Recently, I talked with a pet owner who had turned 50. To celebrate, she went skydiving, canoed a long river, and performed in a burlesque show—all in one weekend! When I saw her two days later, she complained that her knees hurt (mine hurt just thinking about it). Most likely, it was from degenerative joint disease, something we all experience as we age. Better known as arthritis, it’s also a pain our pets aren’t immune to. For pet owners, the difficulty is knowing when pets are in pain. They don’t say, “I had such a great time chasing that tennis ball yesterday, but I’m feeling sore today.” They get up a little slower, but still look at the tennis ball to see if it needs more chasing.
Pain signs include getting up more slowly, doing more stretching, taking longer to go up and down stairs, hesitating before jumping up on furniture or into a vehicle, and sleeping on the floor rather than jumping to a high perch. As someone once said to me, pets don’t feel sorry for themselves. They won’t yelp, whine, or moan when they have chronic pain.
There are great new treatments available for pet arthritis pain. One for cats is Solensia, a monthly injection approved by the FDA and available earlier this year. I wanted to try it on one of my cats first, although I didn’t think they showed any signs of arthritis. By age 12, 90 percent of cats are thought to have arthritis signs. My oldest, Catalina, at 16 seemed to jump up on the bed and run up the steps just fine. She didn’t like being brushed much on her lower back and wasn’t grooming well, but I thought this had always been the case. I gave her an injection anyway, assuming she had to have some arthritic joint changes.
Solensia and the recently approved Librela, for arthritic dogs, are monoclonal antibodies. We have a lot of antibodies—proteins in our blood that bind to an antigen and destroy it. When we are infected with a virus, our immune system reacts by making antibodies that bind to part of the virus, removing it from the bloodstream and destroying it.
But arthritis isn’t due to a virus or bacteria. There’s a whole cascade of things that lead to pain and joint inflammation. One is something called nerve growth factor. The monoclonal antibodies in Solensia and Librela bind to nerve growth factor. Monoclonal means they’re the same antibody, binding and destroying the same thing. Because these antibodies are made from cat or dog protein, when injected, the cat or dog doesn’t recognize the new protein as foreign and doesn’t bother it, so there are no side effects and it’s safe, even in animals with other diseases.
About a week after giving Catalina her first Solensia injection, I realized how much chronic pain she had. One evening, she was in the bathtub wanting me to throw paper balls for her to chase. It had been at least a year since I saw her do that. She jumped up and wanted petting along the full length of her body, and was more willing to have her lower back brushed. After a second injection, she pulled toys out of the toy box. The third injection found her getting into a window 12 feet above the ground! She definitely had chronic pain that I completely missed. I’m sold on the benefits of Solensia, and Librela should be available for dogs by the time you read this article. I’ll be trying it out on my nine-year-old collie, Scout.
Other injections can also be useful for arthritis. While Solensia and Librela remove molecules involved in inflammation, Adequan (polysulfated glycosaminoglycan) slows down joint cartilage loss and restores joint lubrication. This decreases inflammation and helps improve the cartilage left in the joint. These injections are given under the skin twice a week for a month then repeated when signs of arthritis return.
Spryng is a new product consisting of naturally occurring proteins injected directly into the diseased joint. The proteins act like cartilage, filling the joint and providing a new joint cushion and lubrication.
We’ve also had success with laser therapy. When I first heard about laser therapy, I was pretty skeptical. How could a cold laser help with pain or speed healing? It’s just a red light, right? But I had heard it worked, so I looked into it more and then brought the technology into my clinic.
Cold laser therapy uses focused light (low-power lasers or LEDs) to activate a process called photobiomodulation, or PBM. Photons from the light penetrate the tissue, interacting with cell mitochondria. This triggers biological events that increase cellular metabolism, which decreases pain and inflammation and accelerates healing and tissue repair. It’s different than high-power lasers that cut or destroy tissue.
We were trained to use the laser and started offering it to cats and dogs with specific joint arthritis pain. For chronic pain, it can take up to six sessions for good improvement (session length depends upon the number of joints being lasered). I’ve even used it on some of my own joints. Because it penetrates cells, it’s useful for more than just joint pain. We use it to decrease pain and inflammation and speed healing in many areas: surgical incisions, lungs (bronchitis), bladder (cystitis), ear infections, anal glands, paw infections, and more.
We use a class IV laser, which is more powerful, penetrates deeper, and works more quickly than products purchased on the internet for at-home use. The smaller ones can help, but take longer to penetrate the joint. They’re also not regulated, like many other “medical devices.”
In addition to the new arthritis therapies, there are still oral nonsteroidal anti-inflammatories as well as supplements that can be used alone or in combination with other treatments. The goal is to keep your pet comfortable and active for as long as possible. Ask your veterinarian if these treatments would benefit your arthritic pet.
