Evaluation of acupuncture for the treatment of pain associated with naturally-occurring osteoarthritis in dogs: a prospective, randomized, placebo-controlled, blinded clinical trial

Abstract

Background Acupuncture has been used as a treatment for pain associated with osteoarthritis (OA) for thousands of years; however, there is a lack of definitive evidence for this indication in humans or animals. The aim of this study was to prospectively evaluate the efficacy of acupuncture on lameness and clinical function in dogs affected by naturally-occurring OA using objective outcome measures. A total of 32 client-owned dogs completed this prospective, randomized, placebo-controlled, blinded clinical trial, using a cross-over design. Participants were assigned to receive placebo or acupuncture treatment once weekly for 4 weeks in random order with a two-week wash-out period in between treatment phases. Outcome measures included ground reaction forces (GRF), subjective orthopedic scoring (SOS), activity counts (AC), and owner-completed clinical metrology instruments (CMI; Canine Brief Pain Inventory [CBPI] and Client Specific Outcome Measures [CSOM]). For statistical comparison, baseline GRF, SOS, and CMI data were compared to data obtained 1 week after each treatment phase. Similarly, total weekly AC of the final week of each treatment phase were compared to the baseline week. Results Evidence of differences between baseline versus acupuncture and placebo treatments was not identified for the following outcome measures: GRF, AC, or SOS. However, evidence of differences was identified for some of the CMI scores, including the CSOM questionnaire which showed evidence of improvement when comparing baseline versus acupuncture (p = 0.0002) as well as between placebo versus acupuncture treatments (p = 0.035) but not between baseline versus placebo treatments (p = 0.221). Conclusions The applied acupuncture protocol did not show improvement in function when using objective outcome measures for OA in dogs; however, certain CMI measurements recorded some degree of treatment response.

Intra-Articular Injections of Allogeneic Mesenchymal Stromal Cells vs. High Molecular Weight Hyaluronic Acid in Dogs With Osteoarthritis: Exploratory Data From a Double-Blind, Randomized, Prospective Clinical Trial

“…There were no age or breed restrictions. Only patients with a score of ≥3 based on a previously described ( 27 ) Subjective Orthopedic Scoring system (SOS) grading for combined scores of “Lameness at walk” and “Lameness at trot” were included. Lameness secondary to OA could be bilateral, but one side had to be worse based on both subjective (SOS grading) and objective (%BWD) measurements.…”

“…Various outcome measures were scheduled to be collected at weeks 0, 4, 8, 12, 24, 36, and 48 of the trial (see Figure 1 ). Objective gait analysis was performed using a pressure sensitive walkway (Tekscan HR Walkway ™ 6 VersaTek System), and %BWD, defined as {[PVF (N) of the limb/total PVF (N) of all four limbs in one gait cycle] × 100}, was collected as previously described ( 27 ). Briefly, animals were evaluated at the walk or trot (based on their preference), but the velocity was kept consistent between time points.…”

Proposed Canadian Consensus Guidelines on Osteoarthritis Treatment Based on OA-COAST Stages 1–4

“…Photobiomodulation ( 64 ) and acupuncture ( 65 ) are considered appropriate modalities to support the multimodal therapy approach based on subjective outcome measures and clinical experience of some panelists; see detailed description in appendix.…”

“…Extensive human studies have shown a beneficial effect of acupuncture in the treatment of OA ( 177 ), but metanalyses are not always conclusive and the claimed small analgesic effect cannot be clearly distinguished from bias ( 178 ). Veterinary studies are not different ( 65 ), in parts due to the difficulties in pain assessment and the challenges of standardizing a treatment protocol. The differentiation of electroacupuncture vs. dry needle acupuncture is one of the questions that would be interesting to have answered.…”

Chronic Pain in Dogs and Cats: Is There Place for Dietary Intervention with Micro-Palmitoylethanolamide?

“…From a veterinary perspective, this represents a definitive recognition of animal pain and poses veterinary practitioners in an “algological position”, i.e., to play a proactive role in recognizing, assessing and managing animal pain. Indeed, many efforts have been made in this direction during the last decades and several European and US groups are moving toward the development of better protocols to detect [ 2 , 3 , 4 , 5 , 6 , 7 ], measure [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ] and treat [ 7 , 15 , 16 , 17 , 18 ] animal pain accordingly. The ever-increasing availability of well-designed pain scales for acute and chronic pain in dogs and cats [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ] and the Pain Management Guidelines [ 27 , 28 ] are good examples.…”