Welcome to Justanswer! I am Dr. Altman and happy to assist you both today!
I am sorry to hear Cole has hip and elbow disease requiring medical management. Unfortunately Pardale should not be used longterm in dogs as it can cause issues with liver disease over time
There are so many options available to us now to help our beloved four-legged friends outside of the normal nonsteroidals (rimadyl, previcox, metacam, deramaxx, or the pardale he is currently taking). I will list them individually but all can be used in combination to assist your dog in getting comfortable
1.) Gabapentin- this is called neurontin in people. It works by dulling the nerve firing associated with pain and is my top choice for senior pets because it is not metabolized as readily by the liver and is easier on a senior pet. The pros are that it is not pricey, has no high end dose so if the pain escalates as your pet gets older we simply adjust the dose, and is easier on older pets. The cons is that it has to be given consistently because withdrawing it suddenly causes what is called rebound of pain which is higher then original level, can cause mild sedation initially
2.) Tramadol- this is in the opioid class so it is given as needed for pain when there are bad days. It can be given longterm to senior pets two to three times daily if needed as you are already administering
3.) Alternative medicine: laser or light therapy, acupuncture, physical therapy, massage therapy. All are fantastic ways to help minimize pain, increase strength, and allow rest more comfortably. If there is a physical therapy facility in your area they would have all of these. Typically I will start with acupuncture and/ or laser therapy and then add in the physical therapy once we are more comfortable. I often see remarkable results with one to two sessions
4.) Adequan injections. These are pricey but given twice weekly subcutaneously (I have owners give the medication at home after a demonstration to minimize the visits) for four weeks then taper frequency as improvement is seen and if there are bad periods then increase frequency once again
5.) Supplements: Glucosamine sulfate 1500 mg daily, fish oil with 1500 mg EPA & DHA daily, Vitamin E, Ester C are all great to slow progression of disease and assist in comfort
I hope this information is helpful but please let me know how else I can assist you both today. My dog has been on Gabapentin for pain for several years now and is doing great! If I note she is having progressive pain then I simply adjust her dose which you would want to do with the aid of your veterinarian.
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