Vet Advice With Dr. Liz Bales - Management Options for Arthritis Pain

Vet Advice
Vet Advice With Dr. Liz Bales - Management Options for Arthritis Pain


Question: Lacy Savoie Our 9yr old, 75 lb German shepherd mix, Sheena, was diagnosed this week with degenerative hip disorder. She is 100% capable of walking and moving, but the rubbing of her hip joints are now causing pain. She is now taking Galliprant. We were given information on Adequan injections as well. The cost of adequan seems slightly cheaper in the long run than the galliprant and the reviews are pretty great from what I have seen. Is there a reason my vet would suggest galliprant over the injections? Which do you recommend to your patients and why?

Management Options for Arthritis Pain

Dr. Liz Bales: Dear Lucy,

You and Sheena are not alone. Canine Hip Dysplasia (CHD) is a painful condition common in many large breed dogs, including German Shepards.  This condition occurs when the top end of the thigh bone does not sit properly in the hip joint.  Overtime, this leads to joint instability and ultimately painful arthritis.  You may have seen Sheena back off of her physical activity and not want to run, jump or climb like she used to.  There are a lot of conditions that can cause this set of symptoms. Great job getting her to the veterinarian and getting her diagnosed.

It would be great if I could tell you that there is one best way to help Sheena. Unfortunately, it is just not that simple.

Treatment options can be confusing. Your veterinarian has the most complete health information for your dog and is in the most informed position to make the best decision. I recommend calling, or scheduling an appointment just to talk and make sure that you understand your options and are a team in decision making for your dog.  You are both on the same side - to make Sheena as comfortable as possible and slow the progression of disease within your budget. Communication is the best way to do that.

There is no one perfect therapy for every dog. Your dog may have signs that would make your vet choose one treatment option over another - like changes on blood work that might make a particular medicine dangerous for Sheena and previous response to therapy.

One thing that seems to help every dog is to reduce the amount of weight that the hips need to carry. The most important thing that you can do for your dog is to get them to a healthy weight.  That alone can alleviate much of the pain and slow the progression of disease.

The goal of medical therapy is to reduce pain and slow the progression of degeneration in the joint. The mainstay of medical therapy to control the pain associated with CHD are NSAIDS (Nonsteroidal Anti Inflammatory Drugs.) 

Warning, human NSAIDS can be very dangerous for dogs and should be avoided. 

Luckily, there are NSAIDS developed specifically to be safe and effective for dogs. Each dog will respond a little differently to each medicine - like you may have better luck with one medicine over another for your headache. There are many for your vet to choose from including Rimadyl, Deramaxx, Previcox and more. Again, like all drugs, NSAIDS can have side effects and are not recommended for dogs with certain medical conditions. Galliprant is a new drug from the piprant class of anti-inflammatory drugs that controls pain with less side effects than traditional NSAIDS.

Adequan is not an NSAID. Adequan is a polysulfated glycosaminoglycan, given in the form of an injection, that helps to prevent the breakdown of cartilage and slow the progression of disease. Adequan may be used separately from, or in addition to NSAIDS or Galliprant. Adequan is given in your vet’s office by injection every 3-5 days for 8 injections, and then once every 1-2 months. Due to the frequent vet visits and expense, adequan is not for everyone.

Other medical therapies include the short term use of steroids.

In addition to medical management, you can consider physical therapy, and alternative therapy, like acupuncture to help your dog.

If the disease progresses to the point where your dog is in pain, despite all of these tools, there are surgical options.

I am thinking of you and Sheena. I hope Sheena’s pain is managed and the progression of her CHD is very slow.  I know you and your vet will be a great team for her wellbeing.  If you have a struggle communicating with your vet, find one that you do communicate well with.  Your teamwork will be so helpful for Sheena’s success.

Recommendated Reading
How To Treat Arthritis in Dogs

Doc Bales

Written by Dr. Liz Bales, who we are excited to announce will be collaborating with Modern Dog for all things dog health-related, stay tuned!

The University of Pennsylvania School of Veterinary Medicine graduate, Dr. Liz Bales, has only ever wanted to be a veterinarian. She has such a passion for her job, that she says if she weren’t a vet, she would be studying to become one. She loves “helping pets and the people who love them be happy and healthy!  Helping people translate complicated medical information into practical tips on how to care for, and connect with their pets is the best part of her job” Not just a veterinarian, Dr. Bales shares her passion through writing, giving speeches, and appearing on shows such as Fox and Friends, ABC News, and Cheddar. She has even started her own company, Doc and Phoebe, and invented a revolutionary cat product—the Indoor Hunting Feeder.

Dr. Bales’ favorite quote reflects her love and compassion for animals: “When a human dies there is a bridge they must cross to enter into Heaven. At the head of the bridge waits every animal that human encountered during their lifetime. The animals, based on what they know of this person, decide which humans may cross the bridge…and which are turned away.” With this in mind, Dr. Bales tries to live every day by her grandfather’s advice: “These days are precious. Don’t waste them.”

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