Juventix Blogs

WOOF, Canine PRP!

By April 6, 2022No Comments

63.4 million households have a dog as a member in 2020, 38% households total in the US. There is a total of 89.7 million dogs in households in the US in 2020.

The global estimate of dog ownership is 471 million.

During the pandemic, 15% of Americans acquired a pet with the greatest majority being dogs.

  • 37% of Baby Boomers own dogs
  • 52% of Generation X
  • 61% of Millennials

United States by Breed

  1. Labrador Retriever is the number 1 breed
  2. German Shepherd
  3. Golden Retriever

Global by Breed

  1. Bulldog
  2. German Shepherd
  3. Labrador
  4. Husky

U.S. States with the Highest Dog Ownership

  1. Arkansas
  2. New Mexico
  3. Kentucky
  4. Missouri
  5. West Virginia
  6. Mississippi
  7. Alabama
  8. Tennessee
  9. Texas
  10. Oklahoma

U.S. States with the Lowest Dog Ownership

  1. Massachusetts
  2. Connecticut
  3. New York
  4. Rhode Island
  5. Utah
  6. New Hampshire
  7. Maryland
  8. Minnesota
  9. New Jersey
  10. Illinois

The average Cost of owning a dog in 2020 was $1201. In 2018, pet Insurance in the US was $1.42 billion premium payments. 88.9% of the premium was for dogs.

Top 10 Reasons to Visit a Veterinarian with Your Dog

  1. Skin Problems (22% of all reported claims)
  2. Stomach Ailments
  3. Ear Problems
  4. Eye Problems
  5. Pain
  6. Growths
  7. Urinary Tract Infections
  8. Allergy Symptoms

The most common cause of pain in dogs is some form of musculoskeletal abnormality. Of these abnormalities, Osteoarthritis is the most common. Osteoarthritis is also the most common form of arthritis in dogs. In older dogs, OA affects at least 25% or more of the total population.

Osteoarthritis is a chronic disease characterized by the loss of joint cartilage and new abnormal bony formation around the joint leading to pain and ultimately limb dysfunction.

Causes Of Osteoarthritis in the Canine Population

OA occurs in some dogs with no obvious primary causes and can be related to genetics and age.

Majority of OA in dogs is secondary to developmental orthopedic disease:

  • Cranial Cruciate Ligament Disease
  • Hip Dysplasia
  • Elbow Dysplasia
  • Osteochrondritis Dissecans
  • Patella Dislocation

Contributing Factors

  • Obesity
  • Gender
  • Exercise
  • Diet
  • Previous Orthopedic Injuries

Symptoms of OA

  • Reluctance to play or climb stairs
  • Lameness or walking very stiffly
  • Difficulty getting up or laying down
  • Lethargy
  • Weight gain
  • Loss of interest in normal activities

Diagnosis

  • Physical exam with orientation towards the affected joint. Range of motion will often trigger a painful response. Muscle wasting or effusion is noted
  • X-Ray- bony structures can be evaluated
  • MRI- which will not only evaluate bony tissues but soft tissues such as ligaments, tendons and the menisci
  • CT Scanning- will assess bony structural changes in the joints with more complex anatomy such as the elbow, ankle joint or the carpi (wrist joint)
  • Ultrasound- less information than the above but still helpful in location of pathology

Treatment

  • Arthritis is not a condition that is curable but symptoms can be greatly reduced through medical management. Frequent low intensity activity such as swimming can be helpful. High impact activities should be avoided such as running or jumping. Low impact walking on a leash should be continued to help build and continue a good tone of the muscles.
  • Weight control is the most important treatment modality. Fat produces inflammatory mediators that continue the inflammation process. Increased weight puts added strain on the already diseased joints. Dietary supplements such as omega three fatty acids and glucosamine chrondroitin.
  • Acupuncture and laser therapy
  • Trigger point therapy
  • Electromagnetic field therapy and extra corporeal shock wave therapy
  • Physical therapy

Medications

  • NSAIDs for dogs- these meds are similar to those given to humans with side effects of GI upset, ulcers, bleeding, renal failure and liver abnormalities.

Deramaxx (deracoxib)

EtoGesic (etodolac)

Metacam (meloxicam)

Previcox (firocoxib)

Rimadyl (carprofen)

Galliprant (grapiprant)

  • Polysulfated Glycosaminoglycans- PSGAG (Adequann)- This compound works in the cartilage and integrates there and blocks the enzymes that degrade the cartilage and bone. It also suppresses inflammation and stimulates the replacement of cartilage. It is an analogue of heparin and can cause bleeding as well as joint pain, lameness and infection in the joint. Studies showing efficacy are limited.
  • Gabapentin- an anticonvulsant recently felt to be a controlled drug and FDA is to change the schedule of this drug in humans to make it schedule V due to abuse and overdose potential. Multiple side effects- vomiting, diarrhea, somnolence.
  • Amantadine- This is an anti-parkinsonism medicine used to control tremor, also an anti-viral. In dogs, it contributes to pain relief by reducing the development of sensitization to pain in the central nervous system.
  • Tramadol- This is a morphine agonist , as a opioid analgesic, similar to morphine and fentanyl, it directly alters the perception and transmission of pain by activating the morphine receptors in the nervous system.
  • Codeine, Hydrocodone, Morphine- pure narcotics causing sedation, GI side effects, behavioral changes, seizures and addiction potential
  • Tricyclic antidepressants and Selective Serotonin/Norepinephrine Reuptake Inhibitors. These drugs are used in humans to treat chronic pain and neuropathic conditions but studies are limited in the canine population. Examples- Venflaxine, Duloxetine, fluoxetine.
  • Corticosteroids- although widely used as a first line treatment in humans and horses, studies showing long term benefit are lacking and long- term use will degenerate the joint.

Platelet-Rich-Plasma

Platelet-Rich-Plasma is an autologous blood derived concentrate of growth factors which are used to repair and regenerate tissues.

Surgery

Surgical management can be indicated in some instances. Surgery can consist of arthroscopic procedures to total joint replacement. Suture based osteotomy techniques for ligament rupture such as the cranial cruciate ligament or salvage surgery to remove painful components of the joint. Arthrodesis (fusion of joints) and femoral head and neck excision are also surgical procedures used to relieve pain.

Studies of Platelet Rich Plasma in Canine Medicine

  • Therapeutic Potential of Platelet-Rich-Plasma in Canine Medicine Arch Razi Inst 2021 Oct,76(4)  721-730. PMID 35096308

Purpose- The growth factors present in the PRP play a critical role in the promotion of local angiogenesis, regulation of cellular activity, stem cell homing, proliferation and differentiation of different stem cells and the deposition of matrix proteins contributing to tissue regeneration. This review aimed to establish the therapeutic potential of PRP in canine medicine. A literature review was performed to identify authentic academic databases over the last 20 years.

Conclusion- PRP therapy can be considered a simple, safe, and cost-effective method for the treatment of musculoskeletal pathologies. Single dose administration of allogeneic PRP has been reported to be safe and effective in the management of canine osteoarthritis. PRP improved limb function and decreased pain. Furthermore, the combination of PRP with hyaluronic acid yielded improved cartilage preservation.

  • Standardized Platelet-Rich-Fibrin from canine and feline origin: An Analysis on its Secretome Pattern and Architectural Structure Cytokine 2021 Dec; 148:155695  PMID 34496340

Purpose- Although PRF has been advanced as a therapeutic treatment in veterinary use, namely in canine and feline patients, a full characterization of PRF therapeutic factors has never been performed. Thus, the purpose of this study.

Conclusion- PRF may be an efficient therapeutic strategy in canine and feline clinical practice, accelerating the local healing mechanism, through the sustained delivery of signaling molecules involved in the healing cascade.

  • Treatment of Canine Osteoarthritis with Allogeneic Platelet-Rich-Plasma: A Review of 5 Cases Open Vet J 2020 Apr-Jun; 10(2) 226-231. PMID 32821667

Purpose- Osteoarthritis is a major cause of chronic pain and lameness in dogs. The aim of this study was to evaluate the effect of allogenic PRP on the treatment of canine OA.

Conclusion- PRP has therapeutic applicability in different animal species, resulting in a decrease of clinical signs associated with osteoarticular lesions. At the end of treatment in this study, clinical evaluation showed that, in some cases, there were no signs of joint pain in the treated joints as well as no lameness. The encouraging results of this study indicate the need for more studies in order to validate the method aiming for it to become commonly administered to companion animals with degenerative joint disease.

  • The Use of Autologous Protein Solution and Leukocyte Rich Platelet Rich Plasma in Canine Medicine Vet Med Auck 2021 Mar 12: 53-65  PMID 33777723

Purpose- The goal of this manuscript was to compile our clinical experience with L-PRP to provide evidence to small animal veterinarians about areas we have clinical success and to suggest areas of future research. OA was traditionally thought of as a purely mechanical disease. The last 20 years of research has shown a strong biochemical component of OA driven by inflammation.

Inflammation in canine OA can be induced by trauma or genetics. Inflammatory cytokines bind to cells in the joint and induce the secretion of matrix metalloproteases. The MMP degrade the extracellular matrix in the joint. The resulting degradation pieces binds to the joint and induce the secretion of even more inflammatory cytokines. This creates a destructive feed-forward cycle that drives osteoarthritis. A tool to address this feed-forward cycle would require both anti-inflammatory cytokines and growth factors.

Conclusion- This retrospective case series study demonstrated that L-PRP has beneficial clinical outcomes in canine medicine. The logistics of performing blood draws and joint injections are relatively simple and could be adopted into many small animal veterinary practices.

Three very interesting conclusions from the above study:

  1.  Some PRP systems in canine medicine market that they make a pure PRP containing only platelets. However, removing the neutrophil and monocytes from PRP actually lowers the concentration of anti-inflammatory cytokines like interleukin-1 receptor antagonist. This is because the IL-1ra comes from monocytes and neutrophils. Studies have shown that pure PRP does not have high concentrations of IL-1ra because it does not contain WBCs. IL-1ra is present in high concentrations in formulations containing leukocytes.
  2. L-PRP was injected SQ around both stifle joints and provided satisfactory results for 21 months before the patient needed to be injected again. SQ not into the joint but around it.
  3. The management of canine osteoarthritis with NSAIDs is standard practice for many veterinarians. However, there continued use is not without drawbacks. Common adverse effects are associated with the gastrointestinal tract, renal and hepatic adverse effects have been reported less frequently while lethargy and inhibition of coagulation have been reported. Long-term use of NSAIDs required routine blood tests to check for side effects. Studies reporting long term safety data are lacking and adverse event reporting may be incomplete. These combined drawbacks have motivated many to seek alternative treatments to NSAIDs for canine osteoarthritis. PRP does not require daily delivery of medicine, blood tests, and PRP has an excellent safety profile in clinical trials.

Juventix Regenerative Medical is an industry leader in the regenerative medical field. Our Platelet-Rich-Plasma Kits are FDA approved and designed for safety and effectiveness. They are cost effective and easy to use. Our kits provide consistency of product when taken from the same source.

In the above canine studies, the kits that were used needed 30-60cc of blood to process. Juventix Kits need 12 cc. That is a significant difference when treating a small dog.

Juventix Regenerative Medical also offer PRP KITS with non-cross linked hyaluronic acid for clinical applications when it would be beneficial to have both PRP and HA.

Juventix Regenerative Medical offers a patent pending LED Activator to activate the platelets and begin the regenerative process. The activation, a critical step in the release of cytokines and growth factors, is accomplished with light and not with the addition of other chemicals such as Calcium Chloride or Thrombin.

Juventix Regenerative Medical supplies a Bio-Incubator that transforms Platelet-Rich-Plasma into an injectable Platelet-Rich-Fibrin. The PRF, commonly referred to as the “second generation” of platelet products, has a broader range of clinical applications and provides outstanding results.

RESTORE, REVIVE, REGENERATE- JUVENTIX REGENERATIVE MEDICAL

 

Regenerative Regards,

Dr. Robert McGrath

Leave a Reply