Canine Osteoarthritis (OA) is one of the most commonly encountered musculoskeletal disorders and one that veterinary surgeons (VS) and Registered Veterinary Nurses (RVN) are likely to see in day-to-day general practice. So, you may find yourself in an arthritis consult – what should you expect?
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What is osteoarthritis (OA)?
OA is sadly incurable and can result in a complex pain state involving both local (nociceptive) and brain and spine (neuropathic) mechanisms. It is often debilitating and stressful for both your beloved pet and you as an owner; with negative consequences related to pain, mobility and decreased quality of life.
Treatment of OA should ideally be multimodal. This means that the best way to manage it is often to implement many different changes and interventions that all combine to make a positive impact on the condition. This may include medicine prescribed by your vet, diet changes, home adaptations, some supplements, physiotherapy and hydrotherapy among other things. The aim is to alleviate the painful clinical signs associated with the condition. Your vet is likely to prescribe analgesia (pain relief) such as Non-Steroidal Anti-inflammatory drugs (NSAIDs) and may use a polypharmacy (a few different medications) approach using other forms of medical therapy following diagnosis of the condition.
Something that I believe is useful for you as an owner is to go to arthritis consults. There are a few things that may be covered in these, but I will explain why they are so useful to you and a valuable service to engage in.
You may think that the only thing to do in an arthritis consult is to check their pain and adjust the pain medication as required. There are, however, many other things we can check and do that all feed into the final outcome of a case. These include:
The majority our UK pet population is overweight with around 65% of dogs being overweight and between 39% and 52% of cats in the UK being overweight or obese. Obesity has detrimental impact on arthritis management. Therefore if our pet is overweight, a body condition score of 6 or more when using a 9-point system, then some of the time in an arthritis clinic will be dedicated to weight management.
Adipose tissue can act as a rich source of pro-inflammatory mediators; in obese dogs with OA the extent and frequency of lameness seen is closely correlated to body condition. It has been shown that a reduction in bodyweight by 6% to 8% can significantly improve limb function; this is confirmed by one study in dogs that demonstrated preventing obesity delayed the onset of OA and reduced its severity.
Weighing is also useful to check that our medication dosages are correct.
Muscle and body condition check
The muscle on a dog can tell us a lot about their limb function. You may not think your dog is in pain, but dogs and cats are very good at shifting weight from their sore limbs onto a less painful area. Therefore, that muscle group gets used less and starts to atrophy (get smaller). So, muscle condition scoring, checking for any areas of muscle loss and body condition scoring are all useful to undertake in an arthritis consult.
Of course, a part of the clinic will be an assessment of pain; and how well we think we are currently doing. This often means a physical exam, and visually assessing the gait of the animal.
It may also mean you filling in an owner questionnaire such as the LOAD Score to gain numerical data on your dog’s condition. This can help us check the severity of pain. And it helps highlight areas of interest that we need to improve upon, including stiffness or ability to go on walks.
Depending on the facilities at your veterinary practice you may also have the availability of other therapies such as hydrotherapy and physiotherapy; all useful if done correctly to help manage your pet’s condition.
Checking medications are working for you and your pet is always useful. If you are struggling to give a medication then compliance will be poor, and then your pet doesn’t get the medications it needs. So we might check in on how things are going. Be truthful if you are struggling daily to give a tablet to your pet. We may have something different to check.
Often, but not always, our pets with arthritis are more middle to older age. Therefore, some of the consult may suggest a blood test to check for any other issues, called co-morbidities, or to check that your pet is doing well on the medication and that we aren’t seeing any organ changes. We may take a blood test during an arthritis clinic.
Your pet is unique
The most important thing to know is that as each pet is unique, so will the clinic. Every animal responds differently to treatment and every animal has a different arthritis ‘story’.
The clinics are often tailored to you and your pet so you will both get the most out of them.