Variations in the management of canine osteoarthritis: a cross-sectional survey of veterinary practices

There is limited data on how veterinarians implement multimodal therapies for managing canine osteoarthritis (OA). The primary aim of this study was to describe how OA is managed by veterinarians with diverse backgrounds. The secondary aim was to report perceived side effects associated with bedinvetmab (Librela^TM) and grapiprant. The authors hypothesized that variation exists in management patterns among veterinarians with different training backgrounds and experience levels.

A cross-sectional, observational, voluntary response survey was distributed to veterinarians assessing respondent demographics, diagnostic approaches, the frequency of treatment use for canine OA, and perceived adverse events associated with grapiprant and bedinvetmab.

373 responses were analyzed. Non-steroidal anti-inflammatory drugs (NSAIDs) were the most prescribed drug class, and gabapentin, bedinvetmab, and polysulfated glycosaminoglycan (Adequan^®) were the most prescribed non-NSAID medications. The most used nutraceutical and non-pharmacologic treatments were omega-3 fatty acids and weight management. Fifty-three percent of respondents used imaging whenever possible to confirm OA. Those with higher levels of training (specialty training, rehabilitation certificates) and more years of experience used imaging more often. American College of Veterinary Surgery (ACVS) diplomates were less likely to use bedinvetmab and cannabainoids (CBD). American College of Veterinary Sports Medicine and Rehabilitation (ACVSMR) diplomates and rehabilitation-certified veterinarians were less likely to use glucosamine/chondroitin and bedinvetmab and more likely to use ketamine, amantadine, polysulfated glycosaminoglycan, green-lipped mussel, CBD, undenatured type II collagen, eggshell membrane, curcumin, and Boswellia serrata. Diplomates, rehabilitation-certified veterinarians, and more experienced veterinarians used non-pharmacological treatments, including intra-articular injections more often. The most reported perceived side effects of bedinvetmab were paresis/ataxia/proprioceptive deficits (31%) and polyuria/polydipsia (25%). Diarrhea (33%), and vomiting (31%) were the most reported perceived side effects of grapiprant.

There is variation in multimodal approaches to canine OA management influenced by both training and years of clinical experience. While NSAIDs, omega-3 fatty acids, and weight management remain foundational, this study demonstrates a spectrum of utilized adjunctive strategies. The differences highlight opportunities for further research into the safety and efficacy of commonly used therapies. Reported perceived adverse events associated with bedinvetmab and grapiprant underscore the need for pharmacovigilance and further research investigating safety.