Patrick Harte, BVSc MRCVS CertSAO
Patrick has been a veterinary surgeon for many years, but he has always had a special interest in orthopaedic diseases in small animals, and has owned dogs all his life. During his peak years in the 1990’s, he studied for the Certificate in Small Animal Orthopaedics, whilst working in a first opinion and referral practice. He was successful in getting the qualification, and at this time was carrying out a variety of successful orthopaedic surgical procedures on dogs and cats.
About twenty years ago, he moved to a smaller, mainly companion animal practice and became a business partner. His orthopaedic interests then shifted somewhat away from surgery towards the conservative management of the common musculoskeletal conditions affecting dogs and cats, of which osteoarthritis is by far the commonest. His interest in physiotherapy as part of the multimodal management of canine arthritis has been stimulated because his wife is a qualified canine myotherapist and physiotherapist.
Patrick recently came across CAM at a meeting at Langford, and immediately recognised how the group’s aims could bring novel benefits to the thousands of dogs suffering the chronic pain and shortened life spans associated with osteoarthritis.
Patrick kindly agreed to answer the following questions:
What are your feelings on how we currently manage this common debilitating condition in dogs?
I believe that the veterinary profession in general ought to hold up its hand and admit that the current management of canine OA is poor. Speaking from my own experience in general practice, I have found that my veterinary colleagues have a limited arsenal of weapons against OA, based mainly on the usual suspects, NSAID and nutraceuticals. In my case, these colleagues are all female and of varying years post-graduation, so do not all conform to the stereotype of older, male vets.
There is, however, a glimmer of light in the profession as a whole, with the increasing embrace of complementary therapies (as distinct from alternative), and a tentative foray into regenerative medicine. My greatest concern from personal observations is the sub-optimal use of analgesia, based on misconceptions, on the part of both clients and veterinary surgeons, about the risks of side effects of both licensed and non-licensed medications. I regularly come across examples of under-dosing with analgesics. The bottom line is that OA is a PAINFUL condition, and, unless this aspect is treated adequately, dealing with the secondary issues of mobility, muscle atrophy and joint stiffness, for example, is likely to be much more difficult.
As a veterinarian what do you feel is essential for managing canine arthritis effectively?
I feel that it is essential to treat OA using a multifactorial approach, with traditional medications, ‘broad spectrum’ analgesia, complementary therapies, weight control, optimisation of the patient’s environment, and, potentially regenerative medicine. Surgery, has a small, but important place, where appropriate. Of course, not everything will be suitable for every patient. Because the management is likely to involve several modalities, I feel it is vital that very good collaboration and communication between the client and the therapist is a high priority.
How do you see treatment options for arthritis progressing over the next ten years?
Over the next ten years, I expect that there will be an increase in the use of regenerative medicine, based on properly validated evidence, and increasing reliance on complementary therapies, such as physiotherapy, hydrotherapy and massage. There will undoubtedly be novel therapies emerging, but whether these prove to be of value, only time will tell.
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?
My one piece of advice to a person whose dog suffers from arthritis would be to ensure that the patient’s pain relief is optimised. This, of course, goes back to my previous assertion that the condition is a painful one, and chronic, unremitting pain is a terrible burden to endure, for any living creature, which may impact significantly on many other aspects of the patient’s and owner’s lives. Again, good communication and understanding between professionals and clients is imperative, in order to ensure compliance when managing pain.
Patrick Harte
The Sidings Veterinary Surgery
Cirencester
Gloucestershire
GL7 1QW