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Identifying Pain & OA

Prevalence of radiographic appendicular osteoarthritis and associated clinical signs in young dogs

Summary:

This study aimed to determine the prevalence of osteoarthritis (OA) and associated clinical signs in young dogs (aged 8 months–4 years). Each joint was scored for pain reactions (0–4). Orthogonal radiographs of all joints were made under sedation. Each joint was scored for radiographic OA (rOA) severity. Clinical OA (cOA) was defined as an overlap of rOA and joint pain in ≥ 1 joint. The owners of 123 dogs agreed to participate. Overall, 39.8% (49/123) of dogs had rOA in ≥ 1 joint, and 16.3% (20/123) or 23.6% (29/123) dogs had cOA, depending on the cut-off value of joint pain; moderate (2), or mild (1), respectively. Owners of dogs with cOA observed signs of impairment in approximately 30% of cases. Only 2 dogs with cOA were receiving OA pain management. The most commonly affected joints in descending order of frequency were elbow, hip, tarsus, and stifle.

Conclusion:

Radiographically visible OA is common in young dogs (8m- 4y), and 40–60% of dogs with radiographic OA had clinical OA. Pain appears underdiagnosed and undertreated in young dogs.

Author & Journal:Masataka Enomoto, Nicholas de Castro, Jonathan Hash, Andrea Thomson, Aoi Nakanishi-Hester, Erin Perry, Savannah Aker, Emily Haupt, Logan Opperman, Simon Roe, Tracey Cole, Nichola Archer Thompson, J F Innes, B Duncan X Lascelles; Scientific Reports, 2024
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Assessing Chronic Pain In Dogs

Summary:

“Finding precise, reliable, and accurate measures of chronic pain in animals is a difficult effort. However, much research has gone into developing measurement methods to evaluate chronic pain in dogs (and, more recently, cats); this article reviews the pain scales currently available.”

Conclusion:

Details in linked article reviews the following pain scales: Helsinki Chronic Pain Index, Canine Brief Pain Index, Cincinnati Orthopedic Disability Index, Liverpool Osteoarthritis in Dogs.

Author & Journal:Epstein, Mark E., Today’s Veterinary Practice, 2013
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Age-related changes in the musculoskeletal system and the development of osteoarthritis

Summary:

Osteoarthritis (OA) is the most common cause of chronic disability in older adults. Although classically considered a “wear and tear” degenerative condition of articular joints, recent studies have demonstrated an inflammatory component to OA that includes increased activity of several cytokines and chemokines in joint tissues that drive production of matrix-degrading enzymes.

Conclusion:

Understanding the basic mechanisms by which aging affects joint tissues should provide new targets for slowing or preventing the development of OA.

Author & Journal:Loeser, R.F., Clinics in Geriatric Medicine 26, 371–386
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Recognizing Behavioral Signs of Pain and Disease:

Summary:

“The aim of this article is to illustrate some examples of cases that might present as behavioral disorders but are in fact medical conditions.”

Conclusion:

“Observing and collecting complete histories of obvious and subtle changes in behavior will help veterinarians identify and define more precisely all of the signs associated with medical and painful conditions as well as those associated with behavioral disorders.”

Author & Journal:Frank, Diane, Veterinary Clinics of North America: Small Animal Practice, 2014
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Epidemiology of osteoarthritis

Summary:

The developmental orthopedic diseases and associated osteoarthritis are the most common articular diseases in dogs. They account for some 70% of visits for articular disease and related problems within the appendicular skeleton. Twenty two percent of cases were dogs aged one year or under (5). The incidence of OA is increased by trauma as well as obesity, aging and genetic abnormalities.

Author & Journal:Mele, E., Veterinary Focus 17, 4–10
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Ability of the Canine Brief Pain Inventory to detect response to treatment in dogs with osteoarthritis

Summary:

To determine whether the Canine Brief Pain Inventory (CBPI) can detect changes in dogs with osteoarthritis treated with an NSAID or a placebo.

Conclusion:

The CBPI was able to detect improvements in pain scores in dogs with osteoarthritis treated with an NSAID or a placebo. These results, in combination with previous reliability and validity testing, support the use of the CBPI to obtain quantifiable assessments from owners regarding the severity and impact of chronic pain and treatment for dogs with osteoarthritis.

Author & Journal:Climino Brown, Dorothy et al, Journal of the American Veterinary Medical Association, 2008
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Guidelines for recognition, assessment and treatment of pain

Summary:

This document is designed to provide the user with easy‐to‐implement, core fundamentals on the successful recognition and treatment of pain in the day‐to‐day small animal clinical practice setting.

Conclusion:

While not intended to be an exhaustive treatise on the subject matter, the text does provide an extensive reference list and there is additional material on the WSAVA website (www.wsava.org) designed to provide resources for those wanting to further their knowledge of this subject matter based on the current literature.

Author & Journal:Karol Mathews, et al, Journal of Small Animal Practice 55, E10–E68
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Canine Orthopedic Outcome Measures Program: Where Are We Now?

Summary:

The overall goal of COMP was to advance veterinary orthopedic patient care by providing and supporting mechanisms for all clinicians, researchers, industry partners, and regulatory bodies to produce, assess, and implement the highest evidentiary value data for evaluation of safety and efficacy of diagnostic and therapeutic modalities. At project initiation, we estimated that it would take more than 1 million dollars to recruit key personnel, design appropriate studies, produce data, and create, validate and implement the instruments(s). After 6 years of intensive work in all of these areas, a tremendous amount of progress has been made. This editorial summarizes the COMP’s efforts and results, and suggests a way forward to our ultimate goal of optimal patient-centered, evidence based care in veterinary orthopedics.”

Conclusion:

“The good news is that we now have a number of excellent options for effectively measuring outcomes in clinical and translational studies in dogs. The bad news is that we now have a number of different options to sort through to determine what is optimal for each study. So what should you do?” Click the link for the full article and listed solutions from the author.

Author & Journal:Cook, James L., Veterinary Surgery, 2014
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Normal and pathological adaptations of articular cartilage to joint loading

Summary:

Joints are functional units that transmit mechanical loads between contacting bones during normal daily or specialized activities, e.g., sports. All components of the joint, i.e. articular cartilage, bone, muscles, ligaments/tendons and nerves, participate in load transmission. Failure in any of these components can cause joint malfunction, which, in turn, may lead to accumulation of damage in other joint components.

Conclusion:

The importance of the neuromuscular system to the initiation and progression of OA is still poorly understood. Many surgical extra- and intra-articular procedures have been used for the treatment of OA. Although some of the new methods, such as autologous chondrocyte transplantation and mosaicplasty, have given good clinical results, it is reasonable to emphasize that the methods still are experimental and more controlled studies are needed.

Author & Journal:Arokoski JPA, et al, Scan J Med Sci Sports 2000
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