Therapeutic approach to arthritis in dogs
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Arthritis in dogs
Therapeutic approach to arthritis from NSAIDS to PRP
How to cope with this chronic disease and what are the alternatives
Arthritis it’s a very common condition in dogs, related to age, gender, genetic factors as well as obesity, exercise and diet. Arthritis is a disease based on a chronic degenerative process involving articular cartilage, causing deterioration with thickening of the capsule, synovitis and formation of osteophytes. Osteophytes are newly formed bone growths causing further cartilage alteration provoking pain during movement. Arthritis typically occurs as a result of alterations in the cruciate cranial ligament, hip and elbow dysplasia, dissecting osteochondritis, patella luxation.
Some races are more subject than others, some examples are:
Bulldog, Pug, Dogue de Bordeaux, Neapolitan Mastiff, Otterhound, St. Bernard, Brussels Griffon, Clumber Spaniel, Boerboel, Black Russian Terrier
as regards hip dysplasia,
while Chow Chow, Pug, Rottweiler, Bulldog, Fila Brasileiro, Boerboel, Otterhound, Bernese Mountain, Russian Black Terrier, Shar Pei
for elbow dysplasia
What do we need to do to fight arthritis?
The current therapeutic approach to this type of pathology provides a series of actions aimed primarily at relieving pain by side methods such as reducing and/or controlling the weight of the animal through a balanced diet, often integrating some nutraceutical product. Obviously, it is recommended to limit, but not erase, physical activity to not compromise the joint. There are also alternative methods such as acupuncture and laser therapy, although there are not so enough studies to support the efficacy of these practices.
Very common is the administration of Non Stereoidal Anti-inflammatory Drugs, NSAIDS. However they act exclusively on the symptoms, attenuating the pain and the degree of inflammation in the cartilage. Such treatments, however, are not able to regenerate the cartilage layer at the joint site and, for this reason, they are not able to permanently solve the alteration and/or destruction of the articular cartilage.
Arthritis is, in fact, a chronic disease, so acting on the symptoms, does not promote healing. When the reduction of pain is not enough, surgery is used, which includes reconstructive procedures, removals or replacement of the joint through prostheses or even removals of "aggravating" such as bone fragments or cartilage. This practice, however, is extremely invasive and often leads to the formation of adhesions and scar tissues, causing even more pain and difficulty in walking or lameness.
A less invasive alternative treatment is the infiltration of hyaluronic acid (HA), a component of synovial fluid that allows to protect the joint and reduces friction during movement, attenuating inflammation and pain. Although hyaluronic acid has shown a temporary improvement in the clinical condition in some applications, its effectiveness is reduced and has not yet been proven. Hyaluronic acid, once injected, is in fact quickly eliminated from the joint cavity through capillaries or lymphatic vessels, making the treatment ineffective in the medium/long term period. [1].
In regenerative medicine, the application of platelet-rich plasma (PRP) is an equally widespread practice.
The PRP is naturally rich in growth factors and cytokines, essential to stimulate the healing process and regeneration of soft tissues, bone regeneration and the formation of new articular cartilage. Many of the bioactive proteins released by platelets resemble those secreted by macrophages, mesenchymal stem cells and osteoblasts, and therefore play an essential role in tissue regeneration and healing. Growth factors participate in the regulation and synthesis of articular cartilage, also a source of cytokines and chemokines and other proteins that stimulate cell proliferation, chemotaxis and modulate inflammatory response. Once injected at the intra-articular level, the tissue calcium salts activate platelets stimulating the release of growth factors and inducing the gelation of PRP. In the form of gel, the release of growth factors is controlled over time. The gelled structure also acts as a three-dimensional scaffold, stimulating cell migration in the injured/inflamed site, cell proliferationand the release of new extracellular tissue matrix.
The effectiveness of the PRP is prolonged over time when associated with physiotherapy.
Intra-articular administration of PRP can slow down the progress of osteoarthritis by stimulating anabolism in cartilage and, through the modulation of the inflammatory response, also reducing pain. As a result, the animal starts to walk again, without feeling pain. The intra-articular cartilage is again produced, thus reducing bone rubbing.The PRP is also able to induce the production of new synovial fluid, effectively reducing the clutch during movement. PRP is also an autologous product, so it does not produce side effects or risks arising from immunological reactions and its effectiveness is prolonged over time if associated with physiotherapy.
Through several experimental studies, the efficacy of pure hyaluronic acid and a solution of hyaluronic acid mixed with PRP were compared. These studies have shown that the efficacy of hyaluronic acid alone is reduced and is evident in the short period immediately after injection. In contrast, the combination of HA and PRP is not only more effective and clinically evident, but also a long-term effect in the regeneration and maintenance of joint cartilage.Even after a single intra-articular injection, the PRP is able to maintain a stable chronic and irreversible disease such as osteoarthritis. In particular, if combined with proper physiotherapy, the effects of PRP can last for more than 6 months. [2].
Generally you can proceed with a single application, or, in severe cases, you can repeat the application even after 14 days from the first one, giving an additional boost to the regenerative process. [3]
Our solution
Ematik Run
Ematik Run is our product to treat arthritis and tendon pathologies. A simple blood sample allows to obtain up to three applications of the product, to be administered immediately or stored for future applications.
Fonti
1-Lee et al., “A placebo-controlled study comparing the efficacy of intra-articular injections of hyaluronic acid and a novel hyaluronic acid-platelet-rich plasma conjugate in a canine model of osteoarthritis”, Journal of Orthopaedic Surgery and Research; 2019
2- Cuervo et al., “Objective Comparison between Platelet Rich Plasma Alone and in Combination with Physical Therapy in Dogs with Osteoarthritis Caused by Hip Dysplasia”, Animals; 2020
3- Cook et al., “Multiple Injections of Leukoreduced Platelet Rich Plasma Reduce Pain and Functional Impairment in a Canine Model of ACL and Meniscal Deficiency”, Orthopaedic Research Society; 201
