A Modification of the Cheli Craniolateral Approach for Minimally Invasive Treatment of Osteochondritis Dissecans of the Shoulder in Dogs: Description of the Technique and Outcome in 164 Cases.

OBJECTIVE: The aim of this study was to describe a novel minimally invasive surgical approach for the treatment of shoulder osteochondritis dissecans (OCD) in dogs and to retrospectively review our clinical cases treated with this approach. STUDY DESIGN: The study describes a modification of Cheli surgical approach (1985), developed to reduce the degree of invasiveness as well as the incidence of postoperative complications observed in other surgical approaches to the shoulder joint. Medical records of dogs that underwent our minimally invasive approach to the scapulohumeral joint for treatment of OCD from May 2001 to May 2019 were retrospectively reviewed for intraoperative findings and complications. Clinical outcome and complications were also evaluated in the operated dogs with a minimum of a 2-month-follow-up evaluation. RESULTS: A total of 164 shoulders in 141 dogs (23 bilateral), 103 males and 38 females, were examined and treated with our modified craniolateral approach for the treatment of OCD of the humeral head. In all cases, the modified craniolateral approach allowed visibility and adequate exposure of the caudal humeral head surface. Radiographic and clinical follow-up evaluations were available in 123/164 (75%) cases. The clinical outcome was consistent with other reports using different surgical approaches for OCD lesions of the humeral head in dogs. CLINICAL SIGNIFICANCE: This technique provided a reliable approach for surgical treatment of canine shoulder OCD and can be considered a valid alternative to other surgical approaches including arthroscopy.

Effect of dietary supplementation with ultramicronized palmitoylethanolamide in maintaining remission in cats with nonflea hypersensitivity dermatitis: a double-blind, multicentre, randomized, placebo-controlled study.

BACKGROUND: Feline nonflea hypersensitivity dermatitis (NFHD) is a frequent cause of over-grooming, scratching and skin lesions. Multimodal therapy often is necessary. HYPOTHESIS/OBJECTIVES: To investigate the efficacy of ultramicronized palmitoylethanolamide (PEA-um) in maintaining methylprednisolone-induced remission in NFHD cats. ANIMALS: Fifty-seven NFHD cats with nonseasonal pruritus were enrolled originally, of which 25 completed all study requirements to be eligible for analysis. METHODS AND MATERIALS: Cats were randomly assigned to PEA-um (15 mg/kg per os, once daily; n = 29) or placebo (n = 28) while receiving a 28 day tapering methylprednisolone course. Cats responding favourably to methylprednisolone were then administered only PEA-um (n = 21) or placebo (n = 23) for another eight weeks, followed by a four week long treatment-free period. Cats were maintained in the study until relapse or study end, whichever came first. Primary outcome was time to relapse. Secondary outcomes were pruritus Visual Analog Scale (pVAS), SCORing Feline Allergic Dermatitis scale (SCORFAD) and owner Global Assessment Score (GAS). RESULTS: Mean relapse time was 40.5 days (±7.8 SE) in PEA-um treated cats (n = 13) and 22.2 days (±3.7 SE) for placebo (n = 12; P = 0.04). On Day 28, the severity of pruritus was lower in the PEA-um treated cats compared to placebo (P = 0.03). Mean worsening of pruritus at the final study day was lower in the PEA-um group compared to placebo (P = 0.04), whereas SCORFAD was not different between groups. Mean owner GAS at the final study day was better in the PEA-um than the placebo-treated group (P = 0.05). CONCLUSION AND CLINICAL IMPORTANCE: Ultramicronized palmitoylethanolamide could represent an effective and safe option to delay relapse in NFHD cats.

Combining a joint health supplement with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture. An exploratory controlled trial.

Canine cranial cruciate ligament rupture (CrCLR) is a very common pathology. Surgical stabilization is the first choice treatment, although it does not fully eliminate the increased risk of osteoarthritis. This preliminary study was carried out to explore whether a newly formulated joint health supplement would benefit metabolic, clinical and radiographic changes in dogs with CrCLR surgically treated with tibial plateau leveling osteotomy (TPLO). Besides chondroitin sulfate and glucosamine hydrochloride, the studied supplement contained anti-inflammatory and antioxidant ingredients, the main ones being N-palmitoyl-D-glucosamine (Glupamid®) and quercetin. It was thus intended to target not only chondrodegenerative components of osteoarthritis, but also post-injury inflammatory response and oxidative stress of joint tissues. Thirteen dogs underwent TPLO and were randomly allocated to treatment (n = 6) and control groups (n = 7), the former receiving the joint supplement for 90 days. Lameness and radiographic osteoarthritis changes were scored before (i.e., baseline) and at 30 and 90 days post-surgery. Synovial fluid samples were collected from injured stifles at the same time points. Levels of representative metabolites were measured by proton nuclear magnetic resonance spectroscopy in a blinded fashion. In the metabolomic analysis, special attention was paid to lactate, due to its emerging recognition as a key marker of inflammation. In the last time period (from the 30th to the 90th day), lameness improved by a factor of 2.3 compared to control dogs. No significant difference was observed in the radiographic osteoarthritis score between groups. In the first postoperative month, lactate and creatine levels significantly dropped in treated compared to control dogs. Compared to surgery alone, combining the joint supplement with TPLO resulted in a trend to a better clinical outcome in the later time interval but did not influence osteoarthritis radiographic progression. A significantly better rebalance of joint microenvironment in the early time interval (baseline - 30 days) was shown by metabolomic analysis, thus suggesting that the study supplement could limit ongoing inflammatory responses.

Efficacy of ultra-micronized palmitoylethanolamide in canine atopic dermatitis: an open-label multi-centre study.

BACKGROUND: Palmitoylethanolamide is a naturally occurring bioactive lipid, produced on-demand by damage-exposed cells. Palmitoylethanolamide is documented to counteract inflammation, itch and pain. OBJECTIVE: The aim of this 8-week study was to evaluate the efficacy of oral ultra-micronized palmitoylethanolamide (PEA-um) in dogs with moderate atopic dermatitis. ANIMALS: Clinicians from 39 veterinary clinics enrolled 160 dogs with nonseasonal atopic dermatitis and moderate pruritus. METHODS: This was a multi-centre open-label study. On days 0 (D0) and 56 (D56), owners evaluated pruritus with a Visual Analog Scale (VAS) and completed a validated Quality of Life (QoL) questionnaire. Veterinarians assessed the severity of skin lesions using the Canine Atopic Dermatitis Lesion Index (CADLI). RESULTS: Mean pruritus VAS score decreased from 5.7 ± 0.08 cm (range 3.8-7.9 cm) to 3.63 ± 0.19 cm (range 0.1-9.2 cm) (P < 0.0001). At D56, 58% of dogs showed a greater than 2 cm reduction from baseline and 30% showed an absent-to-very mild pruritus (VAS ≤ 2 cm). Mean total CADLI at D56 decreased significantly (P < 0.0001); in 62% of dogs this score reached a value in the remission range (≤5). Mean total QoL score was significantly decreased (P < 0.0001) with 45% of dogs reaching QoL values described for healthy animals. Tolerability was good-to-excellent with only four dogs reporting treatment associated reversible adverse events. CONCLUSIONS AND CLINICAL IMPORTANCE: PEA-um appears to be effective and safe in reducing pruritus and skin lesions, and in improving QoL in dogs with moderate atopic dermatitis and moderate pruritus.

Inhibitory effect of topical adelmidrol on antigen-induced skin wheal and mast cell behavior in a canine model of allergic dermatitis.

BACKGROUND: Adelmidrol is a semisynthetic derivative of azelaic acid and analogue of the anti-inflammatory compound palmitoylethanolamide (PEA). Based upon its physicochemical properties, adelmidrol is suitable for topical application. The main objective of the present study was to evaluate the efficacy of a topical adelmidrol emulsion on early and late inflammatory responses in hypersensitive dogs. Repeated intradermal injections of Ascaris suum extract were performed in both lateral thoracic areas of six conscious hypersensitive Beagle dogs, topically treated during 8 consecutive days. Adelmidrol (2%) was applied to one side and vehicle to the other. 24 hours after the last antigen challenge, two biopsies (adelmidrol- and vehicle-treated side) were obtained for each dog at the antigen injection site. RESULTS: A significant reduction in the antigen-induced wheal areas was observed on the 4th and 7th day of adelmidrol treatment. Moreover, cutaneous mast cell numbers were significantly decreased in biopsies obtained after 8 consecutive days of topical adelmidrol treatment. CONCLUSIONS: The results obtained in the present study show that topical treatment with adelmidrol might represent a new therapeutic tool in controlling the early and late allergic inflammatory skin responses in companion animals.

Effects of palmitoylethanolamide on the cutaneous allergic inflammatory response in Ascaris hypersensitive Beagle dogs.

Palmitoylethanolamide (PEA) is an endogenous lipid mediator with anti-inflammatory and anti-hyperalgesic properties. The main objective of the present study was to evaluate the effects of PEA on the cutaneous allergic inflammatory reaction induced by different immunological and non-immunological stimuli in hypersensitive dogs. Six spontaneously Ascaris hypersensitive Beagle dogs were challenged with intradermal injections of Ascaris suum extract, substance P and anti-canine IgE, before and after a single oral administration of PEA at doses of 3, 10 and 30 mg/kg. A significant reduction in wheal area induced by both antigen and anti-canine IgE challenge was observed after PEA administration. No significant differences were observed between the two higher doses studied, suggesting that the 10 mg/kg dose had exerted the maximum inhibitory effect. When blood levels of PEA were compared with the effects at different times, an evident correlation was obtained. However, the anti-inflammatory effects of PEA were more long-lasting than their plasma concentrations. The intradermal injection of substance P did not reveal any skin reaction (wheal or erythema formation) at any of the concentrations tested. In conclusion, PEA might constitute a new therapeutic strategy for the treatment of allergic inflammatory skin diseases in companion animals.

Improvement of short-term memory performance in aged beagles by a nutraceutical supplement containing phosphatidylserine, Ginkgo biloba, vitamin E, and pyridoxine.

Aged dogs demonstrate cognitive decline that is linked to brain aging. The purpose of the present study was to examine if a commercially available nutraceutical supplement that may be neuroprotective and contains phosphatidylserine, Ginkgo biloba, vitamin E, and pyridoxine could improve cognitive function in aged beagles. Nine aged beagles were tested on performance on a delayed-non-matching-to-position task, which is a neuropsychological test of short-term visuospatial memory. All subjects were tested on 5 baseline sessions; then, to assess the supplement, a crossover design was used in which 1 group received the supplement and the other a control substance in the 1st phase, with treatment conditions being reversed in the 2nd phase. Performance accuracy was significantly improved in supplemented dogs compared with control dogs and the effect was long lasting. These findings suggest that the nutraceutical supplement can improve memory in aged dogs.

Mast cell morphometry and densitometry in experimental skin wounds treated with a gel containing adelmidrol: a placebo controlled study.

The role of skin mast cells (MCs) in wound healing has been extensively investigated. The present study was designed to examine the effect of the aliamide adelmidrol on MCs during healing of experimental cutaneous wounds. Adelmidrol gel or the vehicle alone was applied 3 times daily on 5-mm punch biopsy wounds created on the thoracolumbar skin of 10 dogs. Wounds were allowed to heal by secondary intention. Eight-mm punch samples of the healing wounds were taken on days 1, 2, 4, 8, and 14, for histology. Mast cell numbers were counted and granular content assessed by densitometric analysis on toluidine blue-stained sections. The overall mean granule content was significantly greater in the treated wounds compared to control wounds, whereas no statistically significant differences in MC counts were observed. These data indicate a reduction in MC degranulation in wounds topically treated with adelmidrol suggesting that the compound is able to down-modulate skin MC releasability without affecting their number.

Assessment of the Effect of an Aliamide-containing Topical Gel by Evaluation of the Reduction of Wound Volume Measured by High R.

This study evaluated the use of an aliamide-containing gel in the treatment of skin wounds by employing noninvasive wound volume measurements acquired from wound images of high resolution ultrasonography (HRU). The dorsal thoracolumbar areas of 10 Beagle dogs were clipped and 2 rows of 6 full-thickness 5-mm punch biopsy samples were taken from either side of the midline under general anaesthesia. Wounds were allowed to heal by secondary intention, while treatment gel or base was applied 3 times daily to randomly selected treatment and control groups. Concentric 8-mm punch biopsy samples of the healing wounds were taken on Days 1, 2, 4, 8, and 14 for histopathological assessment. Wounds were imaged with 20 MHz HRU daily over a period of 28 days. Wound volume was calculated using scanner software based on the disk summation method. The wound volume was calculated in longitudinal and transverse ultrasound images and the average of the 2 values was used as the final wound volume. Repeated measures analysis of variance (ANOVA) was used to assess whether wound volume differed significantly over time, and between control and treated animals. Mean wound volume decreased significantly during the 28-day experimental period, and there was a significant time-treatment interaction indicating that the treatment effect varied at different stages during the healing process. Overall, application of the aliamide-containing gel appears to improve wound healing over time.