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Idiopathic, non-infectious, non-erosive arthritis in a bitch. C.R. Hutchings, G.A. Verkerk, K.J. Kissling. New Zealand Vet. J. 1980;28(5). Quote: A 2 1/2-year-old Cavalier King Charles Spaniel bitch was examined because of recurring episodes of lameness and joint swelling over a period of 2 years. Clinical examination, radiography, serology, joint-fluid analysis and histopathology of the joint capsule led to a diagnosis of idiopathic, non-infectious, non-erosive arthritis. Combination therapy with prednisolone, cyclophosphamide and azothioprine produced a rapid improvement in the dog's condition. The features of this disease and its relationship to rheumatoid arthritis and systemic lupus erythematosis are discussed.

Immune-based non-erosive inflammatory joint disease of the dog. 3. Canine idiopathic polyarthritis. David Bennett. J. Sm. Anim. Pract. October 1987; doi: 10.1111/j.1748-5827.1987.tb01316.x. Quote: The features of 67 cases of canine idiopathic polyarthritis are described. Idiopathic polyarthritis includes cases of non-infective polysynovitis which cannot be classified into more defined groups. It most often affects young adult dogs, and pyrexia, inappetence and lethargy are exhibited as well as lameness. Radiography usually shows soft tissue changes. Four types are identified according to certain associations; [34 dogs with] Type I (uncomplicated), [19 dogs with] Type II (infection elsewhere in the body), [8 dogs with] Type III (gastro-intestinal disease) [including one cavalier King Charles spaniel (12.5%)] and [6 dogs with] Type IV (neoplastic disease elsewhere in the body). ... Type III (enteropathic arthritis): polyarthritis associated with gastro-intestinal disease; eg, gastro-enteritis, ulcerative colitis. ... In Type III cases the gastro-intestinal disease was treated usually with antibiotics and kaolin preparations. ... Prednisolone was the drug of choice in the Type I cases and was also used in Types II and III to help resolve the joint inflammation. ... If the animal relapsed at a later date, the dosage regime was repeated. In some cases, especially where relapses were common [including the CKCS], cytotoxic drugs were used; ie, cyclophosphamide or azathioprine.

Alphal-Proteinase Inhibitor Deficiency and Bartonella Infection in Association with Panniculitis, Polyarthritis, and Meningitis in a Dog. P.J. Mellor, K. Fetz, R.G. Maggi, S. Haugland, M. Dunning, E.J. Villiers, R.J. Mellanby, D. Williams, E. Breitschwerdt, M.E. Herrtage. J. Vet. Intern. Med. July 2006; doi: 10.1111/j.1939-1676.2006.tb01823.x. Quote: A 7-year-old male neutered Cavalier King Charles Spaniel dog presented to the referring veterinarian with a 1-day history of right forelimb lameness and was symptomatically treated with carprofen. ... Fourteen weeks (day 98) after the onset of clinical signs, the dog was referred to the Queen’s Veterinary School Hospital, University of Cambridge for the investigation of ongoing lethargy and shifting lameness. ... Panniculitis is an uncommon inflammatory disease of subcutaneous fat characterized by painful, subcutaneous nodules that may ulcerate and form sinus tracts discharging oily material. The dermatologic presentation also may be accompanied by systemic signs. It is an infrequently documented condition in the dog and in many cases the etiopathogenesis remains unknown, or it is putatively described as an immune-mediated disorder. ... A primary presenting sign in the patient was severe shifting lameness with nonlocalized pain. There was neither clinical nor histopathologic evidence of subcutaneous tissue inflammation in the limbs. A complete skeletal radiographic survey failed to identify any lesions. Concurrent bone marrow fat necrosis has been reported in association with canine panniculitis, and bone pain has been noted as a clinical manifestation. Marrow core biopsy did not provide evidence of fat necrosis in the patient. The dog lacked clear clinical and radiographic evidence of joint inflammation, but arthrocentesis supported a diagnosis of neutrophilic polyarthritis. The clinical signs of neck pain and the CSF analysis were consistent with meningitis. ... Bone marrow examination revealed adequate neutrophil production. The degree of neutrophil infiltration within joint fluid and CSF was cytologically assessed as mild to moderate (ie, not suggestive of massive sequestration of blood neutrophils into these areas). The cause of this patient’s neutropenia was not conclusivedly identified, but seems likely to be because of underlying Bartonella infection or immune-mediated neutropenia. ... We suspect that Bartonella acted in concert with A1PI deficiency [alpha1-proteinase inhibitor deficiency], facilitating the clinical manifestation of panniculitis in the patient. To the authors’ knowledge, this is the 1st reported case for either Bartonella-associated or alpha1-proteinase inhibitor deficiency–associated panniculitis in the dog.

Progressive lameness in a Cavalier King Charles Spaniel. Mark Longley, Kinley Smith. BSAVA Companion. April 2011; doi: 10.22233/20412495.0411.10. Quote: An 8-year-old Cavalier King Charles Spaniel presented with a 6-month history of progressive forelimb lameness. The diagnosis and treatment of rheumatoid arthritis is described.

Micronized/ultramicronized palmitoylethanolamide displays superior oral efficacy compared to nonmicronized palmitoylethanolamide in a rat model of inflammatory pain. Daniela Impellizzeri, Giuseppe Bruschetta, Marika Cordaro, Rosalia Crupi, Rosalba Siracusa, Emanuela Esposito, Salvatore Cuzzocrea. Neuroinflammation. August 2014; doi: 10.1186/s12974-014-0136-0. Quote: Background: The fatty acid amide palmitoylethanolamide (PEA) has been studied extensively for its anti-inflammatory and neuroprotective actions. The lipidic nature and large particle size of PEA in the native state may limit its solubility and bioavailability when given orally, however. Micronized formulations of a drug enhance its rate of dissolution and reduce variability of absorption when orally administered. The present study was thus designed to evaluate the oral anti-inflammatory efficacy of micronized/ultramicronized versus nonmicronized PEA formulations. Methods: Micronized/ultramicronized PEA was produced by the air-jet milling technique, and the various PEA preparations were subjected to physicochemical characterization to determine particle size distribution and purity. Each PEA formulation was then assessed for its anti-inflammatory effects when given orally in the carrageenan-induced rat paw model of inflammation, a well-established paradigm of edema formation and thermal hyperalgesia. Results: Intraplantar injection of carrageenan into the right hind paw led to a marked accumulation of infiltrating inflammatory cells and increased myeloperoxidase activity. Both parameters were significantly decreased by orally given micronized PEA (PEA-m; 10 mg/kg) or ultramicronized PEA (PEA-um; 10 mg/kg), but not nonmicronized PeaPure (10 mg/kg). Further, carrageenan-induced paw edema and thermal hyperalgesia were markedly and significantly reduced by oral treatment with micronized PEA-m and ultramicronized PEA-um at each time point compared to nonmicronized PeaPure. However, when given by the intraperitoneal route, all PEA formulations proved effective. Conclusions: These findings illustrate the superior anti-inflammatory action exerted by orally administered, micronized PEA-m and ultramicronized PEA-um, versus that of nonmicronized PeaPure, in the rat paw carrageenan model of inflammatory pain.

Nerve Growth Factor: A Focus on Neuroscience and Therapy. Luigi Aloe, Maria Luisa Rocco, Bijorn Omar Balzamino, Alessandra Micera. Curr. Neuropharmacol. May 2015; doi: 10.2174/2F1570159X13666150403231920 Quote: Nerve growth factor (NGF) is the firstly discovered and best characterized neurotrophic factor, known to play a critical protective role in the development and survival of sympathetic, sensory and forebrain cholinergic neurons. NGF promotes neuritis outgrowth both in vivo and in vitro and nerve cell recovery after ischemic, surgical or chemical injuries. Recently, the therapeutic property of NGF has been demonstrated on human cutaneous and corneal ulcers, pressure ulcer, glaucoma, maculopathy and retinitis pigmentosa. NGF eye drops administration is well tolerated, with no detectable clinical evidence of systemic or local adverse effects. The aim of this review is to summarize these biological properties and the potential clinical development of NGF.

Clinical features and pathological joint changes in dogs with erosive immune-mediated polyarthritis: 13 cases (2004–2012). Magen L. Shaughnessy, Susannah J. Sample, Carter Abicht, Caitlin Heaton, Peter Muir. JAVMA. November 2016;249(10):1156-1164. Quote: Objective: To evaluate the clinical features and pathological joint changes in dogs with erosive immune-mediated polyarthritis (IMPA). Design: Retrospective case series. Animals: 13 dogs with erosive IMPA [including two cavalier King Charles spaniels (15.4%)] and 66 dogs with nonerosive IMPA. Procedures: The medical record database of a veterinary teaching hospital was reviewed to identify dogs with IMPA that were examined between October 2004 and December 2012. For each IMPA-affected dog, information extracted from the medical record included signalment, diagnostic test results, radiographic findings, and treatments administered. Dogs were classified as having erosive IMPA if review of radiographs revealed the presence of bone lysis in multiple joints, and descriptive data were generated for those dogs. All available direct smears of synovial fluid samples underwent cytologic evaluation. The synovial fluid total nucleated cell count and WBC differential count were estimated and compared between dogs with erosive IMPA and dogs with nonerosive IMPA. Results: 13 of 79 (16%) dogs had erosive IMPA. Dogs with erosive IMPA had a mean ± SD age of 7.1 ± 2.4 years and body weight of 8.3 ± 3.4 kg (18.3 ± 7.5 lb). All 13 dogs had erosive lesions in their carpal joints. (See left carpus of an 8-year-old spayed female Cavalier King Charles Spaniel with subjectively moderate subchondral bone lysis accompanied by severe synovial swelling -- in x-ray at right).The estimated median synovial fluid lymphocyte count for dogs with erosive IMPA was significantly greater than that for dogs with nonerosive IMPA. All dogs received immunosuppressive therapy with leflunomide (n = 9), prednisone (3), or prednisone-azathioprine (1). Conclusions & Clinical Relevance: Results indicated erosive IMPA most commonly affected the carpal joints of middle-aged small-breed dogs. Further genetic analyses and analysis of lymphocyte-subsets are warranted for dogs with erosive IMPA.

Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Katharine L. Anderson, Dan G. O’Neill, David C. Brodbelt, David B. Church, Richard L. Meeson, David Sargan, Jennifer F. Summers, Helen Zulch, Lisa M. Collins. Sci. Repts. April 2018;8:5641. Quote: Osteoarthritis is the most common joint disease diagnosed in veterinary medicine and poses considerable challenges to canine welfare. This study aimed to investigate prevalence, duration and risk factors of appendicular osteoarthritis in dogs under primary veterinary care in the UK. The VetCompassTM programme collects clinical data on dogs attending UK primary-care veterinary practices. The study included all VetCompassTM dogs under veterinary care during 2013. Candidate osteoarthritis cases were identified using multiple search strategies. A random subset was manually evaluated against a case definition. Of 455,557 study dogs, 16,437 candidate osteoarthritis cases were identified; 6104 (37%) were manually checked and 4196 (69% of sample) were confirmed as cases. Additional data on demography, clinical signs, duration and management were extracted for confirmed cases. Estimated annual period prevalence (accounting for subsampling) of appendicular osteoarthritis was 2.5% (CI95: 2.4–2.5%) equating to around 200,000 UK affected dogs annually. Risk factors associated with osteoarthritis diagnosis included breed (e.g. Labrador, Golden Retriever), being insured, being neutered, of higher bodyweight and being older than eight years. Duration calculation trials suggest osteoarthritis affects 11.4% of affected individuals’ lifespan, providing further evidence for substantial impact of osteoarthritis on canine welfare at the individual and population level. ... Prevalence estimate. The estimated annual period prevalence of osteoarthritis diagnosis in dogs under primary veterinary care in the UK during 2013 was 2.5% (CI95: 2.4–2.5%). Prevalence of the most frequently affected breeds was also calculated with the most prevalent breeds being large breeds, specifically: Golden Retriever (7.7% of all Golden retrievers), Labrador Retriever (6.1% of all Labradors), Rottweiler (5.4% of all Rottweilers) and German Shepherd Dog (4.9% of all German Shepherds). ... Cavalier King Charles (2.42%).

Spontaneous Septic Arthritis of Canine Elbows: Twenty-One Cases. Ben Mielke, Eithne Comerford, Kate English, Richard Meeson. Vet Comp Orthop Traumatol. November 2018;31(6):488-493. Quote: Objective: This study provides information on clinical features, diagnosis, treatment and associated risk factors of spontaneous septic elbow arthritis in the dog. Methods: Medical records between March 2007 and June 2015 were searched for cases of spontaneous septic elbow arthritis with a diagnosis based on clinical signs, arthrocentesis, cytological and microbiological analysis of elbow joint synovial fluid, radiography and outcome following treatment. Results: Twenty-one cases of septic arthritis were identified [including one cavalier King Charles spaniel]. Pre-existing osteoarthritis was present in 14/15 elbows for which diagnostic imaging was available. Although all cases had increased neutrophil count on synovial fluid cytology, culture was only positive in 12/21. Despite initial improvement in lameness scores (pre-treatment 9/10 [range: 1-10] versus post-treatment 3/10 [range: 1-5]), 11/12 had residual long-term lameness. Recurrence of infection was noted in 3/12 elbows for which long-term (>8 weeks) follow-up was available. There was an acute mortality rate of 2/21 associated with severe systemic sepsis. Clinical significance: Septic arthritis, even in the absence of pyrexia, should be considered as a major differential diagnosis in middle aged, large breed dogs, with pre-existing elbow arthritis, that suffer an acute onset lameness, with elbow joint effusion and discomfort. Antibiotic therapy alone was effective for treatment with high initial response rates. Chronic lameness post-treatment was common, and a high rate of recurrence was seen with 3/12 dogs suffering more than one episode.

The Use of Cannabidiol-Rich Hemp Oil Extract to Treat Canine Osteoarthritis-Related Pain: A Pilot Study. Lori Kogan, Peter Hellyer, Robin Downing. AHVMA J. March 2020;58(Spring):42-45. Quote: The objective of this 90-day pilot clinical trial was to assess the impact of a full-spectrum product containing hemp extract and hemp seed oil on dogs with chronic mal adaptive pain. A total of 37 dogs diagnosed with chronic maladaptive pain primarily as a result of osteoarthritis were enrolled in the study. The dogs were given an initial physical examination that included systematic pain palpation, mapping of pain patterns, informal gait analysis, metabolic profile, and owner interview. The same palpa tions and mappings were performed during each biweekly assessment to identify trends, chart progress, and inform dose adjustments. ... Among these 30 dogs, the dose of CBD needed to achieve a positive effect ranged from 0.3 up to 4.12 mg/kg BID. The 2 dogs in the study requiring the highest dose of the CBD product were both Cavalier King Charles spaniels (not related to one another), and neither of these dogs experienced any changes/elevations in liver enzymes. It is unclear why some patients responded to a very small dose of the CBD product (0.3 mg/kg per dose), whereas the majority required dosing in the range of 1 to 2 mg/kg per dose. ... The metabolic parameters were repeated at the end of the study. Of the 32 dogs that completed the study, 30 dogs demonstrated improved pain support. Of the 23 dogs in the study that were taking gabapentin at the time of enrollment, 10 dogs were able to discontinue the gabapentin, and an additional 11 dogs were able to have their daily dose reduced with the addition of the cannabidiol (CBD) oil. Conclusion: The addition of a hemp- derived CBD oil appears to positively affect dogs with chronic maladaptive pain by decreasing their pain, thereby improving their mobility and quality of life. The reduction in gabapentin dose may be the result of changes in analgesia and/or sedation with the addition of the hemp oil extract.

Oral Transmucosal Cannabidiol Oil Formulation as Part of a Multimodal Analgesic Regimen: Effects on Pain Relief and Quality of Life Improvement in Dogs Affected by Spontaneous Osteoarthritis. Federica Alessandra Brioschi, Federica Di Cesare, Daniela Gioeni, Vanessa Rabbogliatti, Francesco Ferrari, Elisa Silvia D’Urso, Martina Amari, Giuliano Ravasio. Animals. August 2020; doi: 10.3390/ani10091505. Quote: The aim of this study was to evaluate the efficacy of oral transmucosal (OTM) cannabidiol (CBD), in addition to a multimodal pharmacological treatment for chronic osteoarthritis-related pain in dogs. Twenty-one dogs were randomly divided into two groups: in group CBD (n = 9), OTM CBD (2 mg kg−1 every 12 h) was included in the therapeutic protocol (anti-inflammatory drug, gabapentin, amitriptyline), while in group C (n = 12), CBD was not administered. Dogs were evaluated by owners based on the Canine Brief Pain Inventory scoring system before treatment initiation (T0), and one (T1), two (T2), four (T3) and twelve (T4) weeks thereafter. Pain Severity Score was significantly lower in CBD than in C group at T1 (p = 0.0002), T2 (p = 0.0043) and T3 (p = 0.016). Pain Interference Score was significantly lower in CBD than in C group at T1 (p = 0.0002), T2 (p = 0.0007) and T4 (p = 0.004). Quality of Life Index was significantly higher in CBD group at T1 (p = 0.003). The addition of OTM CBD showed promising results. Further pharmacokinetics and long-term studies in larger populations are needed to encourage its inclusion into a multimodal pharmacological approach for canine osteoarthritis-related pain.

A randomized, double-blind, placebo-controlled study of daily cannabidiol for the treatment of canine osteoarthritis pain. Chris D. Verrico, Shonda Wesson, Vanaja Konduri, Colby J. Hofferek, Jonathan Vazquez-Perez, Emek Blair, Kenneth Dunner Jr, Pedram Salimpour, William K. Decker, Matthew M. Halpert. Pain. September 2020; doi: 10.1097/j.pain.0000000000001896. Quote: Over the last 2 decades, affirmative diagnoses of osteoarthritis (OA) in the United States have tripled due to increasing rates of obesity and an aging population. Hemp-derived cannabidiol (CBD) is the major nontetrahydrocannabinol component of cannabis and has been promoted as a potential treatment for a wide variety of disparate inflammatory conditions. Here, we evaluated CBD for its ability to modulate the production of proinflammatory cytokines in vitro and in murine models of induced inflammation and further validated the ability of a liposomal formulation to increase bioavailability in mice and in humans. Subsequently, the therapeutic potential of both naked and liposomally encapsulated CBD was explored in a 4-week, randomized placebo-controlled, double-blinded study in a spontaneous canine model of OA. In vitro and in mouse models, CBD significantly attenuated the production of proinflammatory cytokines IL-6 and TNF-α while elevating levels of anti-inflammatory IL-10. In the veterinary study, CBD significantly decreased pain and increased mobility in a dose-dependent fashion among animals with an affirmative diagnosis of OA. Liposomal CBD (20 mg/day) was as effective as the highest dose of nonliposomal CBD (50 mg/day) in improving clinical outcomes. Hematocrit, comprehensive metabolic profile, and clinical chemistry indicated no significant detrimental impact of CBD administration over the 4-week analysis period. This study supports the safety and therapeutic potential of hemp-derived CBD for relieving arthritic pain and suggests follow-up investigations in humans are warranted.

Point prevalence and clinical course of proteinuria in dogs with idiopathic non-erosive immune-mediated polyarthritis. L. Barker, S. McManus, S. Adamantos, V. Black. J. Sm. Anim. Pract. May 2022; doi: 10.1111/jsap.13503. Quote: Objectives: To describe the point prevalence and clinical course of proteinuria in dogs diagnosed with idiopathic non-erosive immune-mediated polyarthritis. Materials and Methods: Cases presenting to a single referral centre with a diagnosis of idiopathic non-erosive immune-mediated polyarthritis were retrospectively recruited from January 2009 to August 2018. Data including signalment, urinalysis, clinicopathological results, cytology from arthrocentesis, treatment and long-term follow-up were analysed. Dogs were defined as: non-proteinuric (UPC <0.2), borderline proteinuric (UPC 0.2-0.5) or overtly proteinuric (UPC >0.5). Results: Fifty-eight dogs met the inclusion criteria. ... Presenting breeds included cocker spaniel (n=5), Cavalier King Charles spaniel (n=4) [7%], Labrador retriever (n=4), whippet (n=4), springer spaniel (n=3), Chinese crested (n=2), corgi (n=2), Jack Russell terrier (n=2), English pointer (n=2), and 13 dogs of mixed breeds and one each of 18 other breeds. ... Twenty-two dogs were overtly proteinuric (38%), eight dogs were borderline proteinuric (14%) and 28 dogs were non-proteinuric (48%). Repeated urinalysis was performed in nine of 12 dogs with UPC greater than 2.0. The UPC decreased in all nine dogs, with the UPC decreasing to less than 0.5 in 44% of dogs. A greater than 50% decrease in UPC was noted in 44% of dogs, despite seven of nine (77%) receiving prednisolone as either monotherapy or in conjunction with an adjunctive immunosuppressive medication. Clinical Significance: Proteinuria was common in this cohort of dogs diagnosed with primary idiopathic non-erosive immune-mediated polyarthritis. The use of prednisolone does not appear to be contraindicated in proteinuric dogs with idiopathic non-erosive immune-mediated polyarthritis.

Efficacy and safety of cannabidiol for the treatment of canine osteoarthritis: a systematic review and meta-analysis of animal intervention studies. Chanthawat Patikorn, Osot Nerapusee, Kumpanart Soontornvipart, Kanta Lawonyawut, Kachapong Musikpodok, Kanisorn Waleethanaphan, Puree Anantachoti. Front. Vet. Sci. September 2023; doi: 10.3389/fvets.2023.1248417. Quote: Introduction: Canine osteoarthritis (OA) is a degenerative disease with chronic inflammation of internal and external joint structures in dogs. Cannabis spp. contains cannabidiol (CBD), a substance known for various potential indications, such as pain relief and anti-inflammatory in various types of animals, including dogs with OA. As CBD is increasingly in the spotlight for medical use, we aimed to perform a systematic review and meta-analysis to evaluate the efficacy and safety of CBD in treating canine OA. Methods: We searched PubMed, Embase, Scopus, and CAB Direct for animal intervention studies investigating the effects of CBD for canine OA from database inception until February 28, 2023. Study characteristics and findings were summarized. A risk of bias in the included studies was assessed. Meta-analyses were performed using a random-effects model to estimate the effects of CBD on pain scores (0–10), expressed as mean difference (MD) and 95% confidence interval (95% CI). Certainty of evidence was assessed using GRADE. Results: Five articles were included, which investigated the effects of CBD in 117 dogs with OA. All studies were rated as having a high risk of bias. CBD products varied substantially, i.e., oral full-spectrum CBD oil in four studies, and isolated CBD oil and liposomal CBD oil in another study. Treatment duration varied from 4–12 weeks. Meta-analyses of three studies found that, in dogs with OA, treatment with oral full-spectrum CBD oil may reduce pain severity scores (MD; −0.60, 95% CI; −1.51 to 0.31, I2 = 45.64%, p = 0.19) and pain interference scores (MD; −1.52, 95% CI; −3.84 to 0.80, I2 = 89.59%, p = 0.20) but the certainty of evidence was very low. CBD is generally considered safe and well-tolerated in the short-run, with few mild adverse events observed, such as vomiting and asymptomatic increase in alkaline phosphatase level. Conclusion: CBD is considered safe for treating canine OA. CBD may reduce pain scores, but the evidence is very uncertain to conclude its clinical efficacy. High-quality clinical trials are needed to further evaluate the roles of CBD in canine OA.

Librela (Beransa) – Wonder Drug Or Disaster In The Making? Edward Bassingthwaighte. Dogs Naturally. October 2023. Quote: In my professional opinion, there is no way that Librela should ever be considered as a first treatment or intervention for arthritis in dogs.

Canine immune-mediated polyarthritis: A review of 84 cases in the UK between 2011 and 2021. Judith Cruzado Perez, Victoria Travail, Valerie Lamb, Darren Kelly. Vet. Med. & Sci. January 2024; doi: 10.1002/vms3.1306. Background: Immune-mediated polyarthritis (IMPA) is a well-recognised disease in dogs, but studies evaluating the response rates, relapse rates and long-term outcomes are scarce. Objectives: To provide an updated description of the signalment, clinical signs, clinico- pathological findings, distribution between subgroups, rates of response and relapse and long-term outcome of 84 dogs diagnosed with IMPA at a single referral hospital. Methods: Dogs diagnosed with IMPA between January 2011 and December 2021 were identified. Dogs with neutrophilic inflammation in ≥2 joints were included. Cases with <1 month of follow-up, or those missing pertinent data, were excluded. Results: A total of 84 cases were included. ... Cocker spaniels (9/84), Labrador retrievers (6/84), Border col- lies (6/84), Springer spaniels (5/84), Cavalier King Charles spaniels (3/84), Boxers (3/84), German shepherds (2/84), West Highland White terriers (2/84) and Golden retrievers (2/84) were included. The remain- ing cases (32/84) were represented by one individual of different pure breeds. ... An initial response was achieved in 77/84 (92%) cases. Of the cases that initially responded, 37/77 (48%) suffered at least one relapse and 18/77 (23%) suffered multiple relapses. Indefinite treatment was recom- mended in 17/84 (20%) cases. Of the 70 dogs for which at least 12 months of follow-up data were available, 12/70 (17%) were euthanised due to IMPA or for unknown reasons. Conclusion: IMPA carries a fair prognosis, but relapses occur in many cases and euthanasia due to relapsing or refractory disease is not uncommon.

A blinded, randomized and controlled multicenter field study investigating the safety and efficacy of long-term use of enflicoxib in the treatment of naturally occurring osteoarthritis in client-owned dogs. Josep Homedes, Marion Ocak, Sebastian Riedle, Marta Salichs. Frontiers in Vet. Sci. February 2024; doi: 10.3389/fvets.2024.1349901. Quote: Background Enflicoxib is a COX-2 selective NSAID shown to be efficacious and safe in the treatment of pain and inflammation associated with canine osteoarthritis (OA) in clinical studies of 6 weeks duration. Objective This prospective, multisite, blinded, randomized, placebo-controlled, parallel-group field study aimed to confirm the safety and efficacy of enflicoxib in long-term canine OA treatments. Animals A total of 109 client owned dogs with clinical and radiographic signs of OA for at least 3 weeks were enrolled with 78 dogs completing all study visits. Methods Dogs were randomized at a 3:1 ratio to receive enflicoxib (n = 83) or placebo (n = 26) once weekly during 6 months. Dogs underwent veterinary assessments from Day 0 to Day 189 using a clinical sum score (CSS). Efficacy was also assessed by the owners using the Canine Brief Pain Inventory (CBPI). Safety was assessed clinically and by repeated blood and urine sample analysis. The efficacy outcome measure was the treatment response according to the CSS and secondarily the treatment response according to the CBPI. The primary safety outcome was the incidence of adverse events (AEs) and secondarily the evolution of the clinical pathology parameters. Results Percentages of CSS responders for enflicoxib were 71.6; 74.6 and 71.6% on Days 44, 135 and 189 respectively, always showing statistically significant differences (p < 0.05) vs. placebo (41.7, 33.3, and 20.8% respectively). Treatment response according to owner assessments followed the same pattern, achieving significant differences compared to placebo after 2 weeks of treatment. The incidence and type of AEs were as described in previous enflicoxib studies of shorter duration and as for other NSAIDs, with no tendency to increase over time. No relevant changes in hematology, biochemistry or urine parameters were observed. Conclusions and clinical relevance Enflicoxib safety and efficacy profile is maintained after a long-term treatment, which together with its weekly administration, makes it a good alternative for the chronic treatment of dogs with naturally occurring OA.

Cannabidiol plus krill oil supplementation improves chronic stifle osteoarthritis in dogs: A double-blind randomized controlled trial. K. Soontornvipart, P. Wongsirichatchai, A. Pongphuwanun, K. Chatdarong, S. Vimolmangkang. Vet. J. August 2024; doi: 10.1016/j.tvjl.2024.106227. Quote: Osteoarthritis (OA) is the most common orthopedic disorder characterized by chronic inflammation and pain in dogs and cats. Cannabis spp. contains cannabidiol (CBD), a substance with pain relief and anti-inflammatory properties in different animals including dogs with OA. The use of CBD supplements has been increasingly intertwining in veterinary medicine. This study aimed to evaluate the clinical efficacy of CBD + krill oil-supplemented biscuit against canine OA. In total, 30 dogs with stifle OA were randomized and divided into the placebo, krill oil, and CBD + krill oil groups. The Canine Brief Pain Inventory questionnaire was used to evaluate the efficacy of each treatment against pain. Stifle temperature was monitored to identify degrees of stifle inflammation. Two and one dogs in the placebo group were excluded from the study due to worsening lameness and increased pain interference score (PIS) and pain severity score (PSS) at days 14 and 28, respectively. The PIS and PSS scores of the krill oil and CBD + krill oil groups gradually and significantly improved after two weeks of treatment. The CBD + krill oil group had better PIS and PSS scores than the placebo and krill oil groups. However, there was no statistically significant difference in the PIS and PSS scores between the krill oil and CBD + krill oil groups. The stifle temperature of the three groups at different periods did not significantly differ. In conclusion, CBD + krill oil supplements are safe against canine OA. CBD can reduce pain and inflammation. Highlights: • CBD + krill oil-supplemented biscuit significantly reduced pain and inflammation in OA dogs. • Krill oil or CBD + krill oil biscuits both reduced pain, with the latter showing slightly better results. • No side effects were observed when giving the dog the CBD + krill oil-supplemented biscuit.