Osteoarthritis (OA) of the stifle joint is a progressive degenerative disease in dogs, which can have a profound impact on quality of life (Vasseur & Berry 1992; Lazar et al. 2005; Hielm-Bjorkman et al. 2011). The clinical signs of stifle OA include discomfort, limited joint range of motion, loss of muscle mass and muscle tone, and decreased overall limb use. The pain can be difficult to control. One of the primary reasons hindering successful management may be the presence of central nervous system plasticity (Knazovicky et al. 2016). Additionally, while OA is considered a chronic progressive disease, the clinical picture may be quite dynamic with both intermittent periods of acute signs, or ‘flareups,’and periods of clinical quiescence. Given all of these cofactors, it is not surprising that there is variation in the clinical impact between individual dogs.

The goals of medical management are to minimize the clinical signs of OA, maintain or improve limb use and, if possible, slow the progression of the disease. Remember, OA of the joint is an end-stage process; current medical management protocols are directed at ameliorating those clinical signs. It has been proposed that multimodal therapy can yield a