Table 5.
A summary of the steps involved in the practical implementation of the COASTeR consensus guidelines for the treatment of canine osteoarthritis.
| Step | Action | Details | |
|---|---|---|---|
| 1 | Base | Initiate foundational elements | •Applicable to all stages of OA. •Pro-actively seek opportunities for OA evaluation and education according to patient criteria such as life stage. |
| 2 | Stage | Determine the COAST Stage of OA (overall) and COASTeR Stage (to guide treatment) | •Include radiography when determining the overall COAST Stage, but exclude radiography when determining the COASTeR Stage that guides treatment. •Identify patient and/or pet caregiver factors that may affect treatment choice. |
| 3 | Build | Expand foundational elements according to COASTeR Stage | •Address or introduce specific topics and items to further develop foundational elements according to the stage of the disease e.g., a weight management program for COASTeR Stage 1 overweight or obese dogs. |
| 4 | Build | Introduce COASTeR Stage-specific treatment or management options | •Develop the management plan by incorporating other COASTeR stage appropriate treatment/management options. •Consider the strength of the COAST Development Group recommendation during treatment selection. •Incorporate specific patient and/or pet caregiver requirements as appropriate. |
| 5 | Assess | Evaluate treatment response | •Continue to monitor the patient at appropriate intervals. |
| 6 | Build | Add/adjust treatment or management options according to response or disease progression | •If necessary, adjust the treatment plan due to a positive outcome or because further improvement is required. •Consider the strength of the COAST Development Group recommendation during treatment selection. Progression of OA to the next COASTeR Stage will require a more extensive re-evaluation of the management plan. Some treatments are more strongly supported, or different treatments are recommended, for dogs with more severe diseases. •Incorporate specific patient and/or pet caregiver requirements as appropriate. |
| Repeat | Regular assessment of the patient with protocol adjustments if required | ||