A new standardized method for diagnosing osteoarthritis or joint disease in dogs — the Canine Osteoarthritis Staging Tool (COAST) — is now available. COAST is a collaboration between Elanco Animal Health and COAST Development Group. The staging system can be used on all dogs, including those who are preclinical and those with established signs of the disease. Osteoarthritis is a progressive degenerative disease primarily driven by developmental orthopedic disease. It is one of the most common causes of chronic pain in dogs.
Developed by nine clinical experts in the fields of small animal orthopedics, anesthesia and pain management, the tool aims to improve diagnosis and monitoring of dogs with osteoarthritis (OA), with the potential to guide disease-management plans.
“Unlike validated Clinical Metrology Instruments (CMIs) that generate a ‘score’ for dogs clinically affected with osteoarthritis, COAST introduces taking into account risk factors for OA,” explains Mark Epstein, DVM, DABVP (Canine and Feline), CVPP, who led the “Rethinking Canine Osteoarthritis” presentation at the 2019 Veterinary Meeting and Expo (VMX) in Orlando, Fla. “This permits identification of early OA even when patients are minimally impacted by OA in an obvious way – or even altogether asymptomatic. This in turn allows the clinician to introduce treatment strategies early in the course of the disease process, which for dogs most often starts at an early age due to conformational problems that underlie it.”
“We have seen the successful implementation of standardized staging systems for other companion animal diseases, so the possibility of a similar approach for canine OA is particularly exciting,” said Nichola Archer Thompson, global technical marketer for orthopedic health at Elanco. “The COAST approach offers so many potential benefits, but the one that stands out for me personally is an optimized pain control and disease management plan for the dogs. This is something that I believe pet owners, veterinarians, the COAST Development Group and Elanco are all striving for.”
“I’m excited to highlight this tool that will revolutionize the way we approach OA, with a goal of better outcomes for dogs with this debilitating disease,” says Epstein.
How COAST Works
For the staging system to work, a grade of severity is assigned to the affected joints, as well as the dog as a whole, reflecting the extent to which OA affects the animal overall. The veterinary team identifies patients that are likely to have or develop OA, says Epstein. These patients may be identified through historical reports by the owner; observations of position or movement abnormalities by any member of the team; orthopedic abnormalities observed by the veterinarian during examination; and even just risk factors for OA that include breed dispositions (e.g., high prevalence for hip dysplasia, elbow dysplasia), conformation (e.g., chondrodypslasia), being overweight, high exercise level (i.e., agility vs. sedentary), previous history of lameness (joint injury and/or surgery), and age.
“Once such a patient is identified through any of these mechanisms,” says Epstein, “both the owner and the veterinarian ‘Grade the Dog’ using the COAST tool, and the veterinarian will also ‘Grade the Joint.’ COAST will take each of these evaluations and create an ‘OA Stage’ for that patient at that moment in time.”
5 COAST Stages
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 Clinically normal, no OA risk factors
Stage 1 Clinically normal, but OA risk factors present
Stage 2 Mild OA
Stage 3 Moderate OA
Stage 4 Severe OA
Read The Two Most Important Tools in the Treatment of Osteoarthritis in Cats and Dogs, Part I.
Read Treatment of Osteoarthritis, Part II.
Read more about COAST.