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Canine Hip Dysplasia: Reviewing the Evidence for Nonsurgical Management

Summary:

This systematic review of available evidence for nonsurgical management of hip dysplasia considered 14 articles and scored nonsurgical management including: activity restrictions, weight management, acupuncture, modulation of joint disease by polysulfated glycosaminoglycans, mesenchymal stem cell therapy, and extra corporeal shock wave therapy.

Conclusion:

“Weight management is an effective and important component of managing dogs with HD and associated osteoarthritis. Techniques that modulate the progression of joint disease may also be beneficial for treating dogs with HD. Further studies are needed to investigate other methods of managing HD such as hydrotherapy and physical rehabilitation.”

Author & Journal:Shaw, Kristin Kirkby et al, Veterinary Surgery, 2012
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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
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Effects of intramuscular administration of glycosaminoglycan polysulfates on signs of incipient hip dysplasia in growing pups.

Summary:

We tested the hypothesis that treatment of growing, susceptible (to hip dysplasia) pups by IM administration of glycosaminoglycanpolysulfates would mitigate the signs of incipient hip dysplasia.

Conclusion:

Of 8 treated pups, none had subluxation radiographically, whereas 4 of 8 control dogs had femoral head subluxation. Mean Norberg angle on the radiographs was 109.7 degrees +/- 1.6 degrees for the treated group and was 101.5 degrees +/- 1.6 degrees for controls, representing a mean improvement in coxofemoral congruity of 8.2 degrees in the treated pups.

Author & Journal:Lust G, et al, Am J Vet Res 1992; 53:1836-1843
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Evaluation of polysulfated glycosaminoglycan for the treatment of hip dysplasia in dogs.

Summary:

A double-blinded, controlled clinical study was performed to compare the response of adult dogs affected with hip dysplasia to a placebo and three different dosages of polysulfated glycosaminoglycan (PSGAG): 2.2 mg/kg, 4.4 mg/kg, and 8.8 mg/kg. Dogs were randomly assigned to treatment groups. The drug was administered intramuscularly every 3 to 5 days for a total of eight injections. Response to treatment was analyzed based on changes in lameness, range of motion (ROM), and pain on manipulation of the hip joints.

Conclusion:

Eighty-four met all criteria for inclusion in the study. Dogs that were given 4.4 mg/kg of PSGAG showed the greatest improvement in orthopedic scores, whereas dogs in the placebo group showed the smallest improvement; however, the differences in clinical improvement between the four treatment groups were not statistically significant. No local or systemic adverse reactions related to the drug were observed.

Author & Journal:DeHaan JJ, et al, Vet Surg 1994;23:177–181
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Effect of polysulfated glycosaminoglycan on DNA content and proteoglycan metabolism in normal and osteoarthritic canine articular cartilage explants.

Summary:

To study the effect of polysulfated glycosaminoglycan (PSGAG) on proteoglycan metabolism and DNA content of control and osteoarthritic (OA) cartilage.

Conclusion:

OA cartilage was responsive to treatment with PSGAG at 100-fold lower concentration than control cartilage. When treated with PSGAG, articular cartilage explants maintained or increased DNA content at the expense of proteoglycan synthesis. Following MMP activation, proteoglycan degradation was inhibited in OA and control explants in a dose-dependent manner.

Author & Journal:Sevalla K, et al, Vet Surg 2000;29: 407-414
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Effects of treatment with polysulfated glycosaminoglycan on serum cartilage oligomeric matrix protein and C-reactive protein concentrations, serum matrix metalloproteinase-2 and -9 activities, and lameness in dogs with osteoarthritis.

Summary:

To investigate the effects of polysulfated glycosaminoglycan (PSGAG) treatment on serum cartilage oligomeric matrix protein (COMP) concentration, matrix metal-loproteinase-2 (MMP-2) and -9 (MMP-9) activities, C-reactive protein (CRP) concentration, and lameness scores in dogs with osteoarthritis.

Conclusion:

IM administration of PSGAG inhibited COMP degradation in dogs with osteoarthritis. Results indicate that decreases in serum COMP concentrations might be related to improvement in lameness after PSGAG treatment.

Author & Journal:Fujiki M, et al, Am J Vet Res 2007;68:827–833
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