Dr. Robin Downing podcast highlights multimodal OA pain care

Clinician’s Brief is spotlighting osteoarthritis pain management in a sponsored podcast conversation with Dr. Robin Downing, framing the issue around practical, day-to-day decisions for small animal teams. The episode’s core message is straightforward: managing OA pain well means looking beyond a single intervention and helping pet parents recognize subtle pain behaviors earlier, so treatment can be adjusted before mobility and quality of life decline further. (cliniciansbrief.com)

That emphasis fits the broader direction of veterinary pain medicine. The 2022 AAHA pain management guidelines describe pain management as an evolving area and recommend thorough assessment, repeated reassessment, multimodal treatment plans, individualized dosing and monitoring, non-pharmacologic support, and strong client education. In other words, OA care is no longer framed as simply starting an NSAID when a dog struggles on stairs; it’s increasingly treated as a chronic-care workflow that depends on history, physical findings, functional change, and follow-up. A related Clinician’s Brief partner podcast with sports medicine and rehabilitation specialist Dr. Matt Brunke reinforces that same point from a mobility perspective: clinicians should think beyond medications and supplements alone and treat mobility as a major quality-of-life marker for both dogs and cats. In that discussion, Brunke specifically called out cats as easy to overlook in joint-health conversations, noting that indoor lifestyle, obesity, aging, and primary osteoarthritis all contribute to meaningful but sometimes underrecognized mobility decline in feline patients. (aaha.org)

The therapeutic backdrop has also changed. In the U.S., the FDA approved Librela, bedinvetmab injection, on May 5, 2023, calling it the first monoclonal antibody approved for use in dogs and noting that osteoarthritis affects at least 25% of dogs at some point in life. The drug targets nerve growth factor to control OA pain, giving practices another option for dogs that may not be ideal NSAID candidates or that need a different approach. More recently, Zoetis reported results from a clinical trial published in Frontiers in Veterinary Science indicating bedinvetmab provided pain relief comparable to meloxicam over the study period, with a lower adverse-event rate in that trial population. (fda.gov)

But the newer OA toolkit has also brought more scrutiny. FDA safety-related labeling changes for Librela, posted February 18, 2025, added an owner-facing information section and directed veterinarians to discuss the client information sheet before administration. The updated labeling says dogs may need two monthly injections before a response is clear, advises clinicians to review response before each dose, and warns about reported adverse events including balance problems, weakness, paralysis, seizures, increased drinking or urination, urinary incontinence, vomiting, and diarrhea. The FDA has also circulated a Dear Veterinarian letter encouraging adverse-event reporting. (fda.gov)

Industry and expert reaction remains mixed, which is important context for clinicians. A 2025 Frontiers in Veterinary Science paper reported a disproportionate number of musculoskeletal adverse-event reports associated with bedinvetmab compared with several comparator drugs and described a 19-case series reviewed by an independent adjudication panel. In response, Zoetis-affiliated authors published a commentary arguing that the case series and disproportionality methods limit causal inference and stating that the company continues to assess reported adverse events without excluding the possibility of any event. Another commentary listed in Frontiers by Drs. Matt Brunke and Curtis Dewey signals that the debate has extended beyond regulators and the manufacturer into the specialist community. (frontiersin.org)

Why it matters: For veterinary professionals, Dr. Downing’s practical advice lands in a moment when OA management is both more promising and more complicated. The opportunity is better pain control through multimodal care: weight management, rehabilitation, environmental modification, monitoring, and more individualized pharmacology. Brunke’s mobility-focused discussion adds another useful reminder for practice teams: many owners equate mobility with quality of life, and that applies not only to dogs with OA or ligament disease but also to cats whose reduced jumping, play, or activity may be dismissed as normal aging. The challenge is that every added option increases the need for documentation, shared decision-making, and active surveillance. Practices that build structured OA check-ins, functional assessments, weight and activity counseling, and pre-treatment counseling into workflow will likely be better positioned to use both established drugs and newer biologics responsibly. (cliniciansbrief.com)

The communication piece may be the most durable takeaway. AAHA explicitly highlights client education and regular reassessment, and FDA’s Librela labeling now pushes that same conversation more formally. For clinics, that means setting realistic expectations about onset, response variability, exercise changes after pain relief, and when to pause or reconsider therapy. It also means recognizing that pet parents may arrive having seen both positive anecdotal reports and alarming safety discussions online, so clinicians need a calm, evidence-based framework for discussing uncertainty. It also means helping owners recognize that mobility changes in cats and dogs are clinically relevant, not just signs of “slowing down,” and that management may include nutrition, body-condition control, rehab, and home-environment adjustments alongside drug therapy. (aaha.org)

What to watch: Watch for further OA-specific guidance, additional post-marketing safety analyses on anti-NGF therapies, and more emphasis on standardized monitoring protocols as clinics refine how they balance benefit, risk, and pet parent expectations in chronic pain care. Also expect continued attention to practical mobility-support strategies, especially for overweight and aging pets, as clinicians push OA care further toward long-term function rather than short-term symptom control alone. (frontiersin.org)