Osteoarthritis (OA) is a common and debilitating condition in domestic dogs. Alongside pharmaceutical interventions and weight loss, exercise and physiotherapy (PT) are important measures in maintaining patient mobility and quality of life. Physiotherapy for OA aims to reduce pain, optimize muscular function and maintain joint function. Physiotherapeutic plans typically include PT exercises combined with therapeutic modalities, lifestyle and environmental modifications to improve the patient’s overall quality of life and function. Information on therapeutic clinical efficacy of physiotherapeutic measures for canine OA is still very limited. Thus, physiotherapeutic strategies are still primarily based on evidence extrapolated from human protocols tailored to people with OA. The authors propose a simple systematic PT approach for canine OA, prioritizing measures according to simplicity, cost effectiveness and practicality. This guide (the “Physiotherapy Pyramid”) aims to provide a clear stratified approach to simplify decision making and planning for owners, veterinarians and veterinary physiotherapists, leading to more straightforward design and implementation of treatment plans. Measures are implemented starting at the base of the pyramid, subsequently progressing to the top, allowing effective and practical interventions to be prioritized. The levels of the pyramid are in ascending order: environmental modification, exercise plan, OA-specific home exercises and treatment by a veterinary physiotherapist.

This is the first report of aggressive behaviour as the primary presenting sign in two dogs subsequently found to have chronic diskospondylitis, with neither dog showing other typical clinical signs of this condition. Mild signs of pain were elicited on physical examination in both dogs. Further medical investigation revealed signs indicative of chronic diskospondylitis (L7/S1) and treatment with analgesics and antibiotics was commenced. A marked improvement in behaviour was seen in both dogs when on treatment. Dog 1 stopped exhibiting unpredictable episodes of growling and biting when handled or approached and dog 2 stopped vocalising and occasional growling when handled or lifted. Gradual treatment withdrawal (dog 1 after six weeks and dog 2 after four weeks, respectively) caused a recurrence of behaviour signs thus further treatment was recommenced. Continued follow‐up over a year revealed the importance of long‐term use of analgesics to prevent behavioural deterioration when chronic lesions are present.