Canine OA affects more than mobility—chronic pain can alter play, sleep, and behavior, often mistaken for aging. Photo courtesy Zoetis Osteoarthritis (OA) is a highly prevalent condition, affecting an estimated 20-37 percent of dogs over one year old.1 Yet many clinicians struggle to detect it early, particularly in young and small-breed dogs. As veterinary care continues to shift toward preventive medicine and lifelong wellness, there is growing momentum around improving earlier detection and more consistent pain management. Among the emerging therapeutic options is a new class of biologics: monoclonal antibodies (mAbs). Despite growing awareness, many cases still go unnoticed until signs have become severe—highlighting the need for more accessible and owner-friendly treatment options. The challenge of OA pain in dogs OA in dogs is a progressive, degenerative condition that often develops due to joint abnormalities, obesity, or prior injuries. While commonly associated with aging, OA can begin much earlier in life. In fact, a recent study has found radiographic signs of OA have been identified in up to 40 percent of dogs between eight months and four years old.2 Early signs, such as stiffness, decreased activity, or reluctance to jump, are often mistaken by owners as signs of normal aging. In small-breed dogs, signs may be harder to detect due to being lifted and carried more frequently, masking movement changes. More broadly, chronic pain in pets has historically been underrecognized, in part because animals instinctively mask pain when observed in clinical settings. Many pet owners may notice subtle signs at home, but those behaviors are not always evident during exams. Additionally, until recently, limited treatment options meant some pets were not treated until OA was advanced enough to cause visible impairment. Societal and clinical shifts are now driving change. Pet owners increasingly see dogs as close family members, and there is less tolerance for leaving pain unaddressed. These changes are prompting more proactive conversations with veterinary teams. The field is responding with earlier and broader interventions aimed at supporting dogs’ physical function and quality of life. Traditional approaches and the rise of mAbs Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage chronic pain in animals. While generally effective at reducing inflammation and discomfort, they may not always be recommended for long-term use due to the potential of certain side effects. NSAIDs also require daily oral dosing, which can cause compliance challenges for pet owners. In fact, 19-22 percent of pet owners who participated in a dog owner awareness and concept study reported discontinuing NSAIDs due to difficult administration and/or a lack of perceived effectiveness.3 mAbs can be an effective alternative, especially for dogs that cannot tolerate NSAIDs or need more sustained pain relief. They offer a different therapeutic approach by targeting key pain mediators involved in OA progression. Their injectable delivery may reduce the day-to-day treatment burden on pet owners, helping maintain continuity of care. Additionally, mAbs are naturally metabolized by the body, reducing strain on the liver and kidneys. Of note, mAbs targeting NGF should not be used in dogs less than 12 months of age or in breeding, pregnant, or lactating dogs. Hypersensitivity reactions are possible. As more biologics enter the veterinary space, successful implementation depends on education and collaboration across the veterinary team, beyond the prescribing clinician. For example, technicians may assist in identifying subtle pain indicators during wellness visits, while client service representatives can reinforce therapeutic benefits during appointment scheduling or follow-up calls. These touchpoints help build trust and ensure continuity of care. Clear communication around how mAbs work, the benefits of their dosing cadence, and their safety profile, especially in pets with comorbidities, can help educate owners and reinforce the value of consistent care. Of course, all medications have potential side effects, so explaining the risk-benefit profile of a treatment is an important part of the conversation with pet owners. Monoclonal antibodies (mAbs) offer sustained pain relief for treating canine OA. With injectable delivery, they help ease treatment burdens and support better continuity of care. Photo courtesy Zoetis Monoclonal antibodies: Consistent, effective relief mAbs represent a newer class of therapeutics in veterinary medicine. These laboratory-engineered proteins are species-specific and designed to bind with high specificity to a single target—typically a molecule or receptor involved in disease progression. In the case of canine OA, NGF is a key driver of pain, produced by inflamed or damaged tissues. It sensitizes nociceptors and amplifies pain signaling to the central nervous system. Elevated NGF levels are closely linked to chronic pain states, including OA. Anti-NGF mAbs bind to and neutralize NGF, preventing it from activating its receptor (TrkA) on sensory neurons. This targeted action reduces OA-related pain without broadly suppressing other inflammatory pathways. Unlike NSAIDs, which inhibit multiple enzymes, mAbs act upstream in the pain pathway, targeted to offer a more precise pain relief with potentially fewer systemic effects. As biologic therapies, mAbs are metabolized as natural proteins, supporting a favorable safety profile, especially for older dogs or those with organ compromises. Already widely used in human medicine, particularly in the treatment of cancer, autoimmune disorders, and other chronic conditions, the use of mAbs is growing across several areas of veterinary care. In dogs, they have revolutionized the management of allergic dermatitis by delivering targeted, long-acting relief from chronic skin conditions. Most recently, mAbs have offered veterinarians another option that works differently from NSAIDs, to effectively control OA pain in dogs. Up to 40 percent of dogs as young as eight months to four years are found to show radiographic signs of OA.2 In small breeds, subtle signs are often missed since being carried often can mask mobility changes. Photo courtesy Zoetis The future of proactive pain management Canine OA is a chronic condition that affects far more than a dog’s mobility. Dogs experiencing persistent pain may show reduced interest in play, changes in sleep cycles, or increased irritability—behaviors that can be mistakenly attributed to temperament or aging. This type of pain is biologically complex, involving both inflammatory and neuropathic mechanisms, and driven by multiple pathways—including NGF, which amplifies pain signals and contributes to central sensitization. This explains why OA pain can persist even after inflammation is addressed and why behavioral and cognitive changes may emerge as the disease advances. Given the multifaceted nature of OA, timely diagnosis and sustained intervention are critical—not only to limit joint deterioration, but also to prevent pain from becoming entrenched and harder to manage over time. With the earlier identification of OA pain and intervention being prioritized, the veterinary field now has an opportunity to embrace innovative tools that support sustained pain management. Integrating mAbs into an overall OA treatment plan can offer veterinarians a proactive and client-friendly approach. Determining whether its use is appropriate in any particular dog should be considered as part of a risk-benefit assessment by the treating veterinarian. With their effectiveness, demonstrated strong safety profile, and longer intervals between doses, mAbs are well-suited for many dogs requiring consistent, long-term pain relief.4-8 They also help owners follow through with treatment—thanks to convenient, less frequent dosing that supports adherence and reduces stress around daily treatment regimens. Follow-up visits for injections further strengthen the veterinary-client-patient relationship, allowing teams to monitor progress, adjust care plans and engage pet owners in broader wellness discussions. As biologic therapies continue to evolve and new targets are identified, veterinary teams that communicate the value of these innovations will be well-positioned to advance the standard of multimodal, personalized pain management. By integrating these tools today, clinicians can deliver compassionate, evidence-informed care for dogs living with chronic pain. Richard Goldstein, DVM, DACVIM, DECVIM-CA, is board-certified by the American and European Colleges of Veterinary Internal Medicine. He has brought more than two decades of leadership experience in companion animal medicine, spanning clinical care, academia, diagnostics, and pharmaceutical innovation. Dr. Goldstein is the global chief medical officer and head of Medical Affairs at Zoetis. Refereces Wright, A. et al. Identification of canine osteoarthritis using an owner-reported questionnaire and treatment monitoring using functional mobility tests. Journal of Small Animal Practice 63, 609-618 (2022). Enomoto, M. et al. Prevalence of radiographic appendicular osteoarthritis and associated clinical signs in young dogs. Sci Rep 14, 2827 (2024). https://doi.org:10.1038/s41598-024-52324-9. The Link Group. Dog Owner OA Awareness and Concept Test. July 2021. Enomoto M, Mantyh PW, Murrell J, Innes JF, Lascelles BDX. Anti-nerve growth factor monoclonal antibodies for the control of pain in dogs and cats. Vet Rec. 2019 Jan 5;184(1):23. doi: 10.1136/vr.104590. Reid J, Gildea E, Davies V, Thompson J, Scott M. Measuring the effect of the anti-nerve growth factor antibodies bedinvetmab and frunevetmab on quality of life in dogs and cats with osteoarthritis using a validated health-related quality of life outcome measure: an observational real-world study. Front Vet Sci. 2024 Aug 14;11:1395360. doi: 10.3389/fvets.2024.1395360. Monteiro, B.P., Lascelles, B.D.X., Murrell, J., Robertson, S., Steagall, P.V.M. and Wright, B. (2023), 2022 WSAVA guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract, 64: 177-254. https://doi.org/10.1111/jsap.13566 Corral MJ, Moyaert H, Fernandes T, Escalada M, Kira S Tena J, Walters RR, Stegemann MR. A prospective, randomized, blinded, placebo-controlled multisite clinical study of bedinvetmab, a canine monoclonal antibody targeting nerve growth factor, in dogs with osteoarthritis. Vet Anaesth Analg. 2021 Nov;48(6):943-955. doi: 10.1016/j.vaa.2021.08.001. Krautmann M, Walters R, Cole P, Tena J, Bergeron LM, Messamore J, Mwangi D, Rai S, Dominowski P, Saad K, Zhu Y, Guillot M, Chouinard L. Laboratory safety evaluation of bedinvetmab, a canine anti-nerve growth factor monoclonal antibody, in dogs. Vet J. 2021 Oct;276:105733. doi: 10.1016/j.tvjl.2021.105733
