Dr. Robin Downing spotlights OA pain care beyond NSAIDs

CURRENT FULL VERSION: Clinician’s Brief has added to the osteoarthritis conversation with a sponsored podcast episode, “Osteoarthritis Pain: Beyond NSAIDs with Dr. Robin Downing,” in which host Dr. Beth Molleson interviews one of veterinary medicine’s best-known pain experts on practical pain control strategies and client communication. The core message is straightforward: OA pain management is no longer a one-lane discussion centered only on NSAIDs, even though those drugs remain foundational for many patients. That framing also fits with other recent Clinician’s Brief podcast coverage on mobility and joint health, including a sponsored episode with sports medicine and rehab specialist Dr. Matt Brunke that focused on management strategies beyond medications and supplements alone. (cliniciansbrief.com)

That framing reflects how the small animal OA landscape has evolved over the past several years. The FDA approved Solensia for cats in January 2022 and Librela for dogs in May 2023, bringing anti-NGF monoclonal antibodies into U.S. companion animal practice. In parallel, consensus guidelines and review articles have pushed a staged, multimodal approach that combines analgesics with weight optimization, therapeutic exercise, rehabilitation, home-environment changes, and regular reassessment. The Brunke discussion reinforces that broader view by treating mobility as a quality-of-life issue, not just a prescribing decision, and by highlighting that cats as well as dogs are part of the OA conversation. (fda.gov)

The podcast itself appears aimed at helping clinicians translate that expanding evidence base into exam-room decisions. Clinician’s Brief says the episode covers “the most complete and effective strategies for pain control” and how to communicate with pet parents so they can better identify pain and support quality of life at home. That client-facing piece is important because OA often shows up first as reduced activity, reluctance to jump, trouble with stairs, or changes in routine behavior, especially in senior pets. The related mobility podcast adds another practical reminder: clinicians may need to ask more directly about function in the home, particularly in cats, where chronic joint pain often presents as less jumping, less play, or quieter day-to-day behavior rather than obvious lameness. (cliniciansbrief.com)

From a treatment standpoint, the broader literature still supports NSAIDs as a mainstay for canine OA, with grapiprant offering an alternative mechanism through EP4 receptor antagonism. More recent reviews describe bedinvetmab as a targeted monthly option that can be especially useful when NSAIDs are contraindicated, while also stressing that it should sit within, not replace, a multimodal plan. The Brunke discussion complements that point by emphasizing nonpharmacologic support for mobility, including rehab-minded exercise planning and weight control, particularly for pets whose excess body condition is contributing to joint stress. A 2025 Zoetis-announced study comparing Librela with meloxicam reported equivalent pain relief starting at day 14, adding to the evidence base around anti-NGF therapy in dogs. (aaha.org)

Industry and professional commentary has also become more nuanced as uptake has grown. AAHA’s coverage of the FDA’s review of reported adverse events for Librela underscored the need to confirm that pain is truly OA-related, rule out other conditions, and have a clear risk-benefit discussion with the pet parent before prescribing. The FDA has also posted safety-related labeling changes for Librela, reinforcing that pharmacovigilance and case documentation remain part of routine use for newer OA therapies. (aaha.org)

Why it matters: For veterinary teams, this isn’t just another education item on arthritis. It’s a reminder that OA care increasingly depends on structured, long-term management rather than one-time prescribing. The most successful practices are likely to be the ones that combine earlier recognition, staged treatment plans, baseline and follow-up monitoring where appropriate, and better coaching for pet parents on what pain looks like at home. It also means practices may need clearer protocols around when to choose an NSAID, when to consider grapiprant or an anti-NGF biologic, when to add rehab or weight-loss support, and how to document response over time. The added mobility-and-joint-health discussion also sharpens an easy-to-miss point: obesity, inactivity, and aging are major drivers of mobility decline, especially in indoor cats, so OA workflows need to account for species differences in how pain and dysfunction show up. (frontiersin.org)

The conversation has relevance beyond dogs, too. Feline OA remains underrecognized, and expert guidance continues to emphasize that chronic pain in cats often presents behaviorally rather than as obvious lameness. The Clinician’s Brief mobility podcast underscored that cats “get forgotten about sometimes” despite high obesity rates and age-related primary OA, a useful reminder for clinics building screening and follow-up protocols. With Solensia available and updated feline NSAID guidance published in 2024, clinics that build stronger OA workflows may improve care across both species, especially in aging-pet caseloads. (fda.gov)

What to watch: The next phase in OA management will likely center on how clinicians integrate newer biologics into multimodal protocols, respond to evolving safety information, and standardize reassessment intervals as more long-term real-world data emerge. Just as important, expect continued emphasis on practical mobility support outside the prescription pad, including exercise modification, rehab referral, weight management, and home-environment changes that help pets stay functional longer. (fda.gov)