December 2023 25 et al. 2019). There is no cure for OA, but there are now many management options aimed at reducing pain and improving mobility in affected dogs. A multi-modal approach to the treatment of canine OA, including both pharmaceutical and non-pharmaceutical therapies has been proposed to be most effective in treating this disease (Fox 2016, Pye et al. 2022). With more complementary therapies becoming available to veterinary practitioners, this review has aimed to address commonly used non-surgical, non-pharmaceutical treatment options for canine OA and highlight current evidence gaps. Weight management has shown to be beneficial in the management of OA but can take time to see results (Burkholder & Hulse 2000, Mlacnik et al. 2006, Marshall et al. 2010). Therefore, it is important that owners are kept engaged with regular visits for weight checks and pursue an appropriate weight loss programme for their dogs. There is evidence for the use of certain nutraceuticals such as omega-3 fatty acids. Acupuncture, PBMT and ECSWT may also play a role in reducing the clinical signs of OA, although further research is needed to gain a greater understanding of their efficacy (Moreau et al. 2003, Boileau et al. 2009, Souza et al. 2016, de Oliveira Reusing et al. 2021). There is a lack of randomised controlled trials investigating the efficacy of different physiotherapy programmes, both land-based and aquatic, which would aid the development of best practice guidelines for canine OA treatment. For many of the management options outlined in this review, there is a need for larger scale clinical trials to inform veterinary professionals on the best practice for treating canine OA. Objective measurements such as force-plate gait analysis should be used where possible to reduce caregiver bias (Conzemius & Evans 2012) and assessment of the above therapies compared to pharmaceutical therapies alone would be useful to determine their efficacy in reducing clinical signs of canine OA. Assessing the use of different complementary therapies as part of a multi-modal treatment regime in dogs with differing OA severity would allow greater evidence for best-practice in the treatment of this chronic disease. Conflict of interest The author has received funding to undertake a PhD sponsored by Royal Canin. Author contributions Christine Pye: Writing –original draft (lead); writing –review and editing (equal). Natasha Clark: Writing –original draft (equal); writing –review and editing (equal). Natalie Bruniges: Writing –original draft (equal); writing –review and editing (equal). Eithne Comerford: Conceptualization (equal); writing –review and editing (equal). Mandy Peffers: Conceptualization (equal); writing –review and editing (equal). References – see original article Journal of Small Animal Practice • © 2023 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. v Leading Article
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