November 2024
Dear Clients,
Can you believe it’s November already?!?!? It’s almost time for the weather to get cool and sometimes this cool weather can cause our pets to get the morning zoomies but they may also wake up more stiff. Let’s chat about a few tools we have for osteoarthritis and new drugs that have been on the market.
Thankful
Osteoarthritis is treated based on the stage your pet is in.
Stage 0-1: Preclinical disease. Your pet may have underlying dysplasia or participate in high impact sports but is not showing any clinical signs of pain.
Stage 2: Mild disease. Occasional lameness is noted with some evidence of arthritis on radiographs and physical exam.
Stage 3: Moderate disease. Persistent lameness with obvious evidence of arthritis on radiographs and physical exam.
Stage 4: Severe disease. Severe lameness causing difficulties with movement and transitions on a daily basis.
We will begin supplements and preventative strategies in early stages of disease, but as the progression worsens we will intervene more with pharmaceuticals as well modalities and rehabilitation techniques to improve pain management and mobility.
Shockwave on the Elbow Joint
Shockwave therapy is the use of high energy sound waves for musculoskeletal injuries. These sound waves elicit a mechanical disturbance in the tissue and stimulates the body’s own healing processes. Shockwave is very well researched for positive outcomes in bone healing, tendinopathies, pain control, and arthritis management.
We use the Piezowave 2 machine, which uses piezoelectric crystals to produce a focused high energy sound wave.
Once the area has been identified for shockwave, we will start with weekly treatments. Sedation is NOT needed and the patients are comfortable during administration of the pulses. The stimulation of the bodies healing processes could cause 24 hours of soreness, but most pet parents report that their pet had immediate relief after the sessions with no soreness.
The shockwave is boosting the body’s own response to injured tissue, there by eliciting an ongoing healing process, so the effects may be both immediate and long term.
For osteoarthritis conditions, shockwave has been shown to stimulate cartilage growth which are the protective cells of the joint thereby increasing the release of more lubricating fluids such as hyaluronic acid.
NEW DRUG: Librela
A new injectable medication has just hit the market as a new treatment for pain of osteoarthritis in dogs.
This drug is a once a month injection which targets Nerve Growth Factor (NGF), a substance found to cause pain of osteoarthritis. This is an exciting new drug with a lot of promise in treating pain of osteoarthritis.
This injection will be given once monthly for atleast 2 months to determine if there is a reduction in pain. 60% of dogs in the studies had a reduction in owner perceived pain after 2 injections.
This drug may sound like a miracle, but it is not for everyone. If your dog concurrently has any neurologic disease, this medication is not recommended at this time. There are no studies to ensure safe use in neurologic conditions, and NGF is a compound that is neuro-protective in degenerative diseases.
There are no studies on the safety of using Librela long term with anti-inflammatories, so some medication management is necessary to ensure adequate pain management during the use of Librela.
Additionally, it may work so well in some dogs, that they will have a sudden increase in activity level causing injuries to occur in unconditioned patients.
We are happy to help you and your primary care veterinarian in navigating the new drug Librela. It is an exciting new drug with great promise to reduce pain when used in the proper scenario.
Please email us if you or your vet have any questions or concerns.
Happy Thanksgiving!
Peace and Love,
Dr. Lisa Mason