Alternative Intradermal Protocol for Osteoarthritis in Dogs

In the Literature

Alves JC, Santos A, Jorge P, Lafuente P. A multiple-session mesotherapy protocol for the management of hip osteoarthritis in police working dogs. Am J Vet Res. 2022;84(1):ajvr.22.08.0132. doi:10.2460/ajvr.22.08.0132 

The Research …

Osteoarthritis is a potentially debilitating disease that can significantly impact mobility, quality of life, and overall performance in dogs.¹ Treatment often includes administration of systemic medications, which can cause adverse effects and may be contraindicated due to comorbidities. Mesotherapy is an alternative treatment modality involving local administration of pharmaceuticals in microdeposits within the dermis. Benefits of this minimally invasive technique include rapid onset of action, prolonged local action, a drug-sparing effect, and low systemic concentration of the medications.^2,3

This prospective, randomized, double-blinded study included working dogs (n = 30) presented for treatment of hip osteoarthritis. Dogs were randomly assigned to either the treatment (mesotherapy) or control (meloxicam) group. Mesotherapy treatment comprised multiple intradermal injections of a combination of lidocaine, piroxicam, and thiocolchicoside centered medially and laterally around the hip joint on days 0, 7, 14, 21, 35, 49, and 63. Dogs in the control group were given oral meloxicam for 70 days. Response to treatment was assessed via multiple clinical metrology instruments (ie, Canine Brief Pain Inventory, Liverpool Osteoarthritis in Dogs, Canine Orthopedic Index) filled out by each dog’s trainer before treatment (T0) and 15, 30, 60, and 90 days after treatment.

Dogs in the mesotherapy group had significantly better pain severity scores, pain interference scores, and function scores compared with the control group at all times points after treatment was initiated, indicating that dogs treated with mesotherapy had less severe pain, daily activities less affected by pain, and improved function compared with dogs treated with meloxicam. Mesotherapy only led to significantly better gait scores compared with the control group on day 30. No adverse effects were noted in either group except vomiting in one dog in the mesotherapy group.

… The Takeaways

Key pearls to put into practice:

• Mesotherapy is a simple, minimally invasive, cost-effective, low-risk treatment option that can reduce pain levels and improve clinical scores in police working dogs with bilateral hip osteoarthritis. Mesotherapy can be performed by injecting small volumes (0.1 mL) of pharmaceuticals intradermally using 4-mm, 27-gauge needles. Injection sites should be ≈2 cm apart and centered over the area of interest, and the hair and skin should be cleansed prior to injection administration. This procedure can be performed by general clinicians, particularly because only mild restraint without sedation is required.

• Medications used in mesotherapy can include the combination of a local anesthetic, an NSAID or corticosteroid, and a muscle relaxant. Microdeposits of medications allow slow release into the underlying tissue, rapid onset of action, and prolonged local duration of action. Specific medications used in each protocol may differ depending on drug availability and patient needs.

• Adverse effects reported with mesotherapy are rare and include nausea, diarrhea, mild pain, edema, pruritus, and erythema. These effects should be monitored for following treatment.