Treatment of Arthritis in Dogs and Cats with Adequan

Arthritis or degenerative joint disease (DJD) is a very common problem in dogs and cats, particularly as they get older.  Symptoms may include lameness, decreased activity level, having difficulty with stairs, discomfort when getting up and lying down, and sometimes temperament (behavior) changes due to chronic discomfort.

The most common treatment of arthritis in dogs is non steroidal anti-inflammatory drugs such as Rimadyl and Metacam. These are similar to ibuprofen (Advil) for people, but much better tolerated and approved for use in dogs. They act by reducing inflammation and thereby pain in the affected joints. And while these drugs have revolutionized the treatment of arthritis in dogs, when used long term they do require monitoring with blood tests and can potentially cause side effects.

In cats there are no approved non steroidal anti-inflammatory drugs for long term use. Metacam has been used in cats in low doses long term and can be safe, but the label warnings discourage vets from using it this way. So there are not a lot of options in cats to treat arthritis.  Buprenorphine is sometimes used but this is a powerful opioid and probably not appropriate for long term use.

Adequan is an injectable drug that contains polysulfated glycosaminoglycan. Most people are familiar with glucosamine tablets for joint support.  Adequan can be thought of as a more effective injectable version of that nutritional supplement.  And while Adequan is currently only approved for use in horses and dogs, it has been used in cats for chronic arthritis and a form of bladder inflammation called idiopathic cystitis.

How does Adequan work? Like non steroidal anti-inflammatory drugs, Adequan relieves pain by reducing joint inflammation. But in addition to this, Adequan stimulates the production of joint fluid and cartilage so it may actually help to repair damaged joints.

Adequan is administered as a subcutaneous (under the skin) injection twice weekly for 4 weeks. If the response is positive then the frequency is reduced to as little as once a month.

Because of the frequency of the injections, at Eastlake Veterinary Hospital we train the client how to give the injections at home. Recently, my wife Maren and I decided to treat our Pomeranian Chia for her knee arthritis, and chose Adequan because she has a sensitive stomach which could be exacerbated by non steroidal drugs. Since Maren was planning an extended stay in Italy for business reasons, she would have to learn to give the injections herself. She was extremely apprehensive but we worked on it before she left, and yesterday Maren reported from Florence that Chia is symptom free and she feels Adequan is a miracle drug.

Carl Anderson DVM
Eastlake Veterinary Hospital

The Animal Medical Center of Seattle (AMCS) and Animal Surgical Clinic of Seattle (ASCS)

There is a growing trend in veterinary medicine in this country for practices to be owned by large corporations. In fact, one corporation known primarily for its candy brand now owns most of the large specialty referral centers in our area, and a huge number of specialty centers and private practices across the US. A notable exception is the Animal Medical Center of Seattle (AMCS) and the Animal Surgical Clinic of Seattle (ASCS). These two referral clinics are still privately owned and share a large modern veterinary facility in Shoreline.

The AMCS provides 24 hour emergency services, and has board certified specialists available for internal medicine and oncology referrals. The ASCS is staffed with board certified veterinary surgeons that perform advanced surgical procedures by referral.

Dr Ken Sinibaldi, the original  founder of the ASCS, actually leased space at Eastlake Veterinary Hospital for three years while building the original surgery facility on Stone Way. The AMCS was founded in 2009 by Dr Adam Reiss when the new surgery/emergency/referral center was built in Shoreline.

For over thirty years we have referred to the skilled surgeons at ASCS, and we have utilized the equally skilled emergency clinicians, internists, and oncologists at the AMCS from its inception. The board certified specialists in both clinics have gone out of their way to help our doctors care for our client’s pets, frequently taking time out of their busy schedules to counsel us by phone on difficult cases. Both the ASCS and the AMCS have provided quality continuing educations for our doctors and technicians as well. I find it refreshing to have such a good relationship with both of these clinics, and encourage our clients to utilize their emergency and specialty referral services if the need arises.

Carl D Anderson, DVM

Eastlake Veterinary Hospital

February Dental Month!

It’s that time of year again! Receive a 15% discount when you schedule your pet’s dental cleaning during the month of February.

Why is it important to have my pet’s teeth cleaned?

In veterinary dentistry our main concern is the health and comfort of our patients.  As with people, studies in dogs have shown a correlation between periodontal (gum) disease and internal organ dysfunction. The fact is that periodontal disease can have significant negative health consequences in dogs and cats. In the early stages of periodontal disease, teeth cleaning and subsequent care at home may be all that is needed. In late stage periodontal disease extraction of diseased teeth may be the best option. It is important not to ignore fractured teeth as these will invariably abscess and cause discomfort. Treatment of fractured teeth involves either root canal therapy or extraction.

In human dentistry existing problems can be easily diagnosed with the patient awake. Thorough exams and x-rays are performed prior to performing any procedures. In veterinary dentistry a really thorough exam including dental x-rays cannot be accomplished until the patient is under anesthesia. So, the dental cleaning (prophylaxis) is both a diagnostic and treatment modality in dogs and cats.

There are those who recently have been advocating teeth cleaning in dogs and cats without the benefit of general anesthesia. Dr. Greg Dupont, a local board certified veterinary dentist and past president of the American College of Veterinary Dentistry, describes this as “no more than tooth grooming with no appreciable health benefit to the patient.” Also, anesthesia allows an endotracheal tube to be placed to prevent inhalation of particles dislodged during scaling.

What happens when my pet has a dental procedure?

Since dental procedures in dogs and cats are performed under general anesthesia, you will have the option of a preanesthetic blood test; in pets ten years of age or older the preanesthetic blood test is standard. The next step is the administration of a preanesthetic medication to relax the patient. After this an IV catheter is placed and an injection is given to induce anesthesia. An endotracheal tube is then placed in the windpipe to assist breathing and administer gas (isoflourane) anesthesia. IV fluids are started and in many cases an intravenous antibiotic may be given. Anesthesia is monitored carefully during the entire procedure.  Pulse oximeters to measure oxygen saturation, and dopplers to assess blood pressure, are utilized in this regard.

The first step in the dental cleaning is to remove large gross calculus or tartar if present with a forcep. Calculus or tartar is mineralized plaque. Plaque is that sticky film which adheres to your teeth consisting of saliva, food particles, and bacteria. In the final analysis it is plaque that causes periodontal disease. After gross calculus is removed, the remaining calculus and plaque is removed using both a high speed ultrasonic scaler and hand scalers as needed. The most important area to address for your pet’s health is under the gum line. This is the primary reason that dental cleanings in dogs and cats are performed with sedation.

After the teeth have been cleaned the mouth is thoroughly examined. In rare cases oral tumors are discovered during routine dental cleanings. The teeth are evaluated for fractures, malocclusions, and periodontal pockets. Deep pockets around the teeth indicate significant periodontal disease. Dental radiographs using our Schick digital dental x-ray equipment are taken as needed. Sometimes an x-ray will be taken just to evaluate how much bone is being lost around the teeth due to periodontal disease. Generally speaking, problems discovered are addressed with the owner’s consent at the time of the dental cleaning. This avoids the expense of additional anesthetic procedures.

Finally, the teeth are polished to smooth the tooth surface and a dental sealant is applied. The purpose of this is to slow the rate of plaque and calculus accumulation in the future. In dogs we dispense Oravet Sealant Gel to be applied weekly at home. This sealant alone will reduce plaque accumulation by 40%! When your pet is discharged in the late afternoon further instructions will be given regarding strategies to prevent disease recurrence. These may include brushing, special diets,  dentifrices, specially formulated chews, and others. If extractions or oral surgery have been performed we will dispense an analgesic (pain) medication to make your pet comfortable during the healing process. Additionally, oral antibiotics may be prescribed for a week or so.

To set up an appointment for a dental cleaning please call our office. If we have not examined your dog or cat within the last six months a brief predental exam may be recommended. At this visit any appropriate preanesthetic tests can be performed as well as an approximate estimate of what will be done during the procedure. We are looking forward to hearing from you regarding this important health issue for your dog or cat.

Canine Atopic Dermatitis Therapeutic

Canine atopic dermatitis is a very common allergic skin disease in dogs. In fact, some dermatologists estimate that up to one third of the dog population is affected. The primary symptom of atopic dermatitis is itching which can result in hair loss and skin infections and reduced quality of life. Like hay fever, atopy is triggered by seasonal pollen and other airborne allergens.

Canine Atopic Dermatitis Therapeutic (CADI) is a new therapy introduced by Zoetis that helps reduce the itching in atopic dogs. It is a monthly antibody injection that mimics the dog’s immune system to help neutralize the main cause of itching in this population of dogs.

In a study of CADI it was found to reduce itching within one day after a single injection, control itching for a full month, and improve skin condition caused by atopic dermatitis.

I recently treated Tess, my 10 year old German Shepherd with chronic atopic dermatitis, and the response has been amazing. She has not been this itch-free and this comfortable in years.

Carl D. Anderson, DVM