ISSN 2398-2969      

Arthritis: osteoarthritis

icanis

Synonym(s): DJD, osteoarthritis, osteoarthrosis, secondary joint disease, OA


Introduction

  • Progressive disorder of synovial joints characterized by numerous pathological processes leading to structural and functional change of the whole joint, inflammation and nociceptive/inflammatory pain. Leading cause of chronic pain and recently classified as a welfare concern.
  • The most frequently encountered joint disease - synonyms are osteoarthritis (emphasises the inflammatory nature of condition), osteoarthrosis (pathological process different from acute inflammatory process) and secondary joint disease (initiating factors have been identified, eg joint instability due to abnormal conformation, ligament rupture or intra-articular fractures).
  • Prevalence: 2.5% of UK canine population, considered huge underestimate. 20% of dogs over 1 year old in US. 35% of all dogs (unpublished work).
  • Cause: multifactorial albeit commonly secondary to developmental disease and joint trauma.
  • Signs: broad array of associated clinical signs, dependent on stage. Acute or insidious onset lameness of one or more limbs, pain on palpation/manipulation, thickened joints in advanced cases, with/without joint effusion. Gross postural adaptation. Capability and gait changes. Behavioral changes.
  • Treatment: multimodal management including pharmaceutical, nutraceutical, physical therapies, weight control, lifestyle adaptations +/-surgery +/- intra-articular, dependent upon stage and severity of condition.
  • Prognosis: varied, commonly influenced by stage of intervention and degree of multimodal intervention. Surgery may remove signs but may not retain joint function and does not address common multiple joint involvement and associated soft tissue related disease.
  • In old animals, likely to be a major factor in the decision for euthanasia.

Pathogenesis

Etiology

  • Trauma: a single severe injury, likely repetitive joint concussion/ torsion, or low-grade repeated trauma, eg abnormalities of joint anatomy/structure, conformational abnormalities, instability due to severe joint trauma.

Predisposing factors

Pathophysiology

  • Represents the end-stage of a variety of pathological processes. Likely that both biochemical and biomechanical processes are involved → a shift in balance of cartilage anabolism and catabolism leading to degeneration of articular cartilage, remodeling of subchondral bone, synovitis, reduced viscosity and nutritional value of synovial fluid, fibrosis of the joint capsule, production of osteophytes at articular margins and enthesophytes at soft tissue insertions, along side persistent nociceptive and inflammatory pain pathway signaling leading to central sensitization and maladaptive pain/ chronic pain. The pain of OA uncouples from the OA pathology and becomes a disease requiring concurrent management. 
  • Understanding that OA has a complex pathogenesis involving biochemical (inflammatory) and biomechanical contribution is essential to understand the role and appropriate timing of differing interventions. 

Timecourse

  • Months to years. Commonly lifelong.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Mills D S, Demontigny-Bédard I, Gruen M et al (2020) Pain and Problem Behavior in Cats and Dogs. Animals 10, 318 PubMed.
  • Summers J F, O’Neill D G, Church D et al (2019) Health-related welfare prioritisation of canine disorders using electronic health records in primary care practice in the UK. BMC Vet Res 15, 163 PubMed doi.org/10.1186/s12917-019-1902-0
  • Anderson K L, O’Neill D G, Brodbelt D C et al (2018) Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Sci Rep 8, 5641 PubMed doi.org/10.1038/s41598-018-23940-z.
  • Cachon T,  Frykman O, Innes J et al (2018) Face validity of a proposed tool for staging canine osteoarthritis: Canine OsteoArthritis Staging Tool (COAST). Vet J 235 PubMed doi:10.1016/j.tvjl.2018.02.017
  • Lopes Fagundes A L, Hewison L, McPeake K J, Zulch H, Mills D S (2018) Noise Sensitivities in Dogs: An Exploration of Signs in Dogs with and without Musculoskeletal Pain Using Qualitative Content Analysis.Front Vet Sci 5,17 PubMed doi.org.10.3389/fvets.2018.00017.
  • Muller C, Gines J A, Conzemius M, Meyers R, Lascelles B D X (2018) Evaluation of the effect of signalment and owner-reported impairment level on accelerometer-measured changes in activity in osteoarthritic dogs receiving a non-steroidal anti-inflammatory. Vet J 242, 48-52 PubMed doi:10.1016/j.tvjl.2018.10.005.
  • O'Neill Dan, Church D, McGreevy P et al (2013) Longevity and mortality of owned dogs in England. Vet J 198, 638-643 PubMed 10.1016/j.tvjl.2013.09.020.
  • Vandeweerd J M, Coisnon C, Clegg P et al (2012) Systematic review of efficacy of nutraceuticals to alleviate clinical signs of osteoarthritis. J Vet Intern Med 26(3), 448-56 PubMed doi: 10.1111/j.1939-1676.2012.00901.x.
  • Fritsch D A, Allen T A, Dodd C E, Jewell D E, Sixby K A, Leventhal P S, Brejda J, Hahn K A (2010) A multicenter study of the effect of dietary supplementation with fish oil omega-3 fatty acids on carprofen dosage in dogs with osteoarthritis. JAVMA 236, 535-539 PubMed.
  • Boileau C, Martel-Pelletier J, Caron J, Msika P, Guillou G B, Baudouin C & Pelletier J P (2009) Protective effects of total fraction of avocado/soybean unsaponifiables on the structural changes in experimental dog osteoarthritis: inhibition of nitric oxide synthase and matrix metalloproteinase-13. Arthritis Res Ther 11 (2), R41 PubMed.
  • Sanderson R O, Beata C, Flipo R-M, Genevois J-P, Macias C, Tacke S, Vezzoni A & Innes J F (2009) Systematic review of the management of canine osteoarthritis. Vet Rec 164, 418-424 PubMed.
  • Au R Y, al-Talib T K, Au A Y, Phan P V & Frondoza C G (2007) Avocado soybean unsaponifiables (ASU) suppress TNF-alpha, IL-1beta, COX-2, iNOS gene expression, and prostagalndin E2 and nitric oxide production in articular chondrocytes and monocyte/macrophages. Osteoarthritis Cartilage 15, 1249-1255 PubMed.
  • Chan P S, Caron J P, Rosa G J M & Orth M W (2005) Glucosamine and chondroitin sulfate regulate gene expression and synthesis of nitric oxide and porstaglandin E2 in articular cartilage explants. Osteoarthritis Cartilage 13 (5), 387-394 PubMed.
  • Neil K M, Caron J P & Orth M W (2005) The role of glucosamine and chondroitin sulfate in treatment for and prevention of osteoarthritis in animals. JAVMA 226 (7), 1079-1088 PubMed.
  • Innes J F, Fuller C J, Grover E R, Kelly A L & Burn J F (2003) Randomised, double-blind, placebo-controlled parallel group study of P54FP for the treatment of dogs with osteoarthritis. Vet Rec 152 (15), 457-460 PubMed.
  • Canapp S O, McLaughlin R M, Hoskinson J J, Roush J K & Butine M D (2000) Scintigraphic evaluation of glucosamine HC1 and chondroitin sulfate as treatment for acute synovitis in dogs. Am J Vet Res 60 (12), 1552-1557 PubMed.
  • Boon G K (1997) Synovial fluid analysis - a guide for general practitioners. Vet Med 92 (5), 443-451 AGRIS FAO.
  • Johnston S A & Fox S M (1997) Mechanisms of action of anti-inflammatory medications used for the treatment of osteoarthritis. JAVMA 210 (10), 1486-1492 PubMed.
  • Michels G M & Carr A P (1992) Non-infectious, non-erosive arthritis in dogs. Vet Med 92 (9), 798-803 VetMedResource.
  • Ellison R S (1988) The cytologic examination of synovial fluid. Semin Vet Surg 3 (2), 133-139 PubMed.

Other sources of information

  • Bockstahler B, Levine D, Maierl J, Millis D, Wittek K (2019) Essential Facts of Physical Medicine, Rehabilitation and Sports Medicine in Companion Animals. 1st edn VBS GmbH. ISBN 978-3-938274-30-9. 
  • Self I (2019) BSAVA Guide To Pain Management In Small Animal Practice. 1st edn. Gloucester: British Small Animal Veterinary Association. 
  • Fox S (2016) Multimodal Management Of Canine Osteoarthritis. 2nd edn. Milton: CRC Press.
  • Pettitt R A & German AJ (2015) Investigation and management of canine osteoarthritis. In Practice 37, 1-8. 
  • Demko J L, Phan P V, Kramer E A, McLaughlin R & Frondoza C G (2007) Inhibition of prostaglandin E-2 production in chondrocyte microcarrier spinner cultures by the combination of avocado soy unsaponifiables, chondroitin sulfate and glucosamine. Proceedings of the 34th Annual Conference of the Veterinary Orthopedic Society, 25.

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