10 Jun 2025
Image: Donna White / Adobe Stock
“They’re just getting old” is just one of the sentences, or variations thereof, that we hear as veterinary professionals as justification for older patients slowing down, becoming stiff and showing signs of mobility impairment.
This misunderstanding, alongside the very subtle signs of chronic pain in animals, may be one of the reasons that osteoarthritis (OA) is often only diagnosed at a later stage, when the owners present their pets for the more overt and obvious signs.
Yet, early recognition and early treatment can have huge benefits. From amendments to exercise routine (avoiding high-impact, jarring exercise), dietary modification and weight management, avoiding compensatory mechanisms resulting in muscle atrophy and joint instability, through to the benefit from treating pain to reduce central and peripheral sensitisation, such actions can lower the risk of deterioration and progression, and improve quality of life.
So, how do we achieve this aim of earlier recognition? This is likely down to a number of factors including client education, but also ensuring that our history taking is able to tease out the necessary information.
This can be challenging within the short time window of a consultation, which also requires a clinical examination.
The prevalence of OA in dogs is reported in the literature with conflicting values1; the estimates have ranged from 6.6% based on primary care data2 to 20% based on referral data in the UK dog population3.
Estimates from a North American study reported age-specific prevalence values ranging from the aforementioned 20% in dogs older than one year up to 80% in dogs older than eight years4.
Despite the wide range of reported prevalence, it is clear that OA is one of the most common chronic pain conditions seen in dogs, and that increased age is a risk factor for incident OA. Despite this, as veterinary professionals it is clear that some barriers exist to ensuring chronic pain conditions are treated effectively, with the age-old mantra of “they’re just getting older” as a reason for slowness, stiffness and general mobility decline.
So, imagine the challenges we would face with a population of “young” dogs who may present differently, compensate more subtly, and may not obviously show the clinical signs of chronic pain, when having discussions with owners.
Yet, new data certainly suggests that OA may be more common in young dogs than we might have thought. Recent evidence has emerged estimating the prevalence of OA in a young dog population. In one recent study, dogs aged from eight months to four years were assessed for radiographic OA (rOA) and clinical OA (cOA)5.
The results of this study have demonstrated that rOA is very common in young dogs, and approximately 60% of dogs with rOA had cOA with at least mild pain (23.6% of dogs overall) in one or more joints and 40% had cOA with at least moderate pain in one or more joints (16.3% of dogs overall).
Although we are aware that radiographic severity does not always directly correlate with pain perception, the data highlighting such a prevalence of cOA in a young dog population certainly highlights a need for consideration, clinical curiosity and appropriate actions.
The reasons for a high prevalence is not clear, but the data do indicate a high prevalence of rOA in this population of young dogs – particularly in the elbow and hip – supporting the assertion that OA is primarily driven by developmental disease in dogs.
However, as professionals, diagnosis and implementation of a treatment plan could prove challenging – especially as young dogs are easily overstimulated in a veterinary environment and clinical exams are unlikely to be fruitful.
Furthermore, the signs of joint pain in younger dogs do appear, clinically, to be different to those of older dogs. In this cohort, the emphasis was on adaptations of function rather than impaired function, which is more obvious in older dogs; for example, young dogs with hip OA and pain may still be able to go on walks without tiring, still be able to go up and down stairs, and still able to play, while older dogs with hip OA and pain may show obvious impairment in performing these activities.
Furthermore, many of the dogs were bilaterally affected, and it may be that owners are more likely to recognise clinical signs if only a single limb is affected rather than bilateral joints.
Furthermore, it is now recognised that many dogs presenting with behavioural “issues” have a pain element to them, and given that colleagues are reporting increases in “undesirable” behaviour consults, it is always worth doing a comprehensive pain assessment and considering an analgesia trial with these dogs, while recognising that the signs could be subtle.
This highlights the need for in-depth and targeted history taking and screening of dogs to gather adequate information. The high prevalence of disease supports the approach of actively screening younger dogs with the goal to intervene earlier and decrease the impact of OA and OA-associated pain over the dog’s lifespan.
As previously mentioned, a proactive approach is likely to be beneficial; however, its benefit has not been formally assessed. Although it is not known if early intervention, such as regular low-impact activity and avoiding high-impact or jarring exercise, decreases the impact of OA later in life, on balance it seems logical that it would have some positive impact, although the extent of that remains unquantified. Good evidence exists, from lifetime studies in the Labrador retriever, to show that weight management can reduce progression of OA in dogs.
However, clinical OA in dogs is diagnosed at a much later time point, with more than 50% of diagnosed dogs aged from 8 to 13 years6.
When we reflect on the age of the study cohort (up to four years old), with 16.3% to 23.6% of this cohort being diagnosed with mild to moderate pain, this leaves us with the potential consequence of dogs going several years undiagnosed and untreated for chronic pain – a real welfare concern.
This is reiterated in the study where owners identified the presence of clinical signs relatively infrequently (one-third of dogs, 31% for cOA [mild pain] and 30% for cOA [moderate pain]) and few dogs were medically treated.
It can be a surprise to dog owners that a young dog may suffer with OA; in human beings, it is perceived to be a condition of older people. This is true, but the difference is that dogs can commonly have developmental joint disease, which starts the OA process much earlier in life.
It is, therefore, our recommendation that practices engage with these data in a multi-tiered approach.
Owners should be educated, right from health testing breeding animals, through to how to purchase a puppy, and weight management and appropriate exercise regimes, through to recognition of clinical signs and adaptations in younger dogs.
Engaging with a proactive approach and screening young dogs, using tools such as the Liverpool Osteoarthritis in Dogs score, could go some way in early recognition, bearing in mind that young dogs with OA may well have lower scores compared to older dogs with OA.
