Arthritis in Dogs

Hello, vets. Thank you so much for the time you donate to this forum. I appreciate you greatly! ****This question is about arthritis**** I have a Rat Terrier who will be 15 in February. He weighs 20 pounds. He has been healthy his entire life although the last year or so, he's experiencing pain and stiffness from arthritis. He has been taking Dermaxx (25 mg tablet, 1/2 tablet once a day) for about a year. Recently the vet added gabapentin (100mg, twice a day.) I have also been taking him in once or twice a week for laser therapy. For several months I have noticed he's had a hard time laying down. Some days are better than others. The past week, he's had a couple days where it seems even more difficult for him to get into a laying position. Last night was rough. He couldn't get comfortable when he tried lie down to sleep. Other than this, he still enjoys short walks, gets excited and jumps around when he's excited (to see me, get treats, etc) Is there anything more I can do to make it more comfortable for him to lie down? Or is this the end? 😭 I should add, he gets a glucosamine treat daily, as well as an In Prime supplement my vet recommended and Rejensa. He has a heated pet bed, and an orthopedic bed.I'm having real hard time with this and would really appreciate any advice. Thank you so much.

Hello! - and with some pleasure, as you seem to be doing your best for your golden oldie.  I will also take a lot of care in answering your question, because - and I suspect that you'll understand this, when you think about it - I cannot really tell you the answer.  Pain, and the assessment of pain, is hard to nail down.  Just as my Dad told me that he had 'a bit of a twinge' in his stomach when he didn't want to notice the cancer that was slowly filling up his abdomen, so my child (not meaning to deceive) will report severe agony from a slightly pulled muscle when their side are losing at football.  People can generally talk, where as canines cannot:  some dogs, for example, successfully hide a great deal of their pain from their oblivious owners.  All I have to go on here is your carefully observed, but necessarily subjective markers:  that at times, your dog can't get comfortable to sleep, but that he still enjoys going for a walk.  That you have made things as comfortable as you can do, paying attention to the bedding that you use and adding drugs and supplements (always make sure that your vet is aware of what is being taken at any one time, in order to avoid double-up or supplements cancelling one another out.  I have no reason to think that you haven't been doing this).     MORE TO COME

One clinically-proven form of pain relief that you haven't mentioned, accepted by some top pain experts, is acupuncture, but I don't want to hand you any false impressions.  Acupuncture is simply an example of another part of multi-modal (different kinds, used together) pain relief that sometimes improves the clinical picture for some patients. However, the best way to get advice about your pet's level of pain is from your own vet.  It sounds as though you have a close relationship with them, which makes me wonder why you are asking here.  One possibility is that you may be getting towards the end-stage of the disease, and wanting second opinions about a difficult decision that may follow.  If that is the case, I would recommend this article.    https://vethelpdirect.com/vetblog/2020/05/30/how-do-we-know-when-is-it-time-to-put-our-pet-to-sleep/

On the other hand, this may not be the stage you're at and you may simply be wanting to make your dogs' pain control as good as it can be.  (This pattern of being fine during the day but having sleepless nights is common in humans, too:  we all feel less pain when distracted).  In this case, your first point of contact should always be your vet, who should be able to offer you some good advice within normal consultations.  However, the gold standard would be to attend a specialist pain clinic (these can be hard to find - your vet should know what's available in the practice or locally or - indeed - through wider referral, perhaps online).  Such clinics can devote time to looking at different possible signs of pain and objectively scoring it, helping you to determine how much pain is 'too much.'  They may also get you scoring his pain quickly several times a day (e.g out of ten in a diary), thus keeping you alert to his individual patterns and overall trends.  Sometimes this helps to suggest changes that can be made to pain control regimens. Either way and whichever stage things are at, this is the last of three messages.  I hope that this has given you some food for thought.

PS;  Four messages.  To make it clear, I have not checked your dogs' drug-doses etc. here; this is for your vet and not being your vets, we will never get involved in your prescriptions etc. at this level.