What Can I Give My Dog For Arthritis?

There is no animal treatment that provokes more debate than arthritis medication. The sheer number of treatments on offer is bewildering. Why??

  1. Arthritis is common: it’s a big market with a lot of competition from different products
  2. It’s hard to tell when treatment helps: real improvements is often hard to distinguish from the placebo effect
  3. There’s no silver bullet: despite some good options, owners of badly affected dogs know that we still can’t do enough to help them

Your dog isn’t going to complain if you get it wrong. If you have an arthritic dog, you need to know what works. Here I’ll try to show you what the evidence for arthritis treatments tells us.

You might also like: Treating arthritis & pain in cats | Arthritis in rabbits

Dog Arthritis Treatments

I’ll do my best to be as open-minded as I can but I’m also going to be blunt about where the evidence doesn’t sit. Using an ineffective treatment is not just useless, it gets in the way of using something else that might actually work.

Arthritis Supplements & Home Remedies

antinol arthritis treatment
Antinol

Heres a list of the supplements we see being used in dogs. Only one of these has enough evidence to recommend it. Can you guess which one?

  • Glucosamine & chondroitin
  • Green lipped mussel extract
  • MSM (methylsulfonylmethane)
  • Turmeric
  • Rosehip oil
  • Cannabis oil

The answer is green-lipped mussel or GLM. The evidence is only low-grade but it fits with our clinical experience. Read more about cannabis oil below.

4cyte arthritis treatment
4Cyte

Many dog owners will remember Sasha’s Blend. Nowadays most Australian vets have moved on to two other purified products, Antinol and 4Cyte, which have better clinical trials and efficacy in our experience. There are also many over-the-counter GLM supplements. All are given as a daily tablet or capsule.

Dog Arthritis Diets

OK, I was fibbing a little. Did you wonder why I missed out fish oil? Fish oil actually also works as a supplement but in a very, very disappointing way. That is, until you integrate it into a diet.

Most arthritis diets just add fish oil, glucosamine, plus some other ingredients, and hope for the best. Personally, I don’t think any of these work and the evidence is lacking.

dog arthritis food
Hills j/d in tins and dry

One diet does something clever with fish oil and actually works. It’s called Hills j/d. What they do is remove a precise amount of the competing (and common) omega-6 fatty acids so that the omega-3s in fish oil can work unimpeded.

The effects are significant and repeatable especially in mild to moderate arthritis. Even in severe cases, it can help in combination with other treatments. The only time I don’t recommend j/d is in dogs sensitive to changing their food.

Dog Arthritis Injections

Cartrophen-Vet, Zydax, Synovan, and Arthropen are all brands of pentosan polysulfate sodium. It produces excellent results in mild to moderate arthritis and is almost completely free of side effects. There is virtually no arthritic dog that cannot be given Cartrophen safely.

Cartrophen is part of our first line treatment when a diagnosis is made. A course of four injections is given at weekly intervals, and then repeated six months later. Its use can often delay the need for other treatments for many years.

The cost of each Cartrophen injection is typically $40 to $50 depending on body weight.

There are no other recommended arthritis injections. In the past, long-acting cortisone was also used. This is outdated and rarely a good idea due to poor results and significant side effects.

Dog Anti Inflammatory Drugs

The biggest mistake I see is dog owners worrying so much about non-steroidal anti-inflammatory drug (NSAID) side effects that they won’t use them. Once your dog needs pain relief, these drugs are lifesavers and nearly always very safe.

dog pain pyramid


The picture is from a pain management lecture I attended in the UK. It shows the relative importance of different drugs in controlling pain. It’s a welfare issue.

There are plenty of dog NSAIDs to choose from with different side effect risks, efficacy, and costs. They include carprofen, meloxicam, firocoxib, mavacoxib, etodolac, and robenacoxib. We use four of these based on our experience and owner preferences.

When side effects occur they are mainly vomiting and diarrhoea due to gastrointestinal ulcers. If this happens, a pause or change in medication is required. Liver or kidney damage can occur but should be rare if blood testing is performed before, and then again shortly after starting.

Prednisolone and other cortisone drugs are also anti-inflammatory but should definitely be avoided unless there’s no alternative. They do not work well and cause serious side effects at the doses that are needed.

Other Pain Relief Drugs

Tramadol, amantadine, and gabapentin can be used as second-line pain treatments. None of them is likely to work as well as an anti-inflammatory but they often work well in combination with one.

If used carefully, the only side effects are mild sedation when given at higher doses.

Over The Counter Pain Relief

If you visit our page on over the counter and pharmacy dog medicines you’ll see I discuss human drugs for dogs. You’ll also see how dangerous nearly all of these are to dogs.

The only exception is paracetamol (acetaminophen in the US). On its own, it’s fairly useless but is sometimes added to existing pain protocols to improve the response. However, even in this case, there’s usually a better option elsewhere.

Dog Stem Cells

Tricky one. There’s a lot of confusion about stem cells. What they don’t do is regenerate anything in arthritic joints. Instead they are thought to act by releasing chemical signals that shut down inflammation. In other words, as living anti-inflammatories.

There is some evidence that fat-derived mesenchymal stem cells can relieve the signs of canine arthritis. Based on this, we administered stem cell therapy to dogs between 2012 and 2015, with some success.

Why did we stop? Despite the glowing reports, the majority of our patients showed minimal improvement. We feel that until there is more clinical evidence, the cost and effort are better spent elsewhere.

Other Remedies

Lastly, we should never overlook other ways of treating arthritis. First among these is weight loss. I have seen dogs who were still in pain on maximum doses of everything then come off all treatments after successfully losing weight. That’s why I’m a bit too much of a nag about it.

The same goes for moderating the exercise. Still throwing the tennis ball may be what your old Kelpie wants, but they are likely to suffer for it over the rest of the day. Far better to go for long, steady, low-impact walks than too much running or jumping on bad joints. Dogs need you to tell them when to stop.

I have much less experience with physical therapy, acupuncture, chiropractic, cold laser treatments or other alternative remedies. All I will say is this: if it’s working, keep doing it.

By ‘working’ I don’t mean, “he’s looking much more energetic”. I mean being able to show that your dog can definitely do something specific after treatment that they couldn’t do before. Having a good working definition of success like that should minimise any caregiver placebo bias.

This page on the caregiver placebo effect is my attempt to explain the confusion we all face. Thanks for reading this most important topic. If you want to dive deeper, visit our page on the causes and symptoms of arthritis.

Cannabis Oil (CBD, cannibidiol) For Dogs

And finally a note on this controversy. There is very limited evidence of efficacy. A study of 16 dogs found improvements in pain scores for dogs taking oil at 2mg/kg. There was no observed improvement in lameness scores.

Given the very mixed results from human trials and the small size of this trial, we need more evidence to recommend cannabis oil. Access is also very difficult in Australia. I would appreciate comments below from anyone who has found a reliable supply for dogs.

Have something to add? Comments are welcome below and will appear within 24 hours of lodging.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These help topics are from a series regularly posted on Facebook and Twitter. Subscribe via email here to never miss a story! The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

Andrew

27 Replies to “What Can I Give My Dog For Arthritis?”

  1. Hello Andrew,

    My precious 12 .75 year old Maltese schitzu has just managed to achieve a CrCL rupture! I’ve no idea how, I think he may have twisted it when he shook himself as that’s all I saw. Then he couldn’t ground his rear R leg.

    He’s not a candidate for surgery / anaesthetic as we discovered last year. They think he may have Cushings (very enlarged liver), some not good blood test results & heart murmur that seems to remain constant. X-rays show some osteo in his Left knee, but apart from that he was good & happy.

    Now he’s stuffed his good leg & is definitely not happy. Can barely walk or stand, I’m carrying him out for toilet.

    I’ve got Metacam & 4CYTE for him, and have ordered a knee brace.

    After the long winded story, my question. What is your recommendation on how best to non-surgically treat a ruptured CL.

    I feel so inadequate & it breaks my heart seeing him like this, but I also don’t see Time Up for him just yet.

    Thank you in anticipation

    Simba’s Mum

    1. Hi Karen. I would certainly try the non-surgical treatment mentioned in our page on cruciate disease. However, you might be surprised to hear that I also haven’t heard enough yet to stop me doing surgery. I’ve operated successfully on dogs up to 16 years of age, with no owner regrets and no deaths. The risk may be higher, but still acceptably low if the heart is functionally normal, and cushings disease, while a risk, is easily managed. I’d be interested to hear if the knee brace is effective, as I’ve been quite negative about these up to now.

    2. Thanks for your reply Andrew. I’ll certainly absorb your information.

      Earlier last year he was to have a small growth near his anus removed & after pre-op tests they told me they weren’t happy to give him anaesthetic. He’s a very good little dog so one cuddled him, they gave him locals, removed & stitched.

      On the basis of that, I’m not inclined to think it’s safe now.

      I’ve now had a read of your page on cruciate disease.

      I note you say small dogs < 10 kg do have a chance of recovery without surgery . Simba is 7kg & part of that will be the enlarged liver.

      You also recommended the pentosan injections. These were an option in the sheet I was given, but I wasn't advised that one was better than the other, & since I was told to keep him calm and restricted, I didn't think dragging him weekly in and out of house, car, vet etc was the wiser choice, so I elected to go with the 4CYTE & Metacam.

      In your opinion, should I do the injections ? Does that mean stopping the above ? One or both ?

      The brace arrived today, but I can't get on by myself. It's got so many straps & fittings, and he's so small that it's too fiddly. Plus I think I was hurting his leg as he growled ( just a warning, not fiercely) . Guess I'll have to go back to Vet & hope someone can help me.

      Thank you again.

        1. Oh ok – thank you – are you saying he can have the injections as well as the other treatments (he doesn’t like the 4CYTE – I have to wrap it in ham!!)
          Although tonight it seems his appetite may be coming back so things may change.

          He’s had the brace on today ( with help of vet) he’s never used before & im not sure it was on correctly, but at least it gave some restriction today.

          It’s off now and he’s actually snoring! Best sleep in days I think ! ( he did do a tiny weight bearing walk while off)

  2. Hi Andrew,

    I’ve had my 8kg Bichon poodle cross on Cartropen injections every 3 months as well as Previcox daily (he has an adverse reaction to Meloxicam). He developed quite bad diarrhoea after using Previcox every day for 5 weeks. Our vet then took him off Previcox and popped him on to Tramadol for 5 days with a Pro Kolin pre and probiotic, which worked well. Today I gave him his first dose of 4cyte Forte in liquid form, however he was in more pain than usual, and upon investigating, their website states that it acts on anti inflammatory chemicals, which I don’t understand. How could a produc work if it takes away the anti inflammatory aspect? Lastly would Antinol be a better choice?

    1. Hi Brenda. My opinion is that it’s important to compare apples with apples. Whether you use 4cyte or Antinol, the effect is likely to be the same, and Tramadol isn’t thought to do much better. However, that effect is so much less than a well-tolerated anti-inflammatory that I’d keep trying to find one that’s tolerated. Carprofen (similar name, very different drug) often goes well as long as you check liver enzymes after you use it for a few weeks. Around one in 50 dogs get unacceptable liver damage with prolonged use.

  3. Hi,
    Great article!
    I have an 11yo Pomeranian Cross (8kg, inside dog) who started on Antinol about 4 months ago due to stiffness on rising in his back legs. About 2 months ago he became reluctant to weight bear on his front left leg. He had 4 x weekly cartrophen injections, after the first injection there was a noticeable improvement, which tapered off over the coming week. After the 2nd, 3rd & 4th injection there was no obvious improvement.
    It’s now been two weeks since the last injection & he’s worse than ever. Reluctant to walk around the house, wants to be picked up & carried instead. Holds the left paw off the ground when sitting or standing still, limps when he does reluctantly walk. He’s scheduled for another cartrophen injection in two weeks time. The last two days I’ve given him a carprofen tablet to help with pain. Any other suggestions or advice would be greatly appreciated.

    1. Hi Denise. My advice is that there’s not much point in repeating the cartrophen course early, and that you really should get x-rays done of this leg. It’s not typical for an 11-year-old Pomeranian to have such a problem and so I would be wanting to rule out other conditions before I settle on it being arthritis. Then if so, it’s certainly likely that you will need anti-inflammatories such as the ones you have tried.

  4. Hi there,
    I have a 11 year old female german shepherd (Sam) who has early stages of Arthritis according to the vet after a recent check up. All i have noticed myself is sometimes she is slow to get up, but not so if food is involved or going out in the car lol. She is in good health overall. They have recommended as an option Arthropen to help curb the Arthritis. She does have some muscle wastage in hind legs due to her not doing a lot during the day. She likes to chase the ball outside in our small backyard for about 5-10mins. I may look at walking her only from now on and throw the ball a couple of times for her enjoyment.

    Currently we have been giving her a Glucosamine & Chondroitin every day for a while now (Last 8-12 months). So getting to my question, being budget minded I am thinking about whether the Hills j/d diet might be okay on its own (+ supplement?) like if it is almost as good as Arthropen? even if a little expensive the diet would combine costs of food and treatment rolled into one?

    She is near her life expectancy give or take another 2 years (I read avg life is about 11-14), will the Arthritis accelerate as she gets older even while on Hills j/d diet + Supplement? or would the rate be reduced enough to have a quality of life within the next 2 years. I mean if she was younger with Arthritis the diet might not be effective in the long term but Sam is already 11.
    Or would Arthropen on its own be the most effective means to give her the best quality of life, period? I know there are no definite answers with health, but your thoughts on this would be helpful in deciding.
    Thanks.
    (And sorry for lengthy write up.)

    1. Hi Darian. There are so many points here!
      Firstly, the muscle wastage is not from inactivity, it is almost certainly from arthritis, which means it’s more severe than you think.
      Secondly, stiffness or slowness on rising is often the only sign you will get for early arthritis. As it is usually a pain response, it goes away when the dog is distracted by something else, hence not seeing it chasing a ball or when food is around. Just like if you had a bad headache and someone told you you’d won the lottery.
      Thirdly, there’s no way of judging the lifespan but 11 is not that old. I certainly never try to choose my treatments based on how long they will live as this can really come back to bite you in the bum later if you didn’t choose wisely. Especially if you end up having to euthanase Sam because of not being able to get up, which is common and usually due to arthritis.
      Fourthly, sorry to say this but glucosamine and chondroitin were probably a waste of time and money.
      Fifth, yes the treatments you have been recommended are very good and designed to slow progression of arthritis. This means that the dogs that take them should have better joints than the dogs that don’t in the years to come, as well as being more comfortable throughout.
      6th, it’s possible that using just one of them will give enough benefit, but I agree with your vet in doing both. That’s exactly what I’ve just started doing with my old dog showing exactly the same signs.
      7th, for medicine on a budget, these two may give the best bang for your buck, but please don’t reject the idea of anti-inflammatories down the track. Generic carprofen only costs a dollar a day for very good pain control and is probably cheaper than JD, just not quite as safe. However, when the pain increases, the small risks are worth taking.
      Finally, if you do choose just one, the J.D. may be the better choice. At least you’ll be doing something. Good luck

      1. Thanks for your time and reply Andrew. Just to clarify your answers..
        Are you recommending the JD Hills diet over Arthopen with a budgeting perspective? I guess a supplement on top of that be helpful too? Like the Green lipped mussel extract you mentioned in your article?

        1. No, I’m recommending both but I would choose j/d over Arthropen if I could only use one. GLM is OK but not equivalent.

  5. Hi I have a 12 year mareema cross German Shepard. She has been finding it hard to get up latterly. She weighs 30kg and has just started a course of zydax injections. She has just had her third injection. I am wondering if this drug is effective for a dog of her age. She is not showing any signs of improvement, how long does it usually take to show improvement? We also have her on osteocare tablets 2 weeks in doing the 2 tablets a day at the moment. Would love to her your thoughts Thanks jo

    1. Hi Jo. Zydax, or any pentosan injection, may not work well in large dogs above 12 years of age where their arthritis is more severe. I would certainly have tried it too but I usually warn owners that I expect to also add an anti-inflammatory based on response. Otherwise the improvement often seems unsatisfactory. You can read more about anti-inflammatories above.

  6. We have a much loved nearly 13 year old German Shepherd. She’s been on cartrofen injections for nearly 2 years. We use a ramp to get her out of the car but she gets too agitated to go up it so we park so the car is on a slope so she can jump in. She demands a walk every day, not very far but the ride in the car is the real reason I think. She gets a bit tangled up sometimes when walking on slopes.
    Our vet is very good with her and has said she is losing muscle as the arthritis prolongs.
    She is well apart from that, she has always eaten sparingly and weighs about 41 -42k.. of course she is old and sleeps a lot, is an inside dog and doesn’t like change.
    My question of course is what else can we do? She doesn’t seem to be in pain but is getting slower. Any advice you can give would be welcome.

  7. hi andrew i have a 9yr old am staffy 32kg my vet put him on synovan injections on 3rd injection weekly intervals 2 hrs after injection he started a bleed through his pennis took him straight back vet then carried out a blood test which came back as ok he preformed aultra sound and put him on anti biotics due to holidays he has booked him into have an exra in 4 days time says he suspects prostate cancer or bladder cancer i am very worried i took him to this vet because he is close to my home never had any bleeds before injection can u give me your thoughts thanks

    1. Hi George. Although rare, pentosan has been known to cause clotting problems so it’s best to stop the Synovan until the results of the tests are known. However, the most common cause of bleeding from the penis in an entire male dog is benign prostatic bleeding (which responds well to desexing so hopefully this is the cause). If on the other hand your dog is castrated, prostatic cancer is more common, so I’m hoping the ultrasound will be clear. Good luck.

  8. This was quite helpful, I have a 10yo 57kg Alaskan Malamute, he has had one round of Cartrophen about 12 months ago, and is likely due for more as he is struggling with steps and ramps after walking. I will give the Hill’s food a go to help, he could stand to lose a little weight, but Malamutes are very efficient eaters, he can maintain his weight on portions meant for dogs half his size, and with his arthritis he can’t walk long distances anymore, so that is a challenge.

  9. Hello Andrew,
    I’ve just found your website by accident, and have to say it’s one of the most informative I’ve found – I’m talking Australia. Most other sites seem to be located in America.
    We have a 15 yr old Toller, with some arthritis and wasting in hind legs. He enjoys a short walk (at his pace) once the temperature has risen. He doesn’t limp while walking, but sometimes one or other of his hind legs collapses, so we wait, then go on. I know there’s not much can be done for muscle wasting and, of course, he doesn’t whine or complain, but I’d like to do more if I can. He had Synovan, in combination with Onsior, which he didn’t tolerate as he has irritable bowel issues. His weight is constant around 18.5ks. Spleen was removed some 4 yrs ago, and he does have a mild heart murmur. I’d be interested in your thoughts.

    1. Hi Evelyn. Thanks for the question. You’ve certainly made some good choices. I would keep looking for that anti-inflammatory that he will tolerate, as for him it will probably produce the greatest benefit. The list is in the article but I would start with good old carprofen if robenacoxib isn’t tolerated. Also, keep using the Synovan and letting him dictate the pace & speed of his walks. Good luck!

    2. Muscle waste can be a dign of kidney failure. This can be diagnosed with a blood test. My border collie suffered from.kidney failure.

  10. Your article on artheritis in dogs intertest me. I have a 7.2kl Westie who has just had xrays showing small areas of the dreaded A in patches down her right rear leg.
    Is it possible to be sent the artice in an email so my partner can read it too, he is not keen on reading on the computer so I need to have a hard copy.

    1. Thanks for your interest in the article Susanne – I have sent a copy. If you want to receive future posts via email you can sign up via the link at the bottom of the posts and they are sent out in advance of Facebook.

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