Dr James Greenwood BVSc MRCVS
James graduated from Bristol University in 2007 and has enjoyed a successful career working with most companion animal species ranging from dogs, cats, rabbits, horses and even a baby elephant! James is a practicing veterinary surgeon living and working in Bristol.
James has shared his passion for science with his passion for art. Although taught originally to paint, James’ creativity has developed into a deep love for ceramics. James was invited to compete on the first series of BBC2’s ‘The Great Pottery Throwdown’ where he showcased his ceramic skills to the nation.
James has gone on to appear in the hit CBBC children’s television series ‘The Pets Factor’.
James kindly agreed to answer the following questions:
What are your feelings on how we currently manage this common debilitating condition in dogs?
Just like arthritis itself there is no simple answer to this! I think on the whole – awareness is growing and even in the 10 years I’ve been in practice there have been huge shifts in our approach and understanding of arthritis.
However, without doubt, there are still those dogs under our care that slip under the radar and receive substandard arthritis management. ‘Arthritis’ is one of those terms that is used so commonly that whilst most owners will have heard of it, many may not truly understand what arthritis actually is. As a result, those owners are perhaps more susceptible to misinformation online and may already carry a preconceived opinion on how relevant (or perhaps irrelevant) their dogs arthritis is. Some owners are incredibly vigilant whereas others will almost breathe a sigh of relief when I diagnose a lame dog with arthritis exclaiming ‘oh that’s good, it’s just arthritis’. How we approach the owners perception of arthritis is the biggest hurdle to overcome as vets.
But to put the blame entirely on the owners shoulders is also not fair. Consult time constraints mixed with the busy working day of most vets means there is often insufficient time to properly diagnose, discuss and formulate a treatment plan for each individual dog we see. Combine this with the financial implications of management – when you consider the cost per month of hydrotherapy, acupuncture, physiotherapy, prescription diets, NSAID support, veterinary consultations, nutraceuticals – gold standard arthritis management can be incredibly costly. So I think we are constantly making progress, but there is still so much more work to be done.
As a veterinarian what do you feel is essential for managing canine arthritis effectively?
I think owner compliance is key. That relies on trust between the vet and the owner and also continuation of care. It’s not always possible, but I think owners like to see the same vet when dealing with chronic conditions such as arthritis. We also have a responsibility not to judge owners. They may be arthritis sufferers themselves – and may have received very different advice from their own health care provider. So again, we need to invest time into these cases to help owners understand that there is a problem.
Obesity and pain are the biggest concerns in my mind – so if all I can do is convince a reluctant owner to take an NSAID home to have on standby and shift a few kilos – then I still see this as a positive result for the pet. Ideally though I prefer to adopt a multimodal/holistic approach.
We work with a visiting physiotherapist as well as our in house hydrotherapy team and I practice acupuncture. Lots of little changes can have a huge collective benefit. Without doubt nurse clinics are also one of the most effective ways to achieve results in these chronic conditions and our best results are those that have benefited from regular nurse clinics.
How do you see treatment options for arthritis progressing over the next ten years?
I would hope that we could somehow develop a predictive screening test, to encourage breeding from ‘low risk’ lines. I think breed standard has a huge part to play – so there is also responsibility on those regulatory bodies to encourage a healthier body conformation.
Drug therapy will continue to advance – although with more selective analgesics available, the side effects of NSAIDS I would argue are already quite rare. However, I actually believe we already have an incredible ‘tool box’ of options available to us as clinicians (and owners) so perhaps the first step is to simply encourage understanding, awareness and intervention amongst owners, which in itself will improve treatment for our pets. So actually, the future right now is CAM!
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?
You know your own dog better than anyone else – if your intuition is telling you that there is a problem, then you will most likely be right! You are your dogs only voice so come and speak with us about how we can help. No dog should suffer in silence.