Treating osteoarthritis in geriatric dogs
Editor's Note: Ronald McLaughlin, DVM, DVSc, Dipl. ACVS, is a professor and chief of Small Animal Surgery at the College of Veterinary Medicine, Mississippi State University. He also is chief of staff at Mississippi State University's Animal Health Center and head of the Department of Clinical Sciences.
DVM: Do you see patients in a clinical setting, or do you devote your time to research and teaching only?
McLaughlin: Most of my research in this area has been on the management of osteoarthritis, not necessarily in geriatric patients, but in all ages. We've done clinical evaluations of new and existing nonsteroidal anti-inflammatory drugs (NSAIDs), nutraceuticals and other agents. We look to see if certain agents or newer drugs are more effective than what currently is being offered, if patients are more comfortable and whether these drugs should be part of the overall treatment for patients.
There's increasing evidence—in fact, a substantial body of knowledge now—that NSAIDs and nutraceuticals do help control inflammation and reduce the signs of osteoarthritis and, as such, are valuable treatments. However, there are still questions to be answered about which treatments are best and what new treatments might help improve patients' quality of life.
DVM: For veterinarians in clinical practice, what would you recommend as the most effective ways for them to relieve the signs of this condition in older canines?
McLaughlin: The ideal approach is a multimodal one. One treatment alone is unlikely to be fully effective. Rather, a combination of treatments helps make patients more comfortable and relieves signs. A good multimodal approach would entail NSAIDs for anti-inflammatory properties; analgesics for pain; nutraceuticals for comfort and to preserve cartilage; proper nutrition, for example, an omega-3-based diet; weight control or weight loss and physical therapy.
DVM: Are certain breeds most at risk?
McLaughlin: We see osteoarthritis in all breeds of both dogs and cats. That said, we do tend to see older, large-breed, athletic and working dogs with this condition. For the latter two, it may be that their signs are more obvious because the osteoarthritis affects their work.
DVM: What medications would you recommend? Any common contraindications or side effects veterinarians should watch for?
McLaughlin: Long-term use of NSAIDS can cause renal and gastrointestinal problems, especially in geriatric dogs. Veterinarians should watch for clinical signs of those complications and regularly get blood work done on such dogs. Also, veterinarians should never give an animal two NSAIDs at the same time.
A multimodal approach as I described earlier can enable veterinarians to lower the dosage or reduce the frequency of NSAID treatments, which is especially important in dogs that must be on NSAIDs for a long time.
DVM: Other than medications, what treatments, if any, have demonstrated relief in dogs? For example, physical and exercise therapy, massage, acupuncture or any other alternative medicine treatments?
McLaughlin: A lot of work has been done in alternative therapies to see if they reduce osteoarthritis signs. For example, physical therapy is becoming more common in veterinary medicine. With the right protocols and physical therapy modalities, patients have improved.
There's also been recent research that looked at laser therapy, electrostimulation and therapeutic ultrasonography that have shown some benefits, but more work is needed in these areas. The body of knowledge around nutraceuticals certainly has increased and does show some positive effects, though some seem more effective than others, based on the research.