Diagnosis

Rethink OA: Take a proactive approach to diagnosis

While canine osteoarthritis (OA) is the most common cause of chronic pain in dogs, many cases go undiagnosed or are diagnosed late in the disease process after significant joint damage has occurred.1 Allowing the functional and structural changes associated with canine OA to occur is doing a great disservice to the patient. The joint degradation of OA is incurable and early intervention to disrupt the progressive cycle of the multidimensional joint deterioration is the most effective way to manage OA.2

Currently, greater than 50% of canine arthritis cases are diagnosed in dogs aged between 8–13 years.3 And, even though advancing age, increasing bodyweight and obesity contribute to the progression and severity of OA, this high percentage of older age diagnosis is a concern, given the known link between OA and the developmental of orthopedic disease in younger dogs.2

A good first step in rethinking the approach is to consider mobility as a vital sign. Looking for early signs of a problem can help to proactively identify and address canine OA and or degenerative joint disease early in the process. Consider putting protocols in place to screen for or discuss OA at every patient visit.

Adequan Canine veterinarian dalmation clinic img

A Guide for the OA Discussion



Video Transcript Arrow Up

Osteoarthritis (OA)
Getting Pet Owner Involved Video Transcript

Denis J. Marcellin-Little
DEDV, DACVS, DECVS, DACVSMR

“We’ve got to be very sensitive to what the owner sees at home. Even if the owner is not that concerned about what they see, we’ve got to probe them. We’ve got to ask them what’s going on at home, and we’ve got to never dismiss as a clinician some red flags that the owner will bring up.

“An unusual limb position, an unusual way to sleep, an unusual posture or gait most often is going to be the consequence of a painful joint that may not be diagnosed yet.”

David L. Dycus
DVM, MS, CCRP, DACVS-SA

“We want to let them know on the front end this is the expectations and these are the things that we can do to hopefully prevent in some situations,

“...or at least dramatically slow down the progression, so that they may never have clinical signs that we need to manage pharmaceutically or from other options.”

Kristin Kirkby Shaw
DVM, MS, PhD, CCRT, DACVS, DACVSMR

“While osteoarthritis is a potentially debilitating disease, it doesn’t always have to be, and it doesn’t have to be a scary word. We need to frame it in a positive sense and a hopeful sense and give clients the tools to help their own dog.

“And ultimately we, as veterinarians, are the advocate for the dog. And by not having these tough conversations with the client, we’re not doing our job.”

Whit Cothern
DVM

“Having these conversations about osteoarthritis, especially in these higher risk breeds, with the pet owner is vitally important.

“We want to loop them in on the therapies that are available. We want to have the discussions about nutrition and weight management and breed predilections.”

The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.

© 2021, American Regent, Inc.
NP-NA-US-0343 11/2020

Client Assessment

Ask questions about changes in behavior, personality and mobility. Consider a questionnaire with questions about changes in dog’s behavior and mobility.

Patient History

Review for age, weight, past injuries and medications which can indicate a need for an OA diagnosis.

Weight

Discuss and review weight management – especially when visually not controlled.

Orthopedic Exam

Stance Evaluation – identify any abnormalities: weight shifts, elbow flexed and out, stifle out when sitting, etc.
Gait Analysis – lameness score: shortened stride, dragging toenails, ataxia, vocalization, audible clicks and crisscrossing legs can indicate a problem.
Palpation – take a systematic approach, evaluating each joint and the spine for swelling, edema, crepitus plus range of motion, abnormal motion or instability.
Goniometric Measurement – to establish range of motion.

Patient Assessment

Muscle Mass Evaluation – record measurement using a Gulick tape.

Radiography

Goal is to localize to a joint or joints to help rule out other conditions and determine severity.

Laboratory Analysis

Arthrocentesis to determine cause of swelling.
Immune Panels.



Discover if Adequan® Canine (polysulfated glycosaminoglycan) is the right choice.

COAST: A Progressive OA Staging Tool

The Canine OsteoArthritis Staging Tool (COAST) was developed by leading orthopedic experts as a standardized approach to diagnose and monitor dogs with clinical signs of OA, as well as those at risk of developing OA.2

1.

Grade the Dog

  • Clinical Metrology Instrument
    • Degree of Discomfort
    • Static Posture
    • Motion
2.

Grade the Joint

  • Clinical Metrology Instrument
    • Pain Upon Manipulation
    • Passive Range of Motion
    • Radiography
3.

Stage of OA

STAGE 0-1: Pre-osteoarthritis
Injuries or developmental problems are more likely to affect a dog’s joints.
STAGE 2: Mild
Signs include less interest in going on walks and playing.
STAGE 3: Moderate
Signs include limping, struggling to get up, lie down or refusing to climb stairs.
STAGE 4: Severe
The dog loses the ability to walk or function. Signs are always visible.

Would you like to learn more about the COAST tool?

Personalized Treatment Plan:
A Multimodal Approach

If the diagnosis is osteoarthritis, develop a therapeutic approach specific to the dog’s age, stage and physical condition. This may include treatment with Adequan® Canine, the only FDA-approved disease-modifying osteoarthritis drug (DMOAD) that inhibits cartilage loss in a dog’s joints.4,5

  • Disease-Modifying Osteoarthritis Drug
  • Pain Management
  • Exercise
  • Weight Control
  • Adjunct Therapy: physical, hydro, laser, heat/ice
  • Joint Supplements

Learn more about Adequan® Canine

LEARN MORE

Would you like to learn how equine osteoarthritis is diagnosed?

Adequan® Canine brand of polysulfated glycosaminoglycan (PSGAG)
INDICATIONS Adequan® Canine is recommended for intramuscular injection for the control of signs associated with non-infectious degenerative and/or traumatic arthritis of canine synovial joints.
IMPORTANT SAFETY INFORMATION Adequan® Canine should not be used in dogs who are hypersensitive to PSGAG or who have a known or suspected bleeding disorder. It should be used with caution in dogs with renal or hepatic impairment. Adverse reactions in clinical studies (transient pain at injection site, transient diarrhea, and abnormal bleeding) were mild and self-limiting. In post approval experience, death has been reported in some cases; vomiting, anorexia, depression/lethargy and diarrhea have also been reported. The safe use of PSGAG in breeding, pregnant or lactating dogs has not been evaluated. Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian. For additional safety information, please see Full Prescribing Information.
1. 2016 NAVC Proceedings, Osteoarthritis in Dogs and Cats: Novel Therapeutic Advances, M Epstein, DVM, DABVP C/F, CVPP; K Kirkby-Shaw, DVM, MS, PhD, DACVS, DACVSMR.
2. Face validity of a proposed tool for staging canine osteoarthritis: Canine Osteoarthritis Staging Tool (COAST), T. Cachon, O. Frykman, J.F. Innes, B.D.X. Lascelles, M. Okumura, P. Sousa, F. Staffieri, P.V. Steagall, B. Van Ryssen, COAST Development Group, The Veterinary Journal, 235 (2018) 1-8.
3. Mele, E. Epidemiology of Osteoarthritis. Veterinary Focus 17, 4–10 (2007).
4. Clinician’s Brief, Aug 2013, Canine OA, DA Canapp, DVM, CCRT, CVA, DACVSMR
5. Adequan® Canine Package Insert, Rev 1/19.

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