Hey there – sorry to hear that you are having struggles with managing kidney disease and arthritis management.

Have you suggested to your vet a referral to a chronic pain clinic? The vets you will see there have a much greater understanding of medications suitable for OA management. There are many more medications – but they would need to see, palpate and monitor your dog to be able to advise you appropriately.

Advice regarding amantadine and kidney disease is to use at a lower dose than would be initially prescribed.

Gabapentin may be better with more regular dosing – 3-4 x per day

Pregablin is a more predictable and bioavailable gabapentanoid.

Many clinicians will continue to use NSAIDs in stage 2 but will monitor bloods. A study in cats showed that cats actually did better on NSAIDs.

Pardale more frequently would be a logical inclusion.

But there are other medications not used so commonly that may be available to you – Zero Pain Philosophy are two specialists that offer telemedicine advice to your vet at a small fee.

Have you the ability to see a physio/ acupuncture more frequently?

I hope this helps,
Hannah

Hey there

I am sorry to hear that you and your dog are having such a tough time.

Firstly there is a lot more that you can do so don’t worry you are not running out of options. The topic is huge and will be impossible for me to advise you in a single message, but I can send you to the different resources you can gain access to to learn more. We have a YouTube channel that has A LOT of information you will find helpful – look up canine arthritis management and head to the channel and follow the Gwen and Hannah episodes. These are short episodes that are more direct and punchy, and aim to give you a broad overview of the interventions available to you.

Within the channel there are interviews with specialist/ experts and you will learn lots more about different medications you can access. There are a lot more, but they may not be something that your vet hasn’t got lots of experience with. This a rapidly developing field and can be hard to keep up with. A possible next step would be to ask your vet practice if they have a vet with a special interest in pain management, or if you could see a pain specialist at a referral centre.

Key Interviews to listen to are ones with Gwen Covey Crump, Louise Clark and Matt Guerny. You will learn loads xx

Another resource that you may find useful is Holly’s Army on Facebook. This is a community group  with lots of owners, like you, discussing similar complications. I would strongly recommend it. There is also a weight management support service within Holly’s Army that can help you with that problem, as weight loss will definitely help control the pain.

Quick tips I would suggest are

1. Definitely work on getting the weight off. It’s a game changer!. A diet I use very successfully is Hills metabolic mobility. IT has the required joint supplement incorporated.
2. I would consider hydrotherapy as this will be great for mobility of the elbows, weight control and will allow her to move but with less weight/ force going through the limbs.
3. I would approach a physiotherapist for further support. They have many non-pharmaceutical tools to help with pain management.
4. I would go back to your vet and ask for an extended consult to look at all options – drugs wise as well as ask about intra-articular interventions. Ie joint injections!
5. I would look at the home environment and make sure your dog isnt doing lots of steps, dealing with uneven surfaces or slippery floors…. these changes can be game changers too.

I hope this helps

Regards,
Hannah