In this episode of Canine Arthritis Matters, Hannah Capon welcomes Professor Clare Rusbridge, a world-renowned veterinary neurologist, to discuss the complex overlap between neurological and orthopaedic disease in dogs. Together, they explore how conditions such as Chiari malformation, syringomyelia, neuropathies, and osteoarthritis often coexist, and how misinterpretation can lead to over-medication or even unnecessary surgeries.

Clare highlights practical diagnostic tips for vets in general practice, shares stories from her extensive clinical experience, and tackles the risks of polypharmacy when pain is assumed to be the sole culprit. The conversation also explores the role of validated tools like Chiari Check, the importance of reassessment, and the need for a more multidisciplinary approach to chronic pain.

Guest Bio:

Professor Clare Rusbridge is a diplomate of the European College of Veterinary Neurology and Professor in Veterinary Neurology at the University of Surrey. She also serves as a senior neurologist at Wear Referrals. With over 160 scientific publications and numerous book chapters, including contributions to both veterinary and human neurology, Clare is an internationally recognised leader in neuropathic pain.

Her work focuses on Chiari malformation and syringomyelia, and she has been instrumental in raising awareness about neurological causes of chronic pain in dogs. In addition to her clinical and academic work, Clare runs the educational YouTube channel Claire-NeuroVet and serves as a trustee and patron for several welfare organisations, including the Dog Breeding Reform Group and Cavaliers Matter.

Key Takeaways:

1. Neurological disease and orthopaedic pain often overlap, making careful assessment essential to avoid misdiagnosis.

2. Polypharmacy can worsen clinical signs; drug side effects such as sedation may mimic progression of disease.

3. Simple observation tools—like gait videos and pain scoring—can reveal hidden neurological or orthopaedic causes of mobility problems.

4. Chiari malformation and syringomyelia remain under-recognised, particularly in toy and brachycephalic breeds, but screening tools like Chiari Check can help.

5. Chronic pain management requires layered planning: acute care, long-term management, and flare protocols for caregivers and vets.

Relevant Links:

Join the CAM Member Zone

Access exclusive resources, webinars, and practical tools for managing canine osteoarthritis and chronic pain.

Join here: https://www.caninearthritis.co.uk/member-zone/

Explore the Chiari Treatment Algorithm

Looking for structured guidance on managing Chiari malformation and syringomyelia in dogs? Use the free treatment algorithm here: https://caninechiari.com/treatmentAlgorithm

Chiari Check Questionnaire: https://www.chiaricheck.co.uk/

Clare Rusbridge’s YouTube Channel (Claire-NeuroVet): https://www.youtube.com/@claire-neurovet

Learn more about CAM:

Facebook: https://www.facebook.com/CAMarthritis

Instagram: https://www.instagram.com/canine_arthritis

Youtube: https://www.youtube.com/c/CanineArthritisManagement

LinkedIn: https://www.linkedin.com/company/canine-arthritis-management-ltd

Have questions send them to: info@caninearthritis.co.uk

Stay tuned to learn how early detection can make a significant difference in managing OA in younger dogs.

In this episode of Canine Arthritis Matters, Dr. Hannah Capon is joined by Dr. Mark Epstein, a leading voice in veterinary pain management and co-owner of Total Bond Veterinary Hospitals in the US. Together, they dive deep into the complexities of recognising, assessing, and managing chronic pain in dogs and cats. From validated clinical metrology instruments (COAST, LOAD, CBPI, CSOM) to the promise of anti-NGF monoclonal antibodies, Mark shares insights from both research and everyday practice.

The discussion also touches on the potential role of AI in the near future, the importance of multimodal management beyond pharmaceuticals, and the need for better caregiver communication. With candid reflections on successes, challenges, and the risk of polypharmacy, this episode offers both practical advice and thought-provoking perspectives for anyone involved in chronic pain management.

Guest Bio

Dr. Mark E. Epstein is a board-certified diplomate of the American Board of Veterinary Practitioners in canine and feline practice. He serves as medical director and co-owner of Total Bond Veterinary Hospitals in North Carolina. With decades of experience in companion animal pain management, he is a founding fellow of the ABVP’s Companion Animal Pain Management and the International Veterinary Academy of Pain Management.

Mark is a certified veterinary pain practitioner, frequent lecturer, and author of peer-reviewed journal articles and book chapters. He has chaired the American Animal Hospital Association’s Senior Care Guidelines and Pain Management Guidelines Task Force. Despite his global reputation, Mark emphasizes that most of his work is still first-opinion general practice — making his insights directly relevant to everyday clinicians.

Key Takeaways

1. Pain recognition and assessment remain the biggest challenges in chronic pain management; validated tools like COAST, LOAD, CBPI, and CSOM can help but each has strengths and weaknesses.

2. COAST staging provides a common language for veterinarians, particularly useful for early identification (Stage 1 dogs at risk).

3. Multimodal care must go beyond drugs — weight management, exercise, client education, and lifestyle changes are essential.

4. Polypharmacy requires caution; gabapentinoids in particular may contribute to sedation and proprioceptive issues that are misinterpreted as disease progression.

5. The future of pain management includes monoclonal antibody therapies and potentially AI-based assessment tools, but empathetic caregiver communication will always be central.

Relevant links

For more practical tools, resources, and ongoing education in osteoarthritis and chronic pain management, visit the CAM Member Zone:

https://www.caninearthritis.co.uk/member-zone/

Learn more about CAM:

Facebook: https://www.facebook.com/CAMarthritis

Instagram: https://www.instagram.com/canine_arthritis

Youtube: https://www.youtube.com/c/CanineArthritisManagement

LinkedIn: https://www.linkedin.com/company/canine-arthritis-management-ltd

Have questions send them to: info@caninearthritis.co.uk

Stay tuned to learn how early detection can make a significant difference in managing OA in younger dogs.

In this episode of Canine Arthritis Matters, Dr. Hannah Capon speaks with Dr. Tyler Carmack, Director of Hospice and Palliative Care at Caring Pathways. Dr. Carmack shares her journey from emergency medicine into dedicating her career to hospice and palliative care for companion animals. Together, they explore how end-of-life care can be approached with compassion, planning, and innovation, particularly in cases of chronic pain and osteoarthritis. From emergency kits to integrative therapies and caregiver communication, this conversation sheds light on an area of veterinary medicine that remains under-discussed but deeply impactful.

Guest Bio

Dr. Tyler Carmack is the Director of Hospice and Palliative Care for Caring Pathways. She founded Hampton Roads Veterinary Hospice in 2011 and has practiced exclusively in hospice and palliative care for over a decade. Dr. Carmack has served on the board of the International Association for Animal Hospice and Palliative Care (IAAHPC) since 2016 and lectures internationally on end-of-life care. She holds certifications in animal hospice, palliative care, veterinary acupuncture, Chinese food therapy, traditional Chinese veterinary medicine, and end-of-life care. Her professional passions include pain management and caregiver support during the most difficult stages of a pet’s life.

Key Takeaways

1. Hospice and palliative care are distinct yet complementary approaches—palliative can begin early in life to support comfort, while hospice typically refers to the final stages.

2. Emergency medication kits provide families with peace of mind and help manage crises until veterinary support is available.

3. Tools like quality-of-life and frailty scales can empower caregivers and improve communication with veterinary teams.

4. Simple lifestyle adjustments—traction mats, ramps, and planned mobility support—can dramatically improve quality of life in older or frail pets.

5. End-of-life care requires not only medical expertise but also time, compassion, and proactive planning for both pets and their families.

Relevant links

If you want to deepen your understanding of hospice and palliative care, explore resources at:

Caring Pathways – https://charlotte.caringpathways.com/meet-our-team/dr-tyler-carmack-director-of-hospice-and-palliative-care/

International Association for Animal Hospice and Palliative Care (IAAHPC) – https://iaahpc.org/

For veterinary professionals, further tools and handouts are available in our CAM Member Zone:

https://www.caninearthritis.co.uk/member-zone/

Learn more about CAM:

Facebook: https://www.facebook.com/CAMarthritis

Instagram: https://www.instagram.com/canine_arthritis

Youtube: https://www.youtube.com/c/CanineArthritisManagement

LinkedIn: https://www.linkedin.com/company/canine-arthritis-management-ltd

Have questions send them to: info@caninearthritis.co.uk

Stay tuned to learn how early detection can make a significant difference in managing OA in younger dogs.