Osteoarthritis (OA) is a common condition in dogs that causes pain and inflammation in the joints. It is often seen in older dogs, but can also occur in younger dogs with underlying joint problems.

There are several signs that you can look for to recognize OA in dogs at home. These include:

• Pain: Your dog may show signs of pain when moving, such as limping, whining, or growling.
• Stiffness: Your dog may be stiff and reluctant to move after resting.
• Lameness: Your dog may have difficulty walking or running, and may favor one or more legs.
• Swollen joints: You may notice that your dog's joints are swollen, warm, or tender to the touch.
• Decreased range of motion: Your dog may have difficulty reaching for objects or getting up and down stairs.
• Changes in behavior: Your dog may become less active, irritable, or aggressive.

If you notice any of these signs in your dog, it is important to take them to the veterinarian for a diagnosis and treatment. OA can be a progressive condition, so early diagnosis and treatment are important to help your dog maintain a good quality of life.

There are a number of advanced treatment methods for canine osteoarthritis (OA) that are becoming increasingly available. These methods can help to improve the quality of life for dogs with OA and may even slow the progression of the disease.

Some of the most advanced treatment methods for OA in dogs include:

• Stem cell therapy: Stem cell therapy involves injecting stem cells into the affected joint. Stem cells have the ability to repair damaged tissue, and they may be able to help to reduce pain and inflammation in the joint.
• Platelet-rich plasma (PRP) therapy: PRP therapy involves injecting a concentrated form of platelets into the affected joint. Platelets contain growth factors that can help to repair damaged tissue, and they may also be able to help to reduce pain and inflammation in the joint.
• Hyaluronic acid injections: Hyaluronic acid is a natural substance that helps to lubricate the joints. Hyaluronic acid injections can help to reduce pain and improve range of motion in the affected joint.
• Acupuncture: Acupuncture can help to reduce pain and inflammation by stimulating the body's natural pain-relieving and anti-inflammatory mechanisms. It can also help to improve range of motion by stimulating the muscles and nerves that control movement.
• Shockwave therapy: A non-surgical, non-invasive treatment that uses high-pressure sound waves to promote healing in dogs. It is often used to reduce pain and inflammation in arthritic joints and promote healing in tendon and ligament injuries.

The best treatment method for OA in dogs will vary depending on the severity of the disease, the location of the affected joints, and the dog's overall health. Your veterinarian can help you to develop a treatment plan that is right for your dog.

Here are some additional tips for managing OA in dogs:

• Keep your dog's weight under control. Excess weight puts additional stress on the joints.
• Provide plenty of rest. Your dog may need to take breaks more often when exercising.
• Use a soft bed or crate. This will help to cushion your dog's joints when they are resting.
• Avoid activities that put stress on the joints. This includes running, jumping, and playing on hard surfaces.
• Consider a joint supplement. There are a number of joint supplements available that can help to reduce pain and inflammation.
• Work with your veterinarian to develop a treatment plan. The best treatment plan for your dog will vary depending on the severity of their OA.

A Certified Veterinary Pain Practitioner (CVPP) is a veterinarian who has completed additional training in pain management through the International Veterinary Academy of Pain Management (IVAPM). CVPPs have a deep understanding of the different types of pain that animals experience, as well as the latest pain management techniques.

There are a number of advantages to seeing a CVPP for your dog's pain. CVPPs can:

• They have specialized training in pain management. CVPPs have completed additional training in pain management, which gives them a deep understanding of pain mechanisms and how to best manage pain in pets.
• Diagnose the underlying cause of your dog's pain. Not all pain is caused by the same thing, and CVPPs are trained to identify the underlying cause of your dog's pain. This information can be helpful in developing a treatment plan that is effective
• Create a personalized treatment plan for your dog. There is no one-size-fits-all approach to pain management, and CVPPs will work with you to create a treatment plan that is tailored to your dog's individual needs.
• Monitor your dog's progress and adjust the treatment plan as needed. Pain management is an ongoing process, and CVPPs will monitor your dog's progress and adjust the treatment plan as needed.
• Provide support and education. CVPPs can provide you with support and education about pain management in animals. This information can help you to better understand your dog's pain and how to manage it.  Y

You can find the nearest CVPP by visiting IVAPM’s website: https://ivapm-membership.site-ym.com/search/custom.asp?id=6052

September is National Animal Pain Awareness Month.

There are many issues that cause pain in our pets, such as: Intervertebral Disc Disease, Cruciate Injury, Pancreatitis, Cancer, Periodontal Disease, Muscle Strain, and Bladder Infection. However, Osteoarthritis
is widespread among our pets. Research has shown that 20% of all dogs over the age of one year have some form of arthritis. In cats over the age of six, 61% have arthritis in at least one joint and 48% have
arthritis in 2 or more joints.

Osteoarthritis, also known as degenerative joint disease or arthritis. It is characterized by inflammation of the joint capsule, wearing of the joint cartilage, thinning of the joint fluid, and production of new bone
around the joint. The results of this are a decrease in mobility, function, enjoyment of life and increase in pain.

Age is not a disease! The chronic pain of arthritis can be subtle and a lot of times it is written off as "getting old" or "just slowing down with age". Dogs and cats can easily hide or mask their chronic pain.
They do not show their pain in a way most humans expect them to, they most likely will not cry, whine or yelp out in pain.

Common Signs of Chronic Pain in Dogs
Decreased social interaction
Anxious expression
Submissive behavior
Refusal to move
Guarding behavior
Aggression; biting
Decreased appetite
Self-mutilation (chewing)
Changes in posture

Common Signs of Pain in Cats
Reduced activity
Loss of appetite
Quiet/loss of curiosity
Changes in urinary/defecation habits
Lack of agility/jumping
Excessive licking/grooming
Stiff posture/gait
Guarding behavior
Tail flicking

Diagnosing the cause and location of pain depends on a thorough evaluation by a qualified veterinarian, who will use a good pain scoring system, palpation of all joints and muscles, and possibly diagnostic
imaging such as X rays or an MRI. Arthritis is a progressive painful disease, so the earlier we catch it in life, the better off your pet will be. 

Treatment options to help painful cats and dogs.
STEM CELL THERAPY: Stem cells are used to treat arthritis in dogs, cats, and horses by reducing pain and inflammation. Your pet’s quality of life will be restored with an increased range of motion and regeneration of tendons, ligaments, and bone. Ongoing research shows promise for treating intervertebral disc disease, liver disease, and kidney disease.

PLATELET RICH PLASMA: How does platelet therapy work? The scientific answer is that platelets activate by exposure to damaged tissue, releasing their granular contents which include anabolic growth
factors. These growth factors help attract progenitor cells to the injury site and play a key role in stimulating tissue repair through fibroblast expansion and cellular matrix production. In other, less
technical terms, when the concentrated platelets are injected into the site of damaged tissue, the platelets signal additional healing cells to migrate to the affected area to begin the process of tissue
repair.

ACUPUNCTURE & ELECTRO-ACUPUNCTURE: Acupuncture enhances blood circulation, nervous system stimulation, and the release of anti-inflammatory & pain-relieving hormones.
INTRAMUSCULAR DRY NEEDLING: Dry needling relieves muscle pain with the insertion of a needle into the skin at a myofascial trigger point. The myofascial trigger point is related to the production and
maintenance of the pain cycle. When punctured by the needle, the pain will subside.

SHOCKWAVE THERAPY: Shock wave treatment uses high-energy sound waves to trigger the body’s own repair mechanisms. This non-invasive form of therapy decreases lameness, pain, and inflammation
and encourages the healing of bones and cartilage. It will improve your pet’s quality of life through increased blood flow and a reduced need for non-steroidal anti-inflammatories. Shock Wave Therapy
has even been used in human medicine for over 20 years.

UNDERWATER TREADMILL TRAINING: The buoyancy of walking in water limits the impact on the joints while promoting muscle strength and tone and joint motion. Even dogs that cannot stand on their
own on land, can usually stand in water. This therapy can be beneficial in rehabilitation of fractures, cruciate surgery, neurologic conditions including degenerative myelopathy and disc disease, tendinitis,
weight loss and other disorders where the pet is reluctant to use the limb or there is lack of strength.

PHYSICAL THERAPY: Physical Therapy in veterinary medicine utilizes techniques to increase function and mobility of joints and muscles in animals. Animal rehabilitation can reduce pain and enhance
recovery from injury, surgery, degenerative diseases, age-related diseases, and obesity.

Now is the time to contact your veterinarian to see how they can help your cat or dog lead a better life with less pain. If you do not have a veterinarian that can help you out, you can search for a Pain
Practitioner near you through the International Veterinary of Pain Management. IVAPM is the leading forum and educational resource for veterinary professionals and pet owners interested in animal pain
prevention, management, and treatment. Visit IVAPM.ORG and click on the link at the top "Find an IVAPM Member" and you will be connected to a veterinarian that is dedicated to helping pets get pain
relief.

What is the Dog Elbow Pain Trial?

This clinical trial aims to confirm the effectiveness and safety of a new medicine to control pain associated with osteoarthritis of the elbow in dogs. If your dog qualifies for this study, you should expect to stay in the study for 90 days and have 7 scheduled visits with the veterinarian conducting the study. You will also be required to provide weekly behavioral assessments of your dog.

Because this is a study that is intended to support the drug’s approval, it needs to be “controlled”. This means some dogs receive treatment and others undergo the preparation and everything leading up to an injection of the medication, but do not actually receive the medication being tested. This study is also “blinded” or “masked,” meaning neither you nor the veterinarian making observations will know if your dog received the treatment or not until the end of the study. All owners of untreated dogs will be given an opportunity at the end of the study for their dogs to receive the investigational treatment at no charge.

Does my dog qualify?

Your dog may qualify if it:

• Is at least 1 year old.
• Weighs more than 11 pounds.
• Has a confirmed diagnosis of elbow pain due to osteoarthritis that impacts its’ mobility and quality of life.

Other study criteria may apply. The veterinary investigator will decide if your dog is a good candidate for this study.

If qualified, your dog would receive (at no cost to you):

• Investigational medicine or the procedure without injection of the medication.
• Study-related exams and tests.
• Time with a local veterinarian.

Is it safe to enroll my dog in this study?
Over 200 dogs have been treated in safety studies, including client owned dogs with elbow pain. This study is primarily focused on confirming the effectiveness of the drug. All dogs will be closely monitored, and, in the event of an adverse response or unexpected issue, we would care for your dog as if they were part of our own family. Please feel free to discuss any hesitations with the treating veterinarian, and if at any time prior to treatment you decide not to enroll your dog, you can do so at no charge and with no questions asked.

 See if your dog qualifies by visiting: DogElbowPain.com

As we close out Animal Pain Awareness Month, we wanted to leave you with some information to help you determine if your pet may be experiencing pain.  Unfortunately, pets cannot talk to us to let us know if there is a problem.  Thus, we must rely on other methods to decipher whether they are experiencing any pain.  One of the best methods to determine if your pet is in pain is to observe their behavior.

As we discussed in a recent blog, ( http://blog.vetstem.com/september-is-animal-pain-awareness-month/ )there are several causes of pain, both acute and chronic.  Acute pain may be more obvious while chronic pain may be more subtle.  Often, chronic pain is misconstrued as “getting old” but the International Veterinary Academy of Pain Management (IVAPM) is quick to point out that age is not a disease.  Pain however is a disease and pain management is important to maintain your pet’s quality of life.

So how do you know if your pet is experiencing pain?  Aside from the more obvious signs such as limping, one of the best ways to determine whether your pet may be in pain is a change in their behavior.  This can include an increase in anxiety, depression, or aggression as well as decreased social interaction or play.  Your pet may become less active or have difficulty doing things that were not a problem before.  For instance, they may have trouble getting up from lying down or they may have difficulty jumping or going up and down stairs.

Other changes may include decreased grooming, particularly for cats.  Some pets however over-groom areas of pain and may lick or bite excessively at an area that hurts.  They may also experience decreased appetite as well as changes in their bathroom habits.  Changes in posture as well as increased respiration or excessive panting can also be a sign of pain.  You can view an extensive list of symptoms for both dogs and cats on the IVAPM website. ( https://ivapm.org/common-signs-pain-dogs-cats/ )

It is important to keep an eye out for signs that your pet may be in pain.  Pain management is an invaluable tool in maintaining happy and healthy pets.  Last week, we introduced you to Veterinary Pain Specialist, Dr. Stramel at Advanced Care Veterinary Services.  While his practice focuses primarily on pain management, all veterinarians are equipped to handle painful pets in some capacity.  Your veterinarian may also be able to recommend a local Certified Veterinary Pain Practitioner if you’re seeking a more in-depth approach to pain management.

Dr. Douglas Stramel of Advanced Care Veterinary Services in Carrollton, Texas has been using the Pall Veterinary Platelet Enhancement Therapy System (V-PET™) for nearly three years. A proponent of Regenerative Medicine, Dr. Stramel has been credentialed to perform VetStem Regenerative Cell Therapy since 2007 and began using V-PET™ 2016. V-PET™ is a gravity filtration-based platelet therapy kit that produces a platelet concentrate rich in natural healing cells. Supported by veterinary peer-reviewed publications, V-PET™ has been shown to be an effective regenerative medicine solution for the treatment of joint disease, soft tissue injuries, and to assist in the resolution of wounds in both dogs and horses.

One of Dr. Stramel’s recent patients is a Great Dane named Pinky. At seven years old and 170 pounds, Pinky is considered a senior dog. In mid-2018, Pinky slipped on a wet driveway and ruptured her cruciate ligament. She was unable to put any weight on her right rear leg, which for a dog her size, makes life pretty complicated. She could no longer go on walks and struggled to get in and out of the car. Playing could only be done while Pinky was lying on the floor. She could not go up stairs and had trouble getting on the couch and into the bed. She also struggled to go to the bathroom.

After being told surgery was Pinky’s only option, her owner, Rebecca, took Pinky to Dr. Stramel for a second opinion. As a Certified Veterinary Pain Practitioner, Dr. Stramel is dedicated to providing an array of advanced pain-management techniques for his patients. For Pinky, he recommended treatment with the Pall V-PET™, in addition to acupuncture, laser therapy, and a nonsteroidal anti-inflammatory.

Pinky received her first platelet therapy treatment on June 26th, 2018. After a simple blood collection, Pinky’s blood was run through the specialized V-PET™ filter, which is designed to selectively capture platelets to produce a platelet concentrate. The concentrate was injected directly into Pinky’s right knee. Platelets, when exposed to damaged tissue, are triggered to release growth factors that stimulate tissue repair. Since Pinky was both the donor and recipient, there was very little risk of rejection.

According to Dr. Stramel, Pinky noticeably improved eight days after receiving platelet therapy. Beginning in July, Pinky began weekly acupuncture and biweekly laser therapy sessions. On August 2nd, Pinky received a second injection utilizing the Pall V-PET™ kit. Like before, Pinky’s blood was run through the V-PET™ filter and she received a concentrated dose of platelets into her right knee. Approximately two weeks after the second injection, Pinky was no longer limping. She received two more rounds of acupuncture and one more round of laser therapy at which point it was decided that Pinky was doing so well, she could discontinue both therapies. Currently, Pinky is maintained on one anti-inflammatory pill daily. Before and after videos of Pinky can be found here (after video in the comments).

Though Pinky was non-weight bearing on her right rear leg prior to receiving platelet therapy, her mom reported that she was able to resume all of her normal activities after treatment. She goes on three walks a day, including one walk that is always over a mile. She jumps in and out of the car with ease and has no problem with stairs. Her mom said she has also run around the backyard chasing squirrels. Though Pinky is seven years old, a senior for a dog her size, she was able to bounce back from a torn cruciate ligament with the help of Dr. Stramel and Veterinary Platelet Enhancement Therapy. Pleased with Pinky’s outcome, Rebecca stated, “I would highly recommend PRP as it was a miracle to see her recover so quickly.”

About Douglas Stramel, DVM 
Douglas Stramel received his Doctorate of Veterinary Medicine from Kansas State University in 1991. In 1994, he was accepted as an intern at Dallas Veterinary Surgical Center (DVSC), where he gained extensive knowledge in advanced surgical techniques. He is the first and only Certified Veterinary Pain Practitioner in the Dallas/Fort Worth area.

About VetStem Biopharma, Inc. 
VetStem Biopharma is a veterinarian-lead Company that was formed in 2002 to bring regenerative medicine to the profession. This privately held biopharmaceutical enterprise, based near San Diego, California, currently offers veterinarians an autologous stem cell processing service (from patients’ own fat tissue) among other regenerative modalities. With a unique expertise acquired over the past 15 years and 17,000 treatments by veterinarians for joint, tendon or ligament issues, VetStem has made regenerative medicine applications a therapeutic reality. The VetStem team is focused on developing new clinically practical and affordable veterinary solutions that leverage the natural restorative abilities present in all living creatures. In addition to its own portfolio of patents, VetStem holds exclusive global veterinary licenses to a large portfolio of issued patents in the field of regenerative medicine.