Clean Run - May 2014 - 32

30 days), but may improve the
comfort and function of a joint long
enough to allow more aggressive
physical rehabilitation and fitness
to intervene before the drug wears
off. Newer approaches to joint injections include PRP (platelet rich
plasma which is full of growth
factors) and stem cells (full of
growth factors as well as a source
of cells that may be able to repopulate tissues such as cartilage).

A long-standing and well-respected modality that is difficult to
place under the previous categories is polysulfonated glycosamino-glycans (Adequan). It is closest
to the interventional concepts in
that it may help promote cartilage
regrowth and decrease inflammation within joints (including the
trending "hot" molecule, interleukin 1). This drug/compound is
injected intra-muscularly or subcutaneously and finds its way into

inflamed joints. When joint function is a component of the pain a
patient is experiencing, this treatment can be extremely effective.
Although this is a non-pharmacologic discussion, this compound
crosses the threshold a little (in
my mind) as a way to modify the
healing ability of tissues.

Conclusion
With non-pharmacological approaches, there is a mixture of
what you can do and what must be
done by a professional. The most
comprehensive application of nondrug modalities will be found with
a rehabilitation practitioner. A specialist who is board-certified by the
relatively new specialty of Sports
Medicine and Rehabilitation has
proved their knowledge base is a
great place to start. However, as a
relatively new branch of veterinary
medicine, there is also a large
pool of people who have educated
themselves because they have a
passion for the material. To find
someone with this training, look
for certification in animal rehabilitation, acupuncture, massage,
chiropractic, etc. It is important to
recognize that certification is not
the same as specialization, but it
is also important to find someone
who truly listens to both the human and the dog.

Regardless of the practitioner, it
is good to stay with the dog while
he is being treated, both to be an
observer and advocate, but also to
learn techniques for following up.
A rehabilitation practitioner, especially when working with a knowledgeable and capable owner, will
rely heavily on work that can be
done at home. It is the everyday
homework that restores function
and comfort to the athletic dog,
and it is the everyday interaction
with your dog that can help clarify
the decisions that go into balancing comfort and the love of a sport
or activity. D

Rob Labruyère, Hubertus J van
Hedel. Strength training versus robotassisted gait training after incomplete
spinal cord injury: a randomized
pilot study in patients depending
on walking assistance Journal of
NeuroEngineering and Rehabilitation
2014, 11:4 doi:10.1186/1743-000311-4

Feine JS, Lund JP: An assessment
of the efficacy of physical therapy
and physical modalities for the
control of chronic musculoskeletal
pain. Pain 1997, 71:5-23.

Mannerkorpi K, Henriksson C:
Non-pharmacological treatment of
chronic widespread musculoskeletal
pain. Best Pract Res Clin Rheumatol
2007, 21:513-534.

Dr. Bonnie Wright is a veterinarian who is board-certified by the American College of Veterinary Anesthesia and Analgesia. She has received training in medical acupuncture,
canine rehabilitation, and is a certified Veterinary Pain Practitioner by the International Veterinary Academy of Pain Management (IVAPM). She is a member of the WSAVA's
Global Pain Council, and the current president of the IVAPM. Dr. Wright works in an emergency and rehabilitation practice in Colorado. She has five dogs: three "littles"
(Chihuahuas) and two "bigs" (a three-legged German Shepherd and a Golden Retriever cross). None are working dogs because Dr. Wright is always working, herself!

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Clean Run - May 2014

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