Osteoarthritis (OA)
Need For Early Diagnosis Video Transcript
B. Duncan X. Lascelles
BSc, BVSc, PhD, FRCVS, CertVA, DSAS(ST), DECVS, DACVS
“The reality at the moment is that despite the fact that osteoarthritis is a young dog disease, we are diagnosing it much
later on in life. In fact, I believe over half of all osteoarthritis cases are diagnosed in dogs between the ages of 8 and
about 12 to 13.
So we’re diagnosing it far too late. The destruction of the joint, the destruction of the organ of the joint has already
occurred. The pain as a disease has already set in.”
Denis J. Marcellin-Little
DEDV, DACVS, DECVS, DACVSMR
“There is tremendous benefit in diagnosing osteoarthritis earlier. Like most medical problems, we do a much better job
treating them when we become aware of them before end-stage, before they become very severe.
Diagnosing the problem early will let us implement a lot of different strategies that are going to modulate the problem
over a long period of time. We’ll be able to treat the problem in simpler ways, in less aggressive ways, in safer ways, in
smarter ways. We’ll have the opportunity to educate the owner or so over time.”
Kristin Kirkby Shaw
DVM, MS, PhD, CCRT, DACVS, DACVSMR
“If you as a veterinarian can identify dogs at risk of developing osteoarthritis, you get the opportunity to change this
dog’s entire life.
You can have powerful conversations with this client and really change the whole course of this dog’s life, keeping
them active for a very, very long period of time.”
Julia Tomlinson
BVSc, MS, PhD, DACVS, CCRP, CVSMT, DACVSMR
“Early diagnosis is really going to help the management to try and keep the patient as active in life and as comfortably active in life as long as possible, which is also going to feed into helping reduce obesity and happiness of the client-dog companionship.”
Bryan T. Torres
DVM, PhD, DACVS-SA, DACVSMR
“One of the huge benefits about being able to identify something like osteoarthritis early is we really improve our chances of maintaining quality of life, maintaining joint function, maintaining the patient, the animal, the dog’s ability to do the things that they love to do for as long as possible. And that really is something that we should all strive to do.”
Whit Cothern
DVM
“We all know that if we can diagnose and begin management of that disease process at a younger age, that it’s a much more successful outcome for all parties involved: the pet, the pet owner, and the veterinarian.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
NP-AC-US-0033 11/2020
Osteoarthritis (OA)
Multimodal Approach Video Transcript
David L. Dycus DVM, MS, CCRP, DACVS-SA
“There are many other avenues of things we can use from a management tool, whether it’s intraarticular injections,
whether it’s the usage of Adequan® Canine, whether it’s the usage of formal physical rehabilitation...
“...or other things, using them together, with the whole goal being to preserve the life of the joint by keeping the dog as
absolutely comfortable as possible, to maintain a great quality of life, and to maintain that strength of the human-animal
bond.”
Kristin Kirkby Shaw
DVM, MS, PhD, CCRT, DACVS, DACVSMR
“I think there’s a misconception among dog owners and veterinarians that dogs with osteoarthritis shouldn’t be active,
that anytime they bend their joints it’s uncomfortable for them. And really, it’s quite the opposite.
“We need to keep those joints moving, whether it is through manual therapy with a physical therapist or a rehab vet or
it’s just having the dog do a series of exercises at home, sit to stand, shake and high five, some really basic things that can
help keep the muscles strong and those joints limber and ultimately change how that dog functions in their life.”
Bryan T. Torres
DVM, PhD, DACVS-SA, DACVSMR
“So when I think about how I manage osteoarthritis in my patients, there are many things that I use...
“...we see these patients later in life, they’re having trouble, they’re having a lameness. They’re sore.
They’re not able to do the things that they want to do, and we end up treating them with these medications or these
nutraceuticals, these nonsteroidals, surgery, other things like that. Something like Adequan® Canine can be very
beneficial in these patients as well. It also can be highly beneficial early on in the disease process.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
PP-AC-US-0309 11/2020
Osteoarthritis (OA)
Not Just An Old Dog Disease Video Transcript
Mark E. Epstein
DVM, DABVP (C/F), CVPP
“If a dog has hip dysplasia, they were born with hip dysplasia. So even as puppies, that pathophysiology is beginning.
Even if they’re not symptomatic, they have the OA and we need to kind of fill that, find those patients.
We need to fill that void in there and then catch it also when it’s just beginning to be symptomatic, when we can educate
pet owners when to recognize those earliest parts.”
B. Duncan X. Lascelles
BSc, BVSc, PhD, FRCVS, CertVA, DSAS(ST), DECVS, DACVS
“So, these young puppies have developmental disease that is driving, initiating osteoarthritis.
“... I think it’s incumbent upon us to try and make the diagnosis of that disease earlier. If we can do that, I think we can
improve the future for those dogs.”
Kristin Kirkby Shaw
DVM, MS, PhD, CCRT, DACVS, DACVSMR
“I think that osteoarthritis is truly a disease that starts in young dogs.
“It’s almost always more often identified in older dogs, but the young dogs that have a risk factor for developing
osteoarthritis are truly the ones that we should be identifying but are most commonly the ones that are being missed.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
NP-NA-US-0342 11/2020
Osteoarthritis (OA)
Treating Early With Adequan® Canine (polysulfated glycosaminoglycan) Video Transcript
Denis J. Marcellin-Little
DEDV, DACVS, DECVS, DACVSMR
“We can positively impact osteoarthritis at its early stages by protecting cartilage. For example, with Adequan® Canine,
we know that cartilage breakdown can be decreased, the cartilage can be protected early in the course of the disease.
“This has a profound positive impact on dogs because we catch the disease at its early stages. We will have healthier
joints for a lifetime.”
Kristin Kirkby Shaw
DVM, MS, PhD, CCRT, DACVS, DACVSMR
“There are certain activities that are better and certain ones that are worse. And then there are some products and some treatments that we can start using earlier on in the osteoarthritis disease process
that can really potentially change the whole course of the disease, and they’re going to be most effective early on.
“And most specifically I’m talking about Adequan® Canine.”
Julia Tomlinson
BVSc, MS, PhD, DACVS, CCRP, CVSMT, DACVSMR
“In my practice Adequan® Canine is one of my initial go-to medications for early osteoarthritis. I really feel that we can
intervene to try and help the joint health a little bit more than we can with some of the other things available to me.
“And I like to be able to minimize the use of nonsteroidals when we’re early in the disease so that we can use it as maybe a rescue medication and use Adequan® Canine more.”
Bryan T. Torres
DVM, PhD, DACVS-SA, DACVSMR
“When it comes to something like osteoarthritis, treating it early is the way to go. This is with any disease process, right?
“And so something like Adequan® Canine that we can use early on when we first diagnose osteoarthritis in a patient,
and we can do that, then make an impact for a long period of time with them can be highly beneficial.”
Whit Cothern
DVM
“We want to have that early discussion about the use of Adequan® Canine, have that out there as one of the therapeutic options, a very important therapeutic option, early in our osteoarthritis management protocols.”
Anne Dagner
DVM
“The first thing I tell clients about Adequan® Canine and why it could be right for their dog is that we really want to slow
the progression of osteoarthritis. And that’s what the main goal is when we’re using this drug.
“The next thing I talk to them about is that it’s been around, it’s been approved by the FDA so that we know it’s a safe and
effective product. So we feel confident when we’re using it in their dog.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
PP-AC-US-0310 11/2020
Osteoarthritis (OA)
Benefits of Adequan® Canine (polysulfated glycosaminglycan) Video Transcript
Mark E. Epstein
DVM, DABVP (C/F), CVPP
“Adequan® Canine has a couple of a really important advantages over any other type of product or therapeutic that you
might be thinking about for joints...
“...and chief among them are that it has data behind it. It has good data behind it in terms of being able to kind of keep
the cartilage from degrading any faster than it otherwise should. And further, it’s FDA approved.”
Denis J. Marcellin-Little
DEDV, DACVS, DECVS, DACVSMR
“Adequan® Canine is remarkable because of its ability to protect the cartilage of dogs that are developing osteoarthritis.
“It’s able to protect cartilage from degeneration, and we don’t have that type of information about other things that we
use in managing osteoarthritis in dogs.”
Kristin Kirkby Shaw
DVM, MS, PhD, CCRT, DACVS, DACVSMR
“In my practice, I talk about Adequan® Canine with almost every patient because I feel like it’s such an important
component of a comprehensive osteoarthritis plan.
“There’s really nothing else out there quite like it.”
Bryan T. Torres
DVM, PhD, DACVS-SA, DACVSMR
“When we think about osteoarthritis, we think about these two concepts of identifying and treating early and treating
the symptoms later on.
“The benefit of Adequan® Canine is that we can use it early on in the disease process and treat these animals and make a
lasting impact.”
Whit Cothern
DVM
“Adequan® Canine provides us a unique opportunity to better control the disease progression of OA with the pet owner.
The fact that this is injectable does help that process, but it also is a product that allows you to practice real medicine.
“You become, again, that trusted valuable resource to the pet owner, and they want to come to you to discuss OA and
OA progression in their pet.”
Anne Dagner
DVM
“When I have a dog that needs Adequan® Canine, and I’m trying to talk to the client about why this drug is the right thing
for their dog, we start by talking about how the drug works.
“We talk about delaying the progression of osteoarthritis. We talk about the proven track record. We talk about Adequan®
Canine being an FDA-approved product, so we have confidence in it using it in their patient.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
PP-AC-US-0311 11/2020
Osteoarthritis (OA)
Need To Treat Early Video Transcript
Mark E. Epstein
DVM, DABVP (C/F), CVPP
“...we only have a certain amount of capital of time and attention from the owner. So it does make it a significant
challenge.
“My guidance would be that with any inclination of a COAST one or a two dog, that if you can make sure that the subject
is brought forward, it is introduced to the client at that point, then you will have gone a step further than probably you
otherwise would have. If we can move the profession that far, that’s an important step to take.”
Denis J. Marcellin-Little
DEDV, DACVS, DECVS, DACVSMR
“It is in the patients, the owners, and our best interests to manage osteoarthritis from its early stages, not from its late
stages.”
Julia Tomlinson
BVSc, MS, PhD, DACVS, CCRP, CVSMT, DACVSMR
“If we start treating very late in the disease, then we’re really just trying to play catch up. We’ve already lost some
motion in the joint so you have some stiffness that’s going to factor in and feed into pain and inactivity, which again is
going to feed into other problems in practice such as obesity.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
NP-NA-US-0344 11/2020
Osteoarthritis (OA)
Getting Pet Owner Involved Video Transcript
Denis J. Marcellin-Little
DEDV, DACVS, DECVS, DACVSMR
“We’ve got to be very sensitive to what the owner sees at home. Even if the owner is not that concerned about what they
see, we’ve got to probe them. We’ve got to ask them what’s going on at home, and we’ve got to never dismiss as a
clinician some red flags that the owner will bring up.
“An unusual limb position, an unusual way to sleep, an unusual posture or gait most often is going to be the
consequence of a painful joint that may not be diagnosed yet.”
David L. Dycus
DVM, MS, CCRP, DACVS-SA
“We want to let them know on the front end this is the expectations and these are the things that we can do to hopefully
prevent in some situations,
“...or at least dramatically slow down the progression, so that they may never have clinical signs that we need to manage
pharmaceutically or from other options.”
Kristin Kirkby Shaw
DVM, MS, PhD, CCRT, DACVS, DACVSMR
“While osteoarthritis is a potentially debilitating disease, it doesn’t always have to be, and it doesn’t have to be a scary
word. We need to frame it in a positive sense and a hopeful sense and give clients the tools to help their own dog.
“And ultimately we, as veterinarians, are the advocate for the dog. And by not having these tough conversations with the
client, we’re not doing our job.”
Whit Cothern
DVM
“Having these conversations about osteoarthritis, especially in these higher risk breeds, with the pet owner is vitally
important.
“We want to loop them in on the therapies that are available. We want to have the discussions about nutrition and
weight management and breed predilections.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
NP-NA-US-0343 11/2020
Osteoarthritis (OA)
Being Proactive Video Transcript
Denis J. Marcellin-Little
DEDV, DACVS, DECVS, DACVSMR
“The incentive to diagnose osteoarthritis earlier is the same as any other disease. I don’t think you would want to wait to
diagnose renal disease until you’re in renal failure or diagnose cardiac disease until you are in heart failure...
“We need to catch osteoarthritis much earlier before the limb fails or the dog fails, and that is going to be [a] cheaper and
more effective way to manage it.
“We need to become much more proactive, more sensitive to the pain perceived by dogs who have osteoarthritis, and
detect it earlier and manage it more comprehensively.”
David L. Dycus
DVM, MS, CCRP, DACVS-SA
“The problem is...that while in the short period of time we can improve the comfort, the issue is that the joint itself has
already become damaged.
“And so, we have to take that opportunity to start discussing with owners about what the long-term aspect is going to be
like in saying that we fixed the issue now, but the end result is going to be the potential for arthritic changes to develop.
“We want to start them at the very beginning course of the stage when we have maybe a little bit of under functioning of
not only the chondrocytes but the synovial sites and we still have a lot of the cartilage left intact that we can work with.
“...as we’re starting to move into that process of slowing down and minimizing progression of arthritic changes, that’s a
very good avenue of timing of when we want to introduce Adequan® Canine rather than waiting until the patient comes
back with severe radiographic signs, severe periarticular fibrosis and a loss of range of motion.”
Julia Tomlinson
BVSc, MS, PhD, DACVS, CCRP,CVSMT, DACVSMR
“I use Adequan® Canine in practice early on [with OA disease] to try and alleviate joint inflammation and to help to
intervene without using a daily oral nonsteroidal or other pharmaceutical. So trying to get ahead of things again to
minimize the things that the owner has to use with the patient.
“I am seeing patients and examining them for subtle signs of joint pain very early on and communicating to the client the
importance of intervention with arthritis.”
Whit Cothern
DVM
“We are establishing and implementing protocols that will provide us the ability to recognize these dogs earlier in the
osteoarthritis process, begin that dialogue with those pet owners, and let them know it’s okay that we found this. They
shouldn’t be scared. If anything, it’s good that we found it early.
“We established protocols in which Adequan® [Canine] is used more proactively in the management of osteoarthritis,
especially in our younger patients, and we’re trying to do this proactively...”
Anne Dagner
DVM
“When we’re starting a dog on Adequan® Canine, we have to talk to the owners about the fact that it’s going to be several
injections in a row as part of the protocol. So to make that easier for them we do a few things.
“We have our owner purchase the whole box at one time to start so that there’s a dedicated box of the medication for their
dog. Then the next thing we do is schedule all of our injections all at one time. We don’t wait and say call to make the next
appointment. We go ahead and get those on the books for all eight injections.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
PP-AC-US-0321 02/2021
Osteoarthritis (OA)
ReThink OA Video Transcript
Mark E. Epstein
DVM, DABVP (C/F), CVPP
“It has become very clear that we need to radically, we collectively as veterinarians need to radically accept that there needs
to be a different way of thinking about osteoarthritis, rethinking how we recognize it, assess it and manage it.
“One of the things that we need to do collectively and in the industry individually as clinicians is to expand our minds.
That expansion is predominantly in the domain of recognizing these are long-lasting diseases, but really essentially for a lifetime, right?”
David L. Dycus
DVM, MS, CCRP, DACVS-SA
“So I think our original approach to arthritic management was to wait on the dog to get older or slow down for us to start really focusing that attention.
“However, we need to start shifting our thought process to thinking more of those conditions that may allow the development of arthritic changes to develop...
“...it allows us to open up the avenue to start with owner education and counseling them on ways that we can go about trying to minimize the progression of arthritic changes,
and how things are going to look throughout that dog’s life and what strategies we’re going to take at various time points to try to improve quality of life and minimize pain
[associated with osteoarthritis] so that they can have the best human animal bond as possible.”
Bryan T. Torres
DVM, PhD, DACVS-SA, DACVSMR
“So historically we have treated osteoarthritis patients when they come in to us. And they already have clinical signs, they’re already lame, they’re already having issues.
“...what we need to do is we need to change the way that we think, change the way that we identify those patients. We need to identify them early. We need to identify them as early as possible so that we can start some therapies then.
“With the expectation that if we can identify and start treating these patients early, we can extend the lifespan of those joints. We can make them more comfortable for a longer period of time and improve their overall quality of life.”
Anne Dagner
DVM
“As we’ve been rethinking osteoarthritis in our practice, one focus has been to move a conversation about weight and weight management, diet and feeding earlier in the dog’s life.
“So that a dog can stay at a healthy weight and a good body condition and never get to that obese stage that really has an effect on arthritis and all the joints.
“Also, talking about addressing osteoarthritis earlier.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
NP-NA-US-0347 02/2021
Osteoarthritis (OA)
Drawbacks of Delaying Treatment Video Transcript
Mark E. Epstein
DVM, DABVP (C/F), CVPP
“The impact of OA, we traditionally think of that as an issue of mobility and abilities. However, and this is again part of
expanding our minds, the impact on that patient is grave in many other ways...
“It’s a long-standing progressive impact on the patient, not just in the joint but in the entire musculoskeletal system as
the body shifts around and shifts weight forward and off certain joints, and on the brain.
“I think that pharma companies as they’ve introduced therapeutics over the years, have done a pretty good job of telling
us what OA is and the pathophysiology, but not really a great job of making sure that we are seeing that in these younger
patients before they’re symptomatic, right?”
Bryan T. Torres
DVM, PhD, DACVS-SA, DACVSMR
“...there needs to be some degree of a paradigm shift where instead of always playing catch up and kind of dealing with it
after it’s already pretty severe, what we want to do is try to reshape the way that we deal with osteoarthritis and maybe
try to identify when we have a patient with a problem like osteoarthritis, when they have it early, trying to get it as early
as possible.
“Address it as early as possible so that we’re not on the back end always playing catch up with these dogs that have these
severe issues.
“But that’s going to take some change from us as veterinarians, and a lot of hard work to try to alter the way that we
practice, alter the way that we look at our patients, alter the questions that we ask in our daily exams.”
Whit Cothern
DVM
“Quite frankly, in our practice, we recognize that osteoarthritis is seeing us, but we’re not seeing osteoarthritis. We’re
likely not spending the time that we need to uncover these younger animals, these younger dogs, as they’re in those
early stages of osteoarthritis.
“We have to let these pet owners know that it’s okay if their dog or young dog is diagnosed with osteoarthritis. In fact, if
we are destined to be diagnosed with osteoarthritis, it’s much better for all parties involved that we find it sooner rather
than later.”
The participants are paid consultants for American Regent Animal Health. The opinions of these consultants may not be representative of American Regent Animal Health.
© 2021, American Regent, Inc.
NP-NA-US-0348 02/2021