OA and Joint Health - Palmer

Question 1

____ is the #1 cause of chronic pain in dogs

Answer 1

OA

Question 2

What are some synonyms for OA?

Answer 2

OA, DJD, Osteoarthrosis, Arthritis

Question 3

In the normal healthy joint the cartilage is ___, yet elastic due to ECM properties. The outer _____ envelope retains water in network of ____ –> cartilage swelling pressure & tugidity. Pumping effect of weight-bearing –> exchange of wastes and nutrients with synovial fluid (metabolic balance)

Answer 3

firm

Collagen

GAGs

Question 4

What happens in the joint with OA?

Answer 4

The initiating event is abnormal stress. Weak cartilage fractures into the synovial fluid. The injured chondrocytes & synoviocyte secretes catabolic enzymes. The leads to destroyed proteoglycan complex. Inflammatory mediators lead to chemotaxis and vascular permeability –> WBCs & protein enter joint fluid –> Pain

Question 5

What are sx (invasive) options for joint repair?

Answer 5

Joint stabilization

Arthroscopy

Joint replacement

Question 6

Lots of pieces to the pie when it comes to restoring patient health… name these! (6)

Answer 6

1. Physical rehab
2. Active lifestyle
3. Nutraceuticals
4. Weight/diet management
5. NSAIDs
6. O education/participation

Question 7

What about cats? What is different in the pie chart compared to dogs?

Answer 7

Same pie chart, big difference is the nutraceuticals… we have to use these “off-label” (e.g. Adequan Canine). And obvi NSAIDs are different (Metaca, vs Rimadyl)

Question 8

Adequan

Answer 8

Polysufated Glycosaminoglycan (GAG)

• blocks synthesis and released of PGE2, lysosomal enzymes, and toxic O2 radicals
• stimulates chrondrocytes and synoviocytes to synthesize collagen, proteoglycans, and HA
• Inhibits catabolic enzymes
• binds to components of cartilage matrix to shield against further degradation

Question 9

Glucosamine Stimulates synthesis of:

Answer 9

ECM:

• glycosaminoglycans
• proteoglycan
• collagen

Its orally absorbed and concentrates in articular cartilage

Question 10

Chondroitin sulfate (CS)

Answer 10

• predominant GAG in articular cartilage
• purified from bovine, whale, shark cartilage
• IL1 production, blocks complement activation, inhibits metalloproteinases
• collagenolysis by chondrocytes

Question 11

Avocado-Soybean Unsaponifiables (ASU)

Answer 11

Dasuquin

Effect on chondrocytic pro-inflammatory gene expression

Question 12

NSAIDs (Rimadyl of Galliprant)

Answer 12

Restoration of comfort and life quality

Galliprant - EP4 receptor

Rimadyl - COX2

Question 13

What other options are there?

Answer 13

You can also try adjunctive analgesia, intra-articular medications, or in cases when these conventional therapies have failed… ortho-biologic and mechanical therapies (e.g. PRP, Stem Cells)