Some veterinarians operate under the assumption that some fictions are fact. Here’s why they shouldn’t.
Although osteoarthritis (OA) is the most common form of arthritis in dogs and cats, many animals suffer well into the late stages of the disease before pet owners seek treatment. Are veterinarians doing their part to fully understand the signs of OA and educate their clients about how to prevent the disease’s progression? Many well-intentioned doctors may unknowingly perpetuate misperceptions that could be delaying the treatments their patients need.
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Joyce A. Login, DVM, senior manager of veterinary specialty operations at Zoetis, sets the record straight about 3 of the most common myths associated with OA.
Too often, Dr. Login said, people believe that arthritic issues are just a normal part of aging and that it’s commonplace for senior animals to experience discomfort. “I have a very strong belief that age is not a disease.”
“It’s important for clients to understand—especially for pets that are going to be prone to it—that OA is a chronic disease and it’s not going to go away,” she continued. “But we can help these animals.”
Rather than writing off the pain as an inevitable consequence of growing old, implement therapies that can treat the current pain while simultaneously working with the client to prevent the condition from progressing.
On the flipside, it’s incorrect to assume that OA only develops as animals enter their senior years. The fact is that the disease is often genetic and developmental. It’s this misperception, Dr. Login explained, that likely causes many veterinarians to miss out on talking to clients who have at-risk puppies and kittens.
As she pointed out, some breeds are prone to OA as well as certain medical conditions that may accelerate the onset of degenerative joint disease. “If an animal has some kind of a dysplasia or congenital problem, that patient could start developing OA very early in life. It could be a 2-year-old border collie; it doesn’t have to be a 12-year-old Labrador retriever.”
Instead, Dr. Login suggested that veterinarians start to build joint- and pain-related questions into their history taking or, at the very least, pay attention to signs that could be an indication of OA, such as behavioral changes, a dog that no longer greets its owner at the door, or a pet that is persistently licking or chewing a particular area of its body.
When it comes to the medications available to alleviate the chronic pain of joint disease, Dr. Login encouraged veterinarians to challenge the belief that nonsteroidal anti-inflammatory drugs shouldn’t be used long-term. “A number of publications show that long-term therapy can continuously improve clinical signs in dogs without an increase in adverse effects,” she explained. “We may be doing an injustice to these animals in giving them short bursts of pain management rather than long-term therapy, which is what the disease needs.”
The recent data about the relative ineffectiveness of tramadol as a pain reliever was a shock to many in the veterinary community and sent doctors looking for new answers to an age-old question. “As much as we would all love to have some magic bullet or 1 little thing that works, it’s still the basics,” Dr. Login said.
She continues to recommend multimodal therapy for patients and encourages veterinarians to initiate conversations with clients about weight control and exercise for their pets. There are also environmental factors that come into play, she added, like making sure rugs in the home won’t cause the pet to slip. These nonmedical therapies combined with nutraceuticals like chondroitin are often the recommended multimodal approach.
But that doesn’t mean hope for “the magic bullet” is lost. “I think there is an incredible amount of work being done in this space,” Dr. Login said. “We know there is work being done in finding new places in the pain pathway that could be blocked beyond just the COX pathway. For example, monoclonal antibodies are being looked at as well as genetic modifications of the joints.”
Even from a delivery standpoint, Dr. Login predicted changes that will provide multiple ways of administering medications beyond pills. “It’s not Star Trek. It’s not happening in 20 years. Everyone should keep an ear to what is happening in this space because there is an awful lot going on.”