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HOLISTIC CONCEPTS ABOUT ARTHRITIS, LAMENESS & STEM CELL THERAPY

John Simon — Thu, 06 May 2010 01:08:23 +0000

Arthritis is probably the most common of the chronic diseases that progressively steels quality life from our senior dogs. Osteoarthritis is a chronic inflammatory disease that can effect any size dog or cat but is seen much more often in larger breed dogs. Arthritis often starts with stiffness and is first noticed when the older dog has a hard time rising in the morning. In time the owner may noticed that their dog is slower going up the stairs and may be reluctant to jump into the car.. A dog with hip displasia or hip arthritis tends to run like a rabbit using both back legs at once. As the arthritis progresses the dog may begin to hold up or favor one limb. He or she may walk with short stiff steps and the dog’s gait may show a hind end instability (swaying). At the end stages of arthritis the pet may not be able to rise without the owners help. It is a sad thing to see otherwise healthy animals euthanized because their caregiver is undable to lift them up in order to get them outside when they need to eliminate.

It is my opinion much of the arthritis our dogs experience could be eliminated by changing their diets from a grain based food to a more meat based recipe. Just because the first ingredient on the ingredient list is meat does not make the diet meat based. The only way to distinguish if a food is meat based is to asked the company’s nutritionist (not customer support person) “what percent of their food is meat when measured on a dry matter basis ?” Judged on this basis, most pet foods are no more than 20% meat. Grain based diets are hard for carnivores to digest and the poorly digested large grain protein molecules act as allergens which damage the intestinal lining and result in a “leaky gut syndrome”. This leaky gut allows grain protein molecules to get into the blood stream where they can migrate to the pet’s joints and set up an inflammatory reaction. Feeding a meat based diet helps to prevent the above sequence of events. Supplementing the diet with digestive enzymes, fish oil, and antioxidants will help reduce the likelihood of arthritis.

If your dog has already developed arthritis there are a number of ways to help slow the progression and reduce the discomfort from the disease. Injections of “chondroprotective” substances which increase joint fluid production and encourage cartilage repair can be very effective arthritis remedies. Personally I am not a big proponent of using non steroidal anti inflammatory drugs (NSAIDS) to reduce inflammation and pain because their long term use may result in gastro intestinal, liver, and kidney disease. It has also been shown that long term use of NSAIDs in humans actually results in cartilage degeneration. Providing glucosamine, chondroitin , MSM, Gerizyme, Adequin, Legend, Zeel , systemic enzymes, hyaluronic acid, Comfort Zone and antioxidants in place of NSAIDs can help restore joint integrity and, in my opinion, is a much preferred approach.

Other ways to treat advanced arthritis include physical therapy, acupuncture, chiropractic, “infra-sonic therapy”, “pulsed magnetic therapy”, prolotherapy, gold bead implants, cold laser therapy, Electro Crystal Rebalancing and massage therapy. Teaching pet owners how to massage their pet and provide passive range of motion can be very helpful in extending and enhancing their pets quality of life.

Finally, I want let my readers know about a very exciting advance in arthritis therapy. Adult stem cell technology is now available to help treat advanced arthritis. The stem cells are harvested from the patients own fat. These stem cells can be injected intravenously or directly into joints. These injected primitive cells will develop into connective tissue and cartilaginous cells which will help to rejuvenate the damaged joint. This technology is has already been used successfully in hundreds of dogs and horses and although still on the expensive side is now available to the family pet. Presently I am one of the few veterinarians certified to provide such therapy.

Detecting the early signs of arthritis and instituting early treatment can make a huge difference in the success of therapy. Providing a high quality meat based diet, with omega 3 fatty acids and antioxidants along with weight management can help prevent the onset of arthritis and help extend both the quality and quantity of the pet’s life.

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Woodside Animal Clinic sees pets from all over the greater Detroit Michigan area including Royal Oak, Berkley, Huntington Woods, Ferndale, Pleasant Ridge, Detroit, Hazel Park, Madison Heights, Warren, Centerline, Clawson, Troy, Sterling Heights, Southfield, Birmingham, Bingham Farms, Franklin, Farmington, Farmington Hills, Novi, Wixom, Brighton, Livonia, Plymouth, Commerce, Ann Arbor, Ortonville, Waterford, Union Lake, Rochester, Rochester Hills, Auburn Hills, Utica, Romeo, Windsor, White lake and Toledo

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Prolotherapy in Dogs: non surgical joint repair for a ruptured crucitate ligament

John Simon — Fri, 12 Jun 2009 03:03:07 +0000

You have probably heard of athletes rupturing their “ACL” but didn’t really know what that meant. The abbreviation ACL stands for “anterior cruciate ligament”. This ligament is found inside the knee joint and helps to maintain its overall stability. When this cruciate ligament is stretched or torn as a result of a sudden traumatic movement the knee joint is no longer stable and begins to move in abnormal ways. This abnormal movement results in pain, cartilage degeneration and eventually in arthritis. Conventional medical advice for a cruciate ligament (ACL) rupture would be to have the knee repaired surgically. There are several surgical techniques which are all quite effective in returning the knee joint to normal function, however, they are all quite expensive and have a 3 to 6 month re-cooperative period where the dog is significantly favoring the leg and placing additional stress on the opposite leg.

In a large breed young animal cruciate ligament surgery may be the smartest thing to do but in an older animal the surgery may not be the best route to follow. Consider first that neither anesthetic nor surgery is easy on an older animal. Secondly, understand that the surgery will cause the animal to bare weight entirely on the opposite limb for a good 3 months. This added stress can lead to both arthritis and occassionaly a cruciate ligament tear in the opposite hind leg. The two most recommended cruciate surgeries are the “ lateral suture technique” and the “TPLO”. Both are equally effective in the long run and both have inherent problems. The suture technique surgery uses a heavy duty suture to stabilize the joint. Although rare, this suture can slip, break or even get caught up on arthritic spurs already present. The TPLO is a more aggressive surgery where a portion of the tibial bone is purposely broken in order to change its alignment with the femur. The TPLO knee surgery has more risk of bone infection and could even result in a non union fracture. It is a significantly more expensive surgery and produces no better long term outcome than the less aggressive less expensive suture technique. The TPLO surgery may fail to produce the hoped for stability and is more likely to result in arthritis than the lateral suture technique.

For all of the above reasons, do not jump into surgery without first considering other options. If you search the internet you may discover articles on “prolotherapy” as a method for rehabilitating damaged joints. Prolotherapy has been used for over 30 years to repair hyper-mobile, unstable joints in humans. It however is just starting to take its rightful place in veterinary medicine, although it is still considered to be in the realm of alternative medicine. Prolotherapy, proliferative, or sclerosing therapy are simply different names for the same thing. Prolotherapy is a way of tightening up loose unstable, hyper-mobile joints by injecting a “sclerosing” agent in and around the joint. The sclerosing agent produces a thickening of the joint capsule and of the external ligaments of the joint. This thickening of the ligaments act like scar tissue and eventually contract with time. The thickening and contraction of the ligaments and joint capsule increase joint stability and relieves joint pain. Prolotherapy commonly takes place in 5 to 6 sessions spaced approximately 3 weeks apart. During each session the joint is shaved and disinfected with a surgical scrub. Then multiple injections are carefully placed in the ligaments and joint capsule and even into the joint space. Because of the number of injections most dogs will need to sedated but usually not anesthetized. Although I tell caregivers not to expect any positive results until at least the third treatment I am occasionally surprised to see improvement after just one treatment. Although side effects from prolotherapy are rare, a joint infection is possible and consequently I surgically scrub the knee before each prolo session and give antibiotics to go home. In very rare occasions it is possible for prolotherapy to injure a nerve passing by the knee however this has never happen to me and should not happen if care is taken to apply the sclerosing agents only to those areas of the knee where nerves are abscent.

In order to encourage more rapid fibrosis and joint thickening I often apply soft laser therapy to the knee with a non cutting therapeutic laser device that employs 5 lasers of various frequencies . Soft lasers are therapeutic devices that should not be confused with surgical lasers. The soft laser is painless, quick and has next to no adverse side effects. Soft laser therapy supports the prolotherapy by further encouraging fibrosis of the joint capsule and external ligaments. I also recommend that oral doses of “Orthoflex” and vitamin C be given at home throughout the prolotherapy process. Another modality I often recommend be used in conjunction with prolotherapy is pulsed magnetic therapy. The pulsed magnetic waves reduce pain and help the joint recuperate. Finally, to further support the prolotherapy, injections of “Adequan” and “Legend” can be given to encourage cartilage health, joint fluid production and overall joint rehabilitation.

Prolotherapy for torn cruciate ligaments may not be successful if there is a torn meniscal cartilage in the joint. It is also possible that in spite of multiple injections the thickening of the external ligaments may not be adequate to stabilize the joint and consequently the dog’s lameness remain. That being said, when the choice is between joint surgery or prolotherapy, prolotherapy being safer, less invasive and less expensive makes more sense especially in the senior patient.

Prolotherapy can be performed on almost any joint of the body. Personally I have performed prolo on knee joints, elbow joints, hip joints, the sacro illiacs joints and the lumbo sacral joints.

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Back Pain & Hind Leg Lamenes: Ruptured Disks and Other Spinal Cord Disease

John Simon — Sun, 19 Apr 2009 21:14:06 +0000

There are a number of diseases involving the spinal cord that produce paralysis, weakness and incoordination and consequently are easily confused with each other. These diseases include inter-vertebral disk disease, , degenerative myelopathy, Wobblers, lumbo-sacral stenosis, spinal cord tumors, and fibro-cartilagious infarcts. On initial physical exam all these diseases have a number of symptoms in common. Diagnostic tests which help further define the problem include radiographs, myelograms, and MRI’s. All of the above diseases can cause hind leg weakness, incoordination and gait abnormalities. All cause a break in communication between the brain and back legs such that the head does not always know what the back legs are doing . Such a communication breakdown results in the paws knuckling over, the hind end swaying or collapsing, the dog having a hard time rising or going up stairs and the loss of bladder control. Of these diseases, we can expect that pain may be present with only 3: disk disease, wobblers and lumbo-sacral stenosis. Of the six diseases mentioned, inter-vertebral disk disease, wobblers and fibrocartilaginous infarcts usually have the a sudden onset. .

Intervertebral disk disease in the dog is an all to common problem especially in breeds with long backs and short thick legs, aka. chondrodystrophoid. These breeds include dachunds, bassets, beagles, welsh corgis, Lhasa Apsos, Shih Tzus, American cockers, and French bulldogs. In these breeds the problems may occur as early as 1 to 2 years of age. IVD may also occur in non chondrodystrophoid breeds but usually at 6 to 10 years of age. The most common symptoms of disk disease are pain, weakness, loss of coordination, and paralysis. The disease can also affect bladder control. However in very early stages of disk disease the dog may experience only pain and display an anxious uncomfortable attitude and decrease in activity. As the condition advances the pain commonly becomes very severe and the dog may cry out when he or she moves in a particular way. The next stage of disk disease is often hind leg weakness, incoordination and/or paralysis. At this point the pain may or may not disappear. Commonly this progression happens within days but can extend to weeks. If the disk protrusion occurs in the dog’s neck the pain is often more severe. Just petting the dogs head may cause him or her to cry out. The dog will hold his head and neck in a rigid head down stance and will will turn his whole body instead of bending his neck. Cervical (neck) disk disease can cause neurological problems in both the front and back legs whereas disk disease in the mid back will affect only the back legs.

It is difficult to distinguish cervical disk disease from a disease commonly known as Wobblers. Wobblers (aka cervical vertebral instability) is, as the name implies, a result of an unstable joint in the neck producing pressure on the spinal cord. Wobblers is usually a disease of large, fast growing dogs. Great Danes usually develop the disease as puppies where as in Dobermans the problem occurs more often in adults. The disease most commonly presents as a dog with severe neck pain and gait abnormalities in both front and back legs. To distinguish this disease from a ruptured disk or a spinal tumor requires either a myelogram or an MRI. Of course it is possible for the above symptoms to be caused by a blood clot in the spine or spinal tumor, neither of which occurs with any frequency. Finally, if the breed of dog is correct for disk disease, and if there has been no sudden onset or trauma then there is approximately a 95% chance that a disk rupture has occurred.

Another disease that can easily be confused with inter-vertebral disk disease is Degenerative Myelopathy. Degenerative myelopathy is a slow progressive disease of large older dogs, most commonly the German Shepherds. In its early stages the dog owners often mistakes it for arthritis. Degenerative myelopathy is an insidious, inflammatory, autoimmune disease that develops slowly over years. It is a result of degeneration of the fatty myelin sheath that surrounds most nerves and acts as an insulator. The first sign of degenerative myelopathy is the dragging of the top side of the nails on the back feet. This dragging can be detected either by the sound of the gait or by examining the top side of the back nails for abnormal wear. As the disease progresses the hind limbs become weak and an obvious incoordination develops. The hind legs may cross with one another and the dog may look drunk in the hind end. He or she may stumble. If you place the dog’s foot in a position where the top of the toes are on the floor, the dog will often not return the foot to the proper position or take a long time doing it. This is because there is a loss of “conscious proprioception” which means that the brain does not know the position of the back legs. If a dog has Degenerative myelopath then pushing on the dog’s rear end from side to side often causes the dog to fall over or have a hard time keeping his balance. In the later stages of this disease the hind end will become so weak and uncoordinated that the dog will be unable to get up. If the dog does manage to rise he or she will quickly fall down after taking only a few steps. The only good new about this disease is that there is never any pain involved. It is important to rule out a chronic disk disease before accepting degenerative myelopathy as your pet’s fate. Unfortunately that requires an expensive MRI or myelogram to make such a decision.

Lumbo Sacral Stenosis is known by a number of names such as lumbo-sacral instability, lumbo-sacral malformation, lumbo-sacral malarticulation, spondylolithesis, and cauda equina syndrome. All of these describe arthritis involving the last lumbar vertebrae and the sacrum which is a part of the pelvis. This disease often involves the disk as well. Together both problems progressively narrow the spinal canal which in turn puts pressure on the spinal nerves and causes pain and dysfunction. The most common symptom is pain which involves the back, both hind legs, and the tail. Dogs usually have trouble rising. Defecating and urinating are difficult because of pain. Dogs with this problem find defecation and urination difficult due to pain on squating. They may become incontinent and may be seen biting at their rear end.

Blood clots and fibro-cartilaginous infarcts can also cause similar spinal cord disease but they are quite rare and so I will not discuss them at this time.

Now back to intervertebral disk disease (IVDD). Conventional treatment for IVDD involves medicating with steroids, antioxidants, muscle relaxants, cage rest and surgical decompression. If surgery is indicated a myelogram or MRI must be performed to pin point the exact location of the lesion and confirm the physical diagnosis. These tests commonly can run into many thousands of dollars and should only be considered if the owner is planning to follow through with any surgery indicated by the information these tests provide. Disk fenestration surgery or a vertebral hemi-laminectomy are the surgeries performed to reduce pressure on the spinal cord. Both surgeries can run into the thousands of dollars and the diagnostics plus the surgery could easily run between 4 to 5 thousand. If you have a dog that may require these surgeries you should know that the surgeries are not always successful in restoring function and on occasions dogs can come out of surgery in worse shape than when they went in. You should also be made aware that these surgeries especially those involving the neck require long periods of recuperation.

Owners who are hesitant to put their injured older dogs through anesthesia, surgery, and an extended recuperative period may want to consider holistic modalities as an alternative. For those who cannot afford the expense of high tech diagnostics and surgery I also suggest you take a look at alternative or holistic modalities. The holistic therapies I am talking about include electro acupuncture, cold laser therapy, infrasonic therapy, pulsed magnetic therapy, chiropractic, electro crystal rebalancing, nutritional therapy, prolotherapy, bio identical steroid therapy, antioxidant therapy, megavitamin therapy, and systemic enzyme therapy. Please understand that there are no guarantees with any one or a combination of the above alternative therapies, each case being unique in its own right. We have, however, had some excellent results with these alternative approaches and can offer testamonials to their effectiveness.

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Woodside Animal Clinic is a unique, very personal, one doctor practice where, for over 35 years, Dr. Simon has been healing dogs, cats, birds, rabbits, rodents, and reptiles with both conventional and alternative medicine. Dr. Simon is the author of 4 pet care books and he writes a monthly pet care column in the Mirror newspaper. He is the past president of the Oakland County Veterinary Medical Association.

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Physical Rehabilitation for Pets

John Simon — Sun, 12 Apr 2009 16:59:42 +0000

Physical therapy is something that people who are injured or who have undergone surgery expect to go through as part of their recuperation. Unfortunately it has only been within the last 8 years that physical therapy has been readily available for injured animals. Orthopedic injuries, neurological problems, trauma, and arthritis are all maladies that can benefit from physical therapy.

There are number of therapies that can be utilized to help rehabilitate injured or painful pets. Among them are acupuncture, chiropractic, nutritional and herbal support, intravenous and transcutaneous lasers therapy , pulsed magnetic therapy, infrasonic and ultrasonic therapy, microcurrent stimulation, underwater treadmill, hydrotherapy, prolotherapy, range of motion and therapeutic exercise, massage therapy, balance and proprioception equipment. Other supportive measures we use are systemic enzyme therapy, antioxidant therapy, DMSO, homeopathy, and herbal therapy

The following conditions are just a few we have successfully treated with rehabilitation therapy: Wobblers and intervertebral disk disease, arthritis, cruciate ligament tears, post surgical cruciate ligament repairs, lumbo-sacral stenosis, hip dysplasia, degenerative myelopathy and any soft tissue injury involving post surgical wounds, damaged tendons, ligaments, and muscles.

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Woodside Animal Clinic is a unique, very personal, one doctor practice where, for over 35 years, Dr. Simon has been healing dogs, cats, birds, rabbits, rodents, and reptiles with both conventional and alternative medicine. Dr. Simon is the author of 4 pet care books and he writes a monthly pet care column in the Mirror newspaper. He is a past president of the Oakland County Veterinary Medical Association and has served on the board of both the South Eastern Veterinary Medical Association and the American HolisticVeterinary Medical Association.

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Arthritis Therapies for Dogs and Cats

John Simon — Wed, 23 Apr 2008 21:15:40 +0000

Arthritic pain and lameness is probably the most common of the slow, chronic, diseases that progressively steel quality life from our senior dogs. Osteoarthritis is a chronic inflammatory disease that can effect any size dog but is seen much more often in larger breeds. Arthritis often starts with stiffness and is first noticed when the older dog has a hard time rising in the morning. In time the owner may noticed that their dog is slower going up the stairs and may be reluctant to jump into the car. A dog with hip displasia or hip arthritis tends to run like a rabbit using both back legs at once.

As the arthritis progresses the dog may begin to hold up or favor one limb. He or she may walk with short stiff steps and the dog’s gait may show a hind end instability. At the end stages of arthritis the pet may not be able to rise without the owners help. It is very sad when an otherwise healthy animal is euthanized because their owner is unable to lift them up to get them outside when they need to eliminate.

It is my opinion that much of the arthritis our dogs experience could be eliminated by changing their diets from a grain based food to a more meat based recipe. Just because the first ingredient on the ingredient list is meat does not make the diet “meat based”. The only way to distinguish if a food is meat based is to asked the company’s nutritionist (not customer support person) “what percent of their food is meat when measured on a dry matter basis ?” Judged on this basis, most pet foods are no more than 20% meat. Grain based diets are hard for carnivores to digest and, consequently, the poorly digested large grain protein molecules act as allergens which damage the intestinal lining and result in a “leaky gut syndrome”. This leaky gut allows grain protein molecules to get into the blood stream where they can migrate to the pet’s joints and set up an inflammatory reaction. Feeding a meat based diet helps to prevent the above sequence of events. Finally, keeping your pet on the slender side in old age and better yet all his or her life will definitely reduce the risk of arthritis developing, Supplementing the diet with digestive enzymes, fish oil, antioxidants, and herbal anti inflammatories will help reduce the likelihood of arthritis.

If your dog has already developed arthritis there are a number of ways to help slow the progression and reduce the discomfort from the disease. Injections of “chondroprotective” substances which increase joint fluid and encourage cartilage repair can be very effective. Personally I am not a big proponent of using non steroidal anti inflammatory drugs (NSAIDS) to reduce inflammation and pain because their long term use may result in gastro intestinal, liver, and kidney disease. It has also been shown that long term use of NSAIDs in humans actually results in cartilage degeneration. Providing glucosamine, chondroitin , MSM, Adequin and antioxidants in place of NSAIDs can help restore joint integrity and, in my opinion, is a much preferred approach.

Other ways to treat advanced arthritis include acupuncture, chiropractic, “infra sonic therapy”, “pulsed magnetic therapy”, prolotherapy, low level laser therapy, physical therapy and massage therapy. Teaching pet owners how to massage their pet and provide passive range of motion can be very helpful in extending and enhancing their pets quality of life.

The only problem with stem cell therapy ithat it is relatively expensive and requires the pet be anethetized for the harvesting of the adult stem cells from body fat. Prolotherapy is a less expensive option and one sense could be seen as the “poor man stem cell therapy” because it also stimulates the body produce more supportive connective tissue around the unstable joint.

Detecting the early signs of arthritis and instituting early treatment can make a huge difference in the success of therapy. Providing a high quality meat based diet, with omega 3 fatty acids and antioxidants can help prevent the onset of arthritis and help extend both the quality and quantity of the pet’s life.

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Woodside Animal Clinic sees pets from all over the greater Detroit area including Royal Oak, Berkley, Huntington Woods, Ferndale, Pleasant Ridge, Detroit, Hazel Park, Madison Heights, Warren, Centerline, Clawson, Troy, Sterling Heights, Southfield, Birmingham, Bingham Farms, Franklin, Farmington, Farmington Hills, Novi, Wixom, Brighton, Livonia, Plymouth, Commerce, Ann Arbor, Ortonville, Waterford, Union Lake, Rochester, Rochester Hills, Auburn Hills, Utica, Romeo and Flint.

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Alternative Therapies for Dogs and Cats with Arthritis

John Simon — Wed, 23 Apr 2008 03:05:39 +0000

Dear Dr. Simon,

I have a 12 year old Labrador Retriever named Joe who has had arthritis in his hind legs for the past 3 years. My veterinarian has put Joe on cortisone tablets which have helped allot but have also made him eat and drink too much. Do you know of any alternative approaches to treating arthritis ?

Dear Reader,

I am glad you asked this question. Far too many old arthritic dogs have been put on long term cortisone therapy. Although cortisone is very effective in treating arthritis it can produce many detrimental side effects. One serious problem accompanying cortisone therapy is that it stimulates the animal’s appetite and thirst and consequently he or she gains weight, which puts additional stress on the already painful hind legs and back.

If Joe is at all overweight he should be put on a high fiber low fat diet until he reaches a weight that you might consider “slightly thin”. You should also make sure that his nails are not overgrown and hurting his feet.

One of the most common alternatives to cortisone therapy is to use drugs like aspirin. These “non-steroidal anti-inflammatory” drugs frequently work well in treating the symptoms of arthritis but are not really getting at the cause of the problem. Non-steroidals also tend to irritate the lining of the digestive tract and can result in ulcers.

Fortunately, there are a number of other approaches to the treatment of arthritis. The use of anti-oxidant enzymes, vitamins, and minerals along with medications that encourage the regeneration of joint cartilage and increase the production of joint fluid is a very effective and safe way to begin anti-arthritic therapy.

Frequently arthritis is the result of stretched ligaments, which produce joint instability. Injections into these ligaments know as “prolotherapy” along with supportive oral medication can encourage the ligaments to thicken and reduce abnormal movement.

Other alternative approaches to treating arthritis are acupuncture and magnetic field therapy both of which are considered mainstream medicine in Japan. Western and Eastern herbal therapy, chiropractic, and homeopathy have also been found to be extremely helpful in treating arthritis in pets and humans. Very recently stem cell therapy has become available for helping horses and dogs with arthritis.

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