Tailoring a plan: International opinion on nutraceutical and multimodal management of joint health in dogs and cats (Sponsored by Nutramax Laboratories and Bioiberica)


Tailoring a plan: International opinion on nutraceutical and multimodal management of joint health in dogs and cats (Sponsored by Nutramax Laboratories and Bioiberica)

Osteoarthritis afflicts many dogs and more cats than most in the veterinary profession have previously recognized, and today many treatment modalities are available to veterinarians. As nutraceutical research emerges and veterinarians gain experience with these products, it is evident that a complementary role exists for nutraceuticals in clinically managing joint health in companion animals.

In September 2013, an international group of clinicians, including orthopedic specialists, gathered in Vienna, Austria, to discuss their therapeutic strategies and the efficacy and usefulness of a multimodal approach in canine and feline patients with joint disease.

Osteoarthritis in dogs and cats

Brian Beale, DVM, DACVS (Moderator)
Dr. Brian Beale: Let's first discuss how you recognize joint health problems in your patients. Does the presentation differ between cats and dogs?

Thibaut Cachon, DVM, MsC, DECVS
Dr. Thibaut Cachon: Most of the time dog owners come in because their dog is lame. Cat owners come because their cat is not acting normal; it is less active, less willing to jump. Cat owners do not clearly recognize an orthopedic problem in their cats. And, for cats, a full physical examination — including an orthopedic and a neurologic examination — is difficult to perform and to interpret. It is important to be calm and a bit more patient with cats in order to do a good physical examination.

David Bennett, BSc, BVetMed, PhD, DVM, DSAO, FHEA, MRCVS
Dr. David Bennett: Osteoarthritis is common in cats, particularly in older cats. Cats over 6 or 7 years of age may start developing osteoarthritis and it will progress. It's different than in dogs. In cats, osteoarthritis tends to be generalized — nearly every joint in the cat can be affected or will become affected with time. Yet, it seldom produces lameness in cats.

Changes in behavior or lifestyle at home alert us to the fact that the cat might have osteoarthritis. These cats stop jumping. They don't play with the owners like they used to or with other cats in the household. They don't hunt or groom themselves like they used to. They have problems using their litter tray. While all these clues could indicate other problems, they are highly suggestive of osteoarthritis, which should be at the top of the differential diagnosis list.

Owners often interpret these changes as part of the normal aging process. You've got to ask the owner specific questions relating to the cat's behavior. Owner assessment forms are being developed by a number of groups. The form we use is divided into four behavioral domains — mobility, activity, temperament, and grooming habits.1

The behavioral changes in cats with osteoarthritis are also seen in dogs. That is important because in some small dog breeds lameness can be less evident. Cats with osteoarthritis pose other diagnostic challenges. With cats, arthritic joints often are not thickened to the same degree as in dogs, and cats don't have the large synovial effusions. Crepitus is also rare in cats.

Sune Jerre, DVM, Swedish Specialist Surgery
Dr. Sune Jerre: For dogs, you need an area where you can conduct lameness examinations the same way every time. I always do my lameness examinations outdoors. Sometimes I let the dogs do some of their normal work — catch a ball or other activities.

Martin Unger, DVM, DECVS
Dr. Martin Unger: Always try to evaluate the patient for proprioceptive deficits, and look at the animal's muscle mass. Then palpate the joints. The workup is much more difficult in cats. Most of the time it does not work to palpate a cat symmetrically on both sides at the same time, and they move totally differently when they are in your hospital, so you cannot evaluate them easily. More owners now show me short videos on their phones to demonstrate their cats' behavior.