What Works & How To Introduce It
TOD SAYS...
What works for one dog, may well be ineffective for another. Get advice from your vet before spending money on a product.
Canine osteoarthritis is a complex disease. Every dog is different. A 1 year old Golden Retriever with bilateral mild elbow dysplasia with secondary arthritis is very different to a 10 year old overweight Pug with severe hip dysplasia and secondary arthritis, in addition to spondylosis of the spine and lumbosacral stenosis.
Considering that there is a wide range of clinical presentations of arthritis, hopefully it will become clear that advising whether something will work or not for all cases is impossible.
What works well for one dog may be ineffective for another. What CAM aims to do is equip you with enough information so that you can make the right decisions for your dog and their disease.
Many available interventions have little evidence of benefit. This is a huge hindrance to advising you effectively, however it is unlikely to change any time soon. Quite often readily available products have absolutely no evidence of benefit, while others will suggest benefit based on weak trials performed a long time ago, commonly on a different species, or an induced model of arthritis. Some market themselves on studies that were performed in a lab petri dish, so bear little resemblance to the real life arthritis that you are trying to manage. And some simply suggest benefits based on anecdotes, theoretical belief, or unscientific suggestions.
A logical approach to checking whether something works or not is to monitor its impact on the dog. For example, when introducing an anti inflammatory to a dog that struggles to get up from a lay, does not want to walk more than 3 minutes, has started keeping themselves to themselves and now hates being towel dried; we would expect over a few days to weeks to see an improvement in their willingness to interact, their enthusiasm to walk, their ability to get to their feet and their tolerance of being towel dried. This logical approach is officially termed Client Specific Outcome Measures - CSOMs for short and is a semi objective monitoring technique that has been proven to work in cats!
There are a number of recognised semi objective monitoring tools available for you to use to monitor the impact of introducing something new to your multimodal management plan, or for simply monitoring long term to be the first to know of deterioration in your dog’s quality of life.
Canine Brief Pain Inventory (CBPI) - created at the University of Pennsylvania, US.
This is a very simple tool used extensively in clinical trials. Do not be intimidated by the form you must complete to gain access!
Liverpool Osteoarthritis in Dogs (LOAD) - created at the University of Liverpool, UK.
This is designed to aid in detecting and monitoring osteoarthritis in dogs. This form is accessed via Elanco, who license it from the university. Follow the login instructions or ask your vet for a copy.
Helsinki Chronic Pain Index - created at the University of Helsinki, FI. This questionnaire is available online from the original publication
Canine Orthopaedic Index - created at the University of Pennsylvania, US.
This was designed to quantify the quality of life of dogs with orthopaedic disease. Do not be intimidated by the form you must complete to gain access!
Cincinnati Orthopaedic Disability Index (CODI) - This questionnaire is very different to the above as it encourages the caregiver to identify what has changed with regards their dog’s capabilities and enables them to be monitored, as well as prompting you about everyday activities.
CAM has created a few simple tools to support you in monitoring your dog’s progress such as The Osteoarthritis Booklet Tool - step into the Member Zone to access this and many other invaluable resources.
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purchasing a product
It is a minefield out there and one that is hard to guide you through. However, here are some top tips to bear in mind when considering purchasing a product:
- If it sounds too good to be true, it probably is!
- If it suggests that it can cure or prevent arthritis then avoid it, as both of these are currently impossible.
- If you would struggle to afford it, then hold fire and check in with your vet or therapist as expensive does not mean effective!
- Be wary of well-marketed social media ad products and those that tie you into subscriptions. Instead approach your vet or therapist for their recommended products.
- Always check regarding the safety of a product. Combining different supplements and medications can lead to adverse events, so obtain vet advice if in doubt.
- Read, read, read! CAM was created by a vet who wanted owners to make wise decisions for their best friends, and not fall into lucrative product-promise traps.
- If you would like to introduce a new intervention, be objective. Get baseline data prior to starting use, and then monitor over the trial period. Arthritis naturally waxes and wanes so you are looking for improvement over the long term, not the short term. Short term improvement may well be due to your dog having a simple acute deterioration, which is always going to get better with the passing of time. The addition of a new therapy just happened to coincide with the improvement, but was always going to get better after. Your addition of a new therapy is just coincidence.
- Join Holly’s Army Facebook page, a vet-led owner forum. This forum has many wise owners who have been there, and will be able to advise you. We work hard to ensure members understand the difference between an anecdotal story and evidence, to ensure the advice they contribute is balanced and not sensationalism.
