As a Distribution Sales Representative (DSR), you can make a major difference to pets suffering from osteoarthritis (OA). Yes, you can help more dogs and cats — of all ages — get the treatment they need and deserve.
Now, you may be thinking, “Really? I’m not a practitioner or even part of a treatment team, so how can that be true?”
That’s what we’d like to explain here.
Recently we spoke with Joyce A. Login, DVM, Sr. Manager of Veterinary Specialty Operations - Pain and Specialty at Zoetis. We asked her to give us an update on “the state of osteoarthritis management” and what DSRs need to know so they can make sure all clinics are up-to-date.
We had no idea she was going to surprise us with three facts about diagnosing, treating and managing this common, debilitating condition.
Let’s look at what she had to say… along with your take-aways to bring up during hospital visits.
Surprising fact #1:
Many dogs and cats with osteoarthritis are not diagnosed soon enough or at all.
While osteoarthritis can happen in any animal, any breed, at any age, it’s not typically discussed with all pet owners during annual checkups or specific care visits. Why is that?
Dr. Login told us, “It’s hard to talk with clients about long-term, progressive conditions or diseases that won’t go away. So, we’re not actively discussing them. We generally focus on the more immediate needs.”
“Therefore, ideally, we should be asking every client about OA at every visit. We need to bring up questions that may reveal signs; find a way to raise the question regardless of why they’re there,” Dr. Login continued.
“In short, we need to get more foundational in discussing OA with all clients. There are so many excellent websites and other resources to help the staff and pet owners.”
When you’re visiting practices, encourage them to adopt a routine of asking about every pet.
Teams can easily add to the workup with simple questions, using checklists for dogs and cats. This routine may reveal issues the clients may not have noticed until prompted.
How great would it be to identify more cases and ease pain?
During your visits, ask the practice if they’re using any of these checklists within theirprotocols. If not, you’ll have a chance to be super helpful to the teams:
- AAHA “How to Tell If Your Dog is in Pain”
- AAHA “How to Tell If Your Cat is in Pain”
- Canine Brief Pain Inventory (CBPI)
- Rimadyl (carprofen) OA Checklist (available through your Zoetis rep; Rimadyl is for use in dogs only)
Surprising fact #2:
The current go-to osteoarthritis medication is not necessarily the best for each patient.
Tramadol has been considered a standard medication for treating osteoarthritis in pets. However, in a new study involving 40 dogs with clinical osteoarthritis of the elbow or stifle joint — Lack of effectiveness of tramadol hydrochloride for the treatment of pain and joint dysfunction in dogs with chronic osteoarthritis published in JAVMA— the industry was shaken up by the following finding: “10 days of treatment with tramadol as administered (5 mg/kg, PO, q 8 h) provided no clinical benefit for dogs with osteoarthritis of the elbow or stifle joint.”
Dr. Login said, “Practitioners were fairly shocked to see the results of this study. It indicated that tramadol isn’t metabolized effectively and therefore not helping to ease the clinical signs of osteoarthritis. In fact, the effect wasn’t different from the study’s placebo.”
This is major news that should be shared with your customers. For some patients, switching to another medication could be much more effective; even life-changing.
What other products can you offer? It’s worth exploring the options with every clinic you visit, so they’re aware and making informed choices.
Surprise fact #3:
The lowest effective dose of a pain medication may not be helping.
According to Dr. Login, “In our industry — when we recognize that a patient will need long-term treatment — we tend to go with the lowest effective dose because we believe it’s the safest approach. But truthfully, we’re finding the regular label dose to be as effective, without adverse effects; in fact, much more effective in many cases.”
She added, “It’s important to consider that all FDA-approved NSAIDs must pass the same safety standards. Don’t make a selection based on just the safety profile. Rimadyl® (carprofen) has been available for dogs since 1996, followed by other NSAIDs" (Previcox, Metacam, etc.) "and all are proven to be effective.”
Ask practices how they’re dosing long-term cases. If they’re going with the lowest effective dose, it may open the door to a discussion about adjusting protocols.
Dr. Login also had this recommendation for DSRs going into the practice and talking about patients with osteoarthritis:
“A multi-modal approach is the best. It’s not one single drug or either/or approach that will fix the problem. It comes down to the art of veterinary medicine. Osteoarthritis is certainly a challenge. When you think of a 10-year old Lab versus a 2-year old Corgi, the patients are entirely different in terms of causes, type of pain, etc. Discuss the variety of options, including nutraceuticals and joint protectants (supplements) plus pain management (generally NSAIDs) and exercise.”
For your reference, here are the most recent guidelines, tools and educational materials to review with your customers:
- 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats
- AAHA Pain Management Toolkit
- IVAPM.org: Pain management information for practices and pet owners
- WSAVA Global Pain Council Guidelines
Armed with this information, you can certainly play a key role in helping practices ease the pain of more pets with osteoarthritis.
IMPORTANT SAFETY INFORMATION: As a class, NSAIDS may be associated with gastrointestinal, kidney and liver side effects. These are usually mild, but may be serious. Pet owners should discontinue therapy and contact their veterinarian immediately if side effects occur. Evaluation for pre-existing conditions and regular monitoring are recommended for pets on any medication, including RIMADYL followed by other NSAIDs (Previcox, Metacam, etc.) and all are proven to be effective. Use with other NSAIDS or corticosteroids should be avoided. See full Prescribing Information, attached.