Inter- and intra-observer reliability of thoracic limb circumference measurement methods in sound dogs.

Objective: The primary objectives of this study are to (1) compare the inter- and intra-observer reliability of thoracic limb circumference measurement methods in sound dogs, and (2) determine the most reliable thoracic limb positioning and location on the thoracic limb for performing circumferential measurements. Methods: Thoracic limbs of 10 apparently sound dogs (20 limbs) were blindly and independently measured by 3 observers. Triplicate measurements were performed with dogs in lateral recumbency at 50 and 70% brachial (Br) length (length between the greater tubercle and lateral humoral epicondyle) and 25% ABr length (length between the lateral humeral epicondyle and ulnar styloid process), both with the elbow extended and at an approximate weight-bearing (WB) angle. Intra-class correlation coefficients (ICC) with a 95% confidence interval (CI) were used for data analysis with a p < 0.05 being significant. Results: All measures had significantly good to excellent intra- (ICC 0.836-0.994, p < 0.001) and inter-observer reliability (ICC 0.834-0.996, p < 0.001). Inter-observer reliability was excellent at 25% ABr extended and WB positions, and at 50% Br WB position, with a wider confidence interval at the latter location. Intra-observer reliability was excellent across all observers for 25% ABr extended and WB, and 50% Br WB positions, also with a wider confidence interval at the latter location. Conclusion: Circumferential measurement of the canine thoracic limb was most reliable at 25% ABr length with the elbow either in an extended or WB position.

Feline Osteoarthritis Management.

Feline osteoarthritis is common; despite vague clinical signs, it can result in mobility impairment and quality of life concerns. An integrative approach to management may include analgesic medications, dietary modifications, nutraceuticals, environmental modifications, physical rehabilitation, acupuncture, and regenerative medicine. Management of concurrent disease and consideration for patient tolerance and owner compliance are critical in formulating a treatment plan in cats with osteoarthritis.

Evidence-Based Complementary and Alternative Canine Orthopedic Medicine.

The use of complementary and alternative veterinary medicine (CAVM) continues to become more widespread, especially for the management of chronic pain conditions such as canine osteoarthritis. Many patients have comorbidities that preclude traditional medical options, have not adequately responded to conventional therapies, or have owners interested in pursuing a complementary approach. Evidence-based CAVM can serve as a safe and effective adjunct to manage chronic pain conditions. There is growing evidence in the veterinary literature for the use of acupuncture and some herbal supplements in the multimodal management of canine osteoarthritis. The majority of evidence supporting chiropractic is limited to equine and human literature.

A pilot study examining a proprietary herbal blend for the treatment of canine osteoarthritis pain.

Osteoarthritis is the most common joint disease in dogs. Despite the use of nonsteroidal anti-inflammatory drugs (NSAIDs), many owners seek natural therapies; either to augment the response to NSAIDs, or as a replacement. Substantial research has been directed to investigation of novel therapies. A randomized, double-blinded, controlled study was conducted to assess the efficacy of a herbal remedy for treatment of canine osteoarthritis pain. Client-owned dogs (N = 24) with osteoarthritis were enrolled between 2 veterinary hospitals. Each dog underwent veterinary and owner assessment at 0, 4, and 8 weeks, using the Canine Brief Pain Inventory and Hudson activity scale. Blood was collected for a complete blood (cell) count (CBC) and serum chemistry analysis. The product was deemed to be safe and well-tolerated at the manufacturer recommended dosage, with no significant changes seen in the CBC or serum biochemical analyses. Aside from1 dog that developed gastrointestinal upset, all other dogs tolerated the supplement without complication. The supplement did not statistically improve clinical signs in dogs based on veterinary or owner assessments of lameness. There was a treatment/time effect when assessing veterinary pain scores; however, post-hoc analysis suggests no observable benefit of treatment compared with the placebo group at any time point.

Une étude pilote examinant un mélange d'herbes exclusif pour le traitement de la douleur arthrosique canine. L'arthrose est la maladie articulaire la plus fréquente chez le chien. Malgré l'utilisation d'antiinflammatoires non stéroïdiens (AINS), de nombreux propriétaires recherchent des thérapies naturelles; soit pour augmenter la réponse aux AINS, soit en remplacement. De nombreuses recherches ont été dirigées vers l'étude de nouvelles thérapies. Une étude randomisée, en double aveugle et contrôlée a été menée pour évaluer l'efficacité d'un remède à base de plantes pour le traitement de la douleur arthrosique canine. Les chiens appartenant à des clients (N = 24) souffrant d'arthrose ont été inscrits auprès de deux hôpitaux vétérinaires. Chaque chien a subi une évaluation vétérinaire et par le propriétaire à 0, 4 et 8 semaines, en utilisant le Canine Brief Pain Inventory et l'échelle d'activité Hudson. Du sang a été prélevé pour une numération sanguine complète (CBC) et une analyse biochimique du sérum. Le produit a été jugé sûr et bien toléré à la dose recommandée par le fabricant, sans aucun changement significatif observé dans le CBC ou les analyses biochimiques sériques. Mis à part un chien qui a développé des troubles gastro-intestinaux; tous les autres chiens ont toléré le supplément sans complication. Le supplément n'a pas amélioré statistiquement les signes cliniques chez les chiens sur la base des évaluations vétérinaires ou du propriétaire de la boiterie. Il y avait un effet traitement/temps lors de l'évaluation des scores de douleur vétérinaire; cependant, l'analyse post-hoc ne suggère aucun avantage observable du traitement par rapport au groupe placebo à aucun moment.(Traduit par Dr Serge Messier).

Evaluation of the efficacy of a cannabidiol and cannabidiolic acid rich hemp extract for pain in dogs following a tibial plateau leveling osteotomy.

Objective: To determine the impact of a cannabidiol (CBD) and cannabidiolic acid (CBDA) rich hemp product on acute post-operative pain in dogs following a tibial plateau leveling osteotomy (TPLO), and to evaluate for changes in early bone healing, serum chemistry profiles, and complete blood counts. Methods: In this randomized, placebo controlled, blinded clinical trial, 44 client-owned dogs were assigned to receive either a CBD/CBDA product dosed at 2-2.5 mg/kg PO every 12 h or a placebo for 4 weeks following a TPLO. Variables evaluated before (week 0), and at 2 and 4 weeks post-operatively included standardized veterinary assessments for pain score, weight-bearing, and lameness, the Canine Brief Pain Inventory (pain interference score-PIS, pain severity score-PSS), and serum biochemistry. Complete blood counts were performed at weeks 0 and 4. Additionally, orthogonal radiographs evaluating the degree of healing were taken at week 4. A mixed model analysis, analyzing changes of variables of interest from enrollment baseline to all other time points was utilized, with a p-value ≤ 0.05 considered significant. Results: Of the 44 enrolled patients, 3 were lost to follow up and excluded from analysis. No significant differences were noted between placebo (n = 19) and CBD/CBDA (n = 22) groups at any point in pain score, degree of lameness, degree of weight-bearing, PIS, PSS, or radiographic healing of the osteotomy. A significant finding of elevation of ALP above normal reference range in the treatment group was identified (p = 0.02) and eosinophil count was affected by treatment (p = 0.01), increasing from baseline in placebo and decreasing in treatment groups. Finally, a significant difference (p = 0.03) was noted at 2 weeks post-operatively where 4 patients in the placebo group and no treatment patients received trazodone to facilitate activity restrictions. Clinical significance: Use of a CBD/CBDA rich hemp product dosed at 2-2.5 mg/kg PO every 12 h did not have a significant impact on pain or delay early bone healing. A statistically significant increase in ALP, decrease in eosinophils, and reduced use of trazodone was identified in the treatment group.

Common Uses and Adverse Effects of Hyperbaric Oxygen Therapy in a Cohort of Small Animal Patients: A Retrospective Analysis of 2,792 Treatment Sessions.

Hyperbaric oxygen therapy (HBOT) is commonly utilized for various human conditions with a low incidence of major adverse effects (0.002-0.035%). Despite growing use in veterinary patients, there remains a paucity of literature describing its use and associated complications. The purpose of this study was to report clinical use of HBOT in small animals and identify the rate of major adverse events at a university teaching hospital. Electronic medical records were searched for small animals receiving HBOT between November 2012 and February 2020. Data extracted from the medical records included signalment, treatment indication, and adverse events. Treatment sessions totaled 2,792 in 542 dogs, 24 cats, and 10 pocket pets and exotics. Common indications included neurologic injuries (50.4%), tissue healing (31.4%), control of oomycete infection (5.5%), neoplasia or post-radiation injury (5.4%), and various miscellaneous conditions (7.4%). Observed minor adverse events included agitation in two dogs and vomiting in three dogs. The most common major adverse event was central nervous system (CNS) oxygen toxicity in 19 dogs. Central nervous system oxygen toxicity, manifesting as focal or generalized seizures, occurred in 0.7% of treatment sessions, with increasing age (p = 0.01) and female sex (p = 0.01) identified as risk factors. One dog developed pulmonary edema following HBOT which is a reported adverse event in humans or may have been a manifestation of progression of the dog's underlying disease. No adverse events were noted in cats or other species. In conclusion, HBOT appeared safe across various indications, although oxygen toxicity affecting the CNS was higher than reports in humans. Future prospective, randomized, controlled trials should evaluate specific clinical indications and outcomes.

Measurement of 3-acetyl-11-keto-beta-boswellic acid and 11-keto-beta-boswellic acid in Boswellia serrata Supplements Administered to Dogs.

BACKGROUND: Osteoarthritis is a common canine disease frequently treated with nutritional supplements that often lack independent verification of ingredients, active ingredient concentration, efficacy, or safety. Human supplements containing Boswellia serrata extracts (BSE) with high concentrations of active constituents 3-acetyl-11-keto-ß-boswellic acid (AKBA) and 11-keto-ß-boswellic acid (KBA) are bioavailable, safe, and efficacious in the alleviation of symptoms of naturally occurring osteoarthritis in people. Thus, oral AKBA and/or KBA supplementation could be a promising novel therapy for dogs with osteoarthritis. The primary objective of this study was to determine the concentrations of AKBA and KBA within six human and seven canine market formulations containing BSE administered to dogs, using a derivation of the previously validated high performance liquid chromatography (HPLC) method. The secondary objective was to compare measured concentrations to label claims. RESULTS: The mean concentrations of AKBA and KBA within the formulations tested were 42.3 mg/g AF (0.1-155.7 mg/g AF) and 5.2 mg/g AF (0-24.8 mg/g AF), respectively, with four of the formulations containing an undetectable amount of KBA. None of the market formulations had a label claim for KBA. For the five tested formulations with a label claim for AKBA, the mean percentage of detected AKBA was 173% of the concentration listed on the label (range: 114-224%). Formulations claiming to contain AKBA had a mean AKBA concentration of 98.2 mg/g AF, significantly higher than formulations claiming only to contain BSE (7.4 mg/g AF; p = 0.01). CONCLUSIONS: This study demonstrated a large variation of boswellic acid concentrations in market formulations claiming to contain BSE, with products claiming to contain AKBA containing higher concentrations of AKBA than other products. There was also a large variation in, and overall high, percent difference between label claims and measured concentrations of AKBA. All products met or exceeded label claims. However, differences between label amounts and detected concentrations confirm the need for independent laboratories to quantify concentrations of active ingredients in supplements containing BSE. This would be necessary prior to the use of these formulations in the research or clinical setting.

Comparison of Point Placement by Veterinary Professionals with Different Levels of Acupuncture Training in a Canine Cadaver Model.

Veterinary acupuncture is becoming increasingly implemented for various disease processes, with growing numbers of veterinarians pursuing advanced training to meet the rising demand for this relatively new intervention. Accurate acupoint placement remains challenging, with individual practitioners relying on varying methods of point identification, often compounded by the transpositional nature of points for companion animals. The aim of this study was to assess for differences in acupuncture needle placement of select points between veterinary professionals with three different levels of acupuncture training in an academic teaching environment. Seven participants placed a total of six acupoints on a canine cadaver. Digital radiography was used to document each participant's point placement. Each participant's point location was then compared to a control "correct" point, and the distance between the two points was measured. A significant difference in placement accuracy was identified between the participants when grouped by training level (p = 0.03). These results indicate that veterinary patients receiving acupuncture treatment from veterinarians with different levels of training may subsequently experience varying effects, although further studies are warranted on more specific acupoint description as well as the clinical implications of needle placement accuracy.