DOGUpdate - RESEARCH INSIGHTS Supraspinatus Tendinopathy, Kennel Cough & Pain Sensitivity - Purina Pro Club
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DOG Update
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A NESTLÉ PURINA PUBLICATION DEDICATED TO DOG ENTHUSIASTS VOLUME 20 | SPRING 2022
RESEARCH INSIGHTS
Supraspinatus Tendinopathy, Kennel Cough & Pain Sensitivity
SPRING 2022
SUPRASPINATUS TENDINOPATHY,
KENNEL COUGH & PAIN
ARE FOCUS OF CANINE RESEARCH
Here is a look at recent research that EVALUATING STEM-CELL
is helping to advance care for dogs. THERAPY IN TREATING
One study is evaluating the best SUPRASPINATUS
regenerative medicine approach to TENDINOPATHY
treating a common shoulder injury One of the most common sporting
in dogs. Another is using an airway injuries in dogs is supraspinatus tend-
cell-culture model to study a novel inopathy — an injury akin to a rotator
treatment for kennel cough. Meanwhile, cuff tear in people. Lameness in a front
behaviorists are studying whether dog leg is the most common sign of a partial
breeds from Chihuahua to Great Dane or complete tear of the tendon support-
have different pain sensitivity levels. ing the supraspinatus muscle in the
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Dog Update
shoulder. Repetitive activities such as
agility, flyball, herding, and field trials
involving outstretched forelimbs, quick
turns, and jump-turn combinations put
a dog at risk by causing stress to the
shoulder muscle.
A challenging condition to diagnose,
supraspinatus tendinopathy may lead to
chronic lameness and pain due to the
tearing of the tendon fibers and resulting
inflammation. Untreated disease can
cause mineralization and calcification
of the tendon that ultimately reduces
function of the joint and surrounding
muscle tissue. Treatment with rest,
nonsteroidal anti-inflammatory drugs
(NSAIDs) and physical therapy do not
alleviate the condition long term. Surgery
for chronic cases involves removing the
calcification on the tendon.
Regenerative medicine using platelet-
rich plasma (PRP), adipose stem cells
(ASC) and stromal vascular fraction
(SVF) provides alternative therapies
for supraspinatus tendinopathy as well
as other joint diseases. An investigation
underway at The Ohio State University
in collaboration with Virginia-Maryland
College of Veterinary Medicine aims to
learn the most effective regenerative
medicine treatment for this type of
tendon injury in dogs. Funded by the
AKC Canine Health Foundation, the
research is considered a landmark
clinical trial as it is the first evidence-based
study looking at these novel treatments
for supraspinatus tendinopathy.
“We have found that PRP and stem-
cell therapies accelerate and promote
healing through tissue regeneration and
reduced scaring,” says lead investigator
Jennifer G. Barrett, DVM, PhD, DACVS,
DACVSMR, the Theodora Ayer Randolph performs the clinical assessment and
professor of equine surgery at Virginia- treatments, and Dr. Barrett provides the
Maryland College of Veterinary Medicine. regenerative therapies. For the stem-cell
“Dogs become comfortable, and those procedure, Dr. Kieves provides a half-
with partial tears in the supraspinatus inch cube of adipose (fat) tissue —
tendon tend to heal completely rather essentially the size of a sugar cube
than to completely tear the tendon as — and blood samples for extracting
often happens when dogs are not treated.” stem cells from dogs being treated for
Having followed dogs treated for this supraspinatus tendinopathy.
condition for many years retrospectively, Dogs are randomly assigned to one of
Dr. Barrett has begun a collaboration three treatment groups, each having
with Nina R. Kieves, DVM, DACVS, 20 dogs. The treatment groups are
DACVSMR, assistant professor of described below:
small-animal orthopedic surgery at • Stromal vascular fraction group, a
The Ohio State University. Dr. Kieves fast-turnaround method in which
3
SPRING 2022
roughly 10,000 stem cells are extract- enced canine kennel cough. A honking
ed from the adipose tissue and sound, strong cough, runny nose, leth-
quickly returned for treatment. argy, and loss of appetite are telltale
• Stem cell with PRP group in which 1 to signs of canine infectious respiratory
5 million stem cells are produced to disease (CIRD) complex caused by
aid therapy. The PRP, which contains various viral and bacterial pathogens.
“We have found that PRP growth factors that aid healing, is Easily spread through airborne droplets
extracted from a dog’s own blood. and direct contact with a contagious dog
and stem-cell therapies • Blind control group in which dogs or contaminated object, kennel cough
receive blood serum injections. This can quickly affect all dogs in a kennel
accelerate and promote group is eligible for regenerative or those living closely together. Most
medicine therapy following the com- dogs recover without treatment in 10
healing through tissue
pletion of their progress evaluation. to 14 days. Preventive vaccines are
regeneration and reduced “We hope that this research study will available for the Bordetella bronchi-
show which of two regenerative ther- septica bacterium, a common cause
scaring.” apies is best for treating this difficult of kennel cough with signs ranging from
injury in dogs,” Dr. Barrett says. “We mild upper-respiratory illness to severe
Jennifer G. Barrett, DVM, PhD, DACVS, are happy that all dogs treated in the bronchopneumonia, as well as some of
DACVSMR, the Theodora Ayer Randolph study will have access to stem-cell the viral causes. Antibiotic treatment
professor of equine surgery, Virginia- therapy at the conclusion of the trial may ease the clinical signs of infected
Maryland College of Veterinary Medicine if it proves to be most effective.” dogs with bacterial infections, but they
do not work for viral infections.
DEVELOPING A MODEL TO “While there are vaccines, they vary in
EVALUATE POTENTIAL NEW efficacy and sometimes fail to induce a
THERAPY FOR KENNEL sufficient immune response to slow or
COUGH stop infection,” says Gisela Soboll Hussey,
Owners who train their dogs in group DVM, PhD, associate professor of patho-
settings and participate in sports where biology and diagnostic investigation
there are lots of dogs have likely experi- at Michigan State University. “We are
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Dog Update
developing a canine airway cell-culture UNDERSTANDING
model to study the viral pathogens PERCEPTIONS ABOUT
that contribute to kennel cough and DOG BREEDS’ SENSITIVITY
to evaluate the efficacy of a modified TO PAIN
interferon lambda as a new therapy.” Theoretically, all dogs should have
Funded by Morris Animal Foundation, similar pain thresholds, but according
and the Office for Research and Graduate to over 90 percent of respondents, half of
Studies and the Department of Patho- which were veterinarians, of an online
biology and Diagnostic Investigation at survey, there are differences among
the College of Veterinary Medicine at dog breeds. Small-breed dogs, such
Michigan State University, the research as Chihuahua and Maltese, were rated
focuses on prevention strategies using as being less tolerant of pain than
interferons, which are proteins found some of their larger cohorts, such as
naturally in the body that have an Doberman Pinscher and Rottweiler.
important role in fighting infectious The survey findings, published “We are developing a
diseases. “We are hopeful this will provide March 17, 2020, in PLOS One, piqued
an emergency therapeutic or an adjunct interest by the investigators to continue canine airway cell-culture
therapy to use with vaccines to effec- studying beliefs about how dog breeds
tively reduce or control CIRD infections,” differ in their sensitivity to pain. The
model to study the viral
Dr. Hussey says.
Nine bacterial and viral pathogens are
AKC Canine Health Foundation is pathogens that contribute
funding the follow-up research underway
linked to CIRD. Besides Bordetella bron- at North Carolina State University. to kennel cough and to
chiseptica, they include the bacteriums, Lead investigators Margaret Gruen,
Mycoplasma cynos, found in dogs with DVM, MVPH, PhD, DACVB, assistant evaluate the efficacy of a
pneumonia, and Streptococcus equi. subsp. professor of behavioral medicine, and
zooepidemicus, which can cause mild Duncan Lascelles, BVSc, PhD, DECVS, modified interferon lambda
upper-respiratory disease and subclinical DACVS, professor of translational pain
infections. Neither has a vaccine treatment. research and management, are working as a new therapy.”
Viral pathogens that can cause CIRD to learn if perceptions about dog breeds’
and for which there are vaccine treat- varied pain thresholds are scientifically Gisela Soboll Hussey, DVM, PhD,
ments are: adenovirus-2, which can grounded. Rachel Cunningham, DVM, associate professor of pathobiology
cause a harsh cough and mild upper- a postdoctoral research associate who and diagnostic investigation, Michigan
respiratory signs; distemper virus, pro- is now a surgical intern at Michigan State State University
ducing respiratory signs combined with University, and Rachel Park, a graduate
lethargy, ocular discharge and fever; student in the Comparative Biomedical
influenza virus, ranging from subclinical Sciences program, conducted the study.
to severe disease with secondary bacte- “Our null hypothesis is that dogs
rial infection; and parainfluenza virus, regardless of their breed have similar
a highly contagious, upper-respiratory pain thresholds,” Dr. Gruen says. “The
illness. Viral pathogens for which there risk of ungrounded, preconceived beliefs
are no vaccine treatments are herpes- about dog breeds’ pain tolerance is that
virus-1, which causes subclinical or mild it could negatively impact clinical treat-
respiratory signs in adult dogs and ments and result in unnecessary pain for
severe disease in neonates, and respira- dogs believed to have low pain sensitivity.”
tory coronavirus, which ranges from sub- The current study comprises 147 dogs
clinical to mild upper-respiratory signs. representing 10 breeds. Included are
Long-term immune protection from Chihuahua, Maltese, Jack Russell Terrier,
viruses involves a strong interferon Boston Terrier, Golden Retriever, Labra-
defense. “By using interferons directly dor Retriever, Border Collie, Siberian
as a treatment, there may be an advan- Husky, American Staffordshire Terrier,
tage for immediate protection and also and German Shepherd Dog.
for stimulating better vaccine immunity,” “We screened dogs by performing
Dr. Soboll Hussey says. “Interferons may physical and orthopedic examinations
function like a broad-spectrum antiviral to ensure they are free of conditions
that helps protect dogs against multiple causing chronic pain, as this can change
viral groups. This is what we hope to their neurobiology and lower their pain
find out.” thresholds,” Dr. Gruen says. “Owners
5
SPRING 2022
completed the Canine Behavioral The results of the study are expected to
Assessment & Research Questionnaire be published in 2022. Not revealing their
(C-BARQ), which gathers information discoveries, Dr. Gruen says, “If there are
about their dogs’ personalities, breeding, breed differences in pain sensitivity,
overall health, and behavior.” future work will look at understanding
Quantitative sensory testing in which genetic associations and how to advance
the investigators examined the threshold understanding of effectively treating
at which dogs would withdraw their pain in a breed-specific manner.
paws from pressure or heat provided “If there are no differences among
scientific insights. “Imagine that I slowly breeds related to pain sensitivity, then
push my finger into you until you say, it is important to understand our percep-
‘Hey, stop doing that,’” explains Dr. tions of breed differences to ensure
Gruen. “That’s basically what we did dogs of every breed receive appropriate
but in a more sophisticated way.” pain management and to understand
Bonnie Giles of Chesterfield, South where these beliefs came from.”
Carolina, enrolled her two Golden The notion that human perceptions
Retrievers, “Willow,” 11 years old, and influence how dog breeds’ pain sen-
“Eve,” 8 years old, in the study. “It is sitivity is interpreted aligns with the
interesting that there may be different generalized group characterization
pain tolerances among dog breeds,” hypothesis summarized in the PLOS
Giles says. “Both my dogs are really One article on the survey results. “This
calm, as they are retired breeding hypothesis predicts that people will rate
moms for service dogs. Willow was dogs of different breeds as having differ-
a certified therapy dog. I’ve been ent pain sensitivity based on group traits
through C-sections (cesarean sec- like physical appearance and social
tions) and minor veterinary proce- behavior stereotypes,” says Dr. Gruen.
dures with them. In my opinion, they The online survey included 2,131
always seem unfazed by pain.” responses, of which 1,078 came from
COURTESY OF DR. MARGARET GRUEN/NORTH CAROLINA STATE UNIVERSITY
AVERAGE PAIN SENSITIVITY RATINGS BY THE GENERAL PUBLIC & VETERINARIANS
Respondents to an online survey rated pain sensitivity for pictures of dogs not described by their breed names, ranging from 0 for
not sensitive at all to 100 for most sensitive imaginable.
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Dog Update
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ed provided the article is used in its
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To request permission to reprint
this article, please contact the editor
at: Barbara.Fawver@purina.nestle.
com. Reprints should include the
veterinarians. Pictures of 28 dog breeds Husky, were rated among the most following attribution: Used with
representing a wide range of sizes, body sensitive to pain by veterinarians.” permission from the Dog Update,
and head shapes, and coat types/ When deciding on individual factors Nestlé Purina PetCare.
lengths were shown though breed believed to influence pain sensitivity and
names were not identified. Respon- response to pain in dogs, the general
dents rated their beliefs about the public was somewhat evenly distributed
pictured breeds’ pain sensitivity on among: a breed’s skin thickness, 41 per-
a scale from 0 to 100, with 0 being cent; environment raised, 40.1 percent;
not sensitive at all and 100 being the genetics, 39 percent; and temperament,
most sensitive imaginable. 35.6 percent. Most veterinarians attributed
“Ratings by the general public were pain sensitivity to temperament, 80.9
driven mostly by size, with smaller dogs percent; followed by genetics, 33.3
rated as more sensitive to pain and percent; environment, 29.5 percent;
larger, heavier dogs rated as less and skin thickness, 9.3 percent.
sensitive,” Dr. Gruen says. “Dogs on As to Giles’ belief that her Golden
breed-specific legislation lists that are Retrievers are largely unfazed by pain,
considered dangerous were generally the online survey reinforced her inter-
rated as less sensitive to pain. These pretation. The general public rated
findings support the prediction that Golden Retrievers around 51 percent
people rate pain sensitivity in dogs on the 1 to 100 scale, indicating the
differently for different breeds based breed has an average threshold for
on their appearance and common pain. Veterinarians rated Goldens
group stereotypes.” around 32 percent, giving the breed a
While dog size appeared to influence rating that reflects low sensitivity to pain.
veterinarians’ ratings, it was not as strong “Ultimately, we think there is strong
a relationship as seen with ratings by the evidence that people rate pain sensitiv-
general public. “Veterinarians tended ity based on breed-specific stereotypes
to rate the dogs based on commonly or phenotypic traits and dog breed
held beliefs about different dog breeds,” archetypes,” reflects Dr. Gruen. “Further
she says. “For example, two large breeds, investigation is needed to more fully
German Shepherd Dog and Siberian comprehend the impact.” n
7
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