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management of osteoarthritis in performance dogs
|osteoarthritis in performance dogs|
these are the questions that went through sally’s mind when she brought dia to see me this past may. Sally has three aussies, but dia is clearly her fiercest competitor when it comes to agility. we discussed retirement, knee braces, surgery, and recovery. neither sally nor dia were ready for leisure life. ultimately I performed a solo surgery to stabilize dia’s right stifle. dia recovered well with lots of hard work and rehabilitation therapy and won her qualifying PSJ by 2 seconds 14 weeks after surgery.
she went on to compete and place 10th in her class at the ASCA agility Finals. not bad for a dog we debated about retiring! now our focus has changed from not if we can get her back to competition, but how to maintain her there. the “X” factor, of course, is arthritis. dia had mild to moderate degenerative joint changes in the right stifle at the time of surgery. while her muscle mass is symmetric and she is running well, photographs reveal a different story. she slightly favors the right leg on takeoff over jumps. in addition, mild muscle tremors are noted after heavy exercise. subtle, but important clues to the underlying condition in her stifle, osteoarthritis.
What Is Osteoarthritis?in fact, osteoarthritis (OA) affects nearly one out of five dogs over one year of age in the U.S. (Johnston SA, 1997). development of organic agriculture as a result of joint stability directly indirect hazards to the joint, or shaded defects cartilage development. dogs that are elderly, obese, or that have had a long athletic career are more likely to suffer from OA.
in all animals, the ends of bones are capped with a hard but slippery tissue called articular cartilage. this material protects the bone ends by absorbing shock and reducing friction between bones during movement. cartilage derives its nutrition from the fluid within the joint called synovial fluid. natural structure the function of the articular cartilage can cause relative discomfort easily. however, the body is designed to repair itself, and why the body’s repair mechanisms fail and OA develops is still incompletely understood. Osteoarthritis is defined as the breakdown and eventual loss of
cartilage within a joint. Once the cartilage starts to wear away, the underlying bone becomes exposed, causing painful rubbing of bone against bone. with enough loss of cartilage, the joint falls on itself, leading to the loss of common form joint instability. the body’s response to the loss of cartilage and joint laxity is a thickening of supporting structures and production of bone spurs along the edges of the joint. these pieces of bone or cartilage can break off and float around inside the joint space.
the effect is like having a pebble in your shoe, though substantially more painful. the result is a vicious cycle of pain and inflammation, ultimately reducing the ability of that joint to fully flex and extend.
the early stages of osteoarthritis are often subtle and can manifest as limping, sensitivity to touch in certain areas, stiffness (especially after rest), and difficulty doing normal day-to-day tasks (rising, lying down, or climbing stairs). In performance dogs, it may be more understated, showing up only as a slower course the time or dropping a bar. these signs are often attributed to old age in dogs, but age in itself is not a disease. while there have
been no studies looking at the prevalence of OA specifically in performance dogs, one would expect an increased incidence in agility dogs due to a lifetime of training and competing over varying terrain.
X-rays are the most readily available and inexpensive method of confirming the presence of OA. unfortunately, by the time degenerative changes are noted on x-rays, it is nearly impossible to reverse the changes that have already occurred and it is extremely difficult to halt the progression of the disease. an earlier diagnosis can be obtained by retrieving fluid from within the joint via a needle (arthrocentesis) and examining that fluid under a microscope to help determine if inflammation is present. this procedure is quick and easy to perform under moderate sedation.
Options for Managing OA:
Frequently asked about the best way to prevent and treat arthritis. while most dog owners are familiar with non-steroidal anti-inflammatory drugs (NSAIDs), many are unaware of the alternative options for medically managing OA. Many of these treatments have few side effects and can significantly reduce the pain and dysfunction of OA. A vast array of alternatives are available and
those alternatives have just as many opinions about their potential benefits.
NSAIDs Nonsteroidal anti-inflammatory drugs are commonly used for the treatment of OA.
Examples of these drugs include Deramaxx, Etogesic, Metacam, Previcox, Rimadyl,
and Zubrin. These drugs are excellent at managing the discomfort associated with OA. in general, NSAIDs are safe if used and monitored properly. Unfortunately, all of these drugs have the potential to produce undesirable side effects, including gastrointestinal, liver, and kidney damage. in addition, the main function they serve is to reduce inflammation and pain (cartilage degradation), but these drugs do little to promote cartilage health (cartilage formation). So in our practice, we often recommend using NSAIDs to offset the trauma of competition by using them the day before and the day following a trial. if long-term administration is necessary, we titrate the drug to the lowest dose possible that relieves clinical signs. we recommend a 48-hour wash-out period between the use of similar drugs within the NSAID family and recommend routine laboratory work be performed every 4-6 months with extended use.
Glucosamine/Chondroitin glucosamine and chondroitin are some of the most widely used products on the market. they both are building blocks of the normal cartilage matrix. when given in combination, glucosamine and chondroitin sulfate reportedly support cartilage production and protect existing cartilage by inhibiting enzymes in the joints that break down cartilage. results of several studies support that their combination has a significant anti-inflammatory effect against laboratory-induced and naturally occurring joint inflammation.
glucosamine and chondroitin products are naturally occurring compounds, are safe to use and have few side effects (most commonly gastrointestinal upset). however, because these compounds are dietary supplements, label claims are not federally regulated. purity is dependent on the manufacturer and can vary among brands. choosing the right supplement can be difficult. when looking for a glucosamine supplement, several things should be considered.
• One is the formulation of glucosamine as hydrochloride (HCL) versus a sulfate preparation. both are well absorbed by the gastrointestinal system. However, glucosamine HCL is preferred, because it is a more stable compound and does not require additives. therefore, glucosamine HCL is 99% pure, as compared to the approximate 80% purity of a sulfate combination. thus, you need to administer less to your dog to get the same benefit, saving money.
• Another consideration when selecting a glucosamine-chondroitin product is brand reliability. For my clients, I often recommend products from a local company (Nutramax Laboratories in Edgewater, Maryland) because I am familiar with their products (Cosequin and Dasuquin). Nutramax has a strong in-house research and development team and independent studies support their products’ safety and efficacy. For brands that I am less familiar with, I recommend owners investigate the product on their own through internet review sites.
More recently, glucosamine-chondroitin sulfate products are being combined with additional anti-inflammatory agents. Nutramax laboratory's newest product Dasuquin is similar to its widely used product Cosequin but has the added benefit of avocado soybean unsaponifiables (ASU) and green tea polyphenols. These ingredients are reported to work in combination with glucosamine and chondroitin sulfate to lower the expression of inflammatory mediators. Methylsulfonylmethane (MSM) is another natural-occurring anti-inflammatory that is being added to supplements. These ingredients are thought to enhance the effectiveness of glucosamine-chondroitin and provide additional pain relief.
Essential Fatty Acids:
Fatty acids are found in many types of food and can be categorized as omega-6 or omega-3. While omega-6 fatty acids are not “bad,” they should be consumed in moderation, as excessive amounts of omega-6 fatty acids or a high omega-6/omega-3, the ratio is thought to promote the development of many diseases, including cardiovascular disease, cancer, inflammatory, and autoimmune diseases. On the other hand, increased levels of omega-3 fatty acids (a low omega-6/omega-3 ratio) exert suppressive effects on the development of these conditions. the perfect ratio of omega-6 to omega3 fatty acids has yet to be determined but is thought to be around 3-4:1 in the dog. Essential fatty acids (EFAs) are specific omega-3 fatty acids (docosahexaenoic acid, or DHA, and eicosapentaenoic acid, or EPA) found in fatty fish? the fish do not produce omega-3 fatty acids, instead of kneading accumulate them from either consuming micro algae or other fish that have consumed microalgae. the concentration of EFAs is, therefore, highest in predatory fish like salmon, tuna, and cod.
essential fatty acids act by replacing harmful arachidonic acid in the cell wall, thereby reducing inflammation. they may also block the expression of certain genes that perpetuate the development of osteoarthritis. foods supplemented with omega-3 fatty acids are available. you can also buy EFAs in capsule and liquid form to add to your dog’s regular diet.
Shellfish supplements have been used as a traditional remedy for arthritis in humans. The New Zealand green-lipped mussel (GLM), in particular, has been shown to have beneficial effects for the treatment of chronic mild to moderate osteoarthritis. GLM contains a unique omega-3 fatty acid, which is thought to reduce inflammation by blocking two important inflammatory pathways.
The thermal treatment of GLM has been shown to destroy its activity. therefore, the processing of whole GLM and incorporation of the GLM product into food products is difficult. it is most readily available as a freeze-dried powder or incorporated into a capsule. there is relatively strong data that daily doses of GLM are effective at reducing total arthritic scores and scores for joint pain and joint swelling after 6-8 weeks of administration. I typically will try GLM in patients that show minimal to no improvement in glucosamine/chondroitin. the brand I recommend is Glycoflex because it combines the benefit of GLM with glucosamine and chondroitin.
adequan is an injectable polysulfated glycosaminoglycan (PSGAG) available for use
in dogs. adequan canine is the only FDA-approved product of its type in the arthritis treatment market. polysulfated glycosaminoglycan is made from an extract from the lung and trachea of cows. the principal component present in PSGAG is chondroitin, and adequan has been evaluated as an effective treatment of OA in adult dogs with no local or systemic adverse reactions related to the drug observed. I often use adequan in conjunction with oral supplements during
periods of heavy activity.
The use of intra-articular steroids has been looked down upon in the veterinary community for many years. In fact, it is difficult to find a published dose for intra-articular use in dogs. Steroids are extremely effective at reducing inflammation by inhibiting major inflammatory mediators and may also have a protective effect on the cartilage matrix by reducing degradative enzymes. however, there is a concern that long term use may depress normal cartilage cell metabolism, composition, and repair.
Systemic side effects typically seen with oral administration of steroids (increased water and food consumption, increased urination, agitation, weight gain) are minimal with intraarticular use. In our practice, we generally reserve intra-articular administration of steroids for severe cases of osteoarthritis that are unresponsive to other methods of treatment. we do not recommend oral administration of steroids for the treatment of non-immune mediated osteoarthritis.
Stem Cell Therapy:
Intra-articular use of stem cells is a hot topic in veterinary medicine previously discussed in CR November 2008. Stem cells are isolated or cultured from fat collected from the patient and injected directly into the affected joints. while a direct understanding of how stems cells work in patients with chronic arthritis is not available at this time, preliminary research suggests relief of clinical signs is primarily derived through anti-inflammatory and immunomodulatory effects. Preliminary data on the use of stem cells for chronic OA is promising, but long-term clinical trials are needed.
So, Which Product Should I Choose?
What was once perceived as holistic and the novel has now become mainstream in the treatment and prevention of OA? Although many products are available, not all products are effective in all patients. Until randomized, double-blind, placebo-based studies are independently performed on a large number of patients, there will still be more questions than answers with regard to the best treatment of OA.
implementation should be part of a balanced plan of weight control, exercise, and NSAIDS when needed. I would recommend consulting with your primary veterinarian before starting your dog on a supplement. Your vet may offer additional insight and experience to help you choose the right supplement for your dog’s specific needs.


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Our beauty and massage salon in Hasselt was founded in August 2019. With our three professional masseuses, we specialise in traditional Thai body massages but you can also visit us for several other massage styles. All our masseuses are all qualified and have more than 10 years of experience in the profession. You are free to make reservations with your favourite masseuse, but you can only visit us for a traditional Thai massage and not for erotic massages. Select one of our massages, then relax and enjoy the benefits of a traditional Thai massage. We work only by appointment.
Discover the traditional Thai massage in Limburg
Traditional Thai massage is an ancient but vibrant tradition that can best be described as a combination of stretching, yoga and acupressure. It considers the energy lines of the body, and although for many it is also just a relaxing massage form, it is very different from the traditional oil massage. The traditional Thai massage finds the perfect balance between focusing on muscles and the ultimate form of relaxation. Depending on the focus, there are different variants available, from the Thai pregnancy massage to the foot and leg massage. Of course, you can also come to us for an aromatic Thai oil massage where you can choose between coconut, jasmine and orange oil.
Traditional Thai massage is part of Thai medicine and is also on the UNESCO World Heritage List.
A Thai massage offers:

domain: health


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(Botox - Allergen or Dysport – Galderma)
Neurotoxins, such as Botox or Dysport, work by inhibiting the contraction of your muscle in and
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Neurotoxins are great for not only smoothing and diminishing lines but also for preventing the increased intensity of those lines as we age.
“I was feeling insecure about the lines and wrinkles in my face and especially my lips as I age. I went to Nova Medical aesthetics and got filler and botox in my face and lips and was shocked by the amazing results! Most of my wrinkles are gone! My lips are wrinkle free, fuller, smoother while still looking so natural. I look more youthful and vibrant. I feel amazing and more confident. The staff were warm and friendly making me feel at ease with this new experience. Best thing i have ever done for myself.”
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At Nova Medical Aesthetics, we provide free consults in order to develop your own customized treatment plan. Whether you are interested in neurotoxin, filler, or Latisse, we would love to answer your questions.


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As one of the first locations where House Call Doctor started, our service has grown across the Townsville area thanks to the support from the community. With what started as just two cars in 2015, our team has no plans on slowing down any time soon.
Townsville, here’s how we’ve helped you.
In the first year of House Call Doctor being launched in Townsville, the service had doubled to four cars delivering thousands of house calls each month.
Now, three years later, our home doctors continuously work hard to treat and even save the lives of residents, including Rachel Carmody.
During a visit for her son in 2017, Ms Carmody, who was recovering from a broken foot, mentioned to Dr Padmaparsad she was also feeling run down with flu-like symptoms.
Thanks to his quick thinking, Dr Padmaparsad pieced together Ms Carmody’s symptoms and advised she needed to visit the emergency department immediately, as she may have had a blood clot.
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Another life-saving moment our Townsville home doctors have experienced was when Julie Vigor’s two children both had stomach pains, yet after returning from the hospital her son Corbin was still not recovering.
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“Our doctors save lives and the service saves taxpayer money – millions and millions of dollars in taxpayer money – by giving people an alternative to hospital emergency departments,” Mr Jennings said.
Have you used the House Call Doctor service in Townsville?


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There are a slew of skincare dos and don’ts, but following all of this supposedly sound advice may do more harm than good. And knowing the whole story on skin will get you closer to the glowing, flawless complexion you’ve always wanted. With help from top experts, get the scoop on nine easy-to-fall-for skin myths that are actually far cries from the truth.
Despite cleansers, scrubs and other skincare products claiming to have pore-opening powers when paired with warm H2O, this advice just doesn’t hold water. Skin’s openings neither change in size nor operate like train doors, says Glenn Kolansky, MD, Director of the Advanced Dermatology Surgery and Laser Center in Tinton Falls, NJ. In reality, hot water loosens hardened dirt, oil and makeup within pores, allowing for better cleansing, explains Dornechia George Carter, MD, a dermatologist with Methodist Charlton Medical Center in Dallas, TX. Still, watch the temperature. Washing your face with too-hot water can strip skin of natural oils and possibly lead to irritation and dryness, warns Dennis Gross, MD, a dermatological surgeon and creator of Dr. Dennis Gross Skincare.
Spa services cost big bucks, and luckily for your budget, this particular treatment isn’t necessary. Facials are relaxing, but they won’t change “skin’s structure and function in the short-term or long-term,” explains David Bickers, MD, Chairman of the Department of Dermatology at ColumbiaDoctors Midtown in New York City. While the intense moisturizing may make skin shinier for a day or two afterward, the fleeting post-facial glow may not be worth the price, says Helen M. Torok, MD, Medical Director of Trillium Creek Dermatology in Medina, OH. And if you’re acne-prone, Ariel Ostad, MD, a dermatologist based in New York City, recommends getting customized treatment suggestions from a dermatologist; spa services are often done the same way for everyone.
Bingeing on pizza and candy bars obviously isn’t good for your health—or your waistline—but are they the acne-causing culprits they’re rumored to be? According to Dr. Ostad, studies have proven that neither type of food is responsible for breakouts. The false association may exist because stress hormones lead to zits—and they’re the same things that call you to the nearest cookie jar, says Michele Green, MD, a dermatologist at Lenox Hill Hospital in New York City. That’s not to say acne and diet are unrelated. If you have pimple problems, limit foods high in carbohydrates and dairy, suggests Joshua L. Fox, MD, founder and director of Advanced Dermatology, PC, of New York and New Jersey. Those are more likely to cause breakouts.
Your mother’s wrinkle-free, so that means you’re destined for complexion perfection, right? Even though genetics play a big part in the aging process, external factors, like sun exposure, facial expressions, smoking, pollution and diet, affect how skin looks over time. So if Mom turned her nose up at tanning and you eschew shade, you may not grow old as gracefully. The bottom line: Good genes aren’t a free pass to flawless skin.
SPF stands for sun protection factor, and the SPF number relates to the amount of time it would take skin to burn. In other words, SPF 15 means sunbathers can bask 15 times longer without getting sunburn than they would without sunscreen. Higher SPF numbers prevent a greater percentage of rays from reaching skin, says Dr. Carter, but the differences between 15, 30 and 45 are smaller than you’d think. For instance, SPF 15 blocks about 93% of the sun’s rays, while SPF 30 blocks 97% and SPF 45 blocks 98%. So doubling the number doesn’t double your skin’s protection, especially since the average person doesn’t apply as much as she should—1 tsp for your face and 1 oz for the uncovered areas of your body, reapplied every two hours. One more thing: Always use sunscreen with broad-spectrum protection, which blocks UVB and UVA rays.
As convenient as sunscreen-infused products are, relying on them for sun protection is a big no-no, says Dr. Fox. “Due to makeup’s thickness and how it binds to the skin, it would take almost 14 times the normal amount of powder used and seven times the normal amount of foundation used to get the desired amount of SPF,” he explains. Although proper sun coverage varies for everyone, a good rule of thumb: Pair SPF 15 sunscreen with SPF 15 cosmetics.
Although evening is primetime for your skin’s repairing process, what’s best for your skin type is more important than whether a cream is marketed for use at a certain time of day. Have dry skin or eczema? Try a cream containing peptides or Vitamin C antioxidants, says Dr. Fox—and use it day and night. If you use anti-aging products, apply those at night, since retinol—their key ingredient—is sensitive to sunlight. Have oily skin? Too much moisturizing can clog pores and result in acne. To rejuvenate skin without the negative side effects, opt for a prescription retinoid, like Retin-A or Differin gel.
Thanks to clever marketing, anything “natural” is assumed to be better for you. But there’s no evidence that natural products are more effective or safer. In addition to there being no regulation on what’s labeled natural, Robyn S. Gmyrek, MD, Director of Cosmetic Dermatology at ColumbiaDoctors Midtown, reminds that “while naturally occurring ingredients aren’t synthetically produced, they still can cause allergic reactions and be harmful.” Dr. Fox’s advice: Find the right product for your specific skin issues with the help of your dermatologist—whether or not the ingredients are all natural.
Sorry, but harsh scrubbing doesn’t keep pimples at bay. Oil overproduction, dead skin cells and bacterial growth cause acne. Excessive scrubbing dries out skin, which prompts extra oil production and more breakouts, says Dr. Gross. Once-a-week exfoliation is more than enough. But if you have active acne, Dr. Ostad suggests skipping exfoliating altogether, since it may spread bacteria to the rest of your face. For sudden breakouts, topical medications and gentle cleansing are your best bets.


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Unlocking the Fountain of Youth with Restylane
In the quest for eternal youth and beauty, science and technology have joined forces to offer a range of solutions that go beyond conventional skincare routines and facials. One such remarkable innovation in the world of cosmetic enhancements is Restylane. If you’re looking to rejuvenate your appearance, enhance your natural beauty, or simply reverse the signs of aging, then Restylane is for you!
What is Restylane?
Restylane is a brand of hyaluronic acid-based dermal fillers designed to restore and rejuvenate the skin’s youthful appearance. Hyaluronic acid is a natural substance found in the human body that contributes to the skin’s hydration and elasticity. Restylane uses a synthetic form of hyaluronic acid, which is biocompatible and safe for cosmetic use. The treatment involves injecting the filler into specific areas of the face to address a variety of concerns, such as fine lines, wrinkles, volume loss, and contouring.
What different types of Restylane filler are there?
Restylane offers a variety of products designed to address specific cosmetic concerns.
Restylane-L is ideal for correcting moderate-to-severe facial wrinkles, such as nasolabial folds and marionette lines. This filler can also be used for lip injections!
Restylane Silk is specially designed for lip augmentation and fine line corrections. This filler provides a subtle, natural-looking enhancement.
Restylane Lyft is perfect for adding volume to the cheeks and midface. It provides a lift to address sagging skin while restoring a youthful contour.
Restylane Refyne and Defyne: Used to smooth out moderate to severe facial wrinkles while maintaining a natural look and flexibility in facial expressions.
Restylane Kysse is specifically designed for lip enhancement, providing a plump, soft, and natural appearance.
What to expect during your experience?
A Restylane treatment is a non-surgical, minimally invasive procedure that can often be completed in under an hour. During your appointment with Essential Aesthetics, you will have a 30-minute consultation with PA Ellie, DMSc, where you can discuss your goals, expectations, and any concerns you have. After the consultation, Ellie Zarnegar, PA DMSc, will prepare the treatment area by cleaning it and may apply a topical anesthetic to minimize any discomfort. The Restylane filler will then be carefully injected into the target areas, with precise control over the amount and placement. After the injection, the treated area will be massaged to ensure an even distribution of the filler. You can immediately see the results following the treatment.
Is there any aftercare following Restylane injections?
One of Restylane major advantages is that it provides immediate results. However, it is suggested to avoid strenuous activities for 24–48 hours after the treatment to minimize the risk of swelling or bruising. Refrain from excessive sun exposure and use sunscreen to protect your skin and maintain the results. Stay hydrated and maintain a healthy lifestyle to extend the longevity of your results.
How long do the Restylane results last?
Results typically last from 6 to 12 months, depending on the specific Restylane dermal filler products used and individual factors.
Restylane has revolutionized the field of non-surgical cosmetic enhancements, offering individuals a way to rejuvenate their appearance and turn back the clock on aging! With it’s versatile range of products, it can address a wide array of concerns, providing natural and long-lasting results.
Interested in learning more about Restylane? Our Danville office is perfectly situated for clients from Orinda, Alamo, Blackhawk, San Ramon, Danville, and the East Bay San Francisco Area. Request a consultation online or call or text us at 925-855-1773.


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- Unfold the mask and carefully place it on your freshly cleansed face, avoiding the eye and mouth contours.
- Remove after 10-12 minutes and tap gently on skin until the serum is completely absorbed.
The mask sheet drenched in a clear serum with Green Tea soothes skin irritated by environmental stressors, refreshing and revitalizing it. Formula is without added parabens.
Contains one single-use face mask.


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With the increase in age, creases start appearing on the face and it is considered as the first sign of aging. Increasing age is an important factor in skin wrinkles. Wrinkles are also common on those skin areas which are continuously exposed to sun radiations. The majority of people are very concerned about their skin. Concerning this, many solutions (creams, lotions, medicines, and natural products) have been presented for curing and preventing wrinkles. Kratom is a natural herbal product and is proving helpful in decreasing the skin-folds that form on the face or corners of the eyes and on other exposed areas with time.
Role of Rhamnose Sugar in Kratom
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