Current evidence for non-pharmaceutical, non-surgical treatments of canine osteoarthritis.

Osteoarthritis is a progressive degenerative disease process that affects a significant proportion of the canine population, impacting these animals' quality of life. Currently, there is no cure and treatment consists of managing the clinical signs of pain and reduced mobility. There are many treatments for canine osteoarthritis and in this review we discuss the evidence base behind non-pharmaceutical, non-surgical treatments of this disease. These treatments include weight management, nutraceuticals, acupuncture, physiotherapies such as therapeutic exercise, hydrotherapy as well as other therapeutic modalities including photobiomodulation therapy, electromagnetic field therapy and others.

Use of Enrofloxacin and Hydrotherapy in the Management of Fibrodysplasia Ossificans Progressiva (FOP) in a Savannah Cat.

FOP is a rare genetic condition, described mainly in man and cats, characterized by progressive, painful debilitation and shortened lifespan. A 10-month-old neutered male Savannah cat was referred for progressive gait abnormalities and multifocal firm masses within the soft-tissues that were unresponsive to previous treatment. Diagnosis of FOP was based on histopathological evaluation of intralesional biopsies, which revealed osteo-cartilaginous metaplasia and fibrocellular proliferation with intralesional chondrogenesis and endochondral ossification. The cat was managed with 5 mg/kg BID enrofloxacin and hydrotherapy for 3 years until acute death. During that three-year period, the cat displayed consistent improvement in endurance, quality of life, and range of motion. Postmortem histopathology further confirmed the diagnosis of FOP via identification of intramuscular and intra-fascial ossification with lymphoplasmacytic infiltration, degeneration, and regeneration of adjacent myocytes. To the authors' knowledge, this is the first report of long-term enrofloxacin treatment and hydrotherapy for the management of FOP in a cat, leading to improved mobility and survival time, and the first report of FOP in an exotic breed cat.

A study using a canine hydrotherapy treadmill at five different conditions to kinematically assess range of motion of the thoracolumbar spine in dogs.

BACKGROUND: Incline treadmill and underwater treadmill (UWTM) exercises are common canine rehabilitation modalities , which are often used in isolation in dogs recovering from spinal surgery. Early use of an incline during UWTM exercise may have the potential to improve rehabilitation outcomes in dogs, but, it is hypothesised that dorsoventral movement of the spine may be excessive meaning it is unsuitable in some circumstances. OBJECTIVES: The purpose of this study was to identify changes in canine spinal kinematics in dogs when using a dry treadmill at different angles of incline compared to an underwater treadmill using the same inclines. METHODS: Eight dogs were encouraged to walk on a dry, horizontal, underwater treadmill as well as under the same conditions with both a 10% and 20% incline. This was then repeated at a 10% and 20% incline with the addition of water to hock level. Data were collected using reflective anatomical markers placed at the occipital protuberance, T1, T13, L3, L7 and sacral apex, captured by a high-speed camera facing the lateral aspect of the treadmill. Dorsoventral motion of the spine as well as flexion, extension and range of motion (ROM) of T1, T13, L3 and L7 were recorded. RESULTS: We found significant differences in dorsoventral spinal ROM at T1, L3 and L7, but no significant differences in T13 ROM. No significant differences were found in flexion and extension of any of the joints assessed when comparing dry conditions to the use of water (P>0.05). CONCLUSIONS: The lack of significant differences in joint flexion and extension at T1, T13, L3 and L7 indicates the potential safe use of combining underwater treadmill and incline exercise in canine rehabilitation. However, a lack of uniformity in results makes distinguishing any patterns of significance difficult. More research is needed to establish the effects of these exercises in additional planes of motion before a treatment protocol can be established.

Safety of early postoperative hydrotherapy in dogs undergoing thoracolumbar hemilaminectomy.

OBJECTIVES: Hydrotherapy is a common part of the postoperative care after surgical treatment of thoracolumbar intervertebral disc extrusion in dogs. There are currently no guidelines on when to commence hydrotherapy after surgery. Early hydrotherapy may be associated with an increased risk of postoperative complications including surgical site infection and neurological deterioration. The goal of this study was to report the prevalence and types of postoperative complications in dogs receiving early hydrotherapy. MATERIALS AND METHODS: Eighty-three dogs commencing hydrotherapy within 5 days after surgical treatment for thoracolumbar intervertebral disc extrusion were included in a retrospective descriptive study. All postoperative complications were recorded. RESULTS: Ten minor and 16 major complications were recorded in a total of 26 dogs. The majority of recorded complications were unlikely, but not excluded to be, caused by the initiation time of hydrotherapy. One dog developed a surgical site infection and one dog had a confirmed further extrusion of the originally operated intervertebral disc, which may have been influenced by early initiation of hydrotherapy. CLINICAL SIGNIFICANCE: Early hydrotherapy is possibly associated with occurrence of postoperative complications. Associations between the reported complications and early hydrotherapy, and possible benefits of early hydrotherapy, need to be further investigated before early initiation of hydrotherapy can be recommended.

A single hydrotherapy session increases range of motion and stride length in Labrador retrievers diagnosed with elbow dysplasia.

Canine elbow dysplasia is a debilitating condition of unknown aetiology and is a common cause of forelimb lameness in dogs. Canine hydrotherapy is a therapeutic approach rapidly increasing in popularity for the treatment of a range of musculoskeletal pathologies. In this study, kinematic analysis was used to assess the effect of a customised hydrotherapy session on the range of motion, stride length and stride frequency of healthy Labrador retrievers (n=6) and Labrador retrievers diagnosed with bilateral elbow dysplasia (n=6). Reflective kinematic markers were attached to bony anatomical landmarks and dogs were recorded walking at their preferred speed on a treadmill before and 10min after a single hydrotherapy session. Range of motion, stride length and stride frequency were calculated for both forelimbs. Data were analysed via a robust mixed ANOVA to assess the effect of hydrotherapy on the kinematic parameters of both groups. Range of motion was greater in the healthy dogs at baseline (P<0.05). Hydrotherapy increased the range of motion of the forelimbs of both groups (P<0.05); dogs with elbow dysplasia demonstrated a greater improvement in range of motion than healthy dogs (P<0.05). Hydrotherapy stride length (P<0.01) of all dogs, but differences were not seen between the two groups. Stride frequency increased after hydrotherapy only in the left limb (P<0.05) in all dogs. These results support the potential of canine hydrotherapy as a therapeutic tool for the rehabilitation and treatment of Labradors with elbow dysplasia. Furthermore, results indicate that hydrotherapy might improve the gait and movement of healthy dogs. However, whether these results are transient or sustained remains undetermined.

Principles and Application of Hydrotherapy for Equine Athletes.

Hydrotherapy has become a key element within equine rehabilitation protocols and is used to address range of motion, proprioception, strength, neuromotor control, pain, and inflammation. Various forms of hydrotherapy can be tailored to the individual's injury and the expected return to athletic performance. This article describes the mechanisms of action of hydrotherapies and potential use in the clinical management of equine musculoskeletal injuries.

Effectiveness of salicylic acid paste for treatment of digital dermatitis in dairy cows compared with tetracycline spray and hydrotherapy.

The effectiveness of salicylic acid paste (PASTE) was tested for topical treatment of 25 acute and 25 chronic digital dermatitis (DD) lesions. Control groups with the same number of acute and chronic DD lesions were treated with topical oxytetracycline spray (SPRAY) and by washing only with water (HYDRO) respectively. The therapeutic effects were evaluated using a pain score, the healing rate, the lesion size and other parameters. Pre-treatment and control examinations were carried out on day 0, 4, 14 and 21. In the PASTE group, 76.0% of acute DD lesions were pain free and 64.0% of acute DD lesions were healed on day 21 showing a normal skin surface (MO). Only 28.0% of acute DD lesions treated with SPRAY and 16.0% treated with HYDRO had healed on day 21. A significantly higher healing rate was revealed in acute lesions for the PASTE compared to the HYDRO group (p < 0.05) for all three re-checks, and for the PASTE group compared with the SPRAY group (p < 0.05) for day 4 and day 14. Healing rates of chronic DD lesions were higher in the PASTE group with 44.0% on day 14 and 36.0% on day 21, compared with 16.0% in the SPRAY and 32.0% in the HYDRO group on day 14, and 20.0% (SPRAY) and 28.0% (HYDRO) on day 21 respectively. The recurrence rate of lesions after they had healed during the study period was 14.5% in total. Digital dermatitis lesions treated with salicylic acid paste and a wrap showed significantly higher healing rates within the study period, odds ratios for healing of acute lesions with PASTE were 4.5 to 6.7 times higher than with SPRAY, and 9.3 to 36.4 higher compared with HYDRO.

Aseptic tenosynovitis of the carpal flexor sheath caused by rupture of the accessory ligament of the deep digital flexor tendon.

A mare was evaluated for acute left forelimb lameness with effusion of the carpal flexor sheath. No osseous abnormalities were noted during radiographic examination. Significant disruption of the accessory ligament of the deep digital flexor tendon was seen during ultrasonographic examination. Carpal sheath effusion and lameness resolved after medical treatment.

Péritendinite aseptique de la gaine du fléchisseur carpien causée par la rupture du ligament accessoire du tendon fléchisseur digital profond. Une jument a été évaluée pour une boiterie aiguë de la patte avant gauche avec effusion de la gaine du fléchisseur carpien. Aucune anomalie osseuse n'a été observée durant l'examen radiographique. Une perturbation importante du ligament accessoire du tendon fléchisseur digital profond a été constatée durant l'échographie. L'effusion de la gaine carpienne et la boiterie se sont résorbées après un traitement médical.(Traduit par Isabelle Vallières).

Evaluation of the status of canine hydrotherapy in the UK.

To establish the current status of canine hydrotherapy in the UK and to ascertain information regarding the current use of hydrotherapy, a questionnaire was sent to 152 hydrotherapy centres throughout the UK, from which 89 responded. Hydrotherapy was found to be a rapidly growing business. Stand-alone centres were in existence; however, many centres were connected to other businesses, including boarding kennels and general practice veterinary surgeries. The dogs using the facility were mainly pedigree breeds, particularly labrador retrievers (30 per cent), and the most commonly encountered conditions were rupture of the cranial cruciate ligament (25 per cent), hip dysplasia (24 per cent) and osteoarthritis (18 per cent). The proportion of qualified versus unqualified staff varied between centres, highlighting a need for improved regulation of this aspect of the industry. However, all the dogs treated by the hydrotherapy centres surveyed were direct veterinary referrals, suggesting a good degree of professionalism in the field and a high regard for the benefits of hydrotherapy.

Prognostic indicators for nonambulatory cattle treated by use of a flotation tank system in a referral hospital: 51 cases (1997-2008).

OBJECTIVE: To evaluate clinical variables assessed during the first 24 hours of hospitalization as prognostic indicators for nonambulatory cattle treated by use of a flotation tank. DESIGN: Retrospective case series. ANIMALS: 51 nonambulatory cattle that underwent flotation treatment. PROCEDURES: Signalment, history, serum biochemical analyses, patient behavior during flotation, and outcome data were collected from medical records. Outcome was survival to discharge from the hospital or nonsurvival (death or euthanasia). Data were analyzed by use of Wilcoxon rank sum, Fisher exact, and chi(2) tests. RESULTS: 19 of 51 cattle survived. Survivors and nonsurvivors did not differ significantly with regard to median weight; age; stage of lactation; duration of recumbency prior to flotation; serum potassium, ionized calcium, or phosphate concentrations at admission to the hospital; or serum creatine kinase activity (value at admission to the hospital, highest value, and last recorded value). Cattle that were able to walk out of the tank after the first flotation treatment were 4.8 times as likely to survive as those that could not. Cattle that did not eat during flotation treatment were 1.9 times as likely to die as those that ate. Cattle that stood apparently normally on all limbs during the first flotation treatment were 2.9 times as likely to survive as those that had an asymmetric stance or were unable to stand. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that objective variables evaluated during the first 24 hours of hospitalization and flotation treatment are associated with outcome among nonambulatory cattle; findings might assist in logical decision making with respect to treatment options.

Management of quadriceps contracture in a dog using a static flexion apparatus and physiotherapy.

A four-month-old golden retriever developed quadriceps contracture following management of a comminuted femoral fracture with an intramedullary pin and cerclage wire. Management involved surgical release of the quadriceps, rigid stabilisation of the fracture, use of a static stifle flexion apparatus and postoperative physiotherapy. The dog returned to full activity with normal stifle function.

The efficacy of a commercial shampoo and whirlpooling in the treatment of canine pruritus - a double-blinded, randomized, placebo-controlled study.

Twenty-two dogs with a history of at least 4 weeks pruritus were studied to determine the effect of whirlpool use on the efficacy of topical therapy with an antipruritic shampoo (Allermyl, Virbac; Bad Oldesloe, Germany). Dogs in group 1 received initially topical therapy with conventional shampooing (2 mL shampoo per kilogram bodyweight) once weekly for 4 weeks. Dogs in group 2 received the same therapy using a whirlpool (Sanwhirl, Peter Aschauer GmbH; Gräfelfing, Germany). The treatments were crossed between the groups resulting in each dog in groups 1 and 2 receiving both therapies. Group 3 was the control group and was treated once weekly in the whirlpool without any shampoo during the 8 weeks of study. Prior to each therapy, dogs were evaluated by a clinician not aware of the type of treatment using a clinical scoring system (Canine Atopic Dermatitis Extent and Severity Index - CADESI). Owners evaluated the pruritus daily on a visual analogue scale. There was a significant difference in pruritus scores but not CADESI scores after therapy between the control treatment and the conventional shampoo therapy or shampoo treatment in the whirlpool. These results provide evidence for the short-term benefit of shampoo therapy for canine pruritus.

Cardiopulmonary function in horses during anesthetic recovery in a hydropool.

OBJECTIVE: To determine the cardiovascular and respiratory effects of water immersion in horses recovering from general anesthesia. ANIMALS: 6 healthy adult horses. PROCEDURE: Horses were anesthetized 3 times with halothane and recovered from anesthesia while positioned in lateral or sternal recumbency in a padded recovery stall or while immersed in a hydropool. Cardiovascular and pulmonary functions were monitored before and during anesthesia and during recovery until horses were standing. Measurements and calculated variables included carotid and pulmonary arterial blood pressures (ABP and PAP respectively), cardiac output, heart and respiratory rates, arterial and mixed venous blood gases, minute ventilation, end expiratory transpulmonary pressure (P(endXes)), maximal change in transpulmonary pressure (deltaP(tp)max), total pulmonary resistance (RL), dynamic compliance (Cdyn), and work of breathing (W). RESULTS: Immersion in water during recovery from general anesthesia resulted in values of ABP, PAP P(endXes), deltaP(tp)max, R(L), and W that were significantly greater and values of Cdyn that were significantly less, compared with values obtained during recovery in a padded stall. Mode of recovery had no significant effect on any other measured or calculated variable. CONCLUSIONS AND CLINICAL RELEVANCE: Differences in pulmonary and cardiovascular function between horses during recovery from anesthesia while immersed in water and in a padded recovery stall were attributed to the increased effort needed to overcome the extrathoracic hydrostatic effects of immersion. The combined effect of increased extrathoracic pressure and PAP may contribute to an increased incidence of pulmonary edema in horses during anesthetic recovery in a hydropool.

The role of exercise and physical modalities in the treatment of osteoarthritis.

Physical rehabilitation is a valuable and often underutilized part of the overall management of small animals with OA. A team consisting of the veterinarian, physical therapist, veterinary technician, and owner is vital to determine and carry out an appropriate therapeutic regimen. To maintain enthusiasm for the program, measurements should be regularly obtained to document progress. In addition, controlled studies should be performed to determine the degree of improvement that may be expected with physical rehabilitation programs.