This article is sponsored content brought to you by Boehringer Ingelheim.
Pain management is critical for animal welfare, and in the clinic for improving patient outcomes, quality of life and supporting the veterinarian-client-animal bond. Advances in veterinary medicine mean that our pets are living longer and consequently, are more frequently living with chronic conditions that involve pain, including osteoarthritis (OA).1,2
Chronic pain impacts many aspects of a patient’s life including gait and movement, the ability to perform normal daily activities, sensitivity to external stimuli, social relationships, and sleep.3 Therefore, “… proper recognition and management of chronic pain can be life preserving”.4
The behavioural changes associated with chronic pain may be gradual in onset and difficult to discern, e.g. subtle changes in gait, exercise tolerance, difficulty getting up and change in muscle mass.4 Some behavioural changes may only be evident in the environment where the pet feels most comfortable, typically their home,2 so owner education is critical as they may not realise that certain behavioural changes in their pet might indicate pain and instead simply interpret it as reduced mobility or the inevitable consequences of aging.4 In dogs it is useful to assess vitality/mobility, demeanour, distress and more obvious indicators of pain e.g. lameness and vocalisation.5
Up to 1 in 5 dogs over 1 year of age, may suffer from OA7 but more than 50% of OA is diagnosed in dogs from 8 years of age.8 Advancing age, increasing bodyweight and obesity contribute to the progression and severity of OA.8
Early intervention has the greatest potential for providing the most effective management of OA by disrupting the progressive, vicious cycle of deterioration.8 “The mainstays of treatment involve methods to alleviate pain, and at all stages NSAIDs are the most predictable analgesics.” 5
Broad treatments for managing OA pain include:5
- Weight optimisation: In obese dogs with OA, bodyweight loss alone caused a significant decrease in lameness.9
- Diet modulation
- Controlled exercise
- Physical rehabilitation
- Environmental modification
- Nutritional supplements
- Base’ analgesics, i.e. NSAIDs, paracetamol (not in cats), corticosteroids (treat underlying immune-mediated disease in polyarthritis)
- Adjunctive analgesics (e.g. tramadol, amantadine, gabapentin, tricyclic antidepressants)
- Disease modifying drugs (e.g. polysulfated glycosaminoglycan)
- Joint replacement
- Excision arthroplasty
- Stem cell therapies
It is ideal to use a multi-modal approach to OA management to ensure the best treatment outcome and quality of life for the patient. “Currently, the greatest weight of evidence for efficacy is for weight management, NSAIDs, dietary optimization (amount and content), and exercise.”5
A key part of chronic pain management is regular evaluation of treatment efficacy. By asking owners to video their pets doing specific activities pre- and post-treatment, positive behavioural changes may be seen. Such positive reinforcement (for the pet owner) can help ensure treatment compliance and maximise the wellbeing of their pet.
The NSAID Previcox is an easy-to-give, flavoured chewable tablet that can be given with or without food and helps manage the pain and inflammation associated with canine osteoarthritis. Previcox provides sustained anti-inflammatory pain relief with a rapid onset of action and excellent safety profile.
To find out more about the benefits Previcox can provide to your patients, team members and pet owners, talk to your Boehringer Ingelheim Territory Manager today.
1. Walsh, K. (2016) Chronic pain management in dogs and cats. In Practice. 38, 155. 2. Monteiro, B.P. et al. (2019) Chronic pain in cats: Recent advances in clinical assessment. J Feline Med Surg. 21, 601–614 (2019).3. Lascelles, D. et al. (2019) Measurement of chronic pain in companion animals: Discussions from the Pain in Animals Workshop (PAW) 2017. Vet J. 250, 71-78.4. Epstein, M. et al. (2015) 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats*. J Am Anim Hosp Assoc. 51, 67–84.5. Mathews, K. et al. (2014) Guidelines for recognition, assessment and treatment of pain: WSAVA Global Pain Council. J Small Anim Pract. 55(6), E10-68. 6. Sanderson, R.O. et al (2009) Systematic review of the management of canine osteoarthritis. Vet Rec. 164, 418–424. 7. Johnston, S.A (1997) Osteoarthritis. Joint Anatomy, Physiology and Pathobiology. 27(4) 699-723. 8. Cachon, T. et al. Face validity of a proposed tool for staging canine osteoarthritis: Canine OsteoArthritis Staging Tool (COAST). Vet J. 235, 1–8 (2018). 9. Marshall, W.G. et al. (2010) The effect of weight loss on lameness in obese dogs with osteoarthritis. Vet Res Commun. 34, 241–253.