Treatment options for working dogs with canine osteoarthritis
By Sarah Love, DVM
Diplomate American College of Veterinary Sports Medicine and Rehabilitation
Diplomate American College of Veterinary Internal Medicine
Certified in Canine Rehabilitation Therapy and Veterinary Spinal Manipulation Therapy
Canine osteoarthritis (or simply known as “OA”) is diagnosed based on the working dog’s medical history and the physical exam. During the exam, the veterinarian will look for any joint swelling, pain on joint manipulation, and signs of lameness/limping. Additional diagnostics may be performed as well, including X-rays, and taking a sample of the joint fluid to have it analyzed for different types and amounts of white blood cells. This tells us what type of inflammation is present and helps us diagnose the specific type of arthritis that is present and what treatment would be recommended.
Fortunately, there are many treatments available for OA in working dogs. Depending on the particular patient, veterinarians may even use a combination of treatments in hopes of keeping working dogs as pain-free as possible and allow them to continue to be out in the field. In general, the groups of treatments we have available are:
* Weight loss and conditioning programs
* Oral medications and supplements
* Subcutaneous or intramuscular injections
* Physical treatments
* Joint injections
Joint-specific therapy is very appealing as a targeted way to treat OA. This is why joint injections are often used by sports medicine and physical rehabilitation veterinarians. Types of joint injections can be broken down into 2 general categories, orthobiologics and non-orthobiologics, each with subtypes.
Types of joint injection therapies include:
* PRP (platelet rich plasma)
* Stem cell therapy
* Hyaluronic acid
* Polyacrylamide hydrogels and other proprietary biomaterials
* Radionuclide (Tin-117m)
Platelet rich plasma (PRP) and stem cell therapies have been studied with mixed results. PRP has shown more success in helping dogs with OA improve function by releasing enzymes to help decrease inflammation and improve the joint fluid health. With PRP, the onset of improved clinical signs typically takes a few weeks to months and can last several months to years. Each dog has a different response. There are many brands of PRP available to veterinarians, each with its own benefits.
Hyaluronic acid typically acts much more quickly to improve the signs of OA but doesn’t last as long. It adds lubrication and may help improve the collagen in the joint. In the canine sports medicine world, these are the ones that you may see used to help get dogs through a specific event or through a season. There are many brands of hyaluronic acid available to veterinarians.
Steroids have been around a very long time and provide short-term benefits in decreasing inflammation in a joint. However, many studies have shown that steroids may cause damage to cartilage within the joint so it is not a therapy that should be used very frequently. Also, the duration of action of steroids is typically very short, lasting only days to weeks.
Polyacrylamide hydrogels and proprietary biomaterials are newer products to the canine world. Some of these have been used in horses and in Europe for several years. They add lubrication and a cushioning type of effect to the joint. However, there is very limited data for these products in dogs and the canine sports medicine world is looking forward to seeing results from studies using these products.
Tin-117m joint injection is a canine-specific product called Synovetin OA®. Similar products have been used to treat humans with OA for many decades in Europe. Synovetin OA is a type of nuclear medicine that injects micro particles into the painful joint. Once there, they are absorbed and destroy the inflammatory cells that cause OA pain. Synovetin OA is has been shown in clinical studies to provide relief for up to 1 year with 1 dose. In actual practice, it has been seen to provide even longer-lasting pain relief. Safety studies of Synovetin OA have shown treatment effects stay inside the joint with no significant adverse effects to the joint itself or to the rest of the body.
Having several products for joint injections available to veterinarians has given us the ability to treat specific sites with targeted therapies, which can give excellent results. They require a very short sedation, are done on an outpatient basis, and require short periods of rest time afterwards. These treatments have improved the care of our canine athletes a great deal, keeping them comfortable and working hard.
For more information on how canine OA is diagnosed, please read the next article.
If you’d like more information about canine OA and Synovetin OA, email [email protected] or call (833) 942-1247.