CVS launches new osteoarthritis training for nurses
Nurses to take central role in evolving lameness clinical improvement project
CVS has launched a new osteoarthritis training programme for its companion animal nurses, to enable them to take a lead in managing this common condition in patients in first opinion practice.
The training is part of a CVS clinical improvement project focusing on lameness, which has evolved over the last year to focus on this degenerative joint disease. It is appropriate for client-facing consulting nurses and those who want to take on more responsibility.
Osteoarthritis is a common problem in small animals. It is estimated that up to 40% of dogs aged 8 months–4 years have osteoarthritis[1] and 90% of cats over 12 years have radiographic signs of degenerative joint disease[2]. Genetics, developmental disorders of bones or joints and injuries such as a cruciate ligament rupture can initiate or trigger the disease. Its pathogenesis involves a degradation of cartilage and subsequent joint remodelling, along with active inflammatory cells and mediators in the surrounding tissues. The incurable condition needs to be managed to the best extent with an individualised patient care plan.
Shameena Shajira, CVS Regional Clinical Lead and Osteoarthritis Project Lead, comments:
“Osteoarthritis is a painful degenerative condition whose progress cannot be reversed. Therefore it is important to diagnose it as early as possible in the disease process and manage the condition in the best possible way. As a profession I do not think we have been doing this consistently enough. For other chronic, progressive conditions like some kidney or heart diseases, we have structured screening and management programmes. But for osteoarthritis, we are still long way from achieving this.”
The CVS Osteoarthritis Nurse Training Programme aims to achieve a big behavioural change in practice. Held over the course of one day, CVS Nurses are taught how to conduct a canine and feline mobility clinics to identify the clinical signs of osteoarthritis, and how to offer clients subsequent support to manage the condition as per the veterinary surgeons’ advice.
Nurses are trained on how to effectively use the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire[3] - a 13-item clinical metrology instrument (CMI) used to assess articular disorders - which includes questions on the pets’ medical background, lifestyle and mobility. Here, individual question scores are summed to provide an overall “LOAD score” suggestive of the animal’s disease presence and severity, with the questionnaire repeated and results tracked over time.
The CVS nurse training programme also tutors colleagues on a range of potential management options to be considered with owners to determine the best course of action. Individual training sections are run on:
- Weight management - looking at body condition scoring, diet recommendation and supporting controlled weight loss in overweight pets
- Exercise - reviewing current level of exercise of a pet and advise around appropriate levels of exercise as per the osteoarthritis disease status
- Environmental modifications - exploring how the home setting can be adapted for mobility impaired animals
- Nutraceuticals - investigating their types, functions and quality products to recommend
- Sleep health - looking at how to reduce joint pressure and pain, along with reviewing orthopaedic beds; and physiotherapy and hydrotherapy - their function, role and appropriateness for osteoarthritis cases, along with registered services to use.
In addition, the training session also includes the practical aspects of setting up and conducting mobility clinics, to empower CVS nurses to undertake this client facing role whilst working under the delegation of a vet.
Shameena adds:
“This training will upskill our nurses and support them in creating a tailored care plan for each patient - which can be modified as necessary for the rest of that animal’s life.
It’s an emerging area for nurses. And we are hoping to move to a new model of client care for chronic conditions – the ‘deliberative model’ - where we engage and onboard the client in the ongoing care for that animal, giving emphasis on their preferences whilst making recommendations with empathy.
Our training days had been launched since November 2024, and so far, we’ve received a lot of interest. Colleagues with two years up to 25 years’ experience are attending these training days. As a result, five training days have already been scheduled in with an average of 20 nurses on each session. We are so pleased to be helping to lead the profession in this journey.”
CVS Group operates across small animal, farm animal, equine, laboratories and crematoria, with over 500 veterinary practices and referral centres in the UK and Australia. In the last five years the company has invested nearly £80 million in its sites, facilities and equipment, in addition to industry leading training and support, to give the best possible care to animals.
[1] Enomoto M, de Castro N, Hash J, et al. Prevalence of radiographic appendicular osteoarthritis and associated clinical signs in young dogs. Sci Rep. 2024;14(1):2827. doi:10.1038/s41598-024-52324-9
[2] Lascelles BDX, Henry JB III, Brown J, et al. Cross-sectional study of the prevalence of radiographic degenerative joint disease in domesticated cats. Vet Surg. 2010;39(5):535-44. doi:10.1111/j.1532-950X.2010.00708.x
[3] Developed by John Innes at the University of Liverpool New tool to help diagnose canine arthritis - News - University of Liverpool