Latest / Senior Pet Talk | for dogs + cats / 3. Is My Pet in Pain? Managing Arthritis in Senior Dogs and Cats

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3. Is My Pet in Pain? Managing Arthritis in Senior Dogs and Cats · Senior Pet Talk | for dogs + cats

• Amanda Steffen: You are listening to Senior Pet Talk, the show where we combine Western and Chinese medicine to give senior dog and cat parents the knowledge, the clarity, and the confidence to make sure that your pets' senior years are their best years yet. I'm Dr. Amanda Stefan. Let's get started. Hello, welcome to the Senior Pet Talk Podcast. I am Dr. Amanda Stefan, integrative senior dog and cat-focused veterinarian, and I am extremely excited today to talk to you about pain control in our senior pets. I am so excited that I had to record this episode and my kids are home and I came to a coffee shop. So I do apologize if there's any background noise. I am doing my best. But I really need to bring you this information. So I promise it is worth dealing with a little bit of background noise if that's the case. We know that 90% of senior cats are going to have arthritis, and over 80% of senior dogs are the age of eight. Most of our senior dogs are living over the age of eight at this point. So we're gonna know that there's arthritis going on. And on bigger dogs, we're gonna see this even earlier, right? So as Sad as that may be to admit, it is something that happens as they get older. However, the really amazing part about that I want to talk to you about today is that there are so many things we can do to make them feel good, to help control that. And I really want to touch on some of the most important ones. And I want to debunk a couple things that people may think about pain management and senior pets. And I'm going to tell you all of it. I'm going to tell you. All the things that I use and recommend. And we're going to touch on why. And I'm excited to bring all of this information to you because it's going to change how you see your senior pet. So get ready. If you have noticed my senior pet is slowing down, I don't know whether the symptom that I'm seeing or the sign that I'm seeing right now is arthritis or is this just normal aging? That is one of the most common questions that I get. And one of the most common things that Pet parents tend to have a difficult time figuring out. And that's valid because we, it is very hard to tell when our senior dogs or cats are in pain. They're very good at hiding it and they're not going to show us that they're in a lot of pain because they're just going to live their life. They don't understand I'm not supposed to feel this way. So they're just going to keep going, right? And when we talk about pain, I want to make sure that, you know, in this episode, I'm going to mostly talk about arthritis pain, but I do want you to know there are other. potential causes of pain in senior pets that should be evaluated as well. One of those things, the big one other than arthritis pain is dental pain. So dental disease causes abscesses and pain in the teeth and things like that. If you've ever had a dental abscess, I have had one in my whole life and it was awful. I was bedridden. I may not have the best pain tolerance either, but it is something that I cannot imagine how our senior dogs and cats just like deal with. Because it's so uncomfortable. So it is really important to make sure that we're staying on top of dental care. Other things, there's question in the veterinarian world is kidney disease painful? You know, things like pancreatitis are painful. There are other things that can be painful for these guys. For this episode, I'm going to focus mostly on arthritis pain and how we remedy that. Although some of these things can be used across for other purposes as well. Okay. I Just want to remind you, senior is not a dirty word. And aging is going to be a natural process. And how beautiful is it that we get to love our pets into their golden years? Cause the alternative is terrible, right? So we want this opportunity to love them into their golden years. And we want this opportunity to be able to have like a softer, different kind of bonding with them. And it can be exhausting. But it's a beautiful way for us to grow and for us to support them in a different way and for us to learn a bit a little bit more about life and how everything changes over time. So take this as a learning opportunity. Know that it's gonna be a little bit different loving your senior pet as they're a senior, but there are plenty of things that we can do. And I want to get into that. Okay. So Often questions I get are my senior pet has arthritis. How can I make them more comfortable? What is the best pain reliever reliever? Do I use CBD? Do I use laser acupuncture? Are those actually worth doing? Or how do I know if it's pain or if it's just aging? So underneath all of that is going to be the same fear that I'm missing something and my pet is going to be in pain and I'm not doing something about it, right? So I always just want to remind people you're doing the best with the information that you have. And Our pets are going to choose us no matter what every time. So you loving them is going to be the best thing. And you're constantly trying to learn how to be better and do better. And we can work ourselves into an oblivion with this hindsight bias. If we think about what we might have been able to do, you know, if we knew about this earlier. And I encourage you to not think about that. I encourage you to. try and focus on the now and the future as opposed to the past, because we need to learn from those things, but also it can wreck us if we let it. And we really just need to focus on the now. That's how our pets live their life. They're so good at it. They're so good at living in this exact moment. And we really should take after them with that. Okay. One of the things that I notice pet parents get frustrated with is when they ask me, well, what Pain control is best for my dog. And I say, I don't know. And that's not because I don't have options. I have a lot of options. I don't know because I don't know what your pet is suffering from. I don't know where their pain is located. I don't know if they have muscle wasting associated with that. I don't know if they have allergies to certain things and they can't have fish oil supplements, or I don't know if they can't have anti inflammatories. I don't know. If they have heart disease and we're gonna need to stay away from things like steroids or certain medications, I don't know. Do they hate going to the veterinary clinic? And we need to make sure we're doing stuff at home as opposed to in the clinic. Do they have liver or kidney dysfunction? And we need to make sure that we're being weary of certain medications in that regard. Are they slipping on the floors? Are they having difficulties getting up and down? How is it affecting their life? And something you will hear me say time and time again is that every pet deserves a different plan. I believe that every person deserves a personalized approach to their care. And I believe that every pet deserves a personalized approach to their care because we have to take into account their quality of life as well as their comfort and things like that. And if Max hates going to the vet and he peas and poops everywhere and stresses out and has stress diarrhea for two days afterwards. I'm sorry, there's going to be a lot of conversations about TMI here. Then it's not okay for him to to go into the clinic for checks every two weeks or for an injection every month. It's just not going to be worth it for him. It's not. So we have to make sure that we're doing what's best for the pet in front of us. And also know that they're going to react differently to things. I have pets that I put on certain medications that it is life-changing for them. And then I have pets that I put on that same medication and there's no change. So it's important for us to know that we have to reevaluate, we have to look at the whole picture and we have to tweak things. Pain management is going to be a little complex. It's going to be time and effort and monitoring small changes and seeing what works and what doesn't. And it's a lot of like cooking a new recipe, right? It's a lot of like, ⁓ do we add this thing into it? And that didn't seem to have a good outcome. So now we're gonna try and add this new thing into it or hey, maybe we need to look at this a different way. It's a lot like that. So two big things that I always push are every pet deserves a personalized plan and pain management. Is multimodal, which means different modes. We're using multiple different things for pain control. That can be changes in the home, that can be pain medications, that can be herbal therapy, that can be alternative options like acupuncture, that can be rehab, whatever it may be. There's a lot of options. And it's important for us to know that. Just one thing is not gonna be the the one thing that fixes it. We're gonna have to come at this from a bunch of different angles because different things work differently. If you ever see something that says this is the magic cure for your dog's arthritis or your cat's pain, I want you to really look at that and evaluate it and talk to some other people that you trust about it, because it is likely they are pulling your leg and it is not true. I always want to be upfront with people is arthritis is there. We're going to be able to do some things to modify that and to help it and to improve it. We're going to be able to do a lot of things for the pain, but we are not typically reversing the arthritis. So it is there. We are just learning how to help it and how to improve comfort levels associated with it. So it's unlikely that we're gonna find one thing that magically fixes it from all angles and we don't need to add something else in. Okay. One of the first things I want to talk about is what is pain? How do we know that our pet is in pain? They're very good at hiding pain. Cats and dogs definitely both hide pain well. So you may still see your dog wag its tail or eat its food well and want to go on a walk with you, but that can still mean they're in pain. They're just showing it in different ways. Cats are gonna hide it even more than dogs. So they're gonna mask things mostly as a survival instinct. Okay. So in dogs, we often just see, hey, they're slowing down a little bit, right? They're hesitating to go up and down the stairs or up and off the furniture. They're licking more excessively at a particular part of their body, like a leg or a joint. They're changing the way that they sit or they lay down. So sometimes they'll be really slow to lay down or get up. They may stay think it's not worth it to get up at some points. You know, they used to get up and follow you into every room and now they're kind of just, it's not worth it because I'm afraid it's going to be painful. So I'm just going to stay here instead. We may notice that they're they're having some muscle loss over their hips and their spine and those types of things. It's going to be those subtle symptoms. They're starting to slip on the floors. They're avoiding hardwood floors or avoiding stairs because they know that those things make them feel uncomfortable and unstable. And they're not able to get around on them as well. So they're just avoiding certain things. Cats are the best at avoiding. So they tend to just say, Well, I'm not going upstairs to go to bed with you anymore because it hurts. So I'm going to be down here. Or they used to jump up on the counter and hang out with you while you were creating. Dinner and now they maybe get up on a stool and they just don't make it all the way up there. Or maybe they're starting to go up the stairs sideways instead of straight on. That's a very subtle change. Or jumping up on a chair to jump up on the counter instead of jumping straight up onto the counter. And maybe they're not wanting to sleep with you anymore because you move and it hurts. So they're they're choosing to sleep other places. They're not grooming themselves as efficiently anymore, especially their back end. they're missing the litter box because it's hard to get in and out of it or it's too small for them to be able to move around without hurting themselves. These are all really important things to know. And it's important for us to keep in mind that most of our senior dogs and cats are going to have arthritis in at least one joint. It often happens more in the back end first, on their spine, between their hips and then their hips, their knees, those types of things. Cats often get it in their shoulders as well. So it's important for us to notice these subtle symptoms first. If you need another chart, I do have a free Asian Gracefully checklist for pain and pain calculators. If you just go to my social media and comment insider on anything, you should get the automated DM to sign up for my. Freebies in my newsletter and I'll send you lots of information there every week too. I love to help. I give away a lot. And I want to give away as much as I possibly can can to help people and to help their pets. This is very dear to my heart. Not only do I love Vemed and I love seeing your dogs and cats and I love helping them, I was that pet parent. And I I've stood exactly where you are, frustrated and confused and helpless. And I don't want people to feel that way. So I'm here to help. I promise. DM me anything you need. Okay. Let's talk about multimodal pain control. Step number one, we're going to talk about Western treatment options. Non-steroidal anti-inflammatory drugs. These are things like carprofen, maloxicam, galloprant. If you're in another Country besides the US, they probably have different names of things, but essentially they're going to be our anti-inflammatories. This is like our doggy a leave. Dogs and cats cannot have a leave. Okay. The cat version is called on Seor. In the UK, they also use maloxicam for cats a lot. I also use meloxicam for cats a lot. That is a conversation to have for sure. But these guys are the backbone of arthritis. In my opinion, because we're talking about actually decreasing the inflammation in the joints, which is a lot of that pain and a lot of where it comes from. So a lot of times I will go into clinics where I do relief work and I'll see that they recommend other options first. And I always have a conversation and say, well, the insides are really the thing that actually helps the arthritis though. There are a lot of things for pain control. There's a lot of pain control options. But when we're talking about actually treating this at the source, we're talking about NSAIDs because they're going to actually decrease the inflammation in those joints and help lubricate everything and keep it comfortable, right? This can be contraindicated in certain patients that have kidney disease or liver disease. So we do need to make sure that we have at least yearly blood work on these guys. That is something to talk to your family vet about. I really love Galloprant and I still use Galliprant in some patients that have elevated liver enzymes, depending on what everything looks like, because it is a very specifically targeted drug. It targets what we call the EP4 receptor, which is specific for osteoarthritis, pain, and inflammation in dogs. In cats, we have ONSUR, we have maloxicam. There's not a labeled amount in the US of giving long-term anti-inflammatories to cats. However, in the UK, they do use maloxicam long-term at a substantially lower dose and then doing it every like one to three days. That is what I use as a protocol for my senior cats that are able to tolerate meloxicam. We do it at that lower dose and we do it at the lowest effective regimen, right? On sewar is also something that has been evaluated or Rubin Accox said longer term. And it's just there's always going to be a conversation to be had. There's always going to be someone who says and said killed my dog or killed my cat. And that's never a conversation we want to have. But I will tell you that anything we put into or onto or around or dog or cat can cause side effects. We know that. On a tangent here, lawn pesticides can cause certain cancers in dogs and cats. We know that I've had cases where something as simple as a fiber like flaxseed has caused a problem in a cat. We have situations where an herb has caused demise of pets. There is a risk to every single thing we do. So we have to Just make an informed decision. That's one of the hardest parts about senior pet care is that you're gonna have to make a decision and you're not gonna know whether it's the right or wrong answer until after you've already made that decision. And I get that, and it is hard, but that is part of being their caregiver, is that we have to make some calls. Next steps. I do want to talk about GABA Pet next and pre-gabalin for a long time, and I feel like some that still Reach for gabapetin right after NSAIDs. And the hospice and palliative care society does not really recommend that anymore. We tend to think of gabapetin like day drinking. If they need some pain relief right now, cool. Yeah, we can do some gabapapetin. But side effects of gabapetin does cause like some wobbliness, ataxia, some sleepiness. And these are all side effects that we don't really want in our senior dogs and cats because We don't know whether that wobbliness is dehydration, is damage to organs, or is just these medications. And then we don't really want them sedated, right? So I don't reach for gabapetin or pregabolin second anymore. It's lower down on my list and it's usually in my flare plan, which means we have a really bad flare up of pain and we need something to help with that. That's when I'll talk to pet parents about gabapetin. Another one that I really like and I don't think is used. as much is an NMDA receptor antagonist. So things like amantidine or subcutaneous ketamine injections. This is becoming more well known. I have a lot of vets reaching out to me now and asking about subcuketamine and doses and results. I see really good results with this in my senior dogs and cats. So basically this is a drug Amantidine and sepkuketamine, they go into the brain and they kind of stop that pain response that happens. Wonderful drugs, and they don't typically have the sedating side effects at the doses that we use them at, and they are typically pretty safe. I will say amantidine is better as an add on medication. It's not one that I typically use alone. I use it once I have an anti inflammatory on board. I'll add in that amantiden. Or we'll talk about injections. We can do ketamine injections at a very low dose once a month. And I've seen fantastic results with this. I do this for some of my in home clients, and it's amazing that I can come in and give them some instant relief and it lasts for a month. So that's that's a really cool thing. Another Thing that I do want to talk about, but I want to preface this by saying never do any of these things without talking to your veterinarian. Over-the-counter wise, aspirin is not helpful. Don't use it, just stop. It doesn't help with pain in dogs, and it is not good for cats. I do not know why pet stores sell canine aspirin in the store. It's the same thing, just put in a chewable. It's the same as 81 milligram aspirin that you would buy at its store. So, first of all, don't waste your money on the super expensive quote-unquote canine aspirin. And don't waste your money on it in general because it doesn't work for pain. Over-the-counter wise, you can talk to your vet about Tylenol. That needs to be said with a huge disclaimer of you need to talk to your vet about this because Tylenol is a no-no for cats. And For dogs, it can be used at specific doses in specific cases. It is not something that we just willy-nilly tell people to use or anything like that, because it can also cause bleeding and it can be contraindicated in certain patients. So it is something that I use in my house, but some palliative care patients, but it is something that I always have conversations with pet parents about. Another one that I really like. For cats that I don't think is talked about as much is Tramadol. And Tramadol is a partial opioid. So it is one of those things where it has controlled drug laws on it. And we do have to make sure that we're having good conversations with pet parents about safety of this drug. And it doesn't work very well in dogs. Most of the time, we used to use Tramadol a lot more, and we don't as much anymore because we just noticed that dogs don't have. great receptors for Tramadol. However, cats do. The problem with Tramidol in cats is that it tastes awful. It's very bitter and cats hate it. However, I have had really good success with creating transdermal tramadol through a compounding pharmacy and all transdermal medications in dogs and cats, a lot of internal medicine specialists will tell you, We don't know the efficacy. And they're not wrong. We don't. We don't know if we put that on the pet, on the ear pinna, which is usually where we do transdermal, it goes through the skin instead of having to go in the mouth as a tablet or a liquid. The transdermal, how well does it absorb through the skin and go into the body? We don't have great studies on that. And anytime we compound a drug, which means that a pharmacy kind of concocts it. in their facility with different things that help it absorb. We have to question, is it going to be made effectively enough to work? However, I will say I've seen a lot of hospice and palliative care cats who do not take oral medications well. And we do things like tramadol, transdermal on the skin, on the ear pinna, and it has given them months of happy life. And that is worth it for me. So it is a conversation that I have too. This is the one that everybody is going to have an opinion about labrella and celestia. Okay. There is actually some recent data put out by a most recent article in the Journal of American Veterinary Medical Association about labrella and dogs worsening and causing basically worsening arthritis. So it's it's causing this major degeneration in the joints. This is usually a group of veterinary surgeons who all are just really up in arms about Labrella. I will say everyone that is going to have a different opinion on things. I see senior dogs and cats exclusively. I focus on really good multimodal pain control for them. I am not a specialist. I am not a surgeon. I am not an internal medicine specialist. I am just someone who is a veterinarian, who is also trained in Chinese medicine. And I like Labrella and Selencia. But I will tell you, I like it in our very end situations. So Labrella and silencia work by attaching to something called nerve growth factor. Nerve growth factor, we do know, is also important for healing. It is important for healing the joints over time and decreasing inflammation, things like that. However, when we have a pet who is in severe pain and nothing else is working anymore, we tried all these other things and nothing is working. And we are At the conversation of euthanasia, I always am going to talk to them about other options that may give their pet pain relief and may give their pet some more good days. So I am not going to withhold Labrella or Cilencia from a pet parent because there have been some cases where it does make things worse. And I think the conversation needs to be this is not our first option. I know when it came out, we just started to reach for librella over anti-inflammatories. And that's absolutely wrong. We need to make sure that we're reaching for the things that are actually modifying disease first and helping the actual arthritis as opposed to just blocking pain. It's just something that we do need to understand that we don't have a great. ⁓ breakdown of all the potential side effects. We don't know what it could cause. We do know that it attaches to nerve growth factor, which is important for the body to have. But if we're talking about patients in their last few months to potentially years of life, why not try? So I think that is the the conversation that I have. I have a lot of older dogs and cats on Labrella or Celentia, and it has been life changing for them. It has given them a lot more really good time. There's a dog, Jake and Robin. Jake, I don't know personally, but I've been virtually consulting with his mom over the past ⁓ like three years. She's been in my world for a long time. And Jake got another good two years after Labrella. He was so painful before that. And it gave him really good time and nothing else did. So why not? You know, I have A lot of other cases, I've given Labrella and Solencia to hundreds of pets and I have seen really good results from it. I have had some cases where they don't respond well. I had a dog who had a fever and GI upset for two weeks, and that was really difficult. And then I've had patients where nothing extremely dramatic, but people will just say, I think it made them worse. And then we just say, Okay, we're not doing it anymore. That's fine. We'll find some some other way to help, we're not gonna continue to do something that could make them worse. And it could make certain patients worse who have underlying neurologic diseases that we don't know about. So I think it's something to definitively talk about with our with pet parents, but I think it's something that needs to be said in the appropriate light. Okay. And the other thing with Labrella and this like thought process of this severe breakdown of the joints and worsening of arthritis is that A lot of these patients, we give this to them and we don't talk to them about this back to play guide. So if your pet has been essentially using a walker, you know, you know the very slow, gentle walking on eggshells walk. If they've been doing that for a while, and then we give them Labrella and they're like, I feel great. And they're running around in the backyard, they're ripping, they're cutting, they're doing all this stuff, and you're like, Whoa, this is so beautiful to watch. I love this so much. That could be bad. We do need to talk about there's a slow, steady way to get back into that activity because if they have severe arthritis and they don't feel it anymore and they're just ripping around the yard, they're gonna make it worse. It's going, it's inevitable that's going to happen. So is the continued breakdown actually something that happens because they feel better and now they're moving better? And I'm not mad at that. Or is it truly that the drug is causing degradation of the arthritis? That's a question that we don't have the answer for yet. Medicine is always changing. Have you ever left the vet with more questions than answers? And then you drive home and you go straight on to Google. Yeah, I hear that a lot. And honestly, it's exactly why I created my senior pet virtual consultations. Imagine we have 45 minutes where we go through everything: your pet's full history, their specific challenges, their daily life, no rushing. We're gonna cover nutrition, integrative options, whole modifications, and quality of life. And I send you a personalized plan after so that nothing slips through the cracks here. But don't just take my word for it. Chelsea called it a senior pup therapy session and said she felt so much better afterwards. Adiba got recommendations her own vet had never thought to suggest, and Denise said that the consult was incredibly informative and helpful, giving her many options to help her dog Loki feel better. This is the conversation that your senior pet deserves. And honestly, The one you deserve to. The link is in the description. I'd love to help you. Moving on from medications, at home options and and alternative options. Obviously, I'm an acupuncturist. I fully believe in acupuncture. I have given pets so much good time. I have brought pets out of hospice with acupuncture. I have given patients who said, you know, I we know we're in our last few months to seeing them for three years with acupuncture. I have just seen hundreds. Of really amazing stories where Western medicine was like, We're tapped, we're done. And I come in with some acupuncture and I'm like, yeah, we got we got a couple more years of good time. This is amazing. So I really like acupuncture. There are a lot of different variable trials in it. As far as like actual evidence-based medicine, it is, I mean, acupuncture has been around for thousands of years. Something's not going to stick around for thousands of years if it doesn't work. So I feel very strongly about acupuncture. Laser therapy and PEMF, these are really good modalities for patients. It's basically like targeted light therapy or photobiomodulation therapy that help to increase healing factors into the area and to decrease inflammation and those types of things. You do have to be careful with laser with cancers, and I think. PEMF is contraindicated in things like hemagasarcoma, certain cancers too. So it is something that always needs to be talked about. Again, multimodal, individualized plan. It's always going to be different. CBD. I just heard from someone that apparently CBD is not allowed anymore in some countries like France. So it is something you may or may not have access to. I do see a lot of people try and use like their local dispensary and their local dispensary with good intention has decided to have a pet protocol and it is not tested or and it is not set up appropriately. So I love CBD for pain, also for cognition and for nerve things and behavior anxiety, but we need to make sure that we're using ones that are appropriate. Ellie Vet is the main one that I recommend. There is also Dr. Hemp Dog that I've seen really good results from. So we want to make sure they're doing some testing and we want to make sure they're doing some research to prove that these products work. That's going to be a lot of the hard part with like things like supplements, is there's not a lot of FDA or USDA regulation on them. So they can kind of put anything out there, and it doesn't mean it's going to work. Thinking about things like Massage, stretching, rehab, these are so underutilized. You can just be sitting on the couch and massaging your pet's spine and their back legs at night. As long as they're comfortable with it, they will tell you when they're not comfortable. Heat therapy. So using some warming pads that are safe for pets if they're if they like heat, you know, especially cats. Our cats love heat. So using those types of things to help. their muscles and their joints is going to be really helpful for them. Stretching, just like us, we should stretch every day. Our pets really could use that help too. Again, rehabilitation is paramount. I have seen so much improvement with a good rehab routine where someone actually puts it into play. Rehab is something I want to get licensed in in the next few years. I just, it's amazing to see the improvements that can happen with that. So If you ever want to come into my world and my program, I do have two different rehab specialists in there and they do live QA's a couple of times a month to help you with your pet. So that's just something to know about. One of the other things that I'll say right now, I don't know as much about, but I have heard really good things and seen some pretty good research is stem cell therapy. This is Talking about giving an injection that helps regenerate things, that's something that can be tried as well. There are other things like golden bead inserts that happen from acupuncture standpoint, put those directly into the joint. There's Sonova 10, which is another injection into the joint. ⁓ there's there's a couple other like injectables that we can use. Those obviously need to be done typically under sedation or anesthesia. So it's just something to to bear in mind. There's also shockwave therapy is another great option. This is basically another version of using like the movement of light and wavelengths to help with pain. There's a never-ending supply of things that we can do. We're talking about supplementation. This is something I really want to tell you about. If a supplement tells you this one supplement's going to fix your dog's arthritis, you should probably just back away. It's not. If they're promising those things, it's not. But there are a lot of supplements that have shown improvement in certain pets. I think with supplements, I always say try it for one to two months and see. If it helps, great. If it doesn't, just discontinue it, you know. Fish oil is the one that most veterinarians are on board with. Fish oil is extremely helpful for osteoarthritis in our senior pets. And the big thing The misconception that I see is that people tend to use too low of a dose for arthritis pain. They need a really high dose. Like a 75-pound dog needs like 3,000 milligrams, which most like dasiquin only has like 80 milligrams per chew, right? Like it's not gonna be enough. You need to have a separate fish oil that we add onto this. Things like muscle builders are really important to help with that as well. Things like Glucosamin hydroin, though it's a hit or miss one right now. There's new information that says maybe it doesn't work that well. I don't know. Then we talk about turmeric and UC2 collagen. Those are some things that I have seen decent studies behind and have shown improvements. ⁓ home modifications. This is very underutilized as well. So using ramps, using non-slip rugs on the floors. using line your house with yoga mats and carpet runners. Like I want it to be ugly. That's fine. I just want your pet comfortable. I don't want hardwoods anywhere. I want them all covered. Using treads on the stairs, using nail caps, clipping the fur between their toes, all of these things can make a huge impact, making sure that their food and water bowls are raised to shoulder height so that they're comfortable and can get into those things. Having orthopedic beds, making sure we have a Litter box on every floor. I know that sucks, but have one on every floor. Make sure the litter boxes have a low entry to get into them, a very wide base so they can move around in them and they do not have a lid or they have a very tall lid so that they can hunch over without causing discomfort. All these things are extremely important and can make a world of difference. I've had people tell me that just simply lining their house with yoga mats made their dog so much happier. And they could get around easier and they were more comfortable. And they live most of their life in your home. So let's make them comfortable, right? They deserve that. All right. I think from a Chinese medicine standpoint, we also talk about things like food therapy and herbal support that can complement pets. These things are really important to ideally get a Chinese diagnosis first before we're doing those things. Again, multimodal and personalized. Always very important. Let's see a couple of the other pain medications that I want to touch on. Polysulfated glycosamine glycan, adequine, which is an injection that they get twice a week for four weeks. This can happen in dogs and cats, it's off-labeling cats, but I still like it. This goes into the joint and increases the cartilage and helps to prevent breakdown of cartilage. I really love adequine. I think it's something that should be used early in arthritis. So when we're having some symptoms very early on in the beginning, let's start some adequine. And The continued regimen after that is variable. I usually do once a month injections after that first dose of things. And we can always like redo the loading dose if we need to. Another one that I'm getting more familiar with is called Foresight. And it's an herb that helps and it has actually gotten disease modification changes and it's actually been shown to reverse some damage of arthritis, which is amazing and doesn't happen very often. So that's really important to talk about too. There will be many more. If you want to know all of these in depth, I go really, really deep on this and we get a plan together for you and your pet in my program. We get a flare plan together just for them. We're going to get a personalized plan together just for them. And we're going to check in once a month and make sure that plan is working and tweak things and add things and do all of that. I want to work with your vet to make sure everything is done appropriately and they're safe when we do all of this, but. If you want to get really, really deep into this and you really want to know what is best for your pet and how to help them, I can definitely help you in my program. I promise I have so many beautiful testimonials. I had two people come into my program in February that were ready to euthanize their pet and now their pet is thriving. It is amazing. It speaks for itself. You can find all that information on my website. But yeah. So again, there is no one best. Campaign plan, the plan is built for the pet in front of you. Okay. We're going to have different options for different pets. If we have kidney disease, we're going to different thoughts and options, but we still have options. I think it's very important for you to know there are still things we can do, right? So slowing down these very subtle changes are what everyone's going to need to pick up on a little bit better. We need to make sure we're using multimodal or combined tools and not just going with one and hoping because. We got to treat arthritis from a lot of different angles, right? It's a progressive disease. It's going to get worse. And if we're treating it from a lot of different ways, we're going to just be like blasting it down and we're going to be able to do more and help more that way. You know, insides are kind of my backbone of it, but also I meet pet parents where they are and pets where they are. And I have plenty of people that tell me they don't want to do any medications. And then we just do acupuncture and herbs and laser and PMF and CBD and all these other things. There's so many options, no matter what your comfort level is. So I just want to meet you where you're at. I think it's extremely important that you know that there are a lot of options for you. You are not out of options. I have yet to meet someone who is out of options. Okay. So I also for virtual consultations, if you just want to one off to talk about something, I promise you I can get you at least a page of things to help you. I promise you. Home modifications. Simple things like heat and massage and a lot of these things are free. Just make sure you're you're doing these two. Okay. So if you have any questions or you want some more insight, please feel free to reach out to me again through DMs or through senior petconnection.com. And I am happy to talk more. Remember that you are doing a good job with the information that you have. I am just here to give you more of it every single week. And now you hopefully have a lot more information. I hope that you were taking some notes. And if you know someone else who could benefit from this conversation, please send this to them today. We are not helpless. We are not hopeless. There are more answers, I promise you. More good days can start today. Okay. Thank you for listening to today's episode. I really appreciate you taking the time out of your day to be here with me and to trust what I have to say. So. I appreciate you. Hug on your senior platformy and have a beautiful day. That's it for today. If this episode helped you, please leave a review or rate this podcast so we can get the word out to more pet parents who need to hear that they are doing a good job. And if you're interested in working more with me, you can find me on social media or at senior petconnection.com because we all need to stay connected. Remember that you are doing a great job with the information that you have in this moment. And I am just here to give you more of it. See you next week.