DJD

Question 1

DJD

Answer 1

Aka: Osteoarthritis.
Secondary process.
Includes imbalance or cartilage catabolism and anabolism. Degeneration of articular cartilage. Alterations in subchondral bone. Periarticular ostephytosis. Synovial inflammation.

Question 2

Etiology

Answer 2

Multi factorial disease. 
Arachadonic cascade: COX 2 and LOX
Abnormal biomechanics
Genetics
Trauma
Abnormal nutrition
Obesity
Maintain activity.

Question 3

DJD cytology

Answer 3

Increased cellularity. Mononuclear predominates.

Question 4

Goals of Therapy

Answer 4

Decrease pain, maintain or improve activity, and slow progression.

Question 5

Treatment

Answer 5

Multimodal treatment “The Triad”

Weight management, Medications, and Activity modification

Question 6

Passive range of motion

Answer 6

Therapist assisted movement of a joint through range of motion.
Improved ROM, decreased pain, and joint lubrication

Question 7

Active range of motion

Answer 7

Movement of a joint through ROM performed by the patient.

Improved ROM, decreased pain, and joint lubrication (+/- strength)

Question 8

Rehabilitation

Answer 8

Dogs with nerve stimulation had more weight loss and improved lameness scores.

Question 9

NSAIDS

Answer 9

Target the arachidonic acid cascade by blocking COX.
Good: Block prostaglandin production and leukotriene. Rapid onset. Central effects present but not understood
Bad: washout 1 week to change NSAIDS. Extra caution when giving to cats. COX 2 inhibitors- renal, gastric, and bone side effect. Hepatic necrosis.

Question 10

Other analgesia

Answer 10

Most effective as NSAID adjunct
Amantidine: NMDA antagonist
Gabapentin: GABA analogue
Tramadol: partial opioid and NMDA antagonism.

Question 11

Polysulfated glycosaminoglycans

Answer 11

Injected IM
Decrease collagen degradation and increase collagen, proteoglycan, hyaluronic acid synthesis
Heparin analogue- don’t give before surgery

Question 12

Nutraceutical

Answer 12

Purified or extracted substance that is admin orally to provide agents required for normal body structure, with the intent of improving health and well being.
No FDA regulation and most don’t meet label claims.
Fish oil, chondriotins, omega 3, glucosamine

Question 13

Fish Oil

Answer 13

Anti-inflammatory. Replace omega 6 with omega 3. Decreases PG and leukotrienes

Question 14

Glucosamine/Chondriotin

Answer 14

Promote cartilage repair. Provides building blocks. Anti-inflammatory. Cosequin and dasuquin.

Question 15

excision arthroplasty

Answer 15

Removal of bone to prevent joint contact.
Goal: resolution of pain.
Femoral head and neck excision- must incorporate rehab.
Shoulder
TMJ