Pet Parents Dashboard

Management

COAST Development Group’s international consensus guidelines for the treatment of canine osteoarthritis

Summary:

This report describes consensus guidelines and recommendations for the treatment of canine osteoarthritis (OA) according to the “Canine OsteoArthritis Staging Tool excluding radiography” (COASTeR) stage of OA, by the COAST Development Group. The recommendations are based on evidence-based medicine and clinical experience and are proposed with international relevance in mind. The aim is to provide veterinarians with a practical reference to consolidated information and to support the development of patient-specific OA management protocols and informed treatment choices based on the stage of OA.

Conclusion:

Canine osteoarthritis is a complex disease and only animal healthcare professionals with personal knowledge of the patient can optimize care plans to meet the needs of the patient and requirements of the pet caregiver. This proposal for the first international guidelines for the treatment of canine osteoarthritis (OA), according to the COASTeR OA stage, is intended to provide a practical reference to evidence-based recommendations and expert opinion while leaving decision-making and the development of protocols appropriate to each dog’s specific situation, firmly in the hands of the consulting veterinarian. The authors encourage the use of the COAST staging tool and the COAST canine OA treatment guidelines proposal, and welcome feedback to help guide future updates and the optimization of both ([email protected]).

 

Author & Journal:Thibaut Cachon, Ole Frykman, John F. Innes, B. Duncan X. Lascelles, Masahiro Okumura, Pedro Sousa, Francesco Staffieri, Paulo V. Steagall, Bernadette Van Ryssen; Frontiers in Veterinary Science
Learn More

Total joint replacement in the dog.

Summary:

Total joint replacement has evolved over the past 50 years from a concept that was first attempted in people suffering from osteoarthritis to a commonly applied practice in veterinary medicine. Although many questions have been answered, several controversies still exist, with many implant and technical options being explored.

Conclusion:

Currently, total hip and elbow replacement are commercially available options viable for use in dogs. These options are detailed in this article. Joint replacement for other canine joints (ie, knee, hock, shoulder) that develop osteoarthritis likely will be developed in the near future.

Author & Journal:Conzemius MG, et al, Vet Clin North Am Small Anim 2005
Learn More

Tibial osteotomies for cranial cruciate ligament insufficiency in dogs.

Summary:

To review the biomechanical considerations, experimental investigations, and clinical data pertaining to tibial osteotomyprocedures for treatment of cranial cruciate ligament (CrCL) insufficiency in dogs.

Conclusion:

Currently available data does not allow accurate comparisons between different tibial osteotomy procedures, or with traditional methods of stabilizing the CrCL-deficient stifle. Carefully designed long-term clinical studies and further biomechanical analyses are required to determine the optimal osteotomy technique, and whether these procedures are superior to other stabilization methods.

Author & Journal:Kim SE, et al, Vet Surg 37:111–125, 2008
Learn More

Safety and functional outcomes associated with short-term rehabilitation therapy in the post-operative management of tibial plateau leveling osteotomy.

Summary:

This retrospective cohort study using electronic questionnaires compared the perioperative complication rates of tibial plateau levelling osteotomy (TPLO) surgery and the 8-week, 6-month, and 1-year functional outcomes, between rehabilitation and traditional post-operative management.

Conclusion:

This study suggests that rehabilitationperformed by a certified practitioner is safe and may improve short-term outcomes when used in the initial postoperative managementfor dogs treated with TPLO.

Author & Journal:Romano LS, et al, Can Vet J 56:942-946, 2015
Learn More

Long-term follow-up of avascular necrosis of the femoral head in the dog.

Summary:

In a clinical study of 35 dogs with avascular necrosis of the femoral head, 60 per cent were Yorkshire terriers; the mean age of 33 of the dogs at onset of clinical signs was seven months. The dogs had the following signs: muscle atrophy (n = 25), shortening of the affected leg (n = 14), pain on passive movement of the hip joint (n = 28), and crepitation of the hip joint (n = 8). Radiographic findings were irregular density and flattening of the femoral head in combination with degenerative joint disease. Conservative treatment consisted of exercise therapy, and surgical treatment of a standard femoral head and neck excision.

Conclusion:

In 17 of the dogs the results of therapy were evaluated with the help of a questionnaire. It is concluded that femoral head and neck excision is indicated when conservative treatment fails to lead to clinical improvement within four weeks. Femoral head and neck excision has a good long term prognosis; however, slight intermittent lameness may remain.

Author & Journal:Piek CJ, et al, J Small Anim Pract 1996 37(1):12-18
Learn More

Stabilization of the CORA based leveling osteotomy for treatment of cranial cruciate ligament injury using a bone plate augmented with a headless compression screw.

Summary:

To report the effectiveness of a bone plate/headless compression screw (HCS) construct in preventing tibial plateau angle (TPA) shift postoperatively and to describe radiographic healing of the osteotomy.

Conclusion:

Stabilization of the CBLO using a bone plate augmented with a HCS was effective in maintaining PostTPA and achieving satisfactory radiographic healing.

Author & Journal:Raske M, et al, Vet Surg 42: 759-764, 2013
Learn More

Evaluation of the clinical effects of diet and physical rehabilitation in dogs following tibial plateau leveling osteotomy

Summary:

To assess clinical effects of an omega-3 fatty acid and protein-enriched diet, physical rehabilitation, or both in dogs following tibial plateau leveling osteotomy (TPLO) and arthroscopic surgery for cranial cruciate ligament (CCL) disease.

Conclusion:

Feeding the TF and providing physical rehabilitation during the first 6 months after TPLO were associated with improvements in some indices of clinical outcome and function in dogs. Significant interactions between time and some outcome variables were observed, indicating further research is warranted.

Author & Journal:Baltzer WI, et al, J Am Vet Med Assoc 252:686-700, 2018
Learn More

Systemic administration of glycosaminoglycan polysulphate (arteparon) provides partial protection of articular cartilage from damage produced by meniscectomy in the canine.

Summary:

Bilateral medial meniscectomy was undertaken in 14 mature beagles. Another two underwent arthrotomy (sham-operated controls).

Conclusion:

The results indicated that Arteparon provided some protective effect to AC in the meniscectomised compartment as demonstrated histologically by reduced surface fibrillation, diminished chondrocyte cloning, and maintenance of alcianophilia. The levels of PGs and hexuronate-protein ratios in medial AC of drug-treated meniscectomised animals were found to be comparable to sham controls, whereas these parameters in the nondrug-treated meniscectomized group were depressed.

Author & Journal:Hannan N, et al, J Orthop Res 1987; 5:47-49
Learn More

Femoral Head and Neck Excision.

Summary:

Femoral head and neck excision is a surgical procedure that is commonly performed in small animal patients. It is a salvage procedure that is done to relieve pain in the coxofemoral joint and restore acceptable function of the limb. Femoral head and neck excision is most commonly used to treat severe osteoarthritis in the coxofemoral joint and can be done in dogs and cats of any size or age.

Conclusion:

The procedure should not be overused and ideally should not be done when the integrity of the coxofemoral joint can be restored.

Author & Journal:Harper TAM, Vet Clin North Am Small Anim Pract 2017
Learn More