Dr. Robin Downing revisits multimodal osteoarthritis pain care

A Clinician’s Brief partner podcast featuring Dr. Robin Downing is putting a familiar but still evolving message back in front of small animal teams: osteoarthritis pain management shouldn’t stop at NSAIDs. In the episode, Downing and host Dr. Beth Molleson discuss practical ways to build more complete pain-control plans for arthritis patients and improve conversations with pet parents about recognizing pain and tracking quality of life. The episode was sponsored by PRN Pharmacal and published by Clinician’s Brief as “Osteoarthritis Pain: Beyond NSAIDs with Dr. Robin Downing.” A separate Clinician’s Brief partner podcast, sponsored by Hill’s Pet Nutrition, extends that conversation into mobility and joint health, with sports medicine and rehabilitation specialist Dr. Matt Brunke discussing practical strategies beyond medications and supplements for dogs and cats whose quality of life is affected by arthritis, obesity, injury, or recovery. (cliniciansbrief.com)

The message lands in a veterinary market that has changed meaningfully over the past several years. The 2022 AAHA Pain Management Guidelines for Dogs and Cats formalized a tiered, multimodal approach to both acute and chronic pain, with osteoarthritis identified as one of the best-studied chronic pain conditions in companion animals. Those guidelines stress that radiographic change and clinical pain don’t always correlate well, and they encourage clinicians to use structured assessment tools and repeated reassessment over time. In cats, the evidence base has also continued to develop, including 2024 ISFM/AAFP consensus guidance on long-term NSAID use, reflecting both the need for analgesia and the reality that chronic therapy requires careful monitoring. Brunke’s mobility-focused discussion fits neatly into that framework by emphasizing that joint health is influenced not only by analgesic choice but also by body condition, muscle support, activity patterns, home environment, and rehab-style interventions that help patients keep moving safely. (aaha.org)

Clinician’s Brief framed the Downing discussion around the growing number of therapeutic options available for arthritis patients and the challenge of staying current on how to use them well. The episode description says the conversation focused on implementing “the most complete and effective strategies for pain control,” while also helping pet parents identify pain and improve quality of life. That aligns closely with Downing’s long-standing public commentary on chronic pain, where she has argued for multimodal plans that can include rehabilitation, body composition management, targeted analgesics, and caregiver education, rather than reflexively defaulting to a single medication. In prior dvm360 coverage, Downing also pointed to evidence that tramadol has not shown benefit for canine osteoarthritis pain, reinforcing the shift toward more evidence-based drug selection. Brunke’s comments add a practical rehab lens to the same idea: mobility problems are often multifactorial, and clinicians may need to address strength, conditioning, traction, controlled exercise, and owner expectations alongside pain medication. He also called attention to cats as an especially easy group to miss, noting that many indoor cats are overweight, less active, living longer, and developing primary osteoarthritis that may first appear as subtle lifestyle changes rather than obvious lameness. (cliniciansbrief.com)

The broader treatment landscape helps explain why “beyond NSAIDs” resonates now. FDA approved Solensia for control of osteoarthritis pain in cats in January 2022, the first approved treatment for OA pain in cats in the U.S., and approved Librela for control of osteoarthritis pain in dogs in May 2023, the first monoclonal antibody approved for canine OA pain. Both approvals relied in part on caregiver-reported outcome tools that track pain severity and interference with activity, which mirrors the profession’s increasing use of structured questionnaires such as the Canine Brief Pain Inventory and LOAD. For practices, that means chronic pain management is becoming more measurable, more longitudinal, and more dependent on follow-up systems than on one-time prescribing. It also means newer therapeutics are entering a care model that still depends heavily on fundamentals such as weight control, mobility support, and realistic home management. (news.zoetis.com)

Industry and educational commentary has largely converged around the same core point: osteoarthritis is multifactorial, progressive, and best managed early. AAHA’s educational materials continue to emphasize multimodal care, and recent veterinary trade coverage has argued that early intervention can preserve mobility, maintain healthy activity and weight, and support the human-animal bond. Brunke’s podcast adds concrete examples of what that can look like in practice, especially when clinics move beyond a medication-only mindset and coach owners on safe exercise, recovery goals, and environmental changes that reduce strain on painful joints. That isn’t a dramatic new thesis, but it is increasingly relevant as clinics balance traditional options, rehab referrals, nutrition, environmental modification, injectable biologics, and long-term monitoring for cats and dogs with concurrent disease. (aaha.org)

Why it matters: For veterinarians, technicians, and practice leaders, the real significance is operational. Osteoarthritis care is moving toward chronic disease management models that require earlier identification, consistent pain scoring, staff coaching, and clearer pet parent education about subtle signs such as sleep disruption, reluctance to jump, altered interaction, or decreased willingness to exercise. The Downing podcast reinforces a care philosophy that many clinics endorse in theory but don’t always execute consistently in workflow. Brunke’s mobility discussion makes that even more practical by underscoring how often obesity, deconditioning, and home setup shape outcomes, especially in cats and in dogs recovering from orthopedic injury or surgery. Practices that build repeatable OA protocols, including screening, recheck intervals, multimodal treatment ladders, nutrition and weight conversations, rehab or exercise guidance, and realistic financial discussions, may be better positioned to improve outcomes and strengthen adherence. (cliniciansbrief.com)

That’s especially important in feline medicine, where osteoarthritis has historically been underdiagnosed, and in geriatric canine care, where pain may be normalized as “just aging.” The current evidence and guideline environment supports individualized plans, not one-size-fits-all protocols. NSAIDs remain foundational for many patients, but they now sit within a wider toolkit that may include monoclonal antibodies, adjunctive analgesics, rehabilitation, weight optimization, home modification, and structured caregiver feedback. The practical challenge for clinics is deciding which combinations are feasible, evidence-supported, and sustainable for each household. Brunke’s emphasis on mobility and joint health also serves as a reminder that preserving function is not just about reducing pain scores; it is about helping pets navigate daily life more comfortably and helping owners understand what supportive care at home actually looks like. (pubmed.ncbi.nlm.nih.gov)

What to watch: The next phase is likely to center on how practices integrate newer OA therapies into multimodal protocols, how they monitor long-term outcomes in real-world patients, and whether guideline-driven screening pushes diagnosis and treatment earlier in both dogs and cats. Expect continued interest not just in drug selection, but in how clinics operationalize weight management, rehab access, mobility coaching, and home-environment support as standard parts of osteoarthritis care. (fda.gov)