Degenerative joint disease pain

WSAVA guideline

Key findings

• Approved/proven DJD-OA analgesics: COX-inhibiting NSAIDs, grapiprant (piprant), anti-NGF mAbs (§3.13).
• Greatest weight of evidence: NSAIDs (incl. piprant), anti-NGF mAbs, weight management, omega-3 diet, exercise (§3.13).
• Anti-NGF mAbs — bedinvetmab (dog), frunevetmab (cat), ranevetmab (described): one SC injection gives ≥1 month OA-pain relief; first line; no organ adverse effects; mild skin reactions (alopecia) in cats (§2.17).
• Grapiprant: EP4-receptor antagonist (non-COX), dog 2 mg/kg PO q24 h, RCT-proven (§2.3).
• Box 2: cat DJD largely age-related — "DJD" preferred term; look for joint pain at all ages.
• OA pain is mixed inflammatory + neuropathic (Table 3); amantadine helps NSAID-refractory dogs (§3.12 card; Table 16).
• Paracetamol dogs only (fatal methaemoglobinaemia in cats); corticosteroids only for immune-mediated polyarthritis, never with NSAIDs (§2.3).
• NSAID rules: same drug perioperatively, lowest effective chronic dose, 7-day washout when switching after GI signs (§2.3).
• Monitoring: dog CBPI (OA-validated) + LOAD; cat MiPSC + FMPI/CSOM (Tables 7 & 9).
• Non-drug pillars: weight control, exercise, environment, omega-3, rehab, acupuncture; surgery first line in the growing dog (§3.13).

Drugs named in WSAVA’s own guideline text

As printed in WSAVA’s document, not this app’s own extracted data — see “Related drugs in this reference” below for that.

• Carprofen (Dog)

  Base OA analgesic

• Meloxicam (Dog / Cat)

  Base OA analgesic

• Ketoprofen (Dog & Cat)

  Acute/chronic pain

• Robenacoxib (Dog / Cat)

  OA pain

• Firocoxib (Dog)

  OA pain

• Deracoxib (Dog)

  OA pain

• Cimicoxib (Dog)

  OA pain

• Enflicoxib (Dog)

  OA pain

• Mavacoxib (Dog)

  Chronic OA pain

• Tolfenamic acid (Dog & Cat)

  Acute/chronic pain

• Grapiprant (EP4 antagonist) (Dog)

  OA pain

• Paracetamol (**Dog ONLY**)

  OA pain; NSAID-washout bridge

• Bedinvetmab (anti-NGF mAb) (Dog)

  OA pain — first line

• Frunevetmab (anti-NGF mAb) (Cat)

  OA pain — first line

• Gabapentin (Dog / Cat)

  Neuropathic-component adjunct

• Pregabalin (Dog / Cat)

  Neuropathic component

• Amantadine (Dog & Cat)

  NSAID-refractory OA

Recommendations

• Prioritise NSAIDs (COX + piprant) and anti-NGF mAbs

  Evidence-based (§3.13)

• Weight management, omega-3 diet, exercise — greatest evidence

  Evidence-based (§3.13)

• Anti-NGF mAbs appropriate first-line

  Strong — studies + licensing

• Screen NSAID patients; lowest effective dose; 7-day washout when switching

  Expert consensus (GPC)

• Paracetamol dogs only

  Strong (species toxicity data)

• Add amantadine if NSAID-refractory

  Cited veterinary evidence

• Gabapentinoids/amitriptyline adjuncts; tramadol cats only

  Expert consensus (GPC)

• Corticosteroids only for polyarthritis; never with NSAIDs

  Expert consensus (GPC)

• Tailor to life stage; surgery first line in growing dog

  Expert consensus (GPC)

• Monitor with CMIs (CBPI/LOAD; MiPSC/FMPI)

  Recommended in practice

Related drugs in this reference (9)

The quoted line under each drug is its own already-extracted indication text that matched this condition — the reason it’s listed, not a paraphrase. Open a drug for its full species/route breakdown, calculator, and complete adverse-effect list.

Showing 6 of 9 linked drug records. Open a record for species, route and source details.

• AMANTADINE

  “Adjunctive treatment of chronic pain (osteoarthritis, neuropathic pain, osteosarcoma pain, "wind-up") when NSAIDs/opioids alone are insufficient; reduces opioid…”

  Source dose preview: 3–5 mg/kg, q24h, PO (Dog)

  Adverse-effect notes: Agitation/restlessness, loose stools, flatulence, diarrhea — Mainly early in therapy · Anxiety states, dry mouth — Occasional

• BETAMETHASONE ACETATE

  “BETAVET is indicated for the control of pain and inflammation associated with osteoarthritis in horses.”

  Adverse-effect notes: Adverse reactions reported during a field study of 239 horses of various breeds which had been administered either BETAVET (n=119) or a sali… · The following adverse reactions were reported during the course of a US field study for treatment of otitis externa in dogs treated with DuO…

• CARPROFEN

  “® OstiFenis indicated for the relief of pain and inflammation associated with osteoarthritis and for the control of postoperative pain associated with soft tiss…”

  Source dose preview: 2.2 mg/kg q12h or 4.4 mg/kg q24h, q12–24h, PO or SC (Dog)

  Adverse-effect notes: GI (vomiting, anorexia, diarrhea) — Most common, usually mild (<2%) · Idiosyncratic acute hepatotoxicity — Rare (~0.05%), typically 2–3 weeks after starting

• CYCLOPHOSPHAMIDE

  “Combination chemotherapy (lymphoma/CHOP, leukemias, carcinomas, sarcomas); immunosuppression (SLE, pemphigus, rheumatoid arthritis, glomerulonephritis, IMHA — c…”

  Source dose preview: 50 mg/m² PO 4 days/week, OR 250 mg/m² PO/IV q3 wk; IV 100–300 mg/m² per protocol, Per protocol, PO/IV (Dog)

  Adverse-effect notes: Myelosuppression — Dose-limiting · GI (anorexia, vomiting, diarrhea) — Common

• FRUNEVETMAB

  “SOLENSIA is indicated for the control of pain associated with osteoarthritis in cats.”

  Adverse-effect notes: The safety of SOLENSIA was evaluated in a masked, controlled 112‑day field study to evaluate the effectiveness of SOLENSIA for the control o…

• LEFLUNOMIDE

  “**Immune-mediated disease alternative to azathioprine/mycophenolate**: IMHA/ITP (Evans), myasthenia gravis, polymyositis/polyarthritis (3–4 mg/kg response in po…”

  Source dose preview: **4 mg/kg/day divided (2 mg/kg q12h)** → taper to 2 mg/kg q24h → 25% decrements to stability, q12h → q24h, PO (Dog)

  Adverse-effect notes: GI (inappetence, diarrhea) — dose-related — Most common → **start low, titrate up** · Mild anemia, lethargy — Observed