See Spot suffering from osteoarthritis

See Spot suffering from osteoarthritis

Technicians—doctors need your help in detecting osteoarthritis in your veterinary patients. Here’s how to become an OA advocate in your clinic.
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Oct 13, 2017

See Spot suffering. Get Spot help. (Shutterstock.com)Hey, technicians: Fetch dvm360 speaker Kara Burns, MS, MEd, LVT, VTS (nutrition) says you (yes, you!) can help more pets suffering from osteoarthritis (OA) live without pain and suffering.

How? Ask the right questions, and you can ferret out arthritic patients that are likely flying under your doctor’s diagnostic radar, says Burns.

Let’s face it. Your doctor is busy. She has a lot on her mind—especially during wellness exams—and could really use your help to identify patients that would benefit from an arthritis diagnostic workup or a multimodal treatment plan. If you know the risk factors, prevalence and signs of OA, you can help your doctor spot opportunities to help animals that are otherwise suffering in silence.

If you’d like to become an OA advocate in your clinic, you’ll need to know the answers to these questions:

What’s the No. 1 risk factor for OA development?

Obesity. That means that every fat pet that walks in the front door of your practice either has OA or will have OA soon.

Because so many of our companion animals are fat (59 percent of cats and 54 percent of dogs are overweight or obese, according to the Association for Pet Obesity Prevention), the average person has a hard time knowing what a healthy weight looks like. With this in mind, give your patients—every pet, every time—a body condition score (BCS), says Burns. Pets that have a BCS of 3 out of 5 or 4.5 to 5 out of 9 have the lowest risk of development of OA.1

Do you use diagnosis codes in your practice software? Go ahead and pull up all the pets that are overweight or obese. I dare you. Got a decent sized list going? These clients are excellent candidates for a one-time email newsletter blast that details the risks and signs of OA, reviews treatment options and directs clients to make an appointment to have their pet assessed.

Are your clients still not convinced? Tell them about Purina's Life Span Study. Dogs that maintained a lean body weight lived longer (lean Labrador retrievers in the study lived nearly two years longer) and needed NSAIDs much later in life than their thicker counterparts.

How common is OA in dogs and cats?

OA is considered to be the No. 1 cause of chronic pain in dogs. According to the literature, 20% of dogs suffer from OA,2 33% of all adult cats have OA and 90% of cats older than 12 have OA.3 And these numbers are likely lower than reality, due to underreporting, Burns says.

Is old age a disease?

Yes. It’s incurable. Get the blue juice. Next question.

Joking aside, we know OA shortens the quality and quantity of life in our companion animals. Many pet parents still think that “slowing down” and a loss of vitality are unavoidable in old age, but you know that’s just not true. You likely have a golden opportunity to educate clients that slowing down or grouchy behavior aren’t the new normal—they’re just signs their pet is in pain. We all know clients need to hear something seven times before they remember it, so be the first person to raise their awareness (and then repeat six more times).

What’s the No. 1 sign of OA in small-breed dogs?

A reluctance to climb stairs. Other signs include decreased energy level, lagging behind on walks, grouchiness, sleeping more, changes in sleeping patterns, restlessness or inability to get comfortable and stiffness after lying down.

What’s the No. 1 sign of OA in cats?

Reluctance to jump, or smaller jumps. Pet owners will often report that a cat that used to jump straight onto the counter now uses a chair to reach it.

Remember that 90% of cats older than 12 have arthritis and that the signs can range from subtle to nonexistent. This means that the owner’s evaluation of how their pet is doing at home is critical information. If you ask about changes in jumping behavior, you will likely sleuth out a lot more feline OA.

Increased hiding, decreased social time with the family, excessive barbering, increased aggression, poor hair coat quality and matting from lack of grooming, or inappropriate elimination can also be signs of pain in a cat. Another subtle sign is in the paws: Overgrown claws on a geriatric feline suggests decreased scratching and stretching behavior, which can be a sign of OA.

What’s an easy treatment for OA in cats?

There are no good long-term medications labeled for OA treatment in cats, says Burns. Your clients must feed their cats anyway, so why not have them feed a diet that will reduce pain and inflammation from OA? Burns says therapeutic diets are the easiest way to treat OA in cats, and clients prefer feeding to pilling (for obvious reasons). A recent study showed that a diet high in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and supplemented with green-lipped mussel extract and glucosamine/chondroitin sulfate improved objective measures of mobility in cats.4

What are some of Burns’ favorite joint supplements?

Burns is a fan of green-lipped mussel to enhance joint health, as well as supplements containing milk protein concentrate, which is chondroprotective, helps manage inflammation in many cases by inhibiting neutrophil migration, and does not require an induction period (which reduces the cost to the client). Bonus: It helps with anxiety.

Burns also thinks omega-3 fatty acids are the bomb dot com. About 82% of dogs on high omega-3 fatty acid diets showed measureable improvement in force plate analysis.5

 

References

1. Smith GK, Paster ER, Powers MY, et al. Lifelong diet restriction and radiographic evidence of osteoarthritis of the hip joint in dogs. J Am Vet Med Assoc 2006;229:690–693.

2. Roush JK, Cross AR, Renberg WC, et al. Evaluation of the effects of dietary supplementation with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. J Am Vet Med Assoc 2010;236(1):67-73.

3. Lascelles BD, Robertson SA. DJD-associated pain in cats: what can we do to promote patient comfort? J Feline Med Surg 2010;12(3):200-212.

4. Lascelles BD, DePuy V, Thomson A, et al. Evaluation of a therapeutic diet for feline degenerative joint disease. J Vet Intern Med 2010;24(3):487-495.

5. Moreau M, Troncy E, Del Castillo JR, et al. Effects of feeding a high omega-3 fatty acids diet in dogs with naturally occurring osteoarthritis. J Anim Physiol Anim Nutr (Berl) 2013;97(5):830-837.

 

Dr. Sarah Wooten divides her professional time between small animal practice in Greeley, Colorado; public speaking on associate issues, leadership and client communication; and writing. She enjoys camping with her family, skiing, SCUBA and participating in triathlons.