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- Thermographic imaging of police working dogs with bilateral naturally occurring hip osteoarthritisPublication . Alves, João Carlos Agostinho; Santos, Ana Margarida Moniz Pereira; Jorge, Patrícia Isabel Figueiredo; Lavrador, Catarina Falcão Trigoso Vieira Branco; Carreira, L. MiguelBackground: Digital thermal imaging is a physiologic, non-invasive, contactless, and non-radiating diagnostic tool that can assess a wide range of musculoskeletal conditions, including hip osteoarthritis (HOA). Fifty police working dogs were evaluated to compare the dorsoventral (DV) and lateral (LT) thermographic images in dogs with naturally occurring bilateral HOA. A DV, and left and right lateral LT images were obtained for each animal in six different moments. They were positioned standing in a symmetrical upright position for the DV view. Each image included the area from the last lumbar to the first coccygeal vertebrae. Each LT view was set with the greater trochanter in the centre of the image. Images were taken with a thermographic camera from a distance of 60 cm. Mean and maximal temperatures were recorded, analyzed with ANOVA, dependent samples t-test, and Spearman correlation, with P < 0.05. Results: Nine hundred images were considered, collected from 30 males and 20 females, with a mean age of 6.5 +/- 2.2 years and bodyweight of 26.7 +/- 5.3 kg. The overall value recorded on the DV view was 25.3 degrees +/- 9.1 and 28.4 degrees +/- 2.8 on the lateral view. These were significantly different (P < 0.01) and with a low correlation (r = 0.10, P = 0.03). German Shepard dogs showed significantly lower values on all views than other breeds (P < 0.01), and heavier dogs had higher values on the lateral view. Conclusions: This is the first study that describes digital thermography's diagnostic use to evaluate working dogs with naturally occurring HOA, comparing two different views. Future studies should address each one's value in the diagnosis and response to treatment of this disease.
- Evaluation of four clinical metrology instruments for the assessment of osteoarthritis in dogsPublication . Alves, João C.; Santos, Ana; Jorge, Patricia; Lavrador, Catarina; Carreira, L.MiguelOsteoarthritis (OA) is the most commonly diagnosed joint disease in companion animals, and proper tools are necessary to assess patients and response to treatment. We aimed to perform the psychometric evaluation of several clinical metrology instruments (CMI), developed to evaluate pain and assess outcome. Fifty police working dogs with bilateral hip OA were assessed in a prospective, randomised, double-blinded study. Patients were evaluated using a stance analyser in six different moments divided over a 180-day period. Pedometer step count, weight-bearing symmetry index and deviation from normal weight-bearing were calculated and used for criterion validity. In each evaluation moment, a copy of the Hudson Visual Analogue Scale (HVAS), Canine Brief Pain Inventory (CBPI), Liverpool Osteoarthritis in Dogs (LOAD) and Canine Orthopaedic Index (COI) were completed by the dogs’ handlers. Correlations between CMIs were evaluated as construct validity. Further evaluation was performed with the Kaiser–Meyer–Olin measure of sampling adequacy, Eigenvalue and scree-plot analysis. Internal consistency was tested with Cronbach’s α. Significant weak correlation was found between all CMIs and stance analysis symmetry index measure and deviation, indicating criterion validity. Significant weak correlation was also found between pedometer count and LOAD plus COI. Cronbach’s α was 0.80 for HVAS, 0.98 for CBPI, 0.97 for LOAD and 0.98 for COI. Significant strong correlation was observed between CMIs, indicating construct validity. We present criterion and construct validity of these CMIs, which are able to capture various dimensions of OA. They can be used for the evaluation of osteoarthritis and response to treatment in dogs.
- Characterization of weight-bearing compensation in dogs with bilateral hip osteoarthritisPublication . Alves, JC; Santos, Ana; Jorge, Patricia; Lavrador, Catarina; Carreira, LuisTo describe the weight-bearing compensation in working dogs with bilateral hip osteoarthritis (OA), 50 police working dogs were evaluated with a weight distribution platform at the initial evaluation and after intra-articular treatment (a negative control 0.9% sodium chloride (NaCl), a platelet concentrate, Hylan G-F 20, triamcinolone hexacetonide or stanozolol). Six evaluation sessions were performed, over a 180-day period. Results were compared by breed, age, sex, weight and Orthopedic Foundation for Animals hip grade scores with the Independent Samples T-Test, repeated samples Analysis of variance and Pearson correlation coefficient, P < .05. Animals had a mean age of 6.5 § 2.4 years and a bodyweight of 26.7 § 5.2kg. No significant differences were observed when comparing weight-bearing for different breeds, sex, hip grades or weight during the initial evaluation. Significant differences were observed in deviation (P < .01) and symmetry index (P < .01) between the control and treatment groups during the follow-up period. A weight shift from pelvic to thoracic limbs was observed, with a weak, although a significant, correlation between a pelvic limb and the opposing contralateral thoracic limb. Labrador Retrievers showed higher symmetry index and deviation from normal values during the follow-up period than German Shepherd Dogs and Dutch Shepherd Dogs. Male dogs also showed higher symmetry index and deviation compared with females. At this period, the symmetry index showed a weak, although significant, correlation with body weight. Weight-bearing of all limbs correlated with the remaining limbs, reflecting a more balanced weight distribution than the initial evaluation. The weight distribution platform can be used to evaluate patients, at the initial presentation and during the assessment of response to treatment.
- Efect of a single intra‑articular administration of stanozolol in a naturally occurring canine osteoarthritis model : a randomised trialPublication . Alves, J. C.; Santos, A.; Jorge, P.; Lavrador, C.; Carreira, L.MiguelOsteoarthritis (OA) is a disease with a high negative impact on patient's quality of life and a high financial burden. It is a source of chronic pain and affects all mammals, including humans and dogs. As the dog is a common model for translation research of human OA, and exploring spontaneous dog OA can improve the health and well-being of both humans and dogs. To describe the effect of the intra-articular administration of stanozolol in a naturally occurring canine OA model, forty canine (N = 40) hip joints were randomly assigned to receive stanozolol or saline (control). On treatment day and at 8, 15, 30, 90, and 180 days post-treatment, several evaluations were conducted: weight distribution, joint range of motion, thigh girth, digital thermography, and radiographic signs. Also, synovial fluid C-reactive protein and interleukin-1 levels were evaluated. Results from four Clinical Metrology Instruments was also gathered. Results were compared with Repeated Measures ANOVA, with a Huynh-Feldt correction, paired-samples t-test, or Wilcoxon signed-rank test, with p < 0.05. OA was graded as mild (90%), moderate (5%), and severe (5%), including both sexes. They had a mean age of 6.5 +/- 2.4 years and a bodyweight of 26.7 +/- 5.2 kg. No differences were found between groups at treatment day in all considered evaluations. Weight distribution showed significant improvements with stanozolol from 15 days (p < 0.05) up to 180 days (p < 0.01). Lower values during thermographic evaluation in both views taken and improved joint extension at 90 (p = 0.02) and 180 days (p < 0.01) were observed. Pain and function scores improved up to 180 days. In the control group, radiographic signs progressed, in contrast with stanozolol. The use of stanozolol was safe and produced significant improvements in weight-bearing, pain score, and clinical evaluations in a naturally occurring canine OA model.
- Clinical and diagnostic imaging findings in police working dogs referred for hip osteoarthritisPublication . Alves, J. C.; Santos, A.; Jorge, P.; Lavrador, C.; Carreira, L.MiguelBackground: Osteoarthritis (OA) is the most commonly diagnosed joint disease in veterinary medicine, with at least 80% of the cases of lameness and joint diseases in companion animals being classified as OA. Sporting and working animals are more predisposed to develop OA since they are exposed to chronic fatigue injuries, leading to bone and muscular tissue damage and failure, resulting in clinical signs. To characterize the clinical signs and diagnostic findings of Police working dogs presenting with bilateral hip OA at the time of diagnosis. Fifty animals were evaluated with a bodyweight ≥ 15 kg, be older than two years, and without any medication or nutritional supplements for ≥ 6 weeks. Results: Weight distribution, joint range of motion at flexion and extension, thigh girth, digital thermography, and radiographic signs were collected. Data from different Clinical Metrology Instruments (CMI) were collected: Canine Brief Pain Inventory, Liverpool Osteoarthritis in Dogs, Canine Orthopedic Index, and the Hudson Visual Analogue Scale. Results were compared by breed, age, sex, and Orthopaedic Foundation for Animals hip grades with the Independent Samples T-Test, ANOVA followed by a Bonferroni post hoc test, and Pearson correlation coefficient, with p < 0.05. The sample included 30 males and 20 females, with a mean age of 6.5 ± 2.4 years and a bodyweight of 26.7 ± 5.2 kg. Animals with weight distribution below normal levels had significant variations of joint extension and function scores. This evaluation was the only not correlated with at least one breed. Animals with caudolateral curvilinear osteophyte showed a poorer clinical presentation and worse scores in all considered CMIs. Radiographic changes correlated with age and corresponded to worse CMIs scores and weight distribution. Dutch Shepherd Dogs showed better CMI scores than the other considered breeds. Conclusions: Police working dogs presented with complaints related to hip OA at an early stage of the disease. Hip scores influenced clinical presentation, with moderate cases showing lower thigh girth and worse pain interference and severity, and function scores than mild cases. Patients with severe OA had lower thermographic evaluations than patients with moderate OA. Age was the primary variable influencing considered CMI scores.
- A Preliminary Report on the Combined Effect of Intra-Articular Platelet-Rich Plasma Injections and Photobiomodulation in Canine OsteoarthritisPublication . Alves, J.C.; Santos, Ana; Carreira, L.MiguelOsteoarthritis (OA) is highly prevalent in the canine population. Due to the multiple dimensions of the disease, a multimodal approach is usually favored by clinicians. To evaluate the combined treatment with intra-articular platelet-rich plasma (PRP) and photobiomodulation in dogs with bilateral hip OA, thirty dogs were assigned to a PRP group (PRPG, n = 10), a photobiomodulation group (PBMTG, n = 10), or a combined therapies group (PRP+PBMTG, n = 10). The PRPG received two intra-articular administrations of platelet-rich plasma 14 days apart. The PBMTG received photobiomodulation with a therapeutic laser, with three sessions every other day in week one; two sessions in week two; a single session in week three; and one session/month on follow-up evaluation days. The PRP+PBMTG received the two combined therapies. The response to treatment was evaluated with weight-bearing distribution and the Canine Brief Pain Inventory, the Liverpool Osteoarthritis in Dogs, and the Canine Orthopedic Index. Evaluations were conducted before treatment and +8, +15, +30, +60, and +90 days after initial treatment. Normality was assessed with a Shapiro–Wilk test, and the groups’ results in each evaluation moment were compared using a Mann–Whitney U test. Animals of both sexes (male n = 19, female n = 11) were included in the sample, with a mean age of 7.8 ± 2.5 years and a body weight of 26.5 ± 4.7 kg. Joints were classified as mild (n = 6, three in PRPG, two in PBMTG, and one in PRP+PBMTG), moderate (n = 18, six in PRPG, five in PBMTG, and seven in PRP+PBMTG), and severe (n = 6, one in PRPG, three in PBMTG, and two in PRP+PBMTG). No differences were found between groups at the initial evaluation. All treatments produced clinically significant improvements compared to the assessment on treatment day. The combination of PRP and photobiomodulation produced greater, longer-lasting improvements. PRP and photobiomodulation can improve objective outcomes and client-reported outcome measures in dogs with OA. Their combined use leads to greater, longer-lasting, clinically significant improvements
- A pilot study on the efficacy of a single intra-articular administration of Triamcinolone Acetonide, Hyaluronan, and a combination of both for clinical management of osteoarthritis in Police Working DogsPublication . Alves, João C.; Santos, Ana; Jorge, Patrícia; Lavrador, Catarina; Carreira, L.MiguelObjectives: To describe and compare the use and effectiveness of a single intra-articular injection (IA) of triamcinolone acetonide (TA), hyaluronan (HA), and a combination of both (TA+HA) in police working dogs with natural occurring hip osteoarthritis (OA). Study Design: Prospective, randomized, single-blinded study. Sample Population: Thirty animals with naturally occurring hip OA. Methods: Animals were randomly divided in three groups: GT, treated with 20 mg of TA per hip joint; GH, treated with treated 20 mg of HA per hip joint; and GTH, treated with a combination of 20 mg of TA and 20 mg of HA per hip joint. Response to treatment, measured by the Canine Brief Pain Inventory (divided in Pain Interference Score-PIS and Pain Severity Score-PSS) and the Hudson Visual Analog Scale (HVAS), was evaluated in seven different time points: T0 (before treatment), T1 (after 15 days), T2, T3, T4, T5, and T6 (after 1, 2, 3, 4, and 5 months, respectively). Results were compared using a Kruskal-Wallis test or a Wilcoxon signed ranks test, and p < 0.05 was set. Results: Comparing results of the different time points considered with T0, significant differences were registered in GH at T1 for HVAS (p = 0.03) and PIS (p = 0.04); and in GTH at T1 (p = 0.05 for HVAS and p < 0.05 for PIS), T2 (p < 0.04 for PIS), T3 (p < 0.03 for HVAS and p = 0.05 for PIS), T4 (p < 0.03 for HVAS and p < 0.05), and T5 (p < 0.05 for HVAS). No significant differences were found between groups when comparing scores in each time point. Individual treatment is considered successful with a reduction of >= 1 for PSS or >= 2 for PIS. In GTH, treatment was successful in four animals between T1 and T5 (40%, n = 10) and three at T6-T7 (30%, n = 10) for PSS and three animals of GTH at T1 (30%), two at T2 (20%), three between T3 and T4 (30%), and two between T5 and T7 (20%)
- A first report on the efficacy of a single intra-articular administration of blood cell secretome, triamcinolone acetonide, and the combination of both in dogs with osteoarthritisPublication . Alves, JC; Santos, A; Jorge, P; Carreira, L.MiguelBackground: Osteoarthritis represents a signifcant welfare problem for many dogs, with limited therapeutic options other than palliative pain control. To evaluate the efect of the intra-articular administration of blood cell secretome and triamcinolone, 15 dogs with bilateral hip osteoarthritis were randomly assigned to a blood cell secretome (BCSG, n=5), triamcinolone (TG) or their combination group (BCS+TG, n=5). BCSG received a single intra-articular administration of 3 ml of blood cell secretome, TG 0.5 ml of triamcinolone acetonide 40 mg/ml, and BCS+TG received the combined products. The volume to administrate was corrected to 3.5 ml with saline. On days 0, 8, 15, 30, 60, 90, 120, 150, and 180, a copy of the Canine Brief Pain Inventory (divided into pain interference score—PIS and Pain Severity Score—PSS), Liverpool Osteoarthritis in Dogs (LOAD), Hudson Visual Analogue Scale (HVAS), and Canine Orthopedic Index (COI, divided into function, gait, stifness, and quality of life) was completed. Results were analyzed with the Kruskal–Wallis test and the Kaplan–Meier estimators were conducted and compared with the Log Rank test, p<0.05. Results: Animals in the sample had a mean age of 9.0±2.9 years and a bodyweight of 28.8±4.1 kg. Hips were classifed as moderate (8) and severe (7) osteoarthritis. No diferences were found between groups at T0 regarding considered evaluations. Signifcant diferences were observed between groups in pain scores from+8d-+150d, with BCS+TG exhibiting better results. The same was observed for HVAS and LOAD, from+8d-+120d. Improvements were also observed in several dimensions of the COI. Kaplan–Meier estimators showed that BCS+TG produced longer periods with better results, followed by BCSG and TG. Conclusion: The intra-articular administration of blood cell secretome improved the clinical signs and scores of several clinical metrology instruments in dogs with hip OA, particularly when combined with triamcinolone. Further studies are required.
- A comparison of intra-articular blood cell secretome and blood cell secretome with triamcinolone acetonide in dogs with osteoarthritis: a crossover studyPublication . Alves, JC; Santos, Ana; Jorge, Patricia; Carreira, L.MiguelSimple Summary Osteoarthritis is a very common joint disease in dogs. There are multiple treatments described for the disease, but there is still a need for treatments that change disease progression while managing symptoms. For that reason, a growing interest has arisen around biological treatments such as Blood Cell Secretome. The goal of this study was to compare the intra-articular administration of Blood Cell Secretome to its combined administration with triamcinolone in dogs with hip osteoarthritis. Our results show that Blood Cell Secretome improves the overall condition of OA patients and that the combination with triamcinolone lead to faster and longer-lasting improvements. Osteoarthritis (OA) is a growing welfare problem for dogs and a challenge to manage for the clinician, and most therapeutic options aim to control pain. In a randomized, double-blinded, placebo-controlled, 2-way, 2-period crossover study, we aimed to evaluate the use of Blood Cell Secretome (BCS) administrated intra-articularly, with or without the combination with triamcinolone, in dogs with bilateral hip OA. BCS is an acellular orthobiologic containing anti-inflammatory and anabolic proteins produced from the patient's own blood through extended coagulation in a defined environment. Fifteen dogs were initially assigned to a BCS group (BCSG, n = 5), a triamcinolone group (TG, n = 5), or a combination group (BCS+TG, n = 5). All had bilateral hip OA. After a 180-day follow-up, the crossover was performed with BCSG (n = 7) and BCS+TG (n = 7). BCSG received a single intra-articular administration of 3 mL of Blood Cell Secretome, and BCS+TG received BCS plus 0.5 mL of triamcinolone acetonide (40 mg/mL). The volume in BCSG was corrected to 3.5 mL with saline. In all patients, both hips were treated. For treatment follow-up, a copy of the Canine Brief Pain Inventory (divided into pain interference score-PIS and Pain Severity Score-PSS), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (COI, divided into function, gait, stiffness, and quality of life) was completed on days 0, 8, 15, 30, 60, 90, 120, 150, and 180. Results were analyzed with the Mann-Whitney U test, effect size, and Kaplan-Meier estimators, followed by the log-rank test. p was set at <0.05. Patients of the sample had a mean age of 9.6 +/- 2.9 years and a body weight of 29.2 +/- 3.9 kg. Seven hips were classified as severe osteoarthritis, and eight were classified as moderate. No differences were found between groups at T0. Significant differences were observed in PSS scores at +8d, with BCS+TG exhibiting better results. PIS, PSS, LOAD, stiffness, and function scores were also lower in BCS+TG from +15 to +60d. The two groups showed similar improvements from +90 to +120d. Kaplan-Meier estimators showed that dogs in BCS+TG showed clinically-important differences for longer, despite a positive result in BCSG. The intra-articular administration of BCS alone was able to improve the overall condition of OA patients. Its combined use with triamcinolone acetonide lead to a faster and longer-lasting improvement in pain scores
- Evaluation of two therapeutic options for naturally occurring osteoarthritis in police working dogsPublication . Alves, J. C.; Santos, Ana; Jorge, Patricia; Lavrador, Catarina; Carreira, L.MiguelABSTRACT - To compare the effectiveness of intra-articular (ia) methylprednisolone-acetate and triamcinolone acetonide in the management of naturally occurring hip os-teoarthritis, 20 dogs were divided into two groups according to the drug injected per joint: gt (20 mg of triamcinolone acetonide) and gmpa (40 mg methyl-prednisolone). Animals were treated at T0 (treatment day), and further evalu-ations were conducted at T1 (15 days after treatment), T2, T3, T4, T5, T6, and T7 (one, two, three, four, five, and six months after treatment respectively). Response to treatment was measured using the Canine Brief Pain Inventory and Hudson Visual Analogue Scale, p < 0.05.Treatment was successful in reducing the pain severity score in two an-imals of gt at T1 (20 %), three at T2–T3 (37.5 %), and two at T4–T7 (28.6 %). For gmpa, treatment was successful in two animals at T1 (20 %), four at T2 (40 %), three at T3 (30 %), and two at T4–T5 (20 %). When considering pain interference score, treatment was successful in two animals in both gt and gmpa from T1–T7. No significant differences were observed when comparing each moment with T0 or between groups. Intra-articular ta and mpa injection may be a treatment option for some patients, as some benefited from ia with ta and mpa.