Harmony Coriddi, LVT, CMT, COCM, CAMadvocate Level 1, is a Licensed Veterinary Technician based in the USA who has worked as a canine bodywork practitioner for a number of years. Since graduating from Colby Community College with an Associate’s degree in Veterinary Nursing, she has been continuing her educational journey with the aim of specializing in osteoarthritis/chronic pain management and canine sports medicine, having recently completed Canine Arthritis Management’s CAMadvocate Level 1 and the University of Tennessee’s Canine Osteoarthritis Case Manager (COCM) certificate. She is a member of the Canine Arthritis Management team, working as the CAM Education Coordinator and assisting in the growth of the CAM Education Centre.
Harmony kindly agreed to answer the following questions:
What are your feelings on how we currently manage this common debilitating condition in dogs?
Understanding of canine osteoarthritis (OA) and its management has come a long way in recent years, advancing along with an ever-growing toolbox of available treatments and improved pain management. A multimodal approach to managing OA – now recognised as the gold standard – is steadily gaining more traction, but I feel there is much room for improvement. Not only is a unimodal approach to management still being utilised far too frequently, but there is also a continued lack of identification of the signs of OA, especially early on in the disease. This deficit in recognising OA is perhaps due in part to the rampant misconception that this incredibly complex disease is “just” arthritis and a normal part of aging, commonly written off as the dog “slowing down.” More education and awareness are needed, both among veterinary and canine professionals as well as dog owners. If we can learn to identify the signs of OA earlier, we can have a better chance of influencing the progression of the disease long term.
An evidence-based approach to OA management is also something which must be prioritised more, as I feel that there is an alarming tendency to fall back on using supplements – many of which currently have little to no evidence of efficacy – as a first line of attack, or even the sole modality in treatment. I am constantly surprised to find that a dog showing signs of arthritic pain is on a supplement – or sometimes multiple similar supplements – and nothing else, with no attention paid to weight management, lifestyle, home environment, or even pain control. Dr. Chris Zink, a highly respected canine sports medicine and rehabilitation expert, has noted that, by the time dogs will show signs such as lameness, the pain is already at a 6 out of a 10-point scale. Allowing dogs which may be suffering a 6/10 or higher pain score to continue unabated is unacceptable. We must get better at implementing pain management and the foundations of OA management early on and follow evidenced interventions rather than fads and/or modalities lacking in evidence.
As a veterinary professional, what do you feel is essential for managing canine arthritis effectively?
When it comes to managing osteoarthritis, the one most important factor is the owner’s understanding of the disease and their compliance with the proposed management plan. The key to this is owner education. Educating owners can be challenging at the best of times for a variety of reasons, including time constraints, information overload, and conflicting opinions and advice from unreliable sources. Owners instinctively want to do the best for their dog, but even with a thorough discussion of implementing a management plan at a vet consult, only 20-60% of the information will be retained. We must improve our approach to owner education, perhaps by utilising an external, trustworthy resource such as CAM. That is why I am so excited about the courses CAM has recently released for owners – employing this relatively new concept of online education could be a massive game changer for OA management.
Along with owner education, early identification of OA is essential for effective management. I feel the veterinary profession perhaps needs to continue adapting to technology advancements and start utilising the powerful tools available to most owners: smart phones. Pets will frequently hide signs of pain during vet consultations, but if owners are encouraged to take videos of any abnormalities they’re noticing, whether gait, behavioural, or postural, veterinary professionals will be able to better assess and investigate the cause. Beyond tapping into technology, improved identification once again comes down to owner education and working to change the misconceptions surrounding OA as a whole.
How do you see treatment options for arthritis progressing over the next ten years?
There have been a number of interesting developments recently, with new and potentially very exciting additions to the OA treatment toolbox. It is still early days for some of these interventions, but I think they indicate the continued advancement of our understanding of both OA and our ability to influence its progression. Since canine arthritis is such a multifactorial disease, I am not sure we will ever be able to fully prevent or cure it, but I hope that the next 10 years will see an improved capacity for decreasing the speed of progression and the pain of OA. I expect there will also be a greater acceptance and acknowledgement of the power of lifestyle and home environment adaptations in years to come, as these are common sense interventions which often get overlooked even now. However, regardless of what new scientific advancements occur in the next decade, I feel the emphasis must remain on an evidence-based multimodal approach. There is an inclination to view new interventions such as the recently released monoclonal antibody therapy injectable as “miracle drugs” or panaceas, but at the end of the day, unless they actually stop or prevent the degenerative processes of the disease, they are merely an addition to the toolbox. Each dog is an individual with unique needs, and I hope that will continue to be recognised more widely in treatment and management plans. That being said, I am excited to see what science will uncover in the next 10 years – thrilling times ahead, I’m sure!
If you could have the opportunity to give one tip/piece of advice to an owner with a dog suffering from arthritis what would it be?
Weight management!!! Keeping your dog at ideal weight is THE most important thing you can do to prevent and manage canine arthritis. As a bodywork practitioner and veterinary technician, it gets quite depressing seeing so many dogs who are overweight or obese. It is truly an epidemic of epic proportions, with serious consequences. Weight can be a tricky subject to approach, but my advice would be that the best thing an owner can do is to learn how to body condition score – it is super easy to do, and will give you a way of assessing your dog’s weight at home. And if you score your dog and find that they are overweight but don’t know where to start with weight loss, talk to your veterinarian, check out the available resources through CAM, ask on Holly’s Army – there is lots of support out there, so please don’t be afraid to use it. Weight loss is not easy, so prevention in this case really is the best medicine, but it IS doable. Make small goals to start with – even a 4-6% weight loss can make a potentially huge difference to your dog’s OA – be consistent, and stick with it. It may be a long journey, but it is most definitely worth it!