The field of veterinary chronic pain medicine and veterinary orthopaedics is rapidly developing with new drugs, new diets and new surgeries being developed.CAM strongly believes we already have excellent tools to do a great job at managing our the disease if they are used promptly and correctly, but we are excited by these emerging treatment options that aim to be safer and in some cases more effective at slowing the progression of the disease.
This is a rapidly growing specialist field. If it is not offered in your own practice it can be accessed either at large veterinary referral centres that are equipped to offer the latest treatment options such as ultrasound therapy, laser therapy, shockwave therapy, transcutaneous electrical nerve stimulation therapy and hydrotherapy. There are also small physiotherapy centres, and many individuals who often provide a mobile service. Ask your vet who they would recommend.
The aim of rehabilitation of arthritis cases is to restore function, improve mobility, and relieve pain. As well as helping the owner construct a therapeutic exercise plan that they can continue in their own home.
When performed in trained, skilled hands the results can be astounding. However, it takes some financial input and time and commitment from the owner.
Intra-articular treatment focuses on encouraging good quality healing of damaged tissue, not simply trying to replace it. It is a complicated science of using the body’s own healing substances, concentrating them and directing their action straight at the target.
It has an established place within equine sports medicine proving its worth in countless studies looking at the quality and rate of tendon repair post injury. It is still proving its worth in canine medicine, so it is not widely practiced. Your vet will probably have to consult a specialist to answer your questions about it. It is becoming more accessible in general vet practices with mobile visiting services, and in-house equipment.
- There is not one intra-articular treatment solution for all joints. At different phases of the disease a different biological challenge is posed and this directs which product would be suitable to be injected into the joint. Currently autologous conditioned serum, platelet rich plasma, hyaluronic acid, bone marrow aspirate concentrate, cultured bone marrow derived stem cells, adipose derived cultured progenitor stem cells and stromal vascular fraction are commercially available.
- Clinical trials are very promising but more controlled studies are needed before these therapies are considered in routine management plans.
- An increasing number of practices around the country are embracing using intra-articular joint therapies. Some are using them with preventative health in mind, such as during joint surgery, others are using them to control the clinical signs of arthritis.
A new anti-inflammatory is now available that it more targeted in its action and thus has less side effects. Grapiprant, marketed as Galliprant by Elanco, acts differently to other available medications and hopefully will significantly reduce the adverse drugs reactions currently see in dogs that are on long term medications.
The use of monoclonal antibodies is becoming more mainstream in human medicine, but is very novel in veterinary medicine. This group of medications will be classified as a drug but are actually engineered copies of the dog’s own anti-inflammatory antibodies.
They are still being evaluated and not currently available in the UK, but we hope will become an integral part of arthritis treatment strategies.
This is a very new concept in managing canine arthritis, and hopefully will be an affordable, accessible tool for practitioners to offer owners of dogs that have severely progressed disease within the joint. Your vet is likely to be hesitant to recommend it until there are strong clinical results, and will need to consult a specialist.
It is an implant of a polyacrylamide hydrogel (PAAG-Arthramid) into the joint. It has a stronger position in equine medicine, with a number of studies showing it to be rapidly effective at controlling the pain of arthritis, and being more beneficial that current mainstream joint therapies.