A majority of veterinarians want structured protocol for managing canine osteoarthritis (OA), according to results of a survey conducted by the American Animal Hospital Association (AAHA). The survey also revealed that demand for such protocol is especially needed for detecting OA early in younger dogs.

The survey was conducted by AAHA in partnership with veterinary orthopedist Denis Marcellin-Little, DEDV, DACVS, DACVSMR, CCAT, a professor at the University of California, Davis, School of Veterinary Medicine, and American Regent Animal Health, maker of Adequan Canine polysulfated glycosaminoglycan (PSGAG), which is indicated for control of arthritis signs in dogs’ synovial joints. Results of the survey relied on responses collected from nearly 800 veterinarians, of which approximately 95% agreed that a canine OA protocol is needed. “This consensus is a cry for help—a clear demand for more structure in managing osteoarthritis,” said Marcellin-Little, in a news release.1

A recent study led by a team of investigators at North Carolina State University, College of Veterinary Medicine in Raleigh, investigated the prevalence of OA and clinical signs of the condition in 123 dogs, ages 8 months to 4 years, and found that radiographically visible OA (rOA) is common in young dogs. Approximately 60% of dogs in this study with rOA were also determined to have clinical OA as well as pain. These investigators found that pain associated with OA “appears to be undiagnosed and undertreated in young dogs.”

A self-assessment by AAHA survey respondents revealed a confidence level of 7 of 10 for their understanding of canine OA onset and 8 of 10 for managing the disease. “There’s a bit more confidence in management than in detection, which shows that we should be focusing on early onset,” Marcellin-Little noted.

AAHA survey respondents indicated they generally rely on physical examinations, patient health histories, and radiographs to diagnose OA. However, the survey also found that fewer than 1 in 7 respondents use a client questionnaire to help OA detection.

During a presentation of the study results at the 2024 Veterinary Meeting and Expo (VMX) in Orlando, Florida, Marcellin-Little addressed the low usage of a baseline OA questionnaire with event attendees.

 “It’s free, it’s simple, and it can be done before your visit. [There’s] no work [involved]. You have zero reason not to do it and yet very few people do it,” he said.

What treatment methods do veterinary professionals use to manage OA? The AAHA survey found respondents relying on therapies and resources as follows

Weight loss or optimization of body condition (98%)

Drug addressing the underlying disease, such as PSGAG (71%)

In his talk, a session that was sponsored by American Regent, Marcellin-Little expressed opinion that joint supplements may be overused for managing OA, based on the high percentage of those who reported relying on them. “I love joint supplements, but we can’t just say this is the foundation. It’s an adjunctive strategy. I like the affordability, simplicity and safety…but there’s a risk of over relying on something that is not going to have a big, strong impact,” he said.

Conversely, the UC-Davis professor expressed concern that some other treatment methods, including NSAIDS, pain control drugs, and nonpharmaceutical modalities are being underused by veterinary professionals.

 “NSAIDS have a robust effect size but there is a safety concern and 3% of the dogs are going to identified with an adverse effect,” he said.

Marcellin-Little also urged VMX attendees to consider PSGAG more widely than 71% for OA prevention.

 “We have to remind ourselves to use it early…Controlling inflammation is critically important,” he said.

Citing the “overwhelming” majority of veterinarians who indicated organized protocols dictating OA management are necessary, Marcellin-Little also discussed the reasoning for these protocols. “We want to improve the logistics of managing OA, make it less random, make it more standardized, more efficient. We want better science,” he said.

AAHA survey respondents indicated that OA protocols should include elements of management, education and science. Top responses included early disease management such as repairing cartilage health or slowing degradation, mid-stage management, disease prevention and understanding OA management products and strategies including when to implement them. Providing client education guidelines and resources was also highly sought-after by survey respondents.

Four in 10 veterinarians surveyed agreed that their practice currently has an OA protocol in place, while 7 in 10 survey respondents said they have an OA protocol for senior dogs.

 “Most agree that a protocol is realistic,” said Marcellin-Little.

However, veterinarians were less in agreement about when an OA protocol should be implemented. Only 9.5% said an OA protocol should be implemented on the first visit for all dogs while 35% agreed the protocol should be implemented on the first visit for dogs at risk.

 In his talk, Marcellin-Little expressed a need for more focus on preventing OA. “Let’s make things better here. Let’s move that [35%] up to 95%,” he said.

Other veterinarians surveyed expressed an OA protocol starting at points beyond a fist visit such as post-surgery, when a dog reaches a certain age, or if the patient has an injury, while 89% agreed disease management protocols should be used when a canine shows signs of OA.

Current management of canine OA is largely focused on relieving pain, but optimal management should include an understanding of joint degeneration and inflammation. Treatment should begin early and be proactive with steps that include nutrition, joint protection and health, and an established routine exercise, according to Marcellin-Little.

Survey respondents reported an estimated 45% of their patients living with OA and 26% have early-onset disease. Additionally, 47% of respondents’ patients are predisposed to the condition.

 According to Marcellin-Little, the data justify the need for stronger emphasis on early detection.

However, 75% of veterinarians who responded the study’s survey reported knowing only “a little bit” about canine OA, and fewer than 10% initiate discussions about the condition when beginning a relationship with a patient and client. Based on these findings, investigators concluded that there is opportunity to improve education and resources about the condition and to help increase practitioners’ understanding about what clients need to know about canine OA.

Overall, the study’s findings are a call to action for veterinary professionals to prioritize OA management and detection, according to American Regent. “We should be talking about OA when it’s a nonissue, before it becomes a problem,” added Marcellin-Little.

Survey highlights substantial need for canine osteoarthritis management protocol for veterinarians. News release. American Regen Animal Health. December 7, 2023. Accessed February 8, 2024. 

 Prevalence of radiographic appendicular osteoarthritis and associated clinical signs in young dogs. 

. 2024;14:2827. doi:10.1038/s41598-024-52324-9

Marcellin-Little D. OA management protocol—time for a reset? Presented at: Veterinary Meeting and Expo; Orlando, Florida; January 13-17, 2024.

Articles

Results of a recent survey revealed education about the disease and preventive care are needed

Veterinarians see benefit to canine OA management protocols

The City of Brotherly love has extended that love across the country as the Kennel Club of Philadelphia (KCP) announced its Thanksgiving Day National Dog Show event raised $300,500 in donations. The money donated will go to help support dog and pet related organizations and to help support people in need as well.

 14 national and local organizations will receive funds from the donations, including The AKC Humane Fund, AKC Canine Health Foundation, and Take The Lead, all of which will take the lead on recipients. KCP has pledged $100,00 to the AKC Humane Fund and it will use the funding to create 5 scholarships worth $10,000 each over 2 years for students at the University of Pennsylvania Veterinary School.

The other $200,000 will go to The AKC Canine Health Foundation to help support its efforts into canine health research and then to Take the Lead, an organization that provides support, care, and direct services for those in the sport of purebred dogs who suffer from life threatening or terminal illness. The mission of Take the Lead is to also provide temporary emergency assistance for those impacted by civil disasters such as floods or fires.

"We have worked hard to make our show a success for the club and for the sport and, ultimately, for dogs and people everywhere in this country," said Wayne Ferguson, KCP President Wayne Ferguson, in the release.

 "Speaking for our members, and our great partners NBC and Purina, we are all proud to be able to share that success with so many."

KCP, and its predecessor clubs, has been hosting major dog show events since 1879, putting it in the forefront of the purebred dog world. This year's show will take place on Saturday November 16-17, 2024.

KENNEL CLUB OF PHILADELPHIA DONATES OVER $300,000 TO 14 NATIONAL AND LOCAL DOG-RELATED ORGANIZATIONS. News release. Kennel Club of Philadelphia. February 8, 2024. Accessed February 9, 2024. https://prnmedia.prnewswire.com/news-releases/kennel-club-of-philadelphia-donates-over-300-000-to-14-national-and-local-dog-related-organizations-302057990.html

Kennel Club of Philadelphia. The National Dog Show. Accessed February 9, 2024. 

https://nds.nationaldogshow.com/kennel-club-of-philadelphia/

Over $300,000 will go to 14 national and local dog and pet related organizations as well as supporting organizations helping people in need  

Kennel Club of Philadelphia grants hundreds of thousands to dog-related organizations  

Cancer is the leading cause of death in adult dogs

 with 50% of canines over age 10 dying from this disease.

 Because of its prevalence, veterinary researchers can continuously working to find better options for diagnostic and early detection techniques. One development from PetDx, is a 

, centered on cell free DNA biomarkers extracted from blood, offer a revolutionary approach to detecting cancer through both quantity and quality-based analysis. Another development comes from  researchers in the Virginia Tech College of Engineering, College of Agriculture and Life Sciences, and the Virginia-Maryland College of Veterinary Medicine. A study published in 

 details a new, noninvasive, rapid test using a dog’s urine that allows for potential early detection of cancer.

The decision to use urine stemmed from the understanding that cancer and cancer treatment is known to dysregulate renal structure and function and affect urine composition.

 Researchers had confidence in using a Raman spectroscopy-based technology after successful results using the same technique in other studies on chronic kidney disease, diabetic nephropathy, renal effects of COVID-19 disease, microhematuria, bladder cancer, and chronic Lyme disease.

The methodology used for the study included urine samples collected with voiding, cystocentesis, or catheterization from 89 dogs with no history or evidence of neoplastic disease, 100 dogs diagnosed with cancer (1 of 4 common types including lymphoma, urothelial carcinoma, osteosarcoma, and mast cell tumor), and 16 dogs diagnosed with non-neoplastic urinary tract or renal disease.

 Employing an innovative approach of Raman spectroscopy, researchers examined the urine samples and identified distinct molecular patterns. Notably, cancer-afflicted subjects exhibited a distinctive "fingerprint," suggesting the potential utility of this method for detecting the presence of cancer.

“If a new patient comes into the clinic and provides a urine sample, we can compare it against our database of urine scans to determine if the sample more closely matches a cancer fingerprint or a healthy fingerprint,” said Ryan Senger, MS, PhD, associate professor in the Department of Biological Systems Engineering, in the university release. “With the research that we have done so far, we were more than 90 percent accurate at being able to tell if a new sample had cancer fingerprint or a healthy fingerprint.”

According to Virginia-Maryland College of Veterinary Medicine, blood tests can have an accuracy rate of around 60%,

 and tend to be costly with required laboratory procedures. This new urine screening method offers a rapid initial assessment of a dog's potential cancer markers, eliminating the need to wait for blood test results. Furthermore, it holds the potential for convenient at-home testing in the future.

“Owners could go from paying for expensive testing every few months, to having a urine screening done once every few months, depending on the dog’s risk for cancer, if they wanted to,” said Nikolaos Dervisis, DVM, PhD, DACVIM (Oncology), associate professor of oncology at Virginia-Maryland College of Veterinary Medicine. “This screening would allow veterinarians to decide if further comprehensive testing is needed based on the results.”

Scanning each urine sample was completed in less than 5 minutes with multiple laser scans. The results showed that with an identified spectral fingerprint in participates’ urine, a 92.7% overall accuracy for a cancer vs. cancer-free designation was discovered.

 from these positive results, researchers are hoping to expand the test’s capabilities to determining the best treatment for therapy for diagnosed patients. They are also hopeful that it can evaluate the tumors and detect any reoccurring cases, if applicable. If research advances in these areas show positive results as well, the Virginia Tech team will investigate how to extend its use to other animals and even human health studies.

John Robertson, VMD, PhD, research professor in the Department of Biomedical Engineering and Mechanics, said, “We could potentially measure responses to medicine and chemotherapy in dogs already undergoing treatment, then monitor those dogs to see how they're doing. Can we differentiate the kind of diseases we screen for? Which patients are responding to drugs and why? We’re currently working to collaborate with other institutions to further explore how all these factors can be beneficial.”

A more in-depth assessment of the study with methodology and results can be found in 

Fleming JM, Creevy KE, Promislow DE. Mortality in North American dogs from 1984 to 2004: an investigation into age-, size-, and breed-related causes of death. 

. 2011;25(2):187-98. doi: 10.1111/j.1939-1676.2011.0695.x

Beltrán Hernández I, Kromhout JZ, Teske E, Hennink WE, van Nimwegen SA, Oliveira S. Molecular targets for anticancer therapies in companion animals and humans: what can we learn from each other? 

. 2021;11(8):3882-3897. doi: 10.7150/thno.55760

Robertson JL, Dervisis N, Rossmeisl J, et al. Cancer detection in dogs using rapid Raman molecular urinalysis. 

 2024;11. doi.org/10.3389/fvets.2024.1328058

Brittner B. Innovative screening can detect 'cancer fingerprint' in dogs. Virginia Polytechnic Institute and State University. February 7, 2024. Accessed February 9, 2024. 

https://news.vt.edu/articles/2024/02/coe-innovative-dog-cancer-screening.html

Hottendorf GH, Nielsen SW. Collagen necrosis in canine mastocytomas. 

This is the first rapid test using urine developed by the Virginia Tech College of Engineering, College of Agriculture and Life Sciences, and the Virginia-Maryland College of Veterinary Medicine

Urinalysis offers a noninasive, rapid screening for canine cancer detection

Good morning and happy Friday dvm360 readers! To all our Kansas City Chiefs and San Francisco 49ers fans out there, or those who are just tuning into the Super Bowl to see if Taylor Swift makes it from Tokyo or not, happy Super Bowl weekend! Be sure to listen to our recent 

 of The Vet Blast Podcast with Renee Schmid, DVM, DABT, DABVT, senior toxicologist for the Pet Poison Helpline, as she discusses toxins that are lurking at Super Bowl gatherings to help clients keep their pets healthy and happy.

Here is what was popular this week on dvm360.com:

Tyson, a 3-month-old French bulldog, was scheduled to go to Cornell University to meet with the dentistry and oral services for cleft palate surgery when his primary care veterinarian discovered a cancerous tumor on his jaw. After having a major portion of his jaw removed, the team would soon discover that his jaw had 

, making him the first reported case of jaw regrowth.

Melissa King, PharmD, and Andrew Filewicz, PharmD, 

 the new standards of practice being enforced by the FDA, accreditation organizations, and local state boards of pharmacy for Chapter <795> and Chapter <797>.

 of The Vet Blast Podcast, host Adam Christman, DVM, MBA, and Wendy Myers, CVJ, president of Communication Solutions for Veterinarians, explained how veterinary clinics can successfully charge for technician appoints.

The University of Wisconsin School of Veterinary Medicine recently 

 a study on the vision habits of dogs based on an owner survey published in 

 to determine the factors influences a dog's interest in interacting with video content.

Because French bulldogs are rising in popularity for pet owners across the United States, a careful history collected from clients and education for them on common illnesses seen in the breed can help support their health. 

 in this article recapping a lecture from the Veterinary Meeting & Expo in Orlando, Florida.

 this week that it will not object to temporary importation of Pluset, a porcine pituitary-derived follicle-stimulating hormone and luteinizing hormone, as the United States is experiencing a shortage of the FDA-approved follicle-stimulating hormone (FSH) Folltropin.

This week on dvm360.com: First case of spontaneous jaw growth reported, and other veterinary news 

Entering Veterinary Hospice

Getting a pet often brings comfort, companionship, and love for many years. Unfortunately, as they grow older, they may get sick, leading to either a long-term treatment or preparing for their last moments. The goal of hospice care is not to prolong a pet’s life. It should be used to help a pet enjoy the final phase of its life, however long that might be. Mary Gardner, DVM, discussed 5 key elements of hospice care.

 “I would love for pets to be put in hospice sooner rather than later so they can have better care and support. Typically, veterinarians see them within the last few weeks.”

This step involves talking a pet owner through every medication or treatment option without pushing them in any direction. However, there is more to this step than simply a clinical outline. “Love is the most important thing I prescribe,” said Gardner, as she explained to the audience that she will write love on a prescription pad as part of her patient care. “Wouldn’t we all want thirty more minutes with our pets after they pass?”

The key with any environment is making sure pets are safe and comfortable. Check that they can’t get stuck anywhere, slip on the floor, attempt to climb stairs, or fall into a pool, if the pet owner has one. Often, in this stage, pets will have mobility or sight issues. Certain products—ramps, mats, or harnesses—help with these obstacles.

If there are children in the home, it is important to teach them how to handle a pet who is in pain. This can prevent scenarios like a pet snapping or biting someone in the home.

3. Acknowledging caregiver burden and supporting the caretaker

Caring for a terminally ill pet takes up a lot of time and increases stress and anxiety for the caregiver. A pet’s care is no longer just a usual walk but rather preparing food, cleaning up, refilling medications, and so on. Knowing euthanasia is an option, which differs from hospice care for humans, makes the caregiver burden even bigger. Behind the pet care is a human being. They have their own life that is now segmented with a rather large emotional and physical toll. The caregiver needs support too. Gardner recommended petcaregiverburden.com as a resource for pet owners in a hospice situation.

For Gardner, this is a private and intimate 20-minute conversation that she has with every family. What is said will vary based on the disease and management of the pet. Keeping empathy and love at the forefront of the conversation is crucial.

Having a conversation about euthanasia helps prepare a family. Sometimes, they will not want to discuss euthanasia, or they worry about judgment for wanting to do it or deciding to do it later. “They may have a previous experience that wasn’t so good, and now they’re scared to go through it again,” Gardner reminded the audience.

Aside from euthanasia itself, it is important to let the family know about your schedule as a veterinarian, where they would like the procedure done, who they want to be present, and aftercare options.

Gardner ended her talk by emphasizing her love for her work and the hopes that this information helps bring hospice care to more veterinary clinics.

Gardner M. The 5 Key Ingredients to Veterinary Hospice. Presented at Veterinary Meeting & Expo; Orlando, Florida; January 13-17, 2024

Videos

Entering veterinary hospice

Евгений Шемякин / stock.adobe.com

The 20th annual Puppy Bowl will premiere Sunday, February 11, 2024. According to the Discovery Channel, this year will be the biggest yet, featuring 131 puppies, 73 shelters, and rescues across 36 states and territories.

 This year will also include a new feature: the Puppy Bowl Hall of Fame, which will have 4 previous puppy players return to the game.

“What we’ve done this year to flip the whole script is because it’s sort of a celebration of the fact that it’s the 20th year,” says “Puppy Bowl” referee Dan Schachner said in The Associated Press article. “We’ve decided to go all in on puppy, making it the “most puppiest ‘Puppy Bowl’ ever.”

The Puppy Bowl offers viewers a fun way to see cute puppies run around and play together, scoring touchdowns whenever they take a toy across the end zone, however the main reason this show is put on every year to help raise awareness for pet adoption. According to the ASPCA, as of data from 2019, approximately 6.3 million companion animals enter US animal shelters nationwide every year, with 3.1 million dogs and 3.2 million cats. Unfortunately, approximately 920,000 shelter animals are euthanized (390,000 dogs and 530,000 cats), each year.

 The Puppy Bowl showcases available puppies and kittens up for adoption and ready for viewers to send in applications. It is also a way to remind viewers to adopt a pet at their local shelter if watching the Puppy Bowl sparks their interest in owning a pet.

“We don’t want dogs that are show dogs, that are sitting there with a trainer. We want to see them in all their puppy glory. Part of that is to show what puppies are in their true state,” said Schachner. “They are playful, they are curious, they’re going to get into trouble, they’re going to do crazy things. And from time to time, they’re going to score touchdowns and really impress you.”

Meet the players of Puppy Bowl XX. Discovery Channel. January 11, 2024. Accessed February 9, 2024. 

https://www.discovery.com/shows/puppy-bowl/see/meet-the-players-of-puppy-bowl-xx

Kennedy M. ‘Puppy Bowl’ celebrates a big anniversary this year, one that shelter and rescue pups will cheer. The Associated Press. February 7, 2024. Accessed February 9, 2024. 

https://apnews.com/article/puppy-bowl-2024-20th-anniversary-fe5ab3507eb72f24e170d1cb23c28b52

Pet statistics. ASPCA. 2019. Accessed February 9, 2024. 

https://www.aspca.org/helping-people-pets/shelter-intake-and-surrender/pet-statistics

Introducing the new Puppy Bowl Hall of Fame consisting of puppies featured in previous Puppy Bowl showings