Forward thinking in mobility - Veterinary Practice
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InFocus

Forward thinking in mobility

NIGEL HAYWARD hears the views of renowned orthopaedic surgeon Professor Peter Muir who received this year’s Pet Mobility Award at the WSAVA congress

AT this year’s WSAVA congress,
Professor Peter Muir received the
WSAVA Hill’s Pet Mobility Award
which is given for outstanding work
by a clinical researcher in the field of
canine and feline orthopaedic
medicine and surgery.

Peter Muir, who gained both his
veterinary qualification and PhD from
the Bristol veterinary school, is currently
professor of small
animal orthopaedic
surgery in the School
of Veterinary Medicine
at the University of
Wisconsin-Madison.

He has authored
over 100 peer-reviewed
papers and is
particularly noted for
his work on canine
cruciate disease. While
attending the congress
to receive his award, Professor Muir
shared his thoughts on key issues
affecting pet mobility.

“I’m very excited to receive this
award and to be recognised for my work
on canine mobility,” he said. “I believe
that arthritis in dogs is not a well-
understood condition and that we need
a lot more research. We know that
arthritis is not a specific disease but
more of a pathological condition.

“There is a great potential, for
instance, to use multimodal treatment,
which represents a big step forward.
The use of diets and disease-modifying
agents really widens the choice of
treatments available to the clinician.

“In some cases there is a breed
propensity to joint disease and I think
it’s realistic to reduce onset of the
condition by using interventions, such as
feeding an EPA (eicosapentaenoic acid)
enriched diet when the dog is a young
adult.

“There has been a paradigm shift in
the thinking of the relationship between
rupture of the cranial cruciate ligament
and the development of arthritis. We are
increasingly recognising that we are
treating an immune-mediated disease
rather than injury-related disease. This
means that the choice of surgery over
medical treatment can be hugely
controversial.

“I am sure that many clinicians will be seeing dogs presenting in the
prodromal stage where the cruciates are
starting to tear but the joints are still
relatively stable. Sometimes the owner is
told to wait until the ligaments rupture
completely with the prospect of
expensive surgery ahead.

“That means there is a totally unmet
need to provide a treatment that will
actually prevent progressive deterioration of the
ligament and rupture.
That might be the use
of diet, or drugs to
modulate inflammation
or perhaps the use of
selective breeding to
reduce the incidence of
the trait.

“Knowing more
about the genetics of
the condition may one day allow us to think
about cruciate rupture in a similar way to how we currently think about hip
dysplasia. I think prevention is going to
play a big role in our approaches in the
future.

Measuring mobility

“Of course, the question of how we
should measure mobility objectively is a
very interesting one. The three main
elements are activity, nuanced
behaviours and lameness. If we want to
evaluate a hypothesis that a certain
approach will improve mobility, we need
to measure outcomes across all these
things.

“In the Hill’s studies that were
published in JAVMA this year, a lot of
thought was given to this matter.
Lameness and weight bearing are easier
to measure and force plate data are
considered to be objective. It’s not as
easy to measure patient activity and
behaviour other than by using validated
client questionnaires.

“Pedometers and accelerometers
that allow the data to be downloaded
and an individual objective profile to be
created may better reflect some of those
areas and I am sure they will find a
place in future work.

“I predict that for most dogs with
conditions such as arthritis, their
performance will improve in some but
not all three areas in response to different treatments. Some therapies
target what makes joints painful and so
would only lead to improvement in one
or two parameters.

“It would really help us refine what
elements of multimodal therapy we
choose, knowing that some lead to
improvements in lameness, some in
mobility and some in the behaviours
expressed.

An attitude of mind?

“People who experience mobility issues
associated with pain will often quickly
fall into depressive state. How can we
measure an animal’s well-being? As a
surgeon I feel that animals have no
psychosomatic issues with surgery – if
the patient feels unwell, the clinical
signs are driven by how it feels and
there are no ‘fear of life’ issues.

“With canine limb amputations it is
usually the owner who is worried and
in our clinic they are very likely to see
another dog in the waiting room that
has experienced an amputation,
perhaps due to neoplasia, and to see
that animal coping well: this can be a
great relief.

“I do believe that canine
behaviours are very much breed-related
and some are much more stoic than others. That means the clinical signs
and behavioural responses to pain
expressed by individual animals can be
dramatically different.”

  • Professor Muir received the award
    from Dr Hein Meyer of Hill’s Pet
    Nutrition. The criteria for receiving the
    award are: “Through improvements in
    the mobility and quality of life of pets,
    this person’s research has contributed
    significantly to the well-being of pets’
    lives and to the human-animal bond
    world-wide.” Professor Muir also
    delivered his award lecture at a plenary
    session entitled “The role of stifle
    synovitis in development of cruciate
    rupture in the dog”.

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