When Sugar's arthritis was mild, we used Metacam as needed. When it got really bad this fall, I ended up switching to Tramadol (1-2 50mg every 8 hrs when it flares up, 1 2x day maintenance). That and acupuncture have really helped. She gets a Pepcid 2x day as well because of all her meds. She gets blood work every 6 months for her heart condition anyway. I found Cosamin first, later Dasuquin (made by same company) the glucosamine/chondroitin/msm supplement that worked they best for her. Try Joint Health first though, it's cheaper