Proposed Canadian Consensus Guidelines on Osteoarthritis Treatment Based on OA-COAST Stages 1–4

Abstract

The Canadian consensus guidelines on OA treatment were created from a diverse group of experts, with a strong clinical and/or academic background in treating OA in dogs. The document is a summary of the treatment recommendations made by the group, with treatments being divided into either a core or secondary recommendation. Each treatment or modality is then summarized in the context of available research based support and clinical experience, as the treatment of OA continues to be a multimodal and commonly a multidisciplinary as well as individualized approach. The guidelines aim to help clinicians by providing clear and clinically relevant information about treatment options based on COAST defined OA stages 1–4.

Canine panosteitis and preventive veterinary measures: insights from a case series

“…This decision demonstrates commitment with patient welfare more than disease knowledge itself. Supplement containing glucosamine and chondroitin, nutraceuticals known as chondroprotectants (Johnson et al 2020;Mosley et al 2022), was prescribed. These components are related to chondrocytes and synoviocytes metabolism, synovial fluid and cartilage matrix improvement in osteoarthritis (Johnson et al 2020;Mosley et al 2022).…”

A blinded, randomized and controlled multicenter field study investigating the safety and efficacy of long-term use of enflicoxib in the treatment of naturally occurring osteoarthritis in client-owned dogs

“…Best practice to treat dogs with OA is to follow a multimodal therapy program, and non-steroidal anti-inflammatory drugs (NSAIDs) are recommended at first-line therapy for management of the associated pain and inflammation (2)(3)(4).…”

“…As with most clinical trials assessing the efficacy and safety of NSAIDs in dogs, these field clinical studies with enflicoxib demonstrated its efficacy and safety for a relatively short period. However, considering the chronic nature of canine OA and the current recommendations to prescribe sustained long-term treatments to prevent central sensitization (2), it is necessary to guarantee that long periods of continuous treatment would also be well tolerated under field conditions. Indeed, a previously published systematic review highlighted the lack of long-term clinical trials of NSAIDs (10).…”

Palmitoyl-glucosamine co-micronized with curcumin for maintenance of meloxicam-induced pain relief in dogs with osteoarthritis pain

“…Moreover, OA pain must be viewed as a multifactorial problem and a multimodal approach should be considered, concurrently addressing degenerative and inflammatory pain pathways within the joint. This consists in the combined use of pharmacological and non-pharmacological interventions targeting different steps of OA, in order to achieve the best pain relief and reduce drug use, either in terms of dosage and treatment duration [ 10 ]. In this scenario, combining nutritional interventions with classically used drugs, like non-steroidal anti-inflammatory drugs (NSAIDs), is considered an effective strategy [ 10 , 11 ].…”

“…This consists in the combined use of pharmacological and non-pharmacological interventions targeting different steps of OA, in order to achieve the best pain relief and reduce drug use, either in terms of dosage and treatment duration [10]. In this scenario, combining nutritional interventions with classically used drugs, like non-steroidal anti-inflammatory drugs (NSAIDs), is considered an effective strategy [10,11]. Indeed, although NSAIDs are commonly and successfully used in OA patients [12][13][14][15][16][17], their longterm administration has potential disadvantages mainly in terms of increased incidence of adverse events [18].…”