Clean Run - July 2014 - 44

Extra Corporeal SHOCK WAVE THERAPY
How Sound Waves CAN HELP YOUR DOG HEAL
By Douglas Stramel, DVM, CVPP, CVMA, photos by author
Extra corporeal shock wave therapy, commonly known as
shock wave therapy (SWT) uses high-energy sound waves
called pulses or shock waves to stimulate and speed the
body's own healing process. SWT has been used in human
medicine for over a decade to provide a noninvasive treatment for urinary tract stones.1 The high-energy sound waves
stimulate cells and release healing growth factors that reduce inflammation and swelling, increase blood flow, and
enhance the healing of bones and wounds. SWT can be used
to help with a wide variety of conditions including tendon
and ligament injuries,2, 3, 4, 5 osteoarthritis, 6, 7, 8, wounds, 9, 10
and non-union fractures.11 SWT is noninvasive so it can be
used in these conditions in conjunction with other modalities to help your dog feel better and recover faster. While
most studies show significant improvement after treatment,
the results are not consistent.12 This modality is rather new
in the realm of treating small animals. More widespread use
and further studies will hopefully reveal how this therapy is
best used, and the protocols will be refined to provide more
consistent results.

with a reduction in inflammation and swelling; 2) Release of
growth factors such as VEGF (vascular endothelial growth
factor), eNOS (endothelial nitric oxide synthase), and PCNA
(proliferating cell nuclear antigen) which increase cellular
proliferation and potential tissue regeneration, and 3) Release of bone morphogenetic proteins, which can induce
the formation of bone and cartilage.13

What Is Shock Wave Therapy and How Does It Work?

The following musculoskeletal conditions have been reported, either through clinical studies or anecdotally, to improve
from the use of SWT as the sole method of treatment or as
an adjunctive treatment in a multi-modal approach:

What Is the Common Treatment Protocol?
Treatment protocols have been established for many species, for a variety of indications and severity of disease. A
loud "clicking" noise is created during the production of the
shockwave and the intense stimulation of the shock wave
can be painful, so heavy sedation is used in the majority of
treatments. Most protocols call for two or three sessions of
SWT at three-week intervals. The total dose of shockwaves is
measured as the number of pulses times energy (mJ/mm2)
per treatment area. Pulses are delivered at a measured frequency. Many treatment protocols are available from manufacturers of SWT machines and clinical research testing.

„Chronic wounds
„Lick granulomas
„Delayed or non-union fractures
„Nonsurgical management of digital, metacarpal, and
metatarsal fractures
„Osteoarthritis: hip, elbow, stifle, hock, shoulder
„Supraspinatus tendinitis
„Glenohumeral ligament tears (medial shoulder instability)
SWT consists of high-energy focused sound waves. As sound
waves pass through tissue, energy is dissipated when it
encounters denser tissue, such as bone, cartilage, tendon,
and ligament. The Versatron by PulseVet can create electrohydraulic shock waves with a maximum pressure of 70 MPa
with a rise time measured in nanoseconds. Depth of these
waves can reach up to 110mm.
As energy is deposited in the tissues, a biologic response occurs that promotes healing because of the following effects:
1) Release of cytokines which can help a chronic condition
revert to an acute state and reinitiate the healing process
44

„Osteochondrosis of the shoulder
„Triceps muscle tear
„Fragmented coronoid process
„Biceps tendinitis
„Spinal column issues (intervertebral disc disease, lumbosacral
disease, spondylosis deformans, cauda equine syndrome)
„Iliopsoas muscle injuries
„Patellar tendinitis (especially post-operative anterior cruciate repair)
„Achilles tendinitis
„Calcaneal tendon tears
Clean Run | July 14
Clean Run - July 2014

Table of Contents for the Digital Edition of Clean Run - July 2014
