Osteoarthritis Must Be Higher Priority If Vets Are To Help Manage Chronic Cases
6 years ago 
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Leading osteoarthritis (OA) experts are urging vets to place OA treatment further up the list of priorities if they are to help address a common, long-term problem.
Speaking at a recent round table discussion in central London, experts from the UK and the US met to discuss how OA can be better managed by vets and how improved client communication is key to successful diagnoses and management of the disease.
“The main challenges around managing and treating osteoarthritis for vets is that it is a chronic, insidious problem. It’s also often lower down the priority list and owners don’t recognise the signs; they often ascribe it to ageing. Actually, osteoarthritis is such a common problem that it should be way up our priority list because something like 10-15% of adult dogs have OA,” explained John Innes, CVS Referrals Director based at Chester Gates Veterinary Specialists (BVSc PhD CertVR DSAS (orth) FRCVS).
A key focus of the debate was the need for greater understanding of the condition among pet owners, as Duncan Lascelles, Professor of Small Animal Surgery and Pain Management at NC State Veterinary Medicine (BSc, BVSc, PhD, MRCVS, CertVA, DSAS(ST), DECVS, DACVS) explains:
“The vet profession needs to take a much more active role in the education of owners, and osteoarthritis is a perfect example of this. Many owners consider osteoarthritis to be age related and an inevitable part of the ageing process – unfortunately both of those concepts are erroneous.
“Osteoarthritis can be a young dog disease, it is present in many young dogs because it is caused by developmental diseases, but we only recognise the obvious signs later on when the disability is severe. Also, we should not consider OA-related pain as an inevitable part of the ageing process, it is something that we can prevent by early intervention, early treatment and modification of lifestyle.”
These comments follow hard on the heels of the results from a recent vet survey which revealed that more than three-quarters of vets (76%) believe owners fundamentally misunderstand OA and consider it just a symptom of old age, which results in a barrier to effective treatment of the disease.
The survey of 236 UK practising vets, commissioned by Elanco Animal Health, showed that although the illness is commonplace (49% of vets see OA cases every day), vets are often unable to give their preferred treatment for OA for a range of reasons, from owner misconception of the disease through to perceived side effects and compliance*.
The issue of better education of owners was thoroughly discussed, with both Duncan Lascelles and John Innes discussing at length the value of CMIs (Clinical Metrology Instruments), which are owner-facing questionnaires designed to help vets evaluate the extent and seriousness of OA related pain in dogs.
Duncan Lascelles explained: “The great thing about CMIs is that they have been constructed using language that owners understand, therefore are an easy way to ask owners the right questions in the way that they will understand.
“They [CMIs] allow us to have what can be very difficult conversations with owners. Difficult because we have to think of all the different ways that osteoarthritis might be affecting pets. Because the CMIs include pre-constructed questions, it means that conversations with owners are much easier and, importantly, they’re consistent. Consistency is key to ensure you’re asking the same set of questions each time, every time, so you can follow the evolution of clinical signs over time and assess the beneficial impact of our therapeutics
John Innes added: “We often quiz the owner informally in a consultation, but CMIs gives us the tools needed to formalise this questioning of clients and allow us to put that in context of our knowledge of other patients.”
Both experts said the need for more patient analysis for the treatment of OA highlighted the need for better use of existing tools, such as the LOAD (‘Liverpool Osteoarthritis in Dogs’) questionnaire, which is a 13-item clinical metrology instrument (CMI).
The LOAD questionnaire can be used to help in the assessment of all dogs that have, or are suspected of having, osteoarthritis. It is a convenient, cost-effective, validated, and reliable instrument to help veterinarians determine the severity of OA in dogs, monitor disease progression, and assess the patient’s response to treatment.
For more information contact your Elanco representative or call +44 (0)1256 353131.
ENDS
Pegasus Survey Data 1
*The primary reasons vets choose the treatments they do for OA:
1. Affordable for the owner (70%)
2. Fewer side effects (60%)
3. Targeted action at the site of inflammation (58%)
4. Rapid onset of action (45%)
5. Highly cox 2 selective (25%)
6. Palatable to be given with food (25%)
*The main barriers to vets administering an OA treatment of choice:
1. Owner misconception that OA is just a symptom of old age (76%)
2. Owner perceived side effects of the treatment (71%)
3. Cost to the owner (70%)
4. Lack of owner compliance (32%)
About Elanco
Elanco is a global innovation-driven company that develops and markets products to improve animal health, food animal production and companion animal care in nearly 70 countries. Elanco, a division of leading pharmaceutical company Eli Lilly and Company, employs approximately 7,000 people worldwide, with offices in more than 40 countries. Additional information about Elanco is available at www.elanco.com.
About Onsior 2
Onsior, an OA treatment from Elanco Animal Health, gets to work in just 30 minutes, reaching peak plasma concentration faster than any other veterinary licensed NSAID before targeting pain at its source and providing lasting pain relief.
How does it work? 3
Robenacoxib is mildly acidic, just like inflamed tissues. This means that it is able to enter the inflamed cells in its uncharged form and once inside, the robenacoxib molecules become charged and trapped inside the cell. This results in a slow rate of elimination from inflammatory exudate and synovial fluid in dogs with osteoarthritis, prolonging the analgesic effect in these areas. Robenacoxib also has a short blood half life, leaving the circulation quickly and staying only where it is needed.
References:
1. Pegasus Survery, Vet Times, 2017
2. ONSIOR SPC (European Medicines Agency).
3. Silber, H et al. Pharm Res 2010 27: 2633-2645.
For more information contact:
Tiffany Holland: [email protected]
Tel: 01273 712000
Legals
For the treatment of pain and inflammation associated with chronic osteoarthritis in dogs. For the treatment of acute pain and inflammation associated with musculo-skeletal disorders in cats.
In the UK: Onsior® contains robenacoxib POM-V. In IE: POM. Further information is available from the Summary of Product Characteristics. Advice should be sought from the Medicine Prescriber. For information regarding side effects, precautions, warnings and contra indications refer to product packaging and leaflet.
Onsior® is a registered trademark owned by or licensed to Eli Lilly and Company, its affiliates or subsidiaries. Use medicines responsibly (www.noah.co.uk/responsible) (www.apha.ie/AnimalHealth/VeterinaryCompendium) © 2017 Eli Lilly and Company.
For further information contact Elanco Animal Health on +44 (0)1256 353131, email [email protected], or write to Elanco Animal Health (the animal health division of Eli Lilly and Company Limited), Lilly House, Priestley Road, Basingstoke, Hampshire RG24 9NL, UK.
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