Introducing a logical, comprehensive staging tool for canine osteoarthritis

2019-10-31 Elanco - Dr Lascelles examining young dog, image for AAHA COAST article - blog.jpg

There is a need for a logical, comprehensive staging tool for canine osteoarthritis (OA). Canine OA is the most common cause of chronic pain in dogs. However, the lack of a standardized system for staging OA has contributed to delayed diagnosis and inconsistent approaches to patient evaluation and monitoring. These delays and inconsistent approaches to patient evaluation lead to sub-optimal management of canine OA.

The Canine OsteoArthritis Staging Tool (COAST) directly addresses this gap in our approach to evaluating canine OA. Importantly, it does not just focus on dogs with obvious, more advanced clinical signs of OA. OA is primarily driven by developmental orthopedic disease in dogs, and therefore clinical signs are initiated in young dogs. Although there is no cure for OA, timely diagnosis provides opportunities to implement a patient care plan to control pain, encourage appropriate levels of activity, and maintain musculoskeletal health. The COAST system is the critical first step in improving the future lives of these beloved pets.

 The Canine OsteoArthritis Staging Tool (COAST)

Developed by a consortium of nine clinical experts in orthopedics, anesthesia and pain management, COAST is an easy-to-use, proposed staging system for canine osteoarthritis (OA).

The COAST is recommended be used to stage all dogs, including those that are preclinical but at-risk for OA as well as dogs with established signs of OA. Uniquely, the COAST system incorporates the owner’s overall assessment, a veterinarian’s overall assessment, and a detailed assessment of the joints. A grade of severity is assigned to all these components. Consolidation of the grades into a measure of overall disease severity enables classification of the patient into one of five COAST stages of OA (Stage 0 to 4, ranging from preclinical with no risk factors to severe OA).

image700gs.png

Once staged, the goal of treatment is to prevent clinical signs developing in the preclinical dogs, and reduce the stage in clinical dogs. Engaging the dog owner in the process is critical. Owners know their pets better than anyone, and owners should be an engaged team member in the prevention and/or management of clinical signs associated with OA. Initiating this engagement and owner education at an early stage is vital to improving the future for these dogs. For example, discussions around a dog designated as COAST Stage 1 provide an opportunity to discuss the mitigation of OA risk factors before the development of clinical disease. This gives veterinarians the opportunity to institute preventative measures and educate the dog owner about how to monitor for early signs of clinical OA.

Many dog owners may miss the early signs of OA, and detection can be difficult for veterinary teams in the early stages without a clear and logical approach to screening and early diagnosis.

COAST provides a platform for veterinary teams to standardize early identification and intervention for this important cause of chronic pain in dogs.  

Full details of COAST are available as an open access peer-reviewed article published in The Veterinary Journal

The items used to construct COAST were developed from the expert consensus of The COAST Development group, including members:

Drs. T. Cachon (France), O. Frykman (Sweden), J.F. Innes (UK), B.D.X. Lascelles (US), M.Okumura (Japan), P. Sousa (Iberia), F. Staffieri (Italy), P.V. Steagall (Canada), B. Van Ryssen (Belgium)

The COAST Development group encourages the use of COAST in veterinary clinics in order to gain feedback for the further validation and optimization of the tool. Please contact the corresponding author, Dr. Duncan Lascelles, [email protected] or the group email [email protected], to learn more.

The development of COAST has been made possible by the support of Elanco.