Medications and Supplements

I've mentioned the medications Diego is on before, but since so many of them are recommended for "older dogs," I want to share a little more about them.

All of Diego's medications are prescribed by a veterinarian. All of his supplements are recommended by a veterinarian, but they are available over the counter in most cases. I am fortunate enough to see the positive effects of these products in client dogs, as well as my own.

Adequan
Adequan is an injectable joint supplement. It is not injected into the affected joint(s), rather just under the skin. Most dogs don't even notice the needle prick. From their website: "It helps keep the cartilage healthy and intact, so that the bone in the joint cannot touch other bone." There is a loading dose given (more frequent injections) and maintenance is usually every 3-4 weeks. Diego does best with every 3 week injections.

Boswellia
The product we use, sell, and trust at work is made by Standard Process. From their website: "We take measures to ensure product quality every day. We follow strict guidelines to grow the great majority of our ingredients on our own certified organic farm and perform repeated testing through the manufacturing process to ensure the quality and safety of our supplements." Boswellia Complex works as an anti-inflammatory, supports normal function of the kidneys, maintains and supports joint health, and provides antioxidant activity.

Dasuquin
Dasuquin is an oral joint health supplement. From their website: "Dasuquin is a dual synergestic formula: its specific glucosamine hydrochloride and low molecular weights chondroitin sulfate have demonstrated synergy in stimulating cartilage matrix production while ASU also acts synergestically with glucosamine." Nutramax products have also been tested (and approved) by Consumer Labs, an independent testing facility. What they say is in the product, is in the product.

Gabapentin
The use of Gabapentin (Neurontin) in dogs is generally to treat nerve based pain. Diego was started on Gabapentin prior to his surgery because we know he's sensitive to some medications. We wanted to make sure he could tolerate the Gabapentin, as well as prevent wind-up pain. "Wind-up pain is a heightened sensitivity that results in altered pain thresholds, both peripherally and centrally, such that pain is experienced in areas unrelated to the original source. Wind-up causes a worsening of acute pain." He tolerates the Gabapentin well enough that he's been on a high dose since we took his Fentanyl patch off that was placed during surgery. We attempted to wean down his morning dose a couple weeks ago but there was a noticeable decline in his comfort.

Phycox
After we discovered that Diego didn't tolerate Metacam (vomiting and diarrhea), we looked for non-steroidal anti-inflammatory (NSAID) alternatives. Phycox has a couple products, but the MAX was chosen for Diego because of his age and condition. Phycox MAX has "increased anti-inflammatory activity with greater analgesic effects (pain relief)." He has been on the Phycox since July and I noticed a big decline in the amount of time he spent licking his right carpus within the first month of being on it. I had never used this product before, but I have been very pleased with the results.

Welactin
Welactin is made by the same company as Dasuquin, Nutramax. EPA, an omega 3 fatty acid, has been shown to decrease the inflammatory response when given at high doses. Welactin has a much higher concentration of EPA than other omega 3 fatty acids available, so I have to give less to get the desired result. I also trust the product because it is made by Nutramax.

There used to be a theory that not giving dogs pain medications after surgery made recovery smoother, because the dog self-regulated activity then. Now we know better. Wind-up pain, mentioned above, inhibits effective healing. Diego is on a variety of medications and supplements because it is important for him to be as comfortable as possible while healing. The less pain he feels, the more he will use the rest of his body in a normal fashion. One of the most difficult parts of recovery is making sure the rest of the body continues to move fluidly so that he doesn't injure something else (generally a muscle) due to compensating.

 It is very unlikely that Diego will continue to be on all of these medications for the rest of his life. We assess his pain level on a weekly basis to determine whether or not we can start weaning him down. So far, he hasn't shown us that he will be comfortable without the amount of pain control he currently has.