Managing canine osteoarthritis
Owners can be reluctant to treat their dog's arthritis.
Speaking at the London Vet Show this morning (18 November), geriatrics specialist Zoe Belshaw gave an excellent talk on why owners can be reluctant to treat their dog's arthritis and how we as a profession can address this.
Zoe is involved with the Nottingham Dog Arthritis Project and has spent time talking to owners with arthritic dogs and vets and nurses involved in treating them.
A typical scenario is an owner with the arthritic dog who is recommended treatment by their vet and decides to 'think about it' rather than take action. Zoe investigated why owners seemed so reluctant to act on their vet’s advice.
The first thing that affects decision making is time (the elephant in the room). A ten-minute consult does not give the vet enough time to fully discuss the condition and methods of treatment. However, there are a number of other issues which prevent owners from easily accepting treatment for their arthritic dogs:
1. Many owners have difficulty in recognising chronic pain, often saying that their dog is just getting older and that some 'pain' or stiffness is just a normal process of ageing. Others have difficulty in recognising if their pet is in pain and may not even notice the mobility changes their dog is experiencing. Zoe explained that vets need to explain better what the dog is going through and the kind of pain they are experiencing - i.e. chronic pain is not necessarily pain that makes the dog yelp.
2. Many owners have the incorrect knowledge. They take advice from family, other owners, the internet, Facebook etc., in fact anywhere except their vet. These preconceived ideas make it more difficult for the vet when the owner finally brings their dog for a consultation, said Zoe. Vets need to try to be aware of these preconceived ideas and advice accordingly
3. A lot of owners worry about the side effects of putting their dogs on NSAIDs. This is an interesting area as many owners report that they would rather do nothing and then put their pet on medication as a last resort. The reasoning behind this is that they worry about doing the wrong thing because this would make them feel guilty and that the dog’s illness was their fault. If they do nothing and the pet becomes ill they would feel less guilty.
Zoe explained that vets should consider telling owners about the possible side effects of NSAIDs, but emphasise that the chance these happening are small. If they advise on the signs to look for, the owner may well feel more confident about using the medication. Zoe also emphasised the need for receptionists to be aware of the advice given to owners so that. if they do contact the practice with concerns, they are dealt with accordingly
4. Clients are often not sure if the medication is working because they have nothing to measure progress by. Zoe said that the vet could assist here by helping the owner choose parameters to monitor. For example willingness to walk; distance walked; ability to negotiate steps.
The message of the lecture was that clients need more education about osteoarthritis, and to do this vets need more time to spend with the client. If the client has a belief in the treatment, understands the risk and benefits of the medication, they are much more likely to accept the treatment.
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