Which option best represents a multimodal approach to OA pain management to minimize NSAID use?

• A. NSAIDs alone
• B. Gabapentin or pregabalin, amantadine, topical analgesics, and hydrotherapy
• C. Weight management, physical therapy, environmental enrichment, and NSAIDs when needed with renal monitoring
• D. No analgesia

Answer: (C)

A multimodal approach to OA pain focuses on using several strategies that work through different mechanisms to control pain and improve function, while reducing reliance on any single treatment, especially NSAIDs. The strongest plan combines weight management to lessen joint load, physical therapy to improve range of motion and muscle support, and environmental enrichment to encourage movement and activity. Adding NSAIDs only when needed—and with renal monitoring—provides relief when necessary but minimizes potential kidney and other side effects. This combination targets the disease from multiple angles (weight, movement, and targeted analgesia) for safer, more sustainable pain control.

NSAIDs alone misses the broader, nonpharmacologic strategies that help reduce pain and improve function. The option emphasizing several drugs and hydrotherapy covers some modalities but omits weight management and routine renal safety monitoring, making it less comprehensive as a multimodal plan. No analgesia would fail to address the animal’s pain at all.