Platelet-rich plasma affects the proliferation of canine bone marrow-derived mesenchymal stromal cells in vitro.

BACKGROUND: Reported efficacy of platelet-rich plasma (PRP) in regenerative medicine is contradictory. We validated the effects of PRP on proliferation of canine bone marrow-derived multipotent mesenchymal stromal cells (K9BMMSCs) in vitro. PRP was extracted from blood of six dogs with osteoarthritis. K9BMMSCs were established from bone marrow and characterized for CD90 and CD19 expression by immunocytochemistry. Effects of PRP concentrations on viability of matching autologous K9BMMSCs were validated using MTS assay. RESULTS: Positive CD90 and negative CD19 expression confirmed MSC origin. PRP at 40% volume/volume concentration increased, while PRP at 80 and 100% v/v concentrations suppressed viability of tested K9BMMSCs. CONCLUSION: PRP concentration plays an important role in K9BMMSCs viability, which could affect tissue repairs in vivo.

Bacterial Contamination of Environmental Surfaces of Veterinary Rehabilitation Clinics.

The presence of potentially pathogenic bacteria on veterinary clinic surfaces may be problematic. In this study, we collected swab samples (Fisherbrand, double transport swabs with Stuart's liquid medium) and water samples from five veterinary rehabilitation clinics. Swabs and water samples were transported to a microbiology lab for processing. At the lab, swabs were used to inoculate Hardy's Cdiff Banana Broth (for Clostridium difficile [Cdiff]) and five different types of bacterial growth media, including Hardy CHROM MRSA agar (methicillin-resistant Staphylococcus aureus [MRSA] and S. pseudintermedius [SIM]), mannitol salt agar (S. aureus [SA]), eosin methylene blue agar (enterics [ENT]), Pseudomonas isolation agar (Pseudomonas spp. [PS]), and tryptic soy agar [TSA] (non-specific). The most prominent presumptive species cultured was Cdiff (on nearly 55% of swabs). Bacillus spp. and enteric bacteria were encountered on nearly 35% of swabs, with MRSA and SIM on just over 10% of swabs. The most contaminated sample site was harnesses/life jackets used with the underwater treadmill (33% of swabs). The underwater treadmill water had total bacterial counts from 1,600 to 2,800 cfu/mL. Of all presumptive bacterial species detected, SIM tends to be more pathogenic for dogs. Targeted cleaning/disinfecting in these clinics could help reduce risks for both animals and caregivers utilizing these clinics.

A Systematic Literature Review of Complementary and Alternative Veterinary Medicine: Laser Therapy.

Light therapy, or photobiomodulation, is a collective name for methods where tissue is irradiated with different types of light, with the aim of stimulating healing. Despite being frequently used, there is no consensus regarding the optimal treatment protocols for light therapy, nor its clinical efficacy. A systematic literature review was conducted, searching the relevant literature regarding light therapy in three databases, published between 1980-2020. The risk of bias in each article was evaluated. Forty-five articles met the inclusion criteria; 24 articles were regarding dogs, 1 was regarding cats, and the rest were regarding horses. The indications for treatment were musculoskeletal and neurologic conditions, skin disease and wounds, and pain. The literature review showed conflicting study results and unclear application for clinical use. This can be explained by the wide variety of treatment parameters used in the searched studies, such as wavelength, laser class, dose, and effect, as well as the frequency and duration of treatment. Although some beneficial effects were reported for light therapy, the studies also had limited scientific quality regarding these therapies, with a high or moderate risk of bias.

Use of a colorimeter is a viable method to measure melanin and erythema content in the context of laser beam attenuation by use of a class IV laser in different tissues in dogs.

OBJECTIVE: Patient factors may alter laser photon attenuation, but these factors have not been adequately evaluated in live dogs. Our objective was to evaluate class IV laser beam attenuation (LBA) by canine tissues using a colorimeter to evaluate melanin and erythema indices. We hypothesized that greater melanin and erythema indices and unclipped hair would increase LBA, and these properties would vary among tissues. ANIMALS: 20 client-owned dogs. PROCEDURES: Between October 1 and December 1, 2017, colorimeter measurements and LBA in various tissues before and after clipping overlying hair were evaluated. Data were analyzed using generalized linear mixed models. Statistical significance was set at P < .05. RESULTS: LBA was greater in unclipped (98.6 ± 0.4%) than clipped hair (94.6 ± 0.4%). The least LBA occurred in the pinna (93%) while the greatest occurred in the caudal vertebra (100%) and caudal semitendinosis muscles (100%). Each mm of tissue thickness resulted in LBA of 11.6%. Each unit increase in melanin index resulted in a 3.3% increase in LBA. There was no association of LBA with erythema index. CLINICAL RELEVANCE: To our knowledge, this is the first study that evaluated LBA by different tissues in live dogs using a colorimeter to evaluate melanin and erythema indices. We recommend clipping hair prior to photobiomodulation to decrease laser beam attenuation and using increased laser doses in thicker tissues and dogs with high melanin content. The colorimeter may be helpful in customizing patient treatment dosimetry. Future studies are necessary to determine therapeutic laser doses for adequate photobiomodulation effects.

Development and testing of a stifle function score in dogs.

Objective: The purpose of this study was to develop and test a quantitative stifle function score (SFS) in dogs with unilateral cranial cruciate ligament disease by combining clinical measures and functional tests. The objective of this study was to compare the proposed SFS to a symmetry index (SI) calculated from objective ground reaction forces (GRFs). We hypothesized that the SFS would have a strong correlation with SI. Methods: Dogs with surgically and nonsurgically treated unilateral cranial cruciate ligament rupture and dogs with no known musculoskeletal problems were included in the study. Each dog was scored using the SFS and trotted across a force platform to obtain GRFs and calculate the SI, based on vertical GRFs. Fourteen items were included in the SFS: limb use at a walk, limb use at a trot, lameness at a walk, lameness at a trot, stair climbing, sit-to-stand, dancing, pain response, stifle effusion, thigh circumference/muscle atrophy, stifle extension, stifle flexion, and cranial drawer/tibial thrust, with each item scored based on previously determined criteria. A perfect SFS would receive a score of 100. Results: Twenty-seven dogs were included in the study: twenty-one with unilateral cranial cruciate ligament disease and six control dogs. The mean SFS was 71.5 out of 100. To further characterize the association between SFS and SI the degree of gait asymmetry using SI was classified as <5%, 5.1-10%, 10.1-20%, 20.1-25%, and >25% difference between the pelvic limbs for all dogs. The mean SFS for each of the five categories were 97.8, 85.2, 65.4, 63, and 56.4, respectively. Correlation of SI and SFS was -0.863 (p < 0.0001). All of the individuals evaluated tests in the score were significantly correlated with SI except for pain response and stifle flexion. The SFS is in strong agreement with the SI, as confirmed by Bland-Altman analysis. Conclusion: The SFS had a significant correlation and agreement with the SI calculated from GRFs. This SFS may be a useful, simple, and inexpensive tool to use in a clinical environment to monitor progression during the rehabilitation and recovery process following unilateral cranial cruciate ligament rupture.

Thermographic Evaluation of the Duration of Skin Cooling After Cryotherapy in Dogs Following Tibial Plateau Leveling Osteotomy Surgery.

Objective: To evaluate the duration of cooling after cryotherapy on the skin over stifle joints in dogs after tibial plateau leveling osteotomy (TPLO) surgery using thermography. Materials and Methods: Seventeen client-owned dogs of various breeds were enrolled in the study. Dogs underwent TPLO surgeries, and on the next day, thermal imaging was performed on the operated stifle prior to cryotherapy for baseline. Orthogonal views were repeated at 30-min intervals until the skin over the stifle had thermally equilibrated. An ice pack was applied for 20 min on the medial and lateral aspects of the stifle. Each stifle was then re-imaged every 15 min for the first 60 min then every 30 min subsequently until the temperature was within 1°C of the pre-cryotherapy temperature. Results: Mean skin temperature of the medial view showed no significance difference compared to baseline value at 45 min after cryotherapy was discontinued and after 60 min for the lateral and cranial views. Mean skin temperature was overall higher in the medial view compared to the lateral and cranial during the rewarming period (except immediately after cold application). Mean skin temperatures of all views combined showed a significant decrease in temperature during cryotherapy application, with a slow increase until a plateau was reached after 45 min of rewarming. Conclusions and Clinical Relevance: Dogs undergoing TPLO for cranial cruciate ligament injury showed quicker rewarming period of superficial tissues compared to previous studies. Cryotherapy is a beneficial modality to reduce superficial tissue temperature in dogs undergoing TPLO, acknowledging that these dogs may require more frequent cryotherapy post-operatively due to more rapid rewarming time compared to dogs without surgery.

Forelimb Examination, Lameness Assessment, and Kinetic and Kinematic Gait Analysis.

This article contains a guide for small animal practitioners to use when confronted with the challenge of diagnosing a forelimb lameness. The examination begins by monitoring the dog at a stance and a visual gait assessment. A hands-on evaluation includes the initial examination, checking for asymmetry and muscle atrophy while the dog is standing, and step-by-step instructions for a thorough forelimb examination.

Effects of Cryotherapy on Temperature Change in Caudal Thigh Muscles of Dogs.

OBJECTIVE: The aim of the study reported here was to determine the effect of cryotherapy on the caudal thigh muscles of dogs. We hypothesized that temperature changes would be greatest in superficial tissues and decrease with tissue depth. STUDY DESIGN: Eight mixed-breed dogs (mean weight 21.2 kg, mean age 3.3 years) were studied. Temperature was measured at the skin surface and at depths of 1.0 and 3.0 cm below the skin using needle thermistor probes that were inserted beneath the site of cold pack application. Treatment consisted of a standard 1.0°C cold pack applied for 20 minutes. Temperature was recorded every minute for the 20 minute cold pack treatment, and for 80 minutes following treatment. RESULTS: Cutaneous temperatures significantly decreased (p < 0.01), with rapid rewarming of the skin following cold pack removal. Tissue cooling was less profound with increasing tissue depths, but was still significant (p < 0.05). There was no significant difference in muscle temperature between haired and clipped limbs. CONCLUSION: A single application of a cold pack to the caudal thigh muscles of dogs for 20 minutes resulted in significant temperature reduction at all tissue depths (p < 0.05). This decrease persisted for ∼60 minutes. The presence of hair did not have a significant effect on muscle cooling (p > 0.05).

Nervous system modulation through electrical stimulation in companion animals.

Domestic animals with severe spontaneous spinal cord injury (SCI), including dogs and cats that are deep pain perception negative (DPP-), can benefit from specific evaluations involving neurorehabilitation integrative protocols. In human medicine, patients without deep pain sensation, classified as grade A on the American Spinal Injury Association (ASIA) impairment scale, can recover after multidisciplinary approaches that include rehabilitation modalities, such as functional electrical stimulation (FES), transcutaneous electrical spinal cord stimulation (TESCS) and transcranial direct current stimulation (TDCS). This review intends to explore the history, biophysics, neurophysiology, neuroanatomy and the parameters of FES, TESCS, and TDCS, as safe and noninvasive rehabilitation modalities applied in the veterinary field. Additional studies need to be conducted in clinical settings to successfully implement these guidelines in dogs and cats.

Effects of partial immersion in water on vertical ground reaction forces and weight distribution in dogs.

OBJECTIVE: To assess the impact of partial immersion in water on vertical ground reaction force (vGRF) and vGRF distribution in dogs. ANIMALS: 10 healthy adult dogs. PROCEDURES: Weight placed on each limb of each dog was measured 3 times (1 scale/limb). Dogs were then immersed in water to the level of the tarsal, stifle, and hip joints, and vGRFs were measured. Coefficients of variation for triplicate measurements were calculated. Mixed-effects ANOVAs were used to compare the vGRF for thoracic versus pelvic limbs and the vGRF at various immersion levels as well as the vGRF distributions among limbs at various immersion levels. RESULTS: Mean±SD vGRF before immersion was 249±34 N. It was significantly decreased by 9% after immersion to the tarsal joints (227±32 N), by 15% after immersion to the stifle joints (212±21 N), and by 62% after immersion to the hip joints (96±20 N). The vGRFs were significantly higher for the thoracic limbs than for the pelvic limbs before immersion and at all immersion levels. Dogs placed 64% of their weight on the thoracic limbs before immersion. That ratio did not differ significantly after immersion to the tarsus (64%) or stifle (63%) joints, but was significantly larger after immersion to the hip joints (71%). CONCLUSIONS AND CLINICAL RELEVANCE: vGRF decreased as the depth of immersion increased. The thoracic limb-to-pelvic limb vGRF ratio was unchanged in dogs after immersion to the tarsal or stifle joints, but it increased after immersion to the hip joints.

Surface Electromyography of the Vastus Lateralis, Biceps Femoris, and Gluteus Medius in Dogs During Stance, Walking, Trotting, and Selected Therapeutic Exercises.

Objective: The objective of the study reported here was to evaluate the muscle activity patterns of the vastus lateralis (VL), biceps femoris (BF), and gluteus medius (GM) during stance, walking, trotting, and selected therapeutic exercises in clinically sound, healthy dogs. Our hypothesis was that the muscle activity during all exercises would differ from muscle activity at the stance. Methods: Surface electromyography of the selected muscles was performed during stance, walking, trotting, elevation of forelimbs on a platform, elevation of forelimbs on a platform with hindlimbs on an inflatable balance device, stepping up onto and over an obstacle, standing on a wobble board, dancing backwards, and wearing a leg weight at the walk and the trot. The maximal and mean muscle amplitude (µV) reflecting activity during several motion cycles were compared among the exercises. Results: Mean EMG amplitude of the BF was significantly higher in all exercises (p < 0.05) in comparison to stance. Mean EMG amplitude of the VL was significantly higher (p < 0.05) during walking, trotting, dancing backwards, stepping up and over an obstacle, and at a trot with a leg weight as compared to stance. Mean EMG amplitude of the GM was significantly higher (p < 0.05) during trotting, at a walk and a trot with a leg weight, standing on a wobble board, stepping up and over an obstacle, and dancing backwards when compared to stance. Of the studied exercises, dancing backwards increased the mean EMG amplitude of the BF and GM to the largest degree. Stepping up and over an obstacle increased the mean EMG amplitude of the VL to the largest degree. Conclusion: Compared to stance, the majority of therapeutic exercises examined increased muscle activity to varying degrees in the BF, VL, and GM. Our results may help clinicians to choose specific exercises to target specific muscles during conditioning, strengthening and rehabilitation.

Effect of Therapeutic Ultrasound on Calcaneal Tendon Heating and Extensibility in Dogs.

Objective: To (1) characterize the warming pattern of canine calcaneal tendons during and after four different therapeutic ultrasound (US) treatment protocols, and (2) to quantify changes in tarsal flexion immediately after therapeutic US treatment, and following return to baseline temperature. Design: A prospective, crossover, experimental study. Animals: Ten adult hound-type breed dogs. Procedure: Therapeutic ultrasound (3.3 MHz) was applied to one calcaneal tendon of anesthetized dogs using four different settings applied in random fashion (1.5 and 1.0 W/cm2 continuous, and 1.5 and 1.0 W/cm2 pulsed US) while the temperature of the tendon was recorded by a thermistor needle. The contralateral tendon was used to compare extensibility of the treated soft tissues by measuring changes in tarsal joint flexion before, immediately after, and 5-min after continuous US treatment at 1.5 W/cm2 for 10 min. Results: The greatest increase in tendon temperature occurred with continuous US at 1.5 W/cm2. Pulsed US resulted in minimal tendon heating. Most of the increase in tissue temperature occurred within the first 3 min of US application. Tarsal flexion increased significantly following US treatment; however, it returned to near baseline within 5 min after US was discontinued. Conclusion and Clinical Relevance: Continuous US of the calcaneal tendon at 1.5 W/cm2 resulted in the greatest increase in tissue temperature while maintaining a safe range of tissue temperature increase. Tendon heating and heat dissipation were slightly different from what has been reported for muscle. Our results suggest that 3.3 MHz US applied to tendon for >3 min may not provide additional tissue temperature increase. Therapeutic US resulted in increased tarsal flexion, however the change was only transitory. Therefore, stretching exercises should be performed during and immediately after US.

Variables Affecting Thigh Girth Measurement and Observer Reliability in Dogs.

Objective: The purpose of the study reported here was to describe variables affecting thigh girth measurements preoperatively and 2 weeks after surgical stabilization of the stifle and to examine inter- and intra-observer reliability. Animals: Ten hound-type dogs with experimental, unilateral, cranial cruciate ligament transection, and surgical stabilization. Procedures: Dogs were placed in lateral recumbency for measurements of thigh circumference after the stifle was placed in flexed (F), estimated standing (S), and extended (E) positions. Measurements were made at 50 and 70% of thigh length (TL), with hair unclipped and then clipped prior to surgery, before and 2 weeks after cruciate ligament transection and stifle stabilization, and with and without sedation. A spring tension measuring tape was used to determine thigh girth that allowed a consistent amount of end-tension to be applied to the tape. All measurements were made by two blinded individuals in triplicate, data were recorded for each set of measurements and the mean of the three measurements for each condition was used for analysis. Results: Thigh girth was significantly greater at the more proximal site of 50% TL (36.7 ± 2.6 cm) when compared to the 70% TL (31.7 ± 2.7 cm) (P = 0.001). Sedation did not significantly affect thigh girth at any stifle position at the 70% and 50% TL. Although there were no differences in thigh circumference between the flexion and standing positions at 50% TL (F 38.2 ± 2.8 cm, S 38.1 ± 2.9 cm) and 70% TL (F 33.6 ± 1.6 cm; S 33.6 ± 1.8 cm), full extension of the stifle resulted in significantly less thigh girth (50% TL 36.6 ± 2.6 cm, P = 0.006; 70% TL 31.7 ± 2.6 cm, P = 0.006). Significant decreases in thigh girth were seen after surgery in all limb positions at both measurement sites. The highest correlations between Observer 1 (OB1) and Observer 2 (OB2) with least differences in measurements were with the stifle in the extended position. Agreement between two observers using standard measuring technique was significant at both the 50% (OB1: 34.10 ± 2.93 cm, OB2: 34.08 ± 2.65 cm, P = 0.007, ICC = 0.984) and 70% (OB1: 29.89 ± 2.43 cm, OB2: 30.04 ± 2.30 cm, P = 0.004, ICC = 0.981) TL positions with the stifle placed in extended position. Conclusion and Clinical Importance: Thigh girth measurement may be useful as an outcome measure when appropriate measuring technique is used. It is recommended that thigh girth be obtained at a distance of 70% thigh length, with the leg in an extended position while in lateral recumbency, and the dog relaxed or under sedation. Further studies should be performed in a variety of clinical situations.

The effect of limb amputation on standing weight distribution in the remaining three limbs in dogs.

Despite the fact that limb amputation is a commonly performed procedure in veterinary medicine, quantitative data regarding outcomes are lacking. The intention of this study was to evaluate the effect of limb amputation on weight distribution to the remaining three limbs at a stance in dogs. Ten dogs with a prior forelimb amputation and ten dogs with a prior hindlimb amputation; all of which had no history of orthopaedic or neural disease in the remaining three limbs were included in the study. Standing weight bearing was evaluated with a commercial stance analyzer in all dogs. Five valid trials were obtained and a mean percentage of weight bearing was calculated for each remaining limb. The dogs with a previous forelimb amputation, and also those with a previous hindlimb amputation, had the largest mean increase in weight bearing in the contralateral forelimb. In conclusion, proactive monitoring of orthopaedic disease in the contralateral forelimb may be advisable in dogs with a previous limb amputation. In addition, when determining candidacy for a limb amputation, disease of the contralateral forelimb should be thoroughly evaluated.

Bone and lean tissue changes following cranial cruciate ligament transection and stifle stabilization.

Following cranial cruciate ligament transection and extracapsular stabilization, dual-energy X-ray absorptiometry was used to analyze bone mineral content and lean tissue mass in the surgical and nonsurgical legs (n=14) at 0, 2, 4, and 8 weeks, and to evaluate bone mineral content and bone mineral density (BMD) of the proximal, mid-, and distal tibia of both the surgical and nonsurgical legs (n=15) at 0, 5, and 10 weeks. There was significant loss of bone mineral content and lean tissue in the surgical leg compared to the nonsurgical leg. Significant loss in bone mineral content and BMD was detected in the tibia of the surgical leg and was most pronounced in the metaphyseal region.

Emerging modalities in veterinary rehabilitation.

Many new modalities have been introduced in human and veterinary physical rehabilitation. In many instances, there is sound theory of how they may impact the physiology of various cells, tissues, or organs. This article reviews some of the modalities that have been introduced recently in human and veterinary rehabilitation. Topics include low-level laser, phototherapy, and extracorporeal shock wave treatment.

Biomechanics of rehabilitation.

The biomechanics of motion and rehabilitation are complex, with many tissue types and structures involved. In addition, consideration must be given to the stage of tissue healing with some injuries, such as fractures.A more thorough knowledge of some of the infrequently discussed biomechanical aspects of musculoskeletal tissues and motion during rehabilitation, combined with known features of tissue recovery, should enhance the development of rehabilitation programs for patients.

Introduction to veterinary physical rehabilitation.

Physical therapy is a profession with an established scientific basis in human beings and companion animals. It has a large number of clinical applications in the restoration, maintenance, and promotion of optimal physical function. In providing physical therapy, the goal is to restore, maintain, and promote optimal function, optimal fitness, wellness, and quality of life as they relate to movement disorders and health. A major emphasis is to prevent or minimize the onset, clinical signs, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, and injuries.

Rehabilitation for the orthopedic patient.

An understanding of orthopedic conditions and their medical and surgical treatment is important to help the therapist develop a treatment plan that will help the patient return to function quickly with minimal complications. The therapist must constantly assess the patient for improvement or complications and adjust the therapy plan accordingly. Knowledge of the stages of tissue healing and of the strength of tissues is critical to avoid placing too much stress on the surgical site, yet some challenge to tissues must be provided to optimize the return to function.