Page 1598 - Clinical Small Animal Internal Medicine

1536 Section 13 Diseases of Bone and Joint

Prognosis ized medicine approach (i.e., not all dogs or cats will
VetBooks.ir Dogs and cats can be significantly affected by OA; how- respond the same with the same treatments), will usually
result in a poorer clinical response to therapy (surgical
and nonsurgical) and quality of life as perceived by the
ever, new concepts with a balanced multimodal manage-
ment approach to treat the clinical signs of OA can result owner of the OA patient.
in an acceptable quality of life for the majority of OA Excellent progress continues in the development of
patients, providing fair to excellent prognoses for lame‐ new pharmaceuticals and other agents to combat or even
free function. Included in the formula for prognosis will reverse the degenerative processes of OA. In contrast,
be the consideration of a specific joint affected by OA research and development into exercise/activity man-
(biomechanics, e.g., shoulder vs tarsus) and the degree of agement for the OA companion animal lag significantly
disease present in that joint (e.g., cartilage erosions vs behind those of human medicine, but since the mid‐
minimal cartilage disease). Nonsurgical management 1990s, it has become a major treatment focus in veteri-
must be considered beyond conventional and noncon- nary medicine. Nonetheless, large controlled clinical
ventional pharmacologic treatment to include a balance trials are still needed for “evidence‐based” treatment
created between exercise/activity and weight control protocols (controlled clinical trials) that will allow us to
management. Failure to consider this multimodal treat our OA patients beyond the individual clinician’s
approach to OA treatment, especially in an individual- clinical experience.

Further Reading

Bennett D, Zainal Ariffin SM, Johnston P. Osteoarthritis in Johnston SA. Osteoarthritis: joint anatomy, physiology and
the cat: 1. how common is it and how easy to recognise? pathobiology. Vet Clin North Am Small Anim Pract
J Feline Med Surg 2012; 14: 65–75. 1997; 27: 699.
ComblainF, SerisierS, BarthelemyN, BalligandM, et al. Vandeweerd JM, Coisnon C, Clegg P, et al. Systematic
Review of dietary supplements for the management of review of efficacy of nutraceuticals to alleviate clinical
osteoarthritis in dogs in studies from 2004 to 2014. J Vet signs of osteoarthritis. J Vet Intern Med 2012; 26: 448–56.
Pharmacol Ther2016;39:1–15. Vuolteenaho K, Koskinen A, Moilanen E. Leptin – a link
Impellizeri JA, Tetrick MA, Muir P. Effect of weight between obesity and osteoarthritis. Applications for
reduction on clinical signs of lameness in dogs with hip prevention and treatment. Basic Clin Pharmacol Toxicol
osteoarthritis. J Am Vet Med Assoc 2000; 216: 1089–91. 2014; 114: 103–8.