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All Things Welshie

Musings on living, loving and showing in a house full of Welshies

Photo Gallery

State-of-the-art medical treatment

10/14/2013

2 Comments

 
PictureESWT to leg tendon.
This AM I received my daily 'Dr. Becker newsletter' and there was an article that caught my eye because I hadn't heard of the topic before. The article discussed treatment with Extracorporeal Shockwave Therapy (ESWT) for conditions where the dog has pain or non-healing fractures. The treatment itself has been used with humans for over 25 years-it's the same as the lithotripsy procedure now routinely used for treating kidney stones. It is also used for treating painful plantar fasciitis and for promoting healing in bones that refuse to knit together. The same treatment is now being offered to horses, cats and dogs to treat a variety of conditions.

In dogs, ESWT has been used to relieve pain associated with osteoarthritis, degenerative joint disease, hip/elbow dysplasia, tendon and ligament injuries, even lick granulomas and non-healing tissue conditions and bone fractures. It is thought that the high-powered shock waves work within the dog's body to promote new blood vessel development, reduction of inflammation, and stimulation of collagen production. All these factors contribute to promoting accelerated healing and reducing pain in the affected areas.

I have seen conflicting information about the need for anesthesia prior to an ESWT procedure due to the noise and possible pain associated with treating an already painful injury. I could not always tell if the dogs in photos I found in association with articles about the treatment were anesthetized or sedated. Perhaps it depends upon the type of ESWT device used to generate the shock waves and where the device is placed and the injury that the animal is being treated. So, if you are interested in this procedure, that's an important question to ask, since the anesthesia/sedation certainly has its own expenses and risks.

As far as how often the treatment is given, it depends on what conditions are being treated and what the specific device manufacturer protocols recommend. For example:
Musculoskeletal conditions: every 2-3 weeks for 1-3 treatments until resolution
Wounds: once per week for a treatment, but more than three treatments may be needed if wound is large
Osteoarthritis management: every 1-1.5 weeks for up to 3 treatments, and then repeated at 6-12 months for treatment intervals since CHD is a chronic condition that is not cured by the ESWT.

There can be side effects of the ESWT procedure, including swelling, red or purple discoloration at the site of the shockwave focus, or short term aggravation of the condition. And pain relief may not be noticeable for up to four weeks after the last ESWT session. The literature indicated that side effects are short lived and usually gone within 1-2 days. Some dogs may require standard NSAID's like Rimadyl or Deramax temporarily.

I reviewed professional journal articles about ESWT available through ivis.org, and there have been presentations at veterinary proceedings in Europe since 2004 promoting the use of ESWT, first in equines, followed by canine research. A few canine discussions of veterinary uses for ESWT in both research articles and articles for veterinary professionals are listed below. They may not be available to you without registration at the ivis.org site or the Clinician Briefs site. Both are free registrations, though. If you cannot access these links, the Dr. Becker article is highlighted above and is an excellent overview of the treatment.

-Extracorporeal Shock Wave Therapy (ESWT) for Hip Osteoarthritis
-Effect of extracorporeal shock wave therapy on elbow osteoarthritis in dogs
-Mobility; a multi-disciplined approach (Iams Proceedings)
-August 2013 Clinicians Brief-Shockwave Therapy as a Treatment Option
-July 2012 Clinicians Brief-Nonsurgical Management of CHD
-September 2012 Clinicians Brief-Treating Patellar Ligament Desmitis

So, if your dog has pain due to an injury or a chronic condition that is not getting better, you may want to discuss the use of ESWT with your veterinarian. If your vet practice is not currently authorized to perform the treatment, they should be able to refer you to a veterinary orthopedic specialist who has the training and equipment to provide the treatments your dog needs.

If you and your dog have undergone ESWT, leave a comment and share your experiences with us! 


A future topic will review very new stem cell therapy for canines for treatment of injuries and various conditions...

2 Comments
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    Sandy, interested in lots of things, master of none. Likes cooking, web site creation, her Nook HD+, Star Trek, Babylon 5, and The Voice.

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