Mechanical osteoarthritis of the hip in a one medicine concept: a narrative review.

Human and veterinary medicine have historically presented many medical areas of potential synergy and convergence. Mechanical osteoarthritis (MOA) is characterized by a gradual complex imbalance between cartilage production, loss, and derangement. Any joint instability that results in an abnormal overload of the joint surface can trigger MOA. As MOA has a prevailing mechanical aetiology, treatment effectiveness can only be accomplished if altered joint mechanics and mechanosensitive pathways are normalized and restored. Otherwise, the inflammatory cascade of osteoarthritis will be initiated, and the changes may become irreversible. The management of the disease using non-steroidal anti-inflammatory drugs, analgesics, physical therapy, diet changes, or nutraceuticals is conservative and less effective. MOA is a determinant factor for the development of hip dysplasia in both humans and dogs. Hip dysplasia is a hereditary disease with a high incidence and, therefore, of great clinical importance due to the associated discomfort and significant functional limitations. Furthermore, on account of analogous human and canine hip dysplasia disease and under the One Medicine concept, unifying veterinary and human research could improve the well-being and health of both species, increasing the acknowledgement of shared diseases. Great success has been accomplished in humans regarding preventive conservative management of hip dysplasia and following One Medicine concept, similar measures would benefit dogs. Moreover, animal models have long been used to better understand the different diseases' mechanisms. Current research in animal models was addressed and the role of rabbit models in pathophysiologic studies and of the dog as a spontaneous animal model were highlighted, denoting the inexistence of rabbit functional models to investigate therapeutic approaches in hip MOA.

Conservative Management of Hip Dysplasia.

Hip dysplasia (HD) is a common orthopedic condition seen in small animal patients that leads to osteoarthritis of the coxofemoral joint. The disease can be managed conservatively or surgically. The goals of surgical treatment in the immature patient are to either prevent the clinical signs of HD or to prevent or slow the progression of osteoarthritis. In mature patients surgery is used as a salvage procedure to treat debilitating osteoarthritis. Conservative management can be used in dogs with mild or intermittent clinical signs and includes nutritional management and weight control, exercise modification, physical rehabilitation, pain management and disease-modifying agents.

Physical Rehabilitation for the Management of Canine Hip Dysplasia.

Hip dysplasia is among the most common orthopedic conditions affecting dogs. Joint laxity is responsible for abnormal development of the femoral head and acetabulum, leading to excessive wear of the articular cartilage. Wear leads to secondary osteoarthritis. Rehabilitation is either conservative or after surgical management. Conservative rehabilitation therapies are directed at decreasing pain, improving hip range of motion (ROM), and building or maintaining muscle mass. Postoperatively, rehabilitation focuses on decreasing postoperative pain and inflammation, improving comfort and limb use, and protecting the surgical site. Once the patient has healed, rehabilitation is directed at improving ROM and promoting muscle mass.

Owner assessment of chronic pain intensity and results of gait analysis of dogs with hip dysplasia treated with acupuncture.

OBJECTIVE To evaluate pain intensity and kinetic variables in dogs with hip dysplasia (HD) treated with acupuncture, carprofen, or a placebo. DESIGN Randomized, controlled clinical study. ANIMALS 54 HD-affected dogs and 16 healthy dogs. PROCEDURES Seven HD-affected dogs were removed from the study. Dogs with HD were treated in a blinded manner for 30 days with acupuncture (once weekly for 5 sessions; n = 15), carprofen (4.4 mg/kg [2.0 mg/lb], PO, q 24 h; n = 16), or placebo capsules containing lactose (1 mg/kg [0.45 mg/lb], PO, q 24 h; n = 16). Dogs were evaluated 2 weeks and immediately before (baseline) and 2, 4, and 6 weeks after the onset of treatment. Owners evaluated the dogs' pain intensity with 2 validated questionnaires and a visual analogue scale (VAS) for pain and evaluated degree of lameness with a VAS for locomotion. Kinetics of the hind limbs were also evaluated. Sixteen HD-free dogs were used to assess the evaluation protocol. RESULTS Owners' assessments revealed that outcomes of the 3 treatments did not differ significantly. The Canine Brief Pain Inventory and VAS pain intensity assessments were decreased from baseline at weeks 4 and 6, respectively, but only in acupuncture-treated dogs. The locomotion VAS values were decreased at week 4 in acupuncture-treated and carprofen-treated dogs. Kinetic evaluation findings did not differ among the groups or over time. CONCLUSIONS AND CLINICAL RELEVANCE Neither acupuncture nor carprofen was significantly different from placebo. Acupuncture and carprofen reduced the degree of subjectively evaluated lameness, and acupuncture was associated with a decrease in validated chronic pain scores.

[Use of gold implants as a treatment of pain related to canine hip dysplasia--a review. Part 1: Background and current state of research regarding the effects of implanting gold in tissue]. / Anwendung von Goldimplantaten zur Schmerztherapie bei kaniner Hüftgelenkdysplasie--eine Literaturübersicht. Teil 1: Hintergründe und Stand der Forschung zu Effekten nach Implantation von Gold in Gewebe.

Gold-bead implantation as a method of pain treatment in dogs suffering from osteoarthritic disease is receiving increasing attention in veterinary medicine. For the present article, publications from veterinary books and journals were collected and evaluated, together with related articles in human medicine. After providing an overview of the historical use of gold and gold compounds, the technique of implanting this noble metal is introduced. The reasons for establishing the terms gold acupuncture and gold (bead) implantation are described, considering the question whether and what kind of methodological differences exist behind these terms. Next, previous publications concerning the effects of gold implantation in tissue are summarised. In 2002 it was proven that gold ions are released from the surface of gold implants by a process termed dissolucytosis. Subsequent publications further investigated details about the interaction between gold ions and tissue as well as the distribution pattern of bio-released ions. Gold compounds were previously used for chrysotherapy in human medicine until medication with fewer side effects became established. The anti-inflammatory and immuno-modulatory properties of gold compounds were used to treat rheumatoid arthritis. Current research aims to ascertain whether the anti-inflammatory and immuno-modulating effects of gold compounds are imitated by gold ions released from gold implants at a local level. In conclusion, the present review summarises important findings about the effects of gold implanted in tissue. However, further research is necessary to estimate the limitations and benefits of this auromedication.

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.

Tratamento de displasia coxofemoral com uso de medicamento homeopático / Treatment of hip dysplasia with the use of homeopathic medicament

Os quadros de displasia coxofemoral são cada vez mais comuns nos animais de companhia, acometem principalmente raças de grande porte como Rottweiler, Pastor alemão, Lavrador, etc., mas já existem relatos nos cães de pequeno porte como os Lhasa Apso e em gatos de grande porte como os da raça Main Coon, que têm predisposição a desenvolver essa doença. Os animais acometidos apresentam dor e dificultade ou incapacidade total de locomoção. A ocorrência é maior em animais jovens e tem caráter hereditário. As opções de tratamento incluem cirurgias, tratamentos regeneradores articulares e o uso de analgésicos, todos com o objetivo de minorar a dor do animal. Há também a opção de tratamento com o uso de medicamentos homeopáticos. Este trabalho apresenta a eficãcia dos medicamentos homeopáticos, em dois casos clínicoes de displasia coxofemoral tratados com complexo homeopático Displasia.

Tratamento de displasia coxofemoral com uso de medicamento homeopático / Treatment of hip dysplasia with the use of homeopathic medicament

Os quadros de displasia coxofemoral são cada vez mais comuns nos animais de companhia, acometem principalmente raças de grande porte como Rottweiler, Pastor alemão, Lavrador, etc., mas já existem relatos nos cães de pequeno porte como os Lhasa Apso e em gatos de grande porte como os da raça Main Coon, que têm predisposição a desenvolver essa doença. Os animais acometidos apresentam dor e dificultade ou incapacidade total de locomoção. A ocorrência é maior em animais jovens e tem caráter hereditário. As opções de tratamento incluem cirurgias, tratamentos regeneradores articulares e o uso de analgésicos, todos com o objetivo de minorar a dor do animal. Há também a opção de tratamento com o uso de medicamentos homeopáticos. Este trabalho apresenta a eficãcia dos medicamentos homeopáticos, em dois casos clínicoes de displasia coxofemoral tratados com complexo homeopático Displasia®.(AU)

tratamento em um cao portador de displasia coxo femoral utilizando piscina terapeutica / Physical therapy in dog with hip dysplasia using swimming pool

Objetivo: Avaliar a importancia da fisioterapia na reabilitaçao de caes displasicos, utilizando como recurso principal a piscina terapeutica. Metodo: Foram realizados dez sessoes de fisiotarapia. Tres sessoes realizadsa em solo, utilizando eletroterapia e cinesioterapia para o tratamento da doença de base, a displasia coxo femora. Resultados: Apos as dez sessoes indicadas, constatou-se melhora na distribuiçao de peso, rsultando na melhora da marcha. Conclusoes: Os efeitos do tratamento fisioterapeutico na displasia coxo-femoral foram satisfatorios, tendo em vista a melhora da sintomatologia, o retardo da evoluçao da doença, pois o exercicio aquatico fortalece a musculatura do quadril, diminuindo a instabilidade articular, alem de proprcionar o ganho de condicionamento cardiovascular e ser uma atividade prazeroza para o animal.

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.

Gold bead implants.

Gold bead implantation is an experimental area of study in the acupuncture field dealing with chronic diseases. Special acupuncture techniques are required to implant the gold beads successfully in the proper location. Gold beads are used to treat degenerative joint disease, osteochondritis, osteochondritis dessicans, ventral spondylosis, and seizures.