Clinical Effect of PCSO-524® on 3 Osteoarthritic Cats Associated with Chronic Kidney Disease

Three cats suffering from chronic kidney disease were admitted to animal hospital.

The first cat showed sudden onset of right hindlimb pain without apparent cause. Bladder stone was found in the second cat while the third cat was admitted for nursing care. Caging was applied and fluid therapy were administered for the third cat. All 3 cats had never been diagnosed with arthritis prior to the admission.

X-ray examination showed symptoms of arthritis at hip and stifle joints. PCSO-524® was then administered daily for 60 days.

Pain evaluation using Feline Musculoskeletal Pain Index (FMPI), which is a reliable and effective method for pain evaluation in cats (Benito et al., 2013), showed that, after the treatment, chronic pain was decreased in all of the cats (Appendix 1). The cats’ behavior was nearly normal compared with the behavior before the treatment. Interaction between the cats and owners was improved as well.

By the end of the experiment, UP/C ratio was not altered and blood creatinine tended to decrease.

 

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Cat

A Persian male cat was diagnosed with right hip luxation and left hip injury. While waiting for surgical treatment, the cat was treated with NSAIDs to control pain and inflammation.

After the operation on the right femoral head (right FHNE), the cat received antibiotics and NSAIDs for 10 and 3 consecutive days, respectively. Two weeks after the operation, the lameness and pain of the right hip, as observed from palpation, still remained, but the cat began to bear partial weight.

PCSO-524® was then prescribed and the gait analysis was performed to measure the angle of joint movement.

The monitoring showed increased angle of joint movement and decreased lameness score. This was consistent with the owner report that described less hiding behavior of the cat and improved high jump performance and better quality of life.

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Five dogs with bilateral patellar luxation were presented at the Small Animal Hospital of Faculty of Veterinary Medicine, Chulalongkorn University.

Four dogs had grade 2, 3, and 4 medial patellar luxation in 3, 3, and 2 stifle joints, respectively. One dog had grade 3 bilateral lateral patellar luxation that had recurrent patellar luxation of left stifle joint for 6 months after previous surgery. All dogs had surgical treatment to re-align and stabilize extensor mechanism in the normal position.

The dogs received anti-inflammatory drug and PCSO-524® in combination with rehabilitation to restore normal limb function and muscle mass postoperatively. All dogs achieved good outcomes when compared with pre-operation. Range of motion was normal in all dogs and the patellae were in the normal position.

However, one stifle with previous reluxation and severe osteoarthritis had slightly crepitation when flexed and extended the stifle joint. Patellar luxation causes abnormal wear of the patella and trochlear ridges leading to lameness, muscle pain, and osteoarthritis.

The treatment focuses on stabilization of the stifle joint and restore limb function. Surgical treatment is recommended in most cases. Rehabilitation provides strengthen muscle, improves normal joint function, enhanceslimb function, and prevents complications.

Despite successful treatment for correcting patellar luxation, osteoarthritis remains occurrence in most cases.

Therefore, use of anti-inflammatory supplement such as PCSO-524® is important for long-term management with less side effect and safety for long-term use when compared with non-steroidal anti-inflammatory drugs.

 

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An intact male mixed breed dog aged 2 years engaged in a fight with several dogs resulting in disable of hind limbs and loss control of elimination. Physical and radiographic examination showed fracture and luxation of the 7th lumbar vertebrae. Spinal cord injury (SCI) was also found and the fracture was identified as the cause. The spinal cord trauma could occur since the incident and was left for more than 2 weeks.

Pedicle screw-rod fixation (PSRF) was operated to fix the vertebral column. After the second operation, it was suspected that there was remain of inflammatory cytokines that probably increased after the operation. Anti-inflammatory medication for prohibition of inflammatory cytokines synthesis was essential but its adverse effect must be concerned. The study therefore used holistic treatment including PSRF, non-steroidal drug and PCSO-524® anti-inflammatory extract, in conjunction with physical therapy.

Follow-up examination on neurological system, walking, and urinary system showed promising result. The neurological system was restored, and adverse effect of long-term use had not been found.

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A domestic short hair cat aged 11 years was taken to the hospital due to shaking and weakened hind legs. The cat could not perform high jump for 1 month.

Preliminary diagnosis included early stage of osteoarthritis of left hip and capsulitis.

Pain killers, NSAIDs and gabapentin, were administered but the response was not satisfied. Therefore, multimodal treatment program was initiated. Physical therapy using electrical stimulation and laser beam class 4 in conjunction with PCSO-524® were used. Measurement of joint movement angle (active range of motion; active ROM) in 2 dimensions using Kinovea program was conducted for follow up.

The study found increased active ROM and decreased lameness score after the treatment.

The owner described that the cat showed less isolation behavior and was able to perform vertical jump again. Overall quality of the cat’s life was improved.

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Cat

Male castrated Persian cat aged 12 years was injured at the rear body in an automobile accident causing paralysis of the hind limbs.

X-ray examination found luxation of both pelvic joints and osteoarthritis of hip joint. Nervous disorder of the hind limbs was diagnosed from the absence of the motor and deep pain sensory impulse. MRI examination found no spinal cord damage.

The treatment included electrical stimulation at the hind limb muscle in combination with long-term administration of PCSO-524® (Antinol®).

The hind limbs were functional normally at the end of the treatment and blood chemistry examination at 32 weeks after the treatment showed normal liver and kidney indicators.

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Male Yorkshire terrier dog aged 7 years weight 2.5 kg suffered from lameness of left Hind limb.

Examination found medial patellar luxation of grade 3 and chronic cranial cruciate ligament rupture.

PCSO-524® (Antinol®) 100 mg per day, double size of recommended dose for dogs weighed less than 20kg, was prescribed.

Examination of lameness score and pain on palpation showed improvement after PCSO-524® (Antinol®) treatment. Radiographic images taken before and after 45 days treatment with PCSO-524® (Antinol®) did not find progress of the lesion.

Hematological and biochemistry parameters after 45 days treatment with PCSO-524® (Antinol®) indicated that the medication was safe to use.

 

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Labrador retriever dog aged 7 months with history of right forelimb pain for 1 month was diagnosed as Medial Coronoid Disease (MCD) on both sides.

Radiographic and Computed Tomography (CT) examinations found subtrochlear sclerosis on left elbow. Arthrotomy was operated on the dog using subtotal coronoid ostectomy technique on the medial side of both elbows. Long-term treatment included physical rehabilitation, and nutrition therapy including administration of PCSO-524® and glucosamine/chondroitin sulfate. The dog was followed-up for 6 months for orthopedic examination and assessment by force plate gait analysis.

Two months after the operation, right forelimb could bear body weight, however left forelimb was still lame with lameness score of 1/4. Comparison of radiographic image showed that the left and right elbow was affected from moderate and mild osteoarthritis, respectively. Treatment success for MCD depends on early and accurate detection of the disease and appropriate treatment plan.

Multimodal plan consisting of surgical treatment, medication, nutrition therapy and physical rehabilitation, is proposed.

 

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Male Labrador Retriever dog aged 3 years was suffering from left hind limb pain.

Hematological parameters were normal. Radiographic image showed swollen left stifle joint and mild osteoarthritis. Cranial cruciate ligament rupture was diagnosed.

Firocoxib 5 mg/kg sid for 2 weeks and 2 capsules of ANTINOL ® bid for 1 month were prescribed.

Tibial Plateau Leveling Osteotomy (TPLO) was operated on the dog. Post operation care included Firocoxib 5 mg/kg sid for 2 weeks and 2 capsules of ANTINOL ® bid in combination with physical rehabilitation using laser stimulation and later exercise therapy was added. Clinical signs were improved as indicated by lameness score, muscle mass and range of motion.

Five months after the operation, the dog expressed signs of right hind limb pain and radiographic image showed swollen right stifle joint and mild osteoarthritis of left stifle joint. Partial tear of cranial cruciate ligament was diagnosed. The dog was treated for thrombocytopenia until recovered before Tibial Plateau Leveling Osteotomy (TPLO) was operated on the right knee 3 months later. Radiographic examination post operation showed increased inflammation of both stifle joints.

Surgical treatment was used in combination with medication which included NSAIDs during the first 2 weeks post operation, ANTINOL®, and physical rehabilitation in order to reduce pain and inflammation. The treatment gave satisfactory results. The dog was able to use its legs without lameness, muscle was stronger, stifle angle was better and general health was improved.

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Male Shih tzu dog aged 9 years and 1 month was diagnosed with limb paralysis after jumping 4 days prior to the hospital visit.

The dog showed weak response of forelimb reflex and severe neck pain. X-ray examination showed block vertebrae at C3 and C4.

Magnetic resonance imaging (MRI) examination found mild disc protrusion, compression on spinal cord and myelopathy at C4 and C5 with compression on the right dorsal lamina.

Prednisolone and gabapentin were prescribed to reduce inflammation and pain, respectively.

Follow-up after reduction of prednisolone showed that the dog fell more often while walking and slight neck pain was present. Prednisolone dosage was then increased and PCSO-524® was prescribed to reduce inflammation of the spinal cord. Later examination found that the dog could walk without falling, both forelimbs showed normal reflex, and signs of neck pain disappeared. Termination of prednisolone was then started without any recurrent clinical signs.

 

After continuous treatment with PCSO-524® for 6 weeks, the dog could walk normally, both forelimbs showed normal reflex, and the ALK level was nearly back to the level prior to the treatment.

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