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I haven’t yet written about this therapy, largely because there is little evidence either way and no strong conclusion about efficacy in dogs is possible. Here are a few reviews elsewhere:
American Academy of Orthopedic Surgeons
Arthroscopy. 2016 Mar;32(3):495-505. doi: 10.1016/j.arthro.2015.08.005. Epub 2015 Oct 1.
Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review.
Meheux CJ1, McCulloch PC1, Lintner DM1, Varner KE1, Harris JD2.
To determine (1) whether platelet-rich plasma (PRP) injection significantly improves validated patient-reported outcomes in patients with symptomatic knee osteoarthritis (OA) at 6 and 12 months postinjection, (2) differences in outcomes between PRP and corticosteroid injections or viscosupplementation or placebo injections at 6 and 12 months postinjection, and (3) similarities and differences in outcomes based on the PRP formulations used in the analyzed studies.
PubMed, Cochrane Central Register of Controlled Trials, SCOPUS, and Sport Discus were searched for English-language, level I evidence, human in vivo studies on the treatment of symptomatic knee OA with intra-articular PRP compared with other options, with a minimum of 6 months of follow-up. A quality assessment of all articles was performed using the Modified Coleman Methodology Score (average, 83.3/100), and outcomes were analyzed using 2-proportion z-tests.
Six articles (739 patients, 817 knees, 39% males, mean age of 59.9 years, with 38 weeks average follow-up) were analyzed. All studies met minimal clinical important difference criteria and showed significant improvements in statistical and clinical outcomes, including pain, physical function, and stiffness, with PRP. All but one study showed significant differences in clinical outcomes between PRP and hyaluronic acid (HA) or PRP and placebo in pain and function. Average pretreatment Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were 52.36 and 52.05 for the PRP and HA groups, respectively (P = .420). Mean post-treatment WOMAC scores for PRP were significantly better than for HA at 3 to 6 months (28.5 and 43.4, respectively; P = .0008) and at 6 to 12 months (22.8 and 38.1, respectively; P = .0062). None of the included studies used corticosteroids.
In patients with symptomatic knee OA, PRP injection results in significant clinical improvements up to 12 months postinjection. Clinical outcomes and WOMAC scores are significantly better after PRP versus HA at 3 to 12 months postinjection. There is limited evidence for comparing leukocyte-rich versus leukocyte-poor PRP or PRP versus steroids in this study.
LEVEL OF EVIDENCE:
Level I, systematic review of Level I studies.
I tried to contact you before, but I don’t think it worked. I can’t find answers to these questions anywhere. If you could help me, that would be great, but if you don’t have time, could you at least let me know if you answer them on your blog? They are not really related, but here they are.
What is the difference between Plaqueoff for dogs and ordinary kelp granules? Does the bacteria on marine algae truly soften plaque, and if it does, is there a way to get the same effect without the iodine risks of kelp?
Assuming you can get your dog to drink it, does the Nyla bone water additive do anything other than freshen breath? Also, what is this denta-c referenced in the water additive, breath spray, and foaming tartar remover?
Can the probiotics in kefir survive your dog’s stomach acid? I know the probiotics and yogurt can survive in humans, but the pH levels are different.
If digestive enzymes help dogs with pancreatic insufficiency, why can’t they help dogs with food sensitivities?
Even though the myth about collagen isn’t true, are there any benefits to giving a dog gelatin?
If liquid fish oil causes reduced shedding in my dog, is it really helping, or just masking the symptoms of an allergy?
Do dogs need sunscreen?
Where did the slim doggy App get caloric information for various exercises like swimming, when the only research that has ever been done involves dogs that were running? If they are using human caloric information, which won’t work because dogs metabolize food differently and pull more energy from fat, can they get in trouble for fraudulent marketing? Because there is no research, how are you supposed to know how many calories your dog is burning through exercise if you want to maintain the weight through more than just guesswork?
Art turmeric and mushroom extract beneficial to dogs?
Could you please write about the Slimdoggy app. It will be worth your time. I promise. The developers claim to know how many calories your dog burned during exercise when I can only find one study about that. If they are using human values to extrapolate how many calories your dog burns, that is fraudulent marketing. So basically, when you go to the app, you can put what activities your dog did like swimming, walking, and playing, and it will tell you how many calories your dog supposedly burned. So if actual veterinarians don’t know that information, how do the developers of this app no? Do they have some secret research that they are not sharing with the veterinary community? It is only $2.99 on the App Store. It wouldn’t hurt to at least check it out. I cannot get a hold of the developer and expressed my concerns A review q. that it could be fraudulent, but have gotten no response. What if dog owners are using this app to manage their dogs weight, and the app is based on completely in accurate information? People need to know.
There are a lot of apps like this for humans (I use several for running and other exercise), and they are notoriously inaccurate and inconsistent with each other. There are so many factors involved in the energy consumption during exercise, including sex, age, size, conditioning, other individual factors, environmental conditions, nutrition, etc., that it is impossible to get an accurate result solely from the general type of activity and the duration. My various apps often contradict each other even when they use algorithms that account for some of these factors and when I include heart rate monitoring.
Such apps can give a very crude ballpark, and they are probably most useful in showing us how few calories we burn during most activities. In fact, exercise contributes very little to weight loss, though it has lots of other important health benefits.
It seems quite unlikely that this app could have very accurate output, though I haven’t seen any data about it. And unfortunately, if people are using it to try and guide feeding for weight loss, it’s going to be far less effective than simply reducing calories in a stepwise fashion and monitoring weight.
Hello, I recently adopted two wonderful cats as my first real pets in life. My parents are allergic to everything and it wasn’t until this January that I got tested for allergies and discovered I’m allergic to nothing! So I got me some furballs and am exploring the cat subculture. I recently attended http://www.catcampnyc.com/speakers/ and discovered Lil Bub http://lilbub.com/about who has an extraordinary combination of maladies. It’s unfortunate that her owner hasn’t really found effective treatments for her, and has been forced to explore bogus options from local “wizards”, old hippies in rural Indiana where they live. Of particular interest is their use of “Assisi Loop, which uses Pulsed Electromagnetic Field Therapy.” But really, there’s so much that Lil Bub has to offer a Skeptical Vet that a whole series could be done on her! Please?? I want her to both get real and effective treatment and not have her celebrity used to peddle pseudoscience. Thanks!!
Nzymes were a life saver for my dogs. One, brothers, got a horrible skin rash every summer. We spent so much money at the vet and nothing worked, until Nzymes. I put them on it and he never got that rash again. While I lost him in 2013 to an inoperable chest tumor..his brother will be 14 this year and is healthy as ever. I swear by Nzymes; snake oil it IS NOT!!
Why Anecdotes Can’t Be Trusted
stealing that meme ???
I have been trying to leave a comment, but it will not show up on the thread for some reason. The author of a breakfast boan recipe on paw culture got mad at me when I said I didn’t think her recipe was balanced enough to feed to dogs for breakfast every day. She said how could I know since I’m not an expert in the field. Therefore, I am asking you. Is the following recipe balanced? If so, I will apologize. If not, this person needs to be called out for giving harmful advice to thousands of people on the Internet. here is a link to the recipe.
I think there are several issues involved here. In terms of whether or not this recipe is “balanced,” that depends on how this is defined. In the US, the term “complete and balanced” is legally defined according to the standards set by AAFCO. This has to be demonstrated by laboratory analysis, with or without food trial testing, before the manufacturer can claim their food is complete and balanced.
However, it is ok to feed dogs items that are not complete and balanced so long as they are intended “for supplemental or intermittent feeding” and not the sole source of nutrition over the long term. Since the page you refer to seems to pretty clearly identify these as “treats” rather than a nutritionally complete diet, there would be no claim of “complete and balanced” and no need to prove this is true. It is pretty obvious from the recipe that these would not be nutritionally appropriate for sole, long-term feeding, but it also doesn’t look like anyone is claiming they are, so I don’t think that’s really a problem. Of course, the author is in the UK, and the legal issues are going to be different their.
More concerning is that the author identifies herself as a “canine nutritionist.” She apparently a has a certification from an online organization and runs a nutrition consulting business along with a homeopath. This raises some red flags since homoepathy is the quintessential quackery and rarely are you going to get legitimate scientific advice from somehow who takes it seriously. And an online certificate like this would not count as recognized credentials in nutrition in the US, which are limited to board-certified veterinary nutritionists, so one could make the argument that she is not technically an “expert” either, at least in the U.S. Again, I’m not sure whether the UK system recognizes such certification, and it isn’t clear what other education, if any, the author has in animal nutrition. Most of the information offered on the web site is reasonable and not obviously contrary to science-based nutrition, so I might give her the benefit of the doubt despite the unfortunate associate with homeopathy.
Ultimately, I don’t see any problem with these treats as just that, so long as the overall diet of the dog meets appropriate nutritional standards for the age and life-stage of the pet.
well, I currently feed my dog the grizzly salmon oil. It is a good product, but I was looking for something more concentrated so that I wouldn’t be adding so many calories to my dogs diet. I was using it for reducing shedding, and it was working, but it was also making my dog gain weight. anyways, I was looking into a new fish oil called Tara Max Pro. I was intrigued because it has 1325 mg of omega-3 per teaspoon, so I could feed my dog half as much as I feed of the grizzly. however, I don’t want to use as the Lester fish oil because it hasn’t been studied and dogs. so I asked the manufacture what form of their fish oil wasn’t and they said triglyceride form. I have the email from them. They did not say Re-esterified triglyceride. They said triglyceride. I asked them how their fish oil was so concentrated then because straight triglyceride fish oil would not be that concentrated. they then talked a lot about molecular distillation. Yeah, that is great, you can use that manufacturing process, but then if you leave the oil ethelester form, it’s not a triglyceride is it? further, they say nothing on their website about it being a re-esterified triglyceride. If you look at brands like Nordic naturals, they make that very clear. so what do you think? Is there anyway I can really figure this out without having to buy it and do the Styrofoam cup test? also, sorry for any miss spelling, but AutoCorrect keeps changing some of the words here.
cannot seem to get a response to any solutions you might have to Eosinophilic Stomatitis and the Cavalier King Charles Spaniel other than Prednizone for long term cure. Been to OSU vet and that is all they have. Did blood work. No infections. Eosinophils were normal. Not on gums or tongue, only pallet. Do not think due to dental plaque. Have done diet and not allergic to food.
I’m not sure how you’ve tried to reach out, but sorry if I missed a previous comment. Unfortunately, if there is no identifiable allergen as a trigger, then long-term immunosuppressive medication may be your only option. I did have a dog of my own once who had an eosinophilic granuloma on his palate. It resolved after a couple months on prednisone and after I weaned him off it never recurred. Sometimes there is a trigger we just can’t identify, so it’s always worth a try.
My vet recently recommended a new NSAID, Galliprant (brand name for grapiprant), for my 12-15 year old foster dog with pretty severe mobility issues from (likely) arthritis. When I first got him, I gave him some of my own dog’s Rimadyl for a couple of days until I could get him to the vet. Yes, I know, that’s a no-no, but the dosage was smaller than would be prescribed for the foster dog (75 mg vs 100 mg) and it was only a couple of days, and he was in so much pain he whined and/or yelped frequently. So I did it. Not sorry, because it helped a lot, and I so no digestive or intestinal upset from it. The Galliprant is supposed to be easier on the kidneys and liver – always an issue in older dogs – but it doesn’t seem to be helping quite as much as the Rimadyl did, even at a lower-than-optimal dose. Have you heard of any studies – or even the dreaded anecdotes – addressing the comparative effectiveness of the two NSAIDs?
Grapiprant is very new, and the only research is the clinical trials used for licensing. These do suggest good efficacy and safety, but further research will be needed to confirm this and identify variation in effect with different patients (species, condition, age, other drugs, etc). I am not aware of any studies directly comparing efficacy to the many NSAIDs currently in use.
As for anecdotes, there are many, and as always they are all over the map. This is a hot topic of discussion among vets now since it’s relatively new. You can find those who say it’s a miracle and better than anything they’ve tried as well as others who say it’s worthless, so the anecdotal reports are not really much use. Over time, as research accumulates and it is used in more patients, the answers to your questions should get clearer, but for now all we have is the preliminary research, which looks pretty good but which is only preliminary.
Okay, thank you for the reply. I suspected as much, but I figured you’d be more “plugged in” to the buzz about it, if any.
Thoughts on “allergy-specific immunotherapy” in dogs?
I read about this all the time (but have no direct experience myself). I can’t quite get past:
1) Lack of clear rationale on what supposed to do.
2) Lack of clear evidence suggesting it is effective.
3) Potential for serious adverse reaction (death from anaphylaxis).
Objectively, other than its apparent popularity, I can’t really see anything going for it.
Am I missing something or right to be skeptical?
Well, there is certainly a solid theoretical rationale for immunotherapy, extensive evidence supporting its effectiveness in humans, and some evidence supporting its effetciveness in dogs. there are a number of areas of uncertainty (specific protocol, dose of antigen, the difference if any between individualized immunotherapy based on IDST versus treatment with generic combinations of regional antigens, etc.), but there is definitely more support for it than you seem to suggest. Here are some references:
Loewenstein C, Mueller RS. A review of allergen-specific immunotherapy in human and veterinary medicine. Veterinary
Dermatology 2009; 20: 84–98.
Olivry T, Foster AP, Mueller RS et al. Interventions for atopic dermatitis in dogs: a systematic review of randomized controlled
trials. Veterinary Dermatology 2010; 21: 4–22.
Griffin CE, Hillier A. The ACVD task force on canine atopic dermatitis (XXIV): allergen-specific immunotherapy. Veterinary Immunology
and Immunopathology 2001; 81: 363–84.
We have recently published ‘No Way to Treat a Friend’ an informative and readable exposé of Complementary and Alternative Veterinary Medicine (CAVM) use in animals. Please visit the books webpage for further details: http://www.5mbooks.com/no-way-to-treat-a-friend-lifting-the-lid-on-complementary-and-alternative-veterinary-medicine.html. We thought this book may be of interest to you and your members.
Victoria Delahunty, are you in the know if this be available in the US at some point in time? (wish wish 🙂
Could you please do a post about homemade dog food? I am not talking about raw dog food exactly. I am concerned because of these recipes from Top Dog Tips, Which say they are supposed to be nutritionally balanced, but I do not think they are. With some of them, I wonder where is the B vitamins, vitamin A, vitamin E, and calcium. I have seen many websites like this. These people should get in trouble for lying and saying that there recipes are nutritionally balanced, vet approved, and so forth. Regardless of whether you Think people should make homemade dog food, these websites should not lie about the recipes for those people who want to do it because it will cause them to kill their dogs over time. And that balance overtime thing doesn’t fly because I was reading research that many of these recipes have the same nutritional deficiencies.
I have done several posts about homemade diets, which hopefully will be useful.
I’m not sure where to post this? I would like some opinions. My dog is being treated s/p cataract surgery, 5 months post-op.
We go to a teaching veterinary hospital/clinic. It is expensive.
Do I have the right to request no students, no interns participate in the follow-up appointments?
Thanks in advance
I suspect that if there were any studies published about raw feeding vs commercial diets in cats that you’d have written something about them here. I’ve been trying to find out what is actually known about this but am coming up with nothing. Anything in the works? Thanks.
There are a number of posts on the site about raw diets which have some info. I have a column coming out in January with the most updated references. The bottom line is there is no compelling evidence for benefits and very clear evidence of risk, so still not a great choice.
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