In this case-based session the long-term care of a dog with mobility impairment and osteoarthritis related pain will be discussed. The discussion will include the four important budgets of care (financial, time, emotional and physical), drug choices, adverse drug events, nutrition and dietary supplements. The importance of an integrative approach which combines multiple evidence-based drug and non-drug treatments will be highlighted. Disease trajectories and individualized quality of life assessments will also be included.