Targeting Osteoarthritis Early: Disease-Modifying Strategies

Sponsored by American Regent Animal Health

The prevalence of osteoarthritis (OA) in the canine population is estimated to be nearly 40%.¹ OA, especially in its early stages, is often underdiagnosed, likely because its subtle clinical signs can go unrecognized by owners and veterinarians.^1,2 However, early diagnosis offers the greatest opportunity to provide client education, initiate pharmaceutical intervention, and implement lifestyle changes, all of which can contribute to increased mobility and more active years together.^1-3

Why Early Osteoarthritis Detection Matters

As a progressive, degenerative disease, canine OA worsens over time, gradually becoming more challenging to manage.^2,3 Chronic pathologic processes, including bone spurs, thickened joint capsules, periosteal reactions, and joint effusion, create hurdles to pain control and mobility.² Once cartilage has ultimately worn away from joints, it cannot be brought back.

These painful changes can start developing in dogs at a young age.² Developmental disorders (eg, hip dysplasia, elbow dysplasia, osteochondrosis dissecans) are common underlying causes of OA and can trigger chronic inflammation from a young age, eventually leading to irreversible changes.² However, most dogs are not diagnosed with OA until they are 8 to 13 years of age.² Catching the disease in younger populations and slowing the progressive, vicious cycle of joint deterioration requires routine screening and earlier intervention.²

Standardized Protocols for Smarter OA Screening & Intervention

A comprehensive, clinic-wide canine OA protocol, complete with tools and best practices for screening and treatment, can aid veterinary teams in timely OA detection and optimal intervention. Although 95% of 327 veterinarians surveyed in a study reported that implementing a canine OA protocol would be helpful or is important/necessary, only 41% of 666 veterinarians surveyed reported having already incorporated a management protocol into their practice.⁴

Quick orthopedic assessments during every wellness visit offer an easy, consistent screening approach to early OA detection. By asking every owner the same mobility questions or providing a standard mobility questionnaire to all clients at every appointment, collecting an orthopedic history can become second nature. Staging questionnaires can be automatically delivered to owners of OA patients ahead of wellness examinations, supporting consistent staging throughout the dog’s life as OA progresses.

A Timely Multimodal Approach for a Lasting Impact

OA is a complex, multifactorial disease that requires a comprehensive approach—one that addresses not only pain and inflammation but also joint degradation, mechanical stress, and the challenges of reduced mobility.³ Having a standardized OA treatment protocol in place across the clinic creates a consistent framework for multimodal OA therapy while still allowing flexibility to tailor care to each patient’s needs. Multimodal OA treatment protocols should take into consideration the following for each patient:

• Disease modification: Joint support and protection in the form of polysulfated glycosaminoglycan (PSGAG) can help reduce the loss of articular cartilage in the joint itself. Rather than targeting clinical signs, this option directly treats the disease at the source to slow OA progression.^3,5,6

• Pain control: NSAIDs and monoclonal antibody therapy are considered first-line options for OA pain control in dogs.^3,7 Proper pain control is essential for preventing debilitating central sensitization.^2,3

• Lifestyle modification: Changes such as weight management and appropriate exercise can help reduce cartilage wear and inflammation caused by excessive load bearing and high-impact stress.³

A Close-Up on Polysulfated Glycosaminoglycan Treatment

Adequan Canine (polysulfated glycosaminoglycan) is the only FDA-approved PSGAG and also the only FDA-approved, disease-modifying OA drug proven to inhibit cartilage loss in canine synovial joints.^5,6 Although the specific mechanism of action of Adequan is unknown, studies have shown Adequan Canine can inhibit the loss of key joint components, including proteoglycan, collagen, and hyaluronic acid.⁶ By providing valuable building blocks for cartilage repair in joints, Adequan Canine ultimately helps renew damaged cartilage.⁶ Because PSGAGs help preserve existing cartilage, their effectiveness is maximized when treatment begins early, before extensive degradation has occurred.²

Adequan Canine is administered twice weekly for 4 weeks at 2 mg/lb intramuscularly, for a maximum of 8 injections.⁶ This product is labeled only for this initial 4-week series, but the dosing regimen can be repeated as needed over the dog’s lifetime upon recurrence of clinical signs. The veterinary team should work with clients to monitor the patient’s joint health and mobility during treatment. Adequan Canine should not be used in dogs that are hypersensitive to PSGAGs or have a known or suspected bleeding disorder. Please see important safety information for Adequan Canine below.

Conclusion

The benefit of early OA diagnosis cannot be overstated. Early intervention opens the door to long-term management strategies that can help slow disease progression and preserve mobility over time, including weight management, exercise, and PSGAG therapy.

Early diagnosis hinges on a consistent, comprehensive approach that engages the entire veterinary team and owner in OA screening efforts. A standardized OA protocol (oaprotocolpack.com) can help clinics integrate simple yet thorough OA screening and treatment practices so that every pet can enjoy the comfort and mobility benefits of early, effective OA intervention.

Adequan® Canine polysulfated glycosaminoglycan (PSGAG) solution 100 mg/mL. INDICATIONS & USAGE: Adequan^® Canine is recommended for intramuscular injection for the control of signs associated with non-infectious degenerative and/or traumatic arthritis of canine synovial joints. IMPORTANT SAFETY INFORMATION: Adequan^® Canine should not be used in dogs who are hypersensitive to PSGAG or who have a known or suspected bleeding disorder. It should be used with caution in dogs with renal or hepatic impairment. Adverse reactions in clinical studies (transient pain at injection site, transient diarrhea, and abnormal bleeding) were mild and self-limiting. In post approval experience, death has been reported in some cases; vomiting, anorexia, depression/lethargy and diarrhea have also been reported. The safe use of PSGAG in breeding, pregnant or lactating dogs has not been evaluated. Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian. For additional safety information, please see full prescribing information.

This article was supported by American Regent Animal Health, a division of American Regent, Inc.