Abstract

Objectives: To compare the effect of intra-articular treatment with triamcinolone hexacetonide (TH), stanozolol, hyaluronan, and a platelet concentrate in police working dogs with bilateral hip osteoarthritis (OA).Study Design: Prospective, longitudinal, double-blinded, negative controlled study.Sample Population: Fifty police working dogs with naturally occurring hip OA.Methods: Animals were randomly assigned to a control group (CG, n = 10), TH group (THG, n = 10), platelet concentrate group (PCG, n = 10), stanozolol group (SG, n = 10), and Hylan G-F 20 group (HG). On days 0 (T0), 8, 15, 30, 90, and 180 days post-treatment, weight-bearing distribution was evaluated. In those days, and on days 60, 120, and 150, four clinical metrology instruments were completed. Kaplan–Meier estimators were conducted and compared with the log-rank test. Cox proportional hazard regression analysis was performed to determine treatment survival. Significance was set at p < 0.05.Results: Patients had a mean age of 6.5 ± 2.4 years and body weight of 26.7 ± 5.2 kg. At T0, hips were classified as mild (n = 35), moderate (n = 10), and severe (n = 5), according to the Orthopedic Foundation for Animals grading scheme. No differences were found between groups at that moment considering age, body weight, OFA hip score, and all assessments performed. All treatments improved clinical signs in various OA dimensions in some groups, with a broad effect interval. PCG showed a lower range of variation while maintaining a positive result for more extended periods (p < 0.01 for symmetry index and 0.01 < p < 0.04 in the majority of scores). Breed, age, sex, and OFA grade did not significantly influence response to treatment.Conclusions and Clinical Relevance: This is the first prospective, negative controlled, double-blinded study to compare the effect of a single administration of these IA treatments in dogs with hip OA. HG and PCG recorded more significant improvements throughout the 180-day follow-up. In particular, PCG also registered a lower variation in results, seemingly the best therapeutic option. Nevertheless, improvements were still observed in THG and SG, and these treatment options can be considered, mainly when the first two treatments are not available.

Highlights

  • 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 broadly classified as OA [1,2,3]

  • Patients were randomly assigned to five different groups, using the statistical analysis software, according to the treatment being administered: a control group (CG) (n = 10), receiving an IA administration of 2 ml of NaCl 0.9% per hip joint; a triamcinolone hexacetonide group (THG, n = 10), receiving 20 mg/ml of TH (Bluxam, Riemser Pharma, Portugal) per hip joint; a platelet concentrate group (PCG, n = 10), which received 3 ml of platelet concentrate per hip joint; a stanozolol group (SG, n = 10), to which 0.3 mg/kg of stanozolol (Estrombol, Laboratório Fundacion) per hip joint [64, 65] was administered; and a hyaluronan group (HG, n = 10), which received 2 ml of Hylan G-F 20 (Synvisc R, Sanofi, Portugal) per hip joint

  • Values and scores in PCG showed a lower range of variation while maintaining a positive result for more extended periods

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Summary

Introduction

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 broadly classified as OA [1,2,3]. Clinical metrology instruments (CMIs) aim to evaluate multiple dimensions of OA, and the commonly used instruments in dogs are the Canine Brief Pain Inventory (CBPI, divided into a pain severity score—PSS, and a pain interference score—PIS) and the Liverpool Osteoarthritis in Dogs (LOAD) [12, 14,15,16,17,18,19,20]. Additional validated CMIs include the Hudson Visual Analog Scale (HVAS), a valid tool to assess the degree of lameness in dogs, with force plate analysis as a criterionreferenced standard, and the Canine Orthopedic Index (COI, divided into four scores: stiffness, gait, function, and quality of life—QOL) [21,22,23]

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