Treatment should first and foremost be aimed at treating the underlying cause. Underlying causes are quite variable depending on the breed, the joint involved, history of trauma, etc. Secondary treatments can be broken down into pain management and improving the joint’s overall health or cartilage protection.
The most common drugs used for pain management are non-steroidal anti-inflammatory drugs (NSAIDS). Human over the counter products (ibuprofen, aspirin, etc.) should not be given to dogs or cats. Numerous NSAIDS, such as carprofen or Rimadyl, are approved for canine use and can be obtained from your veterinarian.
Corticosteroids are rarely indicated for treatment of OA. These drugs are excellent anti-inflammatory drugs but may have undesirable side effects.
There are no cartilage protective/regenerative products that reverse cartilage damage. Hyaluronic acid improves joint lubrication and may even induce the joint capsule to produce endogenous lubricants. Hyaluronic acid is frequently used in humans with knee OA and is more commonly being used in veterinary patients. The most effective mode of administration is an intra-articular injection.
Plethoras of nutraceuticals (supplements not regulated by the FDA) are available. Glucosamine and chondroitin are the most well known. While some patient’s clinical signs seem to improve with these products, there is no evidence to support that cartilage damage is halted or reversed. Patients that improve probably experience an anti-inflammatory affect. Virtually none of these products result in cartilage regeneration-period.
Recently fat derived stem cells have been promoted for cartilage regeneration. No evidence exists to support this claim in clinical participants. However, a few patients do show clinical improvement thought to be an anti-inflammatory affect.
The point must be made that virtually all canine OA patients have an underlying anatomical cause. This abnormal anatomy causes the rubbing and wearing away of the associated cartilage. It stands to reason that no product will reverse this process if the abnormal anatomy is left untreated.
Arthroscopy is often used both to diagnose and treat OA. Again, the most important aspect of treatment is aimed at the underlying cause. However, arthroscopy can be used to debride damaged cartilage, remove bone fragments and create small holes in the underlying bone (micro-fracturing) to encourage influx of blood supply and promote healing.
Surgery for the treatment of OA revolves around treating the underlying problem. Examples include ACL repair, total hip replacements and limb alignment treatments for elbow dysplasia and patellar luxations.