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Summary

As more is learned about the pathophysiology of osteoarthritis, we are also becoming more aware of how to implement treatments. Multimodal Management of Canine Osteoarthritis takes an evidence-based approach to the canine patient with osteoarthritis, pursuing the objective of the best available medicine by a variety of means--multiple drugs, agents, adjuncts and delivery methods. Appreciating that surgical intervention may initially be required, particularly for stabilizing a joint, the major focus in this work is the conservative management of osteoarthritis. A clear and visual approach is taken with the overlapping of two three-pointed triangles of management: medical and non-medical. Medical management includes NSAIDs, chondroprotectant and adjunct; while the non-medical management includes weight control/exercise, EPA-rich diet and physical rehabilitation. Each of these approaches has been independently shown to be effective, and while there are no published works on their collective synergism, the multimodal concept is intuitive.

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Excerpts

Multimodal' has become a popular term in the recentmedical literature. Arguably introduced as an acronym for‘balanced anesthesia', denoting induction by a multipledrug approach, multimodal is currently recognized toidentify any protocol that includes multiple drugs, agents,adjuncts, or delivery methods. Marketeers have also cometo embrace the term, as they tout the virtues ofadministering their products as part of a given protocol.Frequently this leads to advertising, where one isencouraged to incorporate a given product within ‘yourmultimodal protocol'. Herein, at issue is actuallyidentifying a foundation protocol.The multimodal management of osteoarthritis describedin this work delineates an evidence-based approach for thecanine patient with osteoarthritis, pursuing the objective ofthe best available medicine. Appreciating that surgicalintervention may initially be required, particularly forstabilizing a joint, the major focus of this work is the‘conservative' management of osteoarthritis. A simplisticapproach is taken with the overlapping of two three-pointedtriangles of management: medical and nonmedical. Medicalmanagement includes NSAIDs, chondroprotectant, andadjunct agents; while the nonmedical management includesweight control/exercise, EPA-rich diet, and physicalrehabilitation. Each of these approaches has beenindependently shown to be effective, and while there are nopublished works on their collective synergism, the concept isintuitive.As we learn more about the pathophysiology ofosteoarthritis, we are also becoming more aware of how toimplement treatments to attack various components ofthese pathways. Our challenge as veterinary healthprofessionals is to maintain awareness of contemporaryissues in treating osteoarthritis so that we can offer caninepatients the care they need and deserve.This textbook is intended for veterinary healthcareprofessionals seeking to understand better the issues relatedto pain management associated with canine osteoarthritis.The images presented are referred to in the text in bold font.The multimodal approach is a trademark of Novartis AG.