcers than other NSAIDs. Meloxicam has been shown, especially at its low therapeutic dose, selectively to inhibit COX-2 over COX-1.