References

Intra-Articular Hyaluronic Acid Compared to Traditional Conservative Treatment in Dogs with Osteoarthritis Associated with Hip Dysplasia

Summary:

“The purpose of this study was to compare the efficacy of the intra-articular (IA) hyaluronic acid injection to traditional conservativetreatment (TCT) in dogs with osteoarthritis (OA) induced by hip dysplasia.”

Conclusion:

“Both treatments reduced the clinical signs associated with hip OA. However, more significant results were achieved with intra-articular hyaluronic acid injection.”

Author & Journal:Carapeba, Gabriel O. L., et al, Hindawi Evidence-Based Complementary and Alternative Medicine Journal, 2016

Low-level laser irradiation induces in vitro proliferation of mesenchymal stem cells

Summary:

To evaluate the effect of low-level laser irradiation on the proliferation and possible nuclear morphological changes of mouse mesenchymal stem cells.

Conclusion:

Low-level laser irradiation stimulated the proliferation of mouse mesenchymal stem cells without causing nuclear alterations. The biostimulation of mesenchymal stem cells using laser therapy might be an important tool for regenerative therapy and tissue engineering.

Author & Journal:Augusto Galvão Barboza,Carlos, et al, eintstein, 2014

Mechanisms of action and potential uses of hyaluronan in dogs with osteoarthritis

Summary:

Consideration of the use of intra-articular hyaluronic acid (IAHA) for treatment of OA in dogs.

Conclusion:

“The mechanisms by which IAHA may lead to improvement in clinical signs and homeostasis in joints affected by OA may include restoration of vis- coelasticity and lubrication, antinociceptive and anti- inflammatory effects, enhancement of anabolic processes, and inhibition of catabolic processes. Because the activity of catabolic and anabolic factors in osteoarthritis is controlled by a complex network of binding proteins, cell receptors, and signaling path- ways, it is likely that these multiple effects interact with each other to result in improvement of joint health. However, in vitro findings and in vivo evidence in other species may not be directly relevant to use of this treatment in dogs. Although currently available data indicate potential benefits of using IAHA for treat- ment of OA in dogs, the authors do not recommend its clinical use until further evidence for clinical efficacy and safety in dogs with OA is provided in the literature.”

Author & Journal:Kuroki, Keiichi, et al, Journal of the American Veterinary Medical Association, 2002

OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis

Summary:

To update and expand upon prior Osteoarthritis Research Society International (OARSI) guidelines by developing patient-focused treatment recommendations for individuals with Knee, Hip, and Polyarticular osteoarthritis (OA) that are derived from expert consensus and based on an objective review of high-quality meta-analytic data.

Conclusion:

These guidelines offer comprehensive and patient-centered treatment profiles for individuals with Knee, Hip, and Polyarticular OA. The treatment algorithm will facilitate individualized treatment decisions regarding the management of OA.

Author & Journal:, R R Bannuru, M C Osani, E E Vaysbrot, N K Arden, K Bennell, S M A Bierma-Zeinstra, V B Kraus, L S Lohmander, J H Abbott, M Bhandari, F J Blanco, R Espinosa, I K Haugen, J Lin, L A Mandl, E Moilanen, N Nakamura, L Snyder-Mackler, T Trojian, M Underwood, T E McAlindon, Osteoarthritis and Cartilage, 2019

Opioids Out, Cannabis In Negotiating the Unknowns in Patient Care for Chronic Pain

Summary:

“Unless the nation develops an increased tolerance to chronic pain, reduction in opioid prescribing leaves a vacuum that will be filled with other therapies.” Consideration for the pharmacological, social and legal role of cannabis as an alternative for prescribing opioids.

Conclusion:

The prescribing of opioid therapy for chronic noncancer pain advanced unchecked until opioid-related adverse events and other consequences reached epic proportions. To ensure the medical community does not repeat this mistake with cannabis, physicians should balance the need to keep pace with the swiftly evolving cultural, social, and legal climate surrounding cannabis use for pain with the imperative to guide practice with sound science.

Author & Journal:Choo, Esther K. et al, JAMA, 2016

Outpatient Oral Analgesics in Dogs and Cats Beyond Nonsteroidal Anti-inflammatory Drugs

Summary:

This article evaluates the current literature on oral analgesics and analgesic adjuncts in dogs and cats. An overview of how dosing recommendations are made covering controlled clinical trials, experimental study design, and pharmacokinetic studies is included.

Conclusion:

The weight of evidence for each drug [Polysulfated glycosaminoglycans, Amantadine, Tramadol, Gabapentin, Pregabalin, Codeine, Hydrocodone, Amitriptyline, Venlafaxine, Duloxetine, Glucosamine and chondroitin, Morphine, Oxycodone, Methadone] is reviewed and compared with the gold standard, controlled clinical trials. Other evidence such as experimental studies, extrapolation of pharmacokinetic studies, and case reports/series is also considered.

Author & Journal:KuKanich, Butch, Veterinary Clinics of North America: Small Animal Practice, 2013

Pharmacokinetics, Safety, and Clinical Efficacy of Cannabidiol Treatment in Osteoarthritic Dogs

Summary:

“The objectives of this study were to determine basic oral pharmacokinetics, and assess safety and analgesic efficacy of a cannabidiol (CBD) based oil in dogs with osteoarthritis (OA).”

Conclusion:

“Pharmacokinetics revealed an elimination half-life of 4.2 h at both doses and no observable side effects. Clinically, canine brief pain inventory and Hudson activity scores showed a significant decrease in pain and increase in activity (p < 0.01) with CBD oil. Veterinary assessment showed decreased pain during CBD treatment (p < 0.02). No side effects were reported by owners, however, serum chemistry showed an increase in alkaline phosphatase during CBD treatment (p < 0.01).”

Author & Journal:Gamble, Lauri-Jo et al, Frontiers in Veterinary Science, 2018

Potential Adverse Effects of Omega‐3 Fatty Acids in Dogs and Cats

Summary:

Fish oil omega‐3 fatty acids, mainly eicosapentaenoic acid and docosahexaenoic acid, are used in the management of several diseases in companion animal medicine, many of which are inflammatory in nature. This review describes metabolic differences among omega‐3 fatty acids and outlines potential adverse effects that may occur with their supplementation in dogs and cats with a special focus on omega‐3 fatty acids from fish oil. Important potential adverse effects of omega‐3 fatty acid supplementation include altered platelet function, gastrointestinal adverse effects, detrimental effects on wound healing, lipid peroxidation, potential for nutrient excess and toxin exposure, weight gain, altered immune function, effects on glycemic control and insulin sensitivity, and nutrient‐drug interactions.

Conclusion:

Adverse effects, if observed, are likely to be dose‐dependent. It is necessary to understand dosages of omega‐3 fatty acids to understand how much fish oil to supplement, or what dietary concentration to aim for when recommending omega‐3 supplementation. Provision of omega‐3 fatty acids can be expressed as milligrams of total omega‐3 fatty acids per kilogram body weight; as milligrams of EPA and DHA per kilogram body weight or metabolic body weight; as a dietary amount on a per energy basis (grams or milligrams per 100 or per 1,000 kcal); or as a dietary amount on a per weight basis (grams or milligrams per 100 grams of diet as fed or on dry matter basis). The amount of omega‐3 fatty acids also can be expressed as a ratio of n‐6:n‐3 fatty acids, or as a ratio of “functional” fatty acids (LA + AA: EPA + DHA). The same enzymes are involved in the metabolism of omega‐6 and omega‐3 fatty acids, resulting in competition between these fatty acids for incorporation into cell membranes and other biological properties. Therefore, dietary excess or deficiency of LA versus ALA may influence conversion rates to downstream products. Dietary amounts of omega‐6 versus omega‐3 fatty acids are frequently expressed as a dietary n‐6:n‐3 ratio in addition to absolute amounts for this reason. However, ALA is not equivalent to EPA and DHA and the total n‐6:n‐3 ratio by itself does not accurately describe the fatty acid composition of the diet. A product with a high total omega‐3 fatty acid concentration could contain high concentrations of ALA, high concentrations of EPA and DHA, or a combination of these fatty acids. Because diets with ALA have different effects when compared with diets enriched in EPA and DHA, the type of omega‐3 fatty acids is crucial information and the lack of distinction between these fatty acids may contribute to the equivocal nature of results of earlier studies.

Author & Journal:C.E. Lenox and J.E. Bauer, J Vet Intern Med.

Preliminary clinical experience of low-level laser therapy for the treatment of canine osteoarthritis-associated pain: A retrospective investigation on 17 dogs

Summary:

Laser therapy (aka photobiomodulation) is often used to treat OA in veterinary patients, but the evidence to support this treatment is weak. At the time of this publication, there was one single prior publication investigating laser therapy for dogs with elbow OA (Looney et. al, Can Vet J 2018). This study found that with the laser and protocol studied (980 nm, 5-12 W, CW, 1-2.4W/cm2, 10-19 J/cm2, non-contact mode, scanning method; treatment 2x week for 3 weeks then once a week for 3 weeks), laser-treated dogs (n=11) showed significantly (p=0.001) greater reduction in lameness compared to sham (n=9) treated dogs. NSAID dose was also able to be decreased in 9 of the 11 laser-treated dogs. The authors of the current study (Barale et. al) aimed to report the clinical outcomes following a different laser therapy protocol in dogs with OA.

Conclusion:

This retrospective report provides a basis for future investigations, needed to clarify whether laser therapy may be beneficial to treat canine OA-associated pain. The preliminary findings are promising and suggest that LLLT may help to reduce the analgesic administration and improving client satisfaction and the quality of life of dogs with OA.

Author & Journal:Loris Barale, Paolo Monticelli, Massimo Raviola, and Chiara Adami, Open Vet J., April 2020

Prospective trial of autologous conditioned plasma versus hyaluronan plus corticosteroid for elbow osteoarthritis in dogs

Summary:

“This prospective, randomized, double-blinded trial compared outcomes in dogs with bilateral elbow osteoarthritis (OA) treated with hyaluronan plus methylprednisolone (HA + S) or autologous conditioned plasma (ACP(®); Arthrex).”

Conclusion:

“These data provide some evidence to support use of either hyaluronan plus methylprednisolone acetate or autologous conditioned plasma alone or as an adjunct to other non-surgical or surgical treatment of elbow OA and may be particularly useful for patients which cannot tolerate other disease- modifying osteoarthritis drugs such as NSAIDs. The evidence for efficacy based upon these data are relatively weak because of the study limitations, but the lack of any complications is valuable in justifying their attempted use when other therapies have failed and in justifying further study of these products to more rigorously assess their benefits.”

Author & Journal:Franklin, Samuel et al, Canadian Veterinary Journal 2013