In this episode, Dr. Kristin Kirkby Shaw and Dr. Hannah Capon discuss cranial cruciate ligament (CCL) disease in dogs, a common and significant issue affecting many breeds. Kristin shares her recent experiences returning to clinical practice and emphasizes the importance of early detection and intervention in managing CCL injuries. They explore the terminology, diagnosis, and treatment options for CCL disease, with a particular focus on its connection to arthritis. The conversation also touches on the challenges of managing arthritis in dogs and the need for a deeper understanding among pet owners and veterinarians alike.

Key Takeaways:

1. CCL Disease and Its Prevalence:

• CCL disease is a common condition in dogs, particularly affecting breeds like Labradors, Rottweilers, and Golden Retrievers. Unlike humans, where ACL injuries are often traumatic, CCL issues in dogs typically develop gradually due to ligament degeneration.

2. Terminology Clarification:

• Understanding the various terms related to CCL disease is important for dog owners. The CCL in dogs is analogous to the ACL in humans, and the “stifle” refers to the dog’s knee joint. Familiarity with these terms helps in better communication with veterinarians.

3. Link Between CCL Disease and Arthritis:

• CCL Disease often begins with synovitis, or inflammation in the joint that starts to weaken the CCL and is essentially early arthritis. As the CCL weakens and instability develops in the stifle, arthritis progresses. Surgery to stabilize the stifle helps reduce arthritis, but long term even dogs that have surgery should be monitored for OA pain.

4. Diagnosis and Early Indicators:

• Early signs of CCL disease in dogs include subtle changes in gait, occasional lameness that is worse after exercise but improves with rest, sitting off to the side on their hip rather than symmetrically, and difficulty rising or jumping. CCL disease is often mistaken for hip arthritis or “general arthritis.” It is important that CCL disease is diagnosed because the treatment recommendations for CCL disease are different than arthritis in other joints.

5. Treatment Options and Challenges:

• Surgical interventions that stabilize the stifle joint, such as the TPLO (Tibial Plateau Leveling Osteotomy), are considered the first line treatment recommendation for CCL disease. TPLO is very effective at returning dogs to an active lifestyle, but it is very important to discuss the pros and cons of surgery with your surgeon. Managing post-operative care and long-term arthritis requires a comprehensive approach that considers the dog’s overall health, lifestyle, and the owner’s resources. If surgery is not pursued, arthritis will be need to be more aggressively managed.

6. Monitoring Sitting Posture:

• Teaching dogs to sit symmetrically from a young age can help in detecting changes in posture that may indicate underlying issues. If a dog starts sitting unevenly, it may be a sign of discomfort or joint problems that need veterinary attention.

7. Incorporating Rehab and Proprioception:

• Integrating rehabilitation or prehabilitation into surgical care plans is helpful. Proprioception exercises, which improve balance and body awareness, are simple yet effective for recovery and preventing further injuries. These exercises can be easily incorporated into daily routines despite their complex-sounding name.

Further links:

https://www.vetmed.wisc.edu/lab/corl/canine-genetic-testing/

https://caninearthritis.org/article/ccl-surgical-and-non-surgical-options-overview/

https://caninearthritis.org/article/ccl-non-surgical/

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Dr James Hunt returns to chat about non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs often get bad press so we asked James to come and clarify some of the facts from the misinformation. He and Hannah explain what NSAIDs are and how they work, adverse events and how to report them and ways to use these drugs as safely as possible. James has worked within research and speciality practice and offers a speciality mobile service in the south-west of the UK. (Published February, 2022 You can find the full video in YouTube https://www.youtube.com/live/GCutKdZl0nw)

More details can be found at http://petpainrelief.co.uk

Dr. James Hunt

is a renowned veterinary surgeon specializing in the management of painful conditions in dogs and cats. With over 25 years of experience, his primary focus has been on pain management. He holds multiple advanced qualifications, including a PhD in pain management, and has published extensively on the subject. Dr. Hunt also founded Pet Pain Relief, a clinical pain referral service in the UK.

Key takehomes

1. Efficacy and Safety of NSAIDs: NSAIDs are highly effective for managing osteoarthritis in dogs, with extensive evidence supporting their use. While they are associated with potential side effects, particularly gastrointestinal (GI) issues, these can be managed through proper dosing, careful monitoring, and selecting the right patient.

2. Importance of Proper Use: NSAIDs should be used at the correct dose and frequency. Owners should be aware of early signs of adverse effects, like decreased appetite, which could indicate GI issues. Consistent, long-term use often leads to better pain management, as intermittent or incorrect dosing reduces their effectiveness.

3. Individual Response Variability: Not all dogs respond to the same NSAID, and it may be necessary to try different NSAIDs to find the most effective one for a particular dog. If no improvement is seen after a few weeks of consistent use, the diagnosis should be re-evaluated.

4. Multimodal Pain Management: NSAIDs are most effective when used as part of a comprehensive pain management plan, which includes weight management, home modifications, and other therapies. This approach can reduce the reliance on NSAIDs over time.

5. Communication with Caregivers: Veterinarians should set clear expectations with pet owners about the outcomes of NSAID therapy. Improvement might not always be in mobility but could be seen in the dog’s mood or engagement. Regular follow-ups are crucial to assess the effectiveness and adjust the treatment plan accordingly.

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Stay tuned to learn how early detection can make a significant difference in managing OA in younger dogs.

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In this special episode, Dr. Hannah Capon, Ernie Ward, and Alex German delve into the critical issue of weight management and obesity in dogs, offering perspectives from both America and England. (May 2021 FULL VIDEO: You can find the full video in CAM MemberZone.

https://caninearthritis.co.uk/member-zone)

There is an obesity epidemic raging through our cat and dog population! The figures are terrifying – with 50-60% of owned cats and dogs being clinically overweight if not obese. CAM was lucky enough to have Dr. Ernie Ward and Prof. Alex German join Hannah Capon to share their immense knowledge and enthusiasm for managing weight in our pets. The health concerns from excess weight include OA, diabetes, cardiovascular disease, and cancer. A big takeaway is that 97% of the causes are human-led, meaning we have a huge opportunity to change. It isn’t just about excess feeding; many factors lead to unhealthy weight gain, but excess weight in youth often persists for life.

Prof. Alex German:

Alex German is the Royal Canin Professor of Small Animal Medicine at the University of Liverpool, a Diplomat of the European College of Veterinary Internal Medicine, and a Senior Fellow of the Higher Education Academy. He has led the Royal Canin Weight Management Clinic for 15 years, focusing on improving the quality of life for overweight pets through clinical excellence, research, and education.

Dr. Ernie Ward:

Dr. Ernie Ward, known as ‘America’s Pet Advocate,’ has dedicated his career to improving animal care. He focuses on obesity, nutrition, behavioral issues, and innovative care for aging pets, always emphasizing the pet’s best interest.

Key Insights:

1. Impact of Weight Loss: A mere 6-9% reduction in a dog's body weight can significantly enhance their quality of life and mood.

2. Osteoarthritis Treatment: Weight loss stands as the most effective treatment for osteoarthritis, supported by substantial scientific evidence.

3. Proactive Weight Management: Monitoring a dog's weight should begin from puppyhood, with regular weigh-ins and recording to promptly address any fluctuations.

4. Sensitive Communication: When discussing weight with dog owners, professionals may want to use phrases such as body shape when discussing weight with dog owners.

5. Health Risks: An obese dog faces severe future health risks, essentially becoming a ticking time bomb.

Relevant links:

Join Holly‘s Army and get support for your weight loss journey: https://www.facebook.com/share/g/8AcWZohTyJh9ykgD/?mibextid=K35XfP

Visit the Association for Pet Obesity Prevention for more resources and information on managing pet obesity. https://www.petobesityprevention.org

Check out the Labrador Lifetime Study for detailed research findings on the impact of weight management on osteoarthritis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830602/

Weight Loss Tips: Subscribe to our 6-day email series here: https://landing.mailerlite.com/webforms/landing/f3m8k3

Enjoy this insightful episode and take a proactive step in managing your pet’s weight for a healthier and happier life.

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Learn more about CARE:

Website: https://caninearthritis.org

Have questions send them to: info@caninearthritis.co.uk

Stay tuned to learn how early detection can make a significant difference in managing OA in younger dogs.