A multimodal approach to caring for a pet living with osteoarthritis (OA) can include a combination of systemic as well as targeted (local) therapies to manage inflammation, pain, and promote tissue health. This type of approach stands to offer the best possible response and quality of life for the affected animal.
Veterinarians typically reach, first, for an oral and/or injectable drug (NSAIDs, etc) when managing a pet with OA. While this is appropriate and usually effective in addressing inflammation and the associated pain, it does not address important aspects of musculoskeletal care. Additional targeted approaches to the care of the affected joint(s) and surrounding soft tissues (muscles, tendons, etc.) are equally important and beneficial to improving a patient's mobility and comfort. Furthermore, these adjunctive therapies may allow for a taper or reduction in the need of medicine (NSAIDs, etc.) over time.
Targeted approaches to musculoskeletal care include “external” therapies (e.g. acupuncture, shockwave therapy, pulsed electromagnetic field therapy, and photobiomodulation or laser therapy), and “internal” therapies which are generally administered by joint (intraarticular) injection. Surgery is also considered a targeted therapy and can be curative for some patients.
As with systemic therapies, not all intraarticular therapies are alike or the same. Some combat inflammation, some enhance joint lubrication, and others may provide a physical cushioning effect (mimicking the function of articular cartilage). A combination of these may be necessary to achieve the desired goal for the individual patient. The intraarticular administration of corticosteroids and local anesthetics should be avoided as they lead to cartilage degradation over time. Throughout the Arthritis Summit we learned about a variety of these therapies and how they can be used in combination to achieve best outcomes.
In his continued discussion of joint injections, Dr. Matthew Brunke shared his perspectives on the use of some of these other intraarticular therapies including platelet rich plasma (PRP), hyaluronic acid, and a newer, non-systemic targeted approach that utilizes a novel radio-isotope to reduce synovitis and relieve joint pain (Synovetin OA).
Benefits of targeted therapies are maximized if patients are treated proactively and early in the course of disease. Once these animals get to feeling better, a physical rehabilitation and/or home-based exercise program can further improve their mobility and overall wellbeing.
In Dr. Brunke’s webinar on this topic of targeted joint care - in addition to joint injections - he discusses photobiomodulation (laser therapy), its benefits for treating OA and other medical problems, and how pet owners can use portable systems in the home to care for their pets. He discusses several intraarticular therapies with an emphasis on the use of a novel therapy (involving nuclear medicine), how it works, and what veterinarians and pet owners need to know regarding this exciting new treatment option.
