Elizabeth Ayrton is a veterinary surgeon who works in a referral behavioural medicine practice in Chester.
Elizabeth graduated in 1985 and worked at the University of Bristol for a year in equine and canine medicine before working in mixed practices in Bath, Cumbria and Wiltshire and then small animal practices in Wiltshire and Cumbria. She then studied for an MSc in Clinical Animal Behaviour at the University of Lincoln and works for Behavioural Referrals Veterinary Practice in Chester , which is owned and run by veterinary behavioural medicine specialist, Sarah Heath. Elizabeth has a great passion for the Bearded Collie inspired by both their character and lovely movement and currently works as Breed Health Co-ordinator trying to do as much as possible to promote health in the breed by liaising with breeders and the Kennel Club.
Elizabeth kindly agreed to answer the following questions:
What are your feelings on how we currently manage this common debilitating condition in dogs?
I still feel that there is an expectancy from some owners and some vets that as dogs age they will get stiff. The approach seems to be to consider this as normal and, as long as they appear to function, to regard it as not being significant enough to warrant treatment. It is only when that stiffness creates problems, often for the humans, that it is addressed. Of the behavioural medicine cases that we see a huge proportion of them have issues with pain which impacts on the dog and owners’ quality of life. In addition, it can lead to decreased welfare for the dog and, if the behavioural problems are severe, can lead to loss of life. Dogs cannot verbally tell us they are in pain but they certainly do tell us. The only way they can express their pain is through body language and behavioural responses and it is our duty to listen to them and note these changes. Dogs can also be very stoical and get on with life despite pain and this is especially relevant in highly motivated breeds. Often the only indications are small changes in behaviour or sometimes in gait and we need to be proactive in getting the owners to look for these. As an example, when I was working in general practice I saw a dog with a dislocated hip as a result of severe bilateral hip dysplasia. That dog was so motivated that it ran the Lake District fells with its owner on a daily basis and it was only when it banged its leg and dislocated it that the owner was aware of any problem.
As a veterinarian, what do you feel is essential for managing canine arthritis effectively?
I feel we need to look at the dog not just in the consulting room but also outside when it is moving and preferably when it is at home and engaging in activities such as going up and down stairs or getting into and out of a car. It is also essential to listen to what both the dog and owner are telling us. Often the gathering of all relevant information can take time so after the initial consultation with the veterinary surgeon practices can use the skills of our nurses in clinics to manage these patients on an ongoing basis. They can get the client to fill in pain scores and can monitor and manage weight. They can also ask relevant questions about the behaviour of the dog and how it changes over time, which can be very important in terms of monitoring response to analgesia. It is important to remember to consider the potential for arthritic change in all our patients but especially the old ones. Considering the issue of arthritis holistically rather than concentrating on one element can help to improve our detection of contributing factors such as floor surfaces within the home, exercise regimes and emotional health of the patient. We can then inform the client about the improved resources available to them to manage pain and quality of life and point them in the direction of appropriate and helpful literature, such as that produced by Canine Arthritis Management.
How do you see treatment options for arthritis progressing over the next ten years?
There has been a significant increase in the availability of veterinary physiotherapy and pain clinics in recent years and this enables better access to these resources for more clients. There are also improved resources on the internet for clients to educate themselves on how best to help their dog. As vets I think we need to be looking at multimodal pain relief much more in order to get the best possible outcome for our patients.
If you could have the opportunity to give one tip/ piece of advice to an owner with a dog suffering from arthritis what would it be?
If an older dog’s behaviour changes ask yourself whether there could be a medical reason for it. A large number of behavioural problems in older dogs are caused by clinical disease either as a sole or a contributory factor. Your dog cannot use verbal language like a person and therefore tries to express how he feels through the use of body language and behaviour… it is important for humans to listen!