Dr. Tamara Grubb is a Diplomate of the American College of Veterinary Anaesthesia & Analgesia with a strong focus in pain management. Dr. Grubb is a graduate of Texas A&M College of Veterinary Medicine. She is an Adjunct Professor of Veterinary Anaesthesia & Analgesia at Washington State University and owns an anaesthesia & pain management consulting and continuing education company (VetAACE), which serves both small and large animal practices. She is President-Elect of the International Veterinary Academy of Pain Management, is a national/international educator and lecturer, and co-author of two books and over 100 research publications and numerous other articles. Dr. Grubbโs favourite achievement is winning the Carl J. Norden Distinguished Teaching Award from students at both Oregon and Washington State Universities.
What are your feelings on how we currently manage this common debilitating condition in dogs?
I think we currently greatly under treat this disease. And that isnโt because we donโt care, it is because we donโt know. Many veterinarians and veterinary nurses werenโt taught about osteoarthritis (OA) pain or chronic pain management in school. There are so many subjects to cover and unfortunately pain is often overlooked. Thus, the level of OA treatment knowledge may be to administer an NSAID โ or some other treatment โ used alone in a patient that desperately needs multimodal analgesia. It is that โwhat else can we doโ part of treatment that is missing for so many. And there isnโt one answer to that question. We have to learn about โ and be willing to try โ a variety of โnext levelโ treatments including drugs and non-pharmacologic treatments. Unfortunately, this isnโt always easy and I think many veterinarians/owners give up out of frustration, but โ again – not because of a lack of caring. The necessity to provide educational material to veterinarians through organisations like CAM and the IVAPM is absolutely crucial.
ย As a veterinary professional/rehabber what do you feel is essential for managing canine arthritis effectively?
Owner education, owner communication and owner compliance. Of course, we need the same thing from veterinarians, but if the dog isnโt presented to us for treatment because the owner doesnโt understand that the change in behavior is due to pain, or we do see the dog but the owner doesnโt understand the treatment or has difficulty administering the treatment, pain wonโt be treated and the animal suffers. We also need more treatments for sure, but we canโt use the treatments we have if we donโt get the owner to bring us the dog. I love the owner education courses at CAM!! Well done!
How do you see treatment options for arthritis progressing over the next ten years?
Iโm excited about and grateful that new treatments are arriving. OA is finally being recognised as a debilitating disease and there are some new, exciting – and effective โ treatments that have been newly released or are on the horizon. We are making progress!
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?
I would want them to understand that they should not anthropomorphise the degree of pain. Just because the ownerโs OA isnโt particularly painful does not mean that their dogโs OA is not painful. I would also want them to understand (okay this is two tips!) that โpain is what the pet says it isโ and that even presumably mild pain can have a devastatingly negative impact on that petโs quality of life. So the owner needs to be educated not to look for pain itself but to look for the impact of pain on their pet, like impaired mobility, behaviour changes, decreased appetite and/or grooming, failure to interact with family members or other pets, etcโฆ