UNDER THE WEATHER Multimodal Management in Arthritis

Arthritis is seen at different life stages in dogs and cats. In younger patients, specially large-breed dogs, it is a result of bad breeding practices resulting in larger joints getting affected (hip/elbow dysplasia). In older dogs and cats, it is the result of age-related degeneration, coupled with obesity, nutritional deficiencies and lack of exercise.

Whatever the cause, the symptoms range from stiffness, crepitus in joints, decreased mobility, reluctance to exercise, limited range of motion as well as pain of varying degrees. Hence pain management of arthritis becomes very important in older patients to improve quality of life. Finding successful treatments against canine osteoarthritis-related pain is challenging due to multimodal pain pathways. The pain associated with osteoarthritis is considered to be chronic, owing to both active inflammation and to a maladaptive component caused by signals sent to the brain. There is no one single drug that will manage (far less cure) arthritis, making a multimodal approach necessary. In order to understand multimodal approach to pain relief, we need to understand the origin of pain. Osteoarthritic pain has three different origins: inflammatory, nociceptive and neuropathic. 

Inflammatory pain occurs due to joint inflammation caused by wear and tear or lack of lubricating fluid causing friction.

Nociceptive pain is a medical term used to describe the pain from physical damage or potential damage to the body.