Meet Monty, a 12 year-old pointer with a long history of osteoarthritis and back pain. He was a very special dog as he acted as a friend for new foster dogs that were rescued from puppy farms. Monty was calm, friendly and showed the new dogs how to act like dogs – chasing squirrels, getting cuddles and stealing food from the bin!
Upon clinical examination, Monty had stiff, thickened stifle joints and increased fluid in both elbow joints. He had been struggling to keep up on walks with his foster friends and was unable to get on and off the sofa (his favourite place to watch TV!). He was even struggling to get comfortable in his bed! Previously he had slept in his owner’s bedroom but was now having difficulty getting upstairs and that meant he had to sleep downstairs. Monty’s owner was concerned about his quality of life and managing his comfort levels. He had been receiving pain relief once daily and physiotherapy sessions.
Following an assessment of Monty’s comfort levels using the Helsinki Chronic Pain Index, gabapentin was introduced for additional pain relief. Unfortunately, gabapentin is not licensed and there is limited information on its use in dogs. This was all discussed with Monty’s owner, who agreed to the treatment. There was some improvement in Monty’s comfort levels after 2-weeks, documented using the same pain index. However, Monty’s owner was still concerned about his comfort levels at night. At this stage memantine, an NMDA antagonist that may be useful for chronic pain was introduced and a 4-week course of acupuncture was initiated. Monty really enjoyed his acupuncture – he promptly fell asleep and only roused when the treat tin appeared!
Within 5-days of receiving memantine, Monty had started to get on and off the sofa for his TV fix and was more eager to interact with his foster dogs. After 4-weeks, Monty was walking in front of his owner instead of trailing behind on walks. Monty continued to receive physiotherapy every 2-weeks and orthopaedic assessment was offered in case surgical management was an option e.g. Elbow arthroscopy. Not every case follows such a positive timeline and there was very limited evidence in dogs for some of the analgesics that were used for Monty’s treatment.
Article provided by Karla Borland
Specialist in Veterinary Anaesthesia and Analgesia