Dr. Gaynor: I interact with a lot of primary care veterinarians, and for me, it tends to come down to the same issue: educating veterinarians that OA is a young dog issue. Primary care veterinarians have to educate owners A Paradigm Shift for Canine Osteoarthritis: Proactive Screening & Earlier Intervention Brought to you by Elanco early—at that first puppy vaccination at 8 weeks of age or whatever it may be. Start talking to them based on that pet’s breed, about risk factors, what to look for that we have predominantly overlooked before. These intermittent signs of OA that go away quickly are not necessarily innocuous events.
Dr. Medina: Early recognition can be challenging for the veterinarian and the client. I don’t get as many referrals for younger dogs, but the ones that I do see were typically out doing some kind of activity, then became lame and painful. Their vets told them to rest, and then they were told it was probably a strain or sprain or some type of soft tissue injury. Sometimes, I’ll get puppies that are referred and they’ve had several of these events in a few months’ time and I find they do have developmental orthopedic disease. So, I think it’s important to educate veterinarians that some of these signs clients are reporting might not necessarily be directly related to OA now but may be related to a risk factor that will develop into OA later on.
Dr. Lascelles: I think you’ve hit on something really important there. Education is an uphill struggle for a lot of reasons. There’s a lack of understanding that OA is driven by developmental disease. No one wants to hear it. Veterinarians don’t want to; owners don’t want to. And on top of all of that, owners may think, “Well, my dog’s still moving around, still goes upstairs. He might struggle, but he eventually gets in the car.” I think a lot of people say, “What’s the big deal?” I think it’s incumbent upon us to explain what the big deal is. It’s a huge deal when a dog can’t walk. When a big dog can’t get up, that’s an emergency. By acting early, we can prevent the “huge deal” problem; by intervening early, we can improve the dog’s whole life.
Dr. Gaynor: We work on the presumption that early intervention helps put the critical dysfunction at bay. Veterinarians are masters at preventive medicine, and if we take that into account, we can presumably help prevent the severity of OA for a longer period of time, just like we help prevent diseases with vaccination.
Dr. Epstein: We need radical acceptance by veterinarians, then translate that to the owner. Vets need to accept the fact that this is inevitable for a subset of our patients—particularly if they have predispositions like being overweight. To radically accept it, embrace it, and change how you approach it in practice, that’s a transformative thing and is more difficult.
Dr. Robertson: At the end of this year, Lap of Love will have provided at-home euthanasia for 65,000 to 70,000 dogs. One of our biggest groups that we help in the home are large dogs with mobility issues because owners can’t get them in a car anymore. The data that we have is very, very sad; lots of dogs that we euthanize have not seen a veterinarian in the 12 to 18 months prior to the date they’re euthanized. We know that either they could have lived longer or at least lived a less uncomfortable life had they seen a veterinarian.