Managing the arthritic patient in today's economy (Proceedings)

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Managing the arthritic patient in today's economy (Proceedings)

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Aug 01, 2010

Just as in the human population, the incidence of osteoarthritis in veterinary patients is very high. Many of the developmental diseases as well as traumatic injuries ultimately become cases of osteoarthritis management. As with any chronic progressive (and largely incurable) disease, the treatment can be frustrating. In fact, treatment of arthritis is easy when the client is patient, willing, and has a lot of money. In most cases, however, the clinician is faced with a number of treatment options to balance against economic realities and expected responses. This session will review the components of osteoarthritis management and provide some logical framework on which to make real-world decisions.

Pathophysiology basics

Taking some of the mystery out of osteoarthritis pathophysiology allows the practitioner to develop a rational approach to therapy and to make sense of the various treatment options. This session will very briefly review the disease mechanisms with an emphasis on clinical application.

Treatment goals

Perhaps the first step in achieving success in managing osteoarthritis is to understand the treatment goals and to effectively communicate those goals to the client. Realistic expectations as to outcome, timeline, and cost will dramatically increase the level of satisfaction on the part of both the veterinarian and the client. Osteoarthritis is a progressive disease which means that despite our best efforts we may ultimately be facing a losing battle. This realization does not imply that increased comfort, function and quality of life are unlikely – it merely suggests that the client should not expect a complete "cure". Furthermore, arthritic patients often have a variety of related problems that will hamper our ability to provide the level of success we desire (including muscle atrophy, joint fibrosis, obesity etc). Addressing these problems and discussing them with clients is vital. Lastly, since the condition is continuous and the patient changes in many ways, continual monitoring and adjustments to the therapy are important – another aspect of treatment that must be communicated up front to the client.