References
Canine osteoarthritis: pathophysiology and management
Abstract
Osteoarthritis (OA), is one of the most commonly seen, chronically painful conditions in dogs and, if left unmanaged often leads to debilitating, painful lameness. In geriatric dogs, the incapacity caused by degenerative joint disease may be the major contributing factor in a decision for euthanasia. This highlights the importance of appropriate, multi-modal management of the disease and good nursing management to facilitate the best quality of life possible for the dog.
The main objectives when treating OA is to slow down the progression of the disease, provide analgesia and address aggravating factors.
For veterinary nurses involved in the provision of analgesia for these patients, it is important to understand the rationale behind using a combination of agents, rather than the reliance on a single drug. In addition, knowledge of the most appropriate analgesic agents for individual patients is essential in order to provide optimal pain relief and reduce the negative effects of specific drugs in high risk or ageing patients.
Veterinary nurses play an integral role in the care of patients with OA and can be a huge source of support and guidance for the patient and owner. A good outcome and improved quality of life for these patients requires a multidisciplinary team that involves the entire pathway of care. Veterinary nurses can facilitate this care via careful assessment, planning, implementation and evaluation of the patient and continued support for the owner.
Osteoarthritis (OA), also termed degenerative joint disease or osteoarthrosis, is one of the most commonly seen, chronically painful conditions in dogs (Lindley and Taylor, 2010) and, if left unmanaged often leads to debilitating, painful lameness. In geriatric dogs, the incapacity caused by osteoarthritis may be the major contributing factor in a decision for euthanasia (May, 1994). This highlights the importance of appropriate, multi-modal management of the disease and good nursing management to facilitate the best quality of life possible for the dog.
OA occurs when there is a loss of articular cartilage (Abercromby et al, 2006) as a result of both biological and mechanical events. These events destabilise the normal coupling of degradation and synthesis of articular cartilage chrondrocytes and extracellular matrix, and subchondral bone (Sharma and Kapoor, 2007). These changes lead to a softening, fibrillation (ulceration and loss of articular cartilage), sclerosis (thickening) and, eburnation (hardening) of subchondral bone, and osteophyte and subchondral cyst (fluid-filled sac in the bone just below the cartilage) formation (Figures 1 and 2) (Sharma and Kapoor, 2007). There are repair mechanisms present within cartilage, although it is likely that they become less efficient with age, which may partly explain the association between OA and ageing (Abercromby et al, 2006).
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