ecallen, Author at PulseVet

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10/13/2025

Senior Dog Arthritis: 6 Non-Invasive Pain Relief Solutions for Veterinarians

Based on the webinar presented by Jane McNae BVSc, MANZCVS, MRCVS, PGCert, CCRT, Dip AnPhys, FHEA*

Osteoarthritis affects 80% of dogs by age eight, but surgery and heavy sedation aren’t your only options. Dr. Jane McNae, BVSc, MANZCVS, MRCVS, PGCert, CCRT, Dip AnPhys, FHEA, a veterinary physiotherapy specialist practicing in Hong Kong, shares her proven non-invasive approaches that help senior pets live comfortably without scalpels or sedation – and how they can transform your practice revenue.

“What I really want to show you today is how in general practice, you can utilize a lot of these non-invasive pain fixes to help your pets.” – Dr. McNae

Why Non-Invasive Arthritis Treatment Works Better Than Surgery

Unlike humans where osteoarthritis typically affects those over 55, our veterinary patients face a different timeline. According to the American Animal Hospital Association, one in five dogs suffers from osteoarthritis by just one year of age. By eight years old, that number jumps to 80% of dogs, with cats showing similarly high percentages.

Dr. McNae’s Hong Kong practice operates entirely without “sharp objects” – no scalpels, no sedation – proving that effective canine arthritis management doesn’t require invasive procedures while maintaining excellent client satisfaction and practice profitability.

Understanding Chronic Pain Management

The key to successful dog arthritis treatment lies in understanding the pain pathway. Pain signals travel from nociceptors (transduction) through the spinal cord (transmission and modulation) to the brain (perception).

The critical distinction: While acute pain serves a protective purpose, chronic osteoarthritis pain becomes maladaptive – offering no benefit while significantly impacting quality of life. This is where targeted, non-invasive veterinary pain management interventions make the biggest difference.

Case Study: Charlie's Transformation Through Non-Invasive Care

Charlie, a nine-year-old Labrador, presented with classic dog joint pain symptoms: slow walking, dragging his left hind foot, and obvious stiffness. Dr. McNae always videos pets walking, finding this helps clients clearly see the pain and understand the need for intervention.

Through her non-invasive pet pain management protocol, Charlie progressed from a stiff, uncomfortable dog to a happy, mobile senior enjoying his golden years.

See how non-invasive treatments can reduce your surgery referrals by 40%. Learn more about Assisi LOOP® therapy, which utilizes targeted Pulsed Electromagnetic Field (tPEMF™) technology to transform arthritis treatment outcomes.

Dr. McNae's Six-Modality Approach to Non-Invasive Pain Relief

Dr. McNae’s approach focuses on client education and empowerment while building practice revenue through effective, repeatable treatments. Her protocol combines six different modalities, with Zomedica’s innovative solutions serving as the cornerstone of her treatment success.

Treatment Comparison: Non-Invasive vs Traditional Approaches

Assisi LOOP® Targeted PEMF (tPEMF™) Therapy: The Gold Standard for Pet Pain Relief

The research-backed choice: Assisi Loop® targeted PEMF Therapy

Energy type: Pulsed electromagnetic field

How it works: Dr. McNae explains to clients that tPEMF “uses the body’s own natural anti-inflammatory processes.” The technology induces the nitric oxide cycle, producing anti-inflammatory molecules that promote circulation, reduce pain and swelling, and speed recovery.

Clinical Advantages Over Traditional Arthritis Treatment

Pain pathway targeting: The Assisi LOOP tPEMF therapy works on both transduction and transmission pain pathways by normalizing blood flow, increasing lymphatic flow, and reducing prostaglandins.

Evidence-based results: Dr. McNae emphasizes choosing research-backed solutions: “There’s a lot of different PEMF available on the market now. For me, it’s about where the research is and not all of those are research-based and not all of those are tested in animals.”

She specifically references Dr. Leilani Alvarez’s placebo-controlled trials at New York Animal Medical Center as pivotal in her decision to incorporate Assisi LOOP therapy, calling it “the gold standard in pulsed electromagnetic field.”

Implementation for Veterinary Practices

Treatment protocol for optimal results:

Frequency: 3-4 times daily initially, typically reducing to 2 times daily
Duration: 15 minutes per session
Placement: Under pet’s bedding or during relaxed periods
Safety: Completely safe alongside prescription medications

Client empowerment advantage: “The best thing I love about the Assisi LOOP and the Assisi LOOP® Lounge is that I can send it home with the client and it empowers them to make decisions about their pet,” Dr. McNae explains. This home-use capability helps clients feel actively involved in their pet’s care while generating ongoing practice revenue.

ROI for practices: Home-use devices create recurring revenue streams while improving client satisfaction and treatment compliance.

Real-World Assisi LOOP Therapy Success Stories

Dr. McNae’s diverse caseload demonstrates the versatility of Assisi LOOP tPEMF therapy:

Momo: Neurological condition with grade one disc pain managed with Assisi LOOP therapy
Chocolate: Post-surgical pain and swelling after femoral head and neck excision
Charlie: Brachial nerve plexus injury managed entirely via Zoom consultations
Chewy (Cockatoo): Neuropraxia and tissue swelling from tight leg ring
IBD Cat: Inflammatory bowel disease management using anti-inflammatory properties Momo (Cart Dog): Four-limb joint collapse in Cushing’s dog using Assisi LOOP Lounge three times daily

Advanced Shockwave Technology for Veterinary Pain Management

The breakthrough: PulseVet® Shock Wave Therapy

Energy type: Pressure waves of sound energy (similar to thunder following lightning)

How it works: Sound energy penetrates deeply through water-based body tissues, creating compressive and tensile forces at tissue interfaces. This triggers cellular release of cytokines and growth factors that stimulate healing.

Clinical Benefits That Exceed Traditional Methods

Measurable improvements:

Increased blood flow and reduced inflammation
Stimulates bone morphogenic proteins for bone healing
Improves tendon and ligament healing through fiber alignment
Provides temporary analgesic effect lasting days to weeks

Dr. McNae’s integration strategy: “I bought shockwave into the practice three years ago when the PulseVet® system from Zomedica finally was able to release an X-Trode™.” The X-Trode technology dissipates peak energy, making treatments comfortable without sedation.

Treatment Protocol for Maximum Effectiveness

Professional treatment schedule:

Sessions: 2-3 treatments, two weeks apart
Response time: Benefits appear within days
Duration: Longer-lasting effects than other therapies
Integration: Use after preparing tissues with other modalities

Applications generating strong client outcomes: Excellent for tendons, ligaments, muscles, post-TPLO procedures, shoulder tendinopathies, bone healing, and multimodal osteoarthritis therapy.

Why PulseVet Shock Wave Works Without Sedation

The revolutionary X-Trode technology makes PulseVet therapy unique in the shock wave market. By dissipating peak energy while maintaining therapeutic effectiveness, Dr. McNae can provide powerful treatments in her non-sedation practice.

“This was the most recent addition to my practice. I’ve been waiting a long time to incorporate shock wave,” Dr. McNae explains. The ability to deliver focused shock wave therapy without sedation opens treatment possibilities for pets who aren’t surgical candidates.

Ready to see PulseVet technology in action? Schedule a demonstration to discover how focused shock wave therapy takes pain control to the next level.

Complementary Modalities in Dr. McNae's Protocol

Dr. McNae’s comprehensive approach includes additional modalities that work synergistically with Assisi Loop therapy and PulseVet shock wave:

Therapeutic laser and photobiomodulation work excellently alongside tPEMF therapy, with Dr. McNae noting that combining laser with Assisi LOOP home therapy creates much faster response times.

TENS therapy provides an additional electrical stimulation option for cases where other modalities may have limitations, often used in combination with Assisi LOOP therapy.

Therapeutic ultrasound serves as another complementary option, particularly useful for recently clipped surgical patients when combined with the primary tPEMF and shock wave protocols.

The Future of Senior Pet Care Revenue

Dr. McNae’s practice demonstrates that effective osteoarthritis management doesn’t require invasive procedures while maintaining strong profitability. By combining evidence-based technologies like Assisi LOOP targeted PEMF therapy and PulseVet shock wave therapy with proper client education, veterinarians can offer comprehensive pain management that improves quality of life for senior pets and builds lasting client relationships.

“If I can give them something that doesn’t make it all controlled by the veterinarian, but helping to empower them, I think it buys their compliance and their better understanding of how we’re trying to help the pet.” – Dr. McNae

These non-invasive approaches offer hope for pets who aren’t surgical candidates and provide additional revenue streams for practices wanting to expand their pain management capabilities without major facility modifications.

Transform your arthritis treatment outcomes today. Discover Assisi Loop® success stories and clinical applications to see how the gold-standard tPEMF technology empowers clients while building practice revenue. Explore PulseVet shock wave research and applications to learn how innovative shockwave technology is revolutionizing veterinary pain management.

Ready to implement these proven protocols? Contact Zomedica’s veterinary specialists to develop a customized implementation plan for your practice, including training, support, and ROI projections.

*Dr. McNae was paid by Zomedica, Inc. for her webinar presentation. Watch the webinar here.

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10/13/2025

ecallenEquine Health

Shock Wave Therapy for Horses: Clinical Evidence for Lameness and Injury Treatment

Eighty-one percent of chronically lame horses unresponsive to conventional navicular treatment improved with shock wave therapy—and stayed sound beyond 12 months.

That’s Dr. McClure’s peer-reviewed research, one of several studies Dr. Kim Keeton shared in her recent Zomedica webinar on equine shock wave therapy using PulseVet technology. Dr. Keeton brings 20 years of equine veterinary experience and 15+ years using PulseVet shock wave technology to her integrative practice outside Athens, Georgia.

Why Electrohydraulic Technology Matters in Equine Shock Wave Therapy

PulseVet shock wave therapy deposits acoustic energy where tissue density changes—tendon-to-bone attachments, joint capsules, bone interfaces—triggering cytokine release that increases blood flow, stimulates neovascularization, and returns chronic conditions to an acute healing phase.

The focal zone comparison:

PulseVet’s electrohydraulic system: 140,000 mm³ tissue affected per pulse
Electromagnetic devices: 61,000 mm³
Piezoelectric (linear trode): 2,476 mm³

Translation: You cover more tissue with fewer pulses. That means 1-3 treatments every 2-3 weeks instead of 4-8 weekly sessions required by piezoelectric systems.

Dr. Keeton’s clinical pearl: “If you can see it on ultrasound, you can treat it with PulseVet shock wave therapy. Both use sound energy.”

Shock Wave Therapy for Navicular Syndrome: 81% Improvement Rate

Dr. McClure’s study enrolled chronically lame horses that had already failed conventional treatment. These weren’t mild cases.

Protocol: 2,000 pulses—1,000 through the frog, 1,000 through heel bulbs at E6 energy

Results: 81% showed decreased lameness with no relapse beyond 12 months.

Practice implication: You can offer clients a non-invasive alternative to neurectomy for one of equine medicine’s most frustrating chronic conditions. Zero complications reported across the study population.

Tendon Injuries: Quality Matters More Than Speed

A 10-horse study (each horse serving as its own control) with collagenase-induced tendonitis demonstrated what Dr. Keeton calls the critical factor: PulseVet shock wave therapy improved the quality of tendon repair, not just healing speed.

For performance horses, that quality differential determines reinjury risk. Suspensory ligament studies backed this up with measurable improvements in fiber alignment scores and echogenicity on ultrasound.

Standard protocol: Three treatments at 3-week intervals.

This makes equine shock wave therapy particularly valuable for sport horses where quality of repair determines return to competition.

Osteoarthritis: Better Than Adequan in Head-to-Head Study

The 2009 carpal OA study compared three groups: placebo, polysulfated glycosaminoglycans (standard Adequan protocol: 7 doses over 28 days), and PulseVet shock wave therapy.

Horses treated with PulseVet therapy showed significantly greater lameness improvement than both other groups.

An earlier hock study (74 horses with tarsometatarsal and distal intertarsal OA) delivered 80% improvement rates:

38% improved one lameness grade
42% improved two grades
Single treatment of 1,000-2,000 pulses

Back Pain: 89% Success Rate, 3-5 Day Return to Work

“Rest does not help a chronic sore back heal,” Dr. Keeton stated bluntly, drawing the parallel to veterinarians’ own back pain experience.

A 74-horse retrospective on PulseVet shock wave therapy for kissing spines and dorsal articular process inflammation showed 89% positive outcomes, with 60% maintaining improvement for 4-6 months.

Why this matters mid-season: Horses rest just 2 days post-treatment, return gradually over 3-5 days. Your performance horse clients don’t lose weeks of competition preparation.

Protocol: 2,000 pulses, single treatment using 35mm trode (midline for spinous processes) and 80mm trode (oblique angle for deeper dorsal articular processes)

Wounds: When Everything Else Fails

Dr. Keeton presented “Doodlebug,” a 5-year-old Quarter Horse mare with biopsy-confirmed habronemiasis persisting over one year despite multiple surgical debridements, ivermectin, moxidectin, corticosteroids, and topical treatments.

Dr. Hugh Worsham (Cumming, Georgia) administered two PulseVet shock wave treatments three days apart—just 500 pulses with the 5mm trode at lowest energy.

The summer sore completely healed.

Another case: a 6-month-old miniature horse with dog attack wounds, suspected clostridial infection, progressive necrosis, and copious purulent discharge. Three PulseVet shock wave treatments (days 5, 8, and 11 post-attack) produced substantial healing by day 32.

The mechanism behind equine shock wave therapy for wounds: Increased blood flow enhances antibiotic penetration. Biofilm disruption tackles resistant infections. Cytokine release (VEGF, TGF-β, PCNA) drives neovascularization.

Exercise-Induced Pulmonary Hemorrhage: Treating EIPH with Shock Wave Therapy

Dr. Beau Whitaker’s barrel racing study represents what Dr. Keeton called “one of the most exciting things coming out of PulseVet shock wave therapy”—treating exercise-induced pulmonary hemorrhage.

Study: 21 barrel racers (13 had bled at their last race, 9 competed on Lasix)

Results:

Average BAL score dropped 1.5 grades
76% improved one grade minimum
47% improved two grades

The insight: All horses had underlying equine asthma. The theory suggests asthma causes EIPH—PulseVet shock wave therapy addresses root pathology, not just symptoms.

Research on PulseVet therapy for equine asthma is being extended through a Clinical Registry for Equine Asthma.

Amplifying Your Orthobiologic Protocols

If you’re already using regenerative medicine in your equine practice, PulseVet shock wave therapy enhances results:

PRP study findings: Shock wave application increased growth factor expression by 33-46% (TGF-β) and 190-219% (PDGF-ββ) compared to controls.

Stem cell research: 500 pulses at low energy doesn’t damage mesenchymal stem cell proliferation or differentiation. Day-3 post-treatment showed increased ALPL indicating osteogenic effects potentially beneficial for fracture healing.

Treatment Duration Reality

Dr. Keeton addressed the chronic condition question directly: Effects typically last 4-12 months before potential retreatment. This makes PulseVet shock wave therapy appropriate for long-term management, not just acute intervention.

Why Major Equine Organizations Choose PulseVet Technology

PulseVet shock wave therapy serves as official ESWT for AQHA, NCHA, NRCHA, World Equestrian Center, US Equestrian, USEA, and USEF. That endorsement reflects 20 years of clinical research backing the technology.

Two decades of equine shock wave therapy research show consistent findings: no serious complications, measurable improvement rates across multiple conditions, and fewer treatments required than alternative systems.

*Dr. Keeton is an employee of Zomedica Inc. and was paid for her webinar presentation. Watch the webinar here.

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09/22/2025

ecallenCanine Health

Give Your Dog the Fastest Path to Recovery: How Shock Wave Therapy Transforms TPLO Healing

When your beloved companion needs TPLO surgery for their torn ACL, you want nothing more than to see them back on their feet, pain-free, and ready to play again. As a loving pet parent, you’re probably wondering what you can do to help them heal faster and get back to being themselves.

The answer might surprise you: Shock wave therapy could dramatically improve your dog’s recovery timeline and overall outcome.

What Makes Shock Wave Therapy a Game-Changer for TPLO Recovery?

Recent veterinary research has shown remarkable results when dogs receive shock wave therapy after TPLO surgery. Dogs treated with postoperative shock wave therapy showed faster weight-bearing recovery compared to those without this treatment. This means your furry friend could be walking more comfortably, sooner.

Here’s what shock wave therapy does for your dog’s healing:

Accelerated Bone Healing: Shock wave therapy has been shown to speed bone healing following TPLO surgery, helping the surgical site integrate faster and more effectively.

Improved Limb Function: Studies demonstrate increased limb use following treatment, meaning your dog will start using their leg normally much sooner than expected.

Reduced Inflammation: The therapy decreases patellar tendon inflammation, which translates to less pain and swelling during recovery.

Enhanced Tissue Repair: Shock wave therapy has been proven to decrease inflammation and increase fiber alignment in tendons and ligaments, promoting stronger, more flexible healing.

The Difference Between Dogs Who Receive Shock Wave Therapy vs. Those Who Don't

Imagine two dogs, both recovering from TPLO surgery:

Max received traditional post-surgical care only. He spent weeks favoring his leg, moving cautiously, and showing signs of discomfort during his recovery. His return to normal activity took the typical 12-16 weeks.

Bella received the same surgery plus shock wave therapy treatments. Within days, she was bearing more weight on her leg, showing less pain, and her bone healing progressed faster than expected. Her veterinarian was amazed at how quickly she returned to her playful self.

The research backs this up: dogs receiving shock wave therapy consistently show faster recovery times and better outcomes compared to those receiving standard care alone.

Why PulseVet®'s Hydro-Electric Technology Leads the Pack

Not all shock wave therapy is created equal. PulseVet devices utilize an electrohydraulic source to create the most effective shock waves for orthopedic and sports medicine indications. This makes a real difference in your dog’s treatment outcome.

Here’s what sets PulseVet shock wave apart:

Proven Technology: PulseVet technology is backed by twenty years of clinical research, giving you confidence in its effectiveness and safety.

Superior Wave Generation: The hydro-electric system creates more consistent, therapeutic shock waves compared to other technologies, ensuring your dog receives optimal treatment every session.

Veterinary-Specific Design: PulseVet shock wave treatments are customizable depending on species, age, and condition being treated, meaning your dog’s treatment is tailored specifically for their needs.

No Sedation Required: PulseVet shock wave technology needs no sedation, reducing stress and risk for your pet while making treatments more convenient.

The Treatment Experience: Stress-Free for You and Your Dog

Preparation of the treatment area is minimal – a technician will shave the dog’s hair in the affected area before treatment begins. Most dogs tolerate the therapy well, and many pet parents report seeing improvements after just a few sessions.

This treatment has been proven-effective and is an affordable treatment option covered by most veterinary insurance plans, making it accessible when your dog needs it most.

Your Dog's Future Starts Now

TPLO surgery already has a high success rate with over 90% of dogs regaining full function of the knee. Adding PulseVet shockwave therapy to their recovery plan could mean the difference between a good recovery and an exceptional one.

Don’t let your dog struggle through a longer, more painful recovery when proven technology can help them heal faster and more completely. Ask your veterinarian about incorporating PulseVet shock wave therapy into your dog’s TPLO recovery plan.

Your four-legged family member deserves every advantage in their journey back to health. With PulseVet shock wave therapy, you’re giving them exactly that – and giving yourself the peace of mind that comes from knowing you’ve done everything possible to help them heal.

To learn more about PulseVet shock wave therapy and find a veterinarian near you who offers this advanced treatment, visit pulsevet.zomedica.com.

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09/22/2025

ecallenCanine Health

Dog Back Pain Diagnosis: Recognizing Lumbosacral Disease in Veterinary Practice

Based on clinical insights from Dr. Matt Brunke, DVM, DACVS-SA, DACVSMR, CCRT in his webinar, “Empowering Vets to Treat More with Less Risk”*

When a client says “my dog doesn’t go upstairs anymore,” many veterinarians immediately think hip dysplasia. But what if the hips are normal? Lumbosacral disease—the canine equivalent of human sciatica—represents one of the most underdiagnosed conditions in veterinary practice.

The statistics are sobering: 27% of police dogs are retired or euthanized due to lumbosacral pathology, with average retirement dropping to 6.6 years instead of the target 8 years. For veterinary professionals managing canine spinal problems, recognizing this hidden epidemic is crucial for improving both diagnostic accuracy and patient outcomes.

The Effects of Dog Back Pain

Lumbosacral (LS) disease involves nerve root compression typically between L7-S1, affecting the most mechanically stressed segment of the canine spine. Unlike obvious conditions that present with dramatic lameness, dog back pain often manifests as subtle behavioral changes that owners attribute to “getting old.”

Critical Impact Statistics:

27% of working dogs retire early due to LS disease
Average retirement age: 6.6 years (target was 8 years)
Bilateral presentation: Common in chronic cases

Understanding the Disease Process

The L7-S1 junction bears the highest mechanical stress in the canine spine, making it vulnerable to multiple degenerative changes:

Intervertebral disc degeneration: L7-S1 most commonly affected
Ligamentum flavum hypertrophy: Spinal canal narrowing
Facet joint arthritis: Secondary instability
Foraminal stenosis: Nerve root compression

This multi-factorial pathology explains why how to diagnose back pain in dogs requires systematic evaluation rather than single diagnostic tests.

High-Risk Breeds and Critical Risk Factors

Primary Risk Breeds:

German Shepherds: Highest documented prevalence
Doberman Pinschers: Second highest risk
Rhodesian Ridgebacks: Significant predisposition
Great Danes: Large breed susceptibility
Labrador Retrievers: Working and sporting lines
Greyhounds: Despite excellent hip conformation

The Transitional Vertebrae Factor

Perhaps the most critical risk factor for dog back pain diagnosis is transitional vertebrae—a finding that dramatically alters prognosis.

Clinical Importance:

8x higher risk for developing degenerative LS disease
Earlier onset: 1-2 years sooner than normal anatomy
Increased hip dysplasia risk: Abnormal pelvic development

Types: Lumbarization, sacralization, or numerical variations (6 or 8 lumbar vertebrae instead of 7).

Diagnostic Examination Protocol

Dog back pain diagnosis requires moving beyond basic orthopedic assessment to include specific neurological tests that reveal lumbosacral pathology.

Pre-examination Essentials:

Rule out hip dysplasia and stifle pathology
Assess general neurological function
Document gait abnormalities

Essential Lumbosacral Tests

Test 1 – Tail Jack Maneuver
The most reliable screening test for lumbosacral disease

Technique:

Elevate tail to maximum comfortable extension
Hold for 10-15 seconds
Positive signs: Pain vocalization, attempts to move away, cessation of panting

Test 1 – Withdrawal Reflex Testing: The Game Changer
Often provides the earliest detectable sign of lumbosacral neuropathy

Critical Assessment:

Pinch digits of each pelvic limb
Normal response: Hip, stifle, AND hock flexion
LS neuropathy: Hip and stifle flex, hock remains extended
Early indicator: Often precedes obvious clinical signs

Test 3 – LS Space Palpation Technique:

Locate L7-S1 junction (epidural landmark)
Apply gentle downward pressure
Observe for pain response, muscle guarding, breathing changes

Neurological Grading
Grade 1: Mild – Intermittent signs, normal withdrawal reflexes
Grade 2: Moderate – Consistent signs, delayed hock flexion
Grade 3: Severe – Constant pain, absent hock flexion

Radiographic Assessment Essentials

Standard Views Required:

Lateral pelvis: L4 through coccygeal vertebrae
Ventrodorsal pelvis: Complete visualization
Extended views: T11 through sacrum for vertebral counting

Critical Findings:

Disc space narrowing (L7-S1 most common)
End plate sclerosis
Step lesions (ventral displacement of L7)
Osteophyte formation

Vertebral Counting Protocol:

Start at T11 (last rib-bearing vertebra)
Count to L7 (should be 7 lumbar vertebrae)
Document any variations—transitional vertebrae dramatically alter prognosis

Dog Back Pain Treatment Strategies

Most cases of canine spinal problems respond well to systematic conservative management.

Phase 1: Acute Pain Control (0-2 weeks)

Activity restriction: Leash walks only

NSAIDs: If appropriate candidate

Controlled environment: Prevent jumping, stairs

Weight management: Critical for long-term success

Phase 2: Rehabilitation (2-8 weeks)

Physical therapy: Controlled exercises
PulseVet® shock wave therapy: 2-3 treatments bi-weekly
Progressive activity increase: Gradual return to function

Pharmaceutical Options for Canine Lumbosacral Disease

First-Line Medications:

Carprofen/Meloxicam: Anti-inflammatory effects
Amantadine: NMDA receptor antagonist
Gabapentin: Neuropathic pain component

PulseVet® Shock Wave Technology

Treatment Protocol for LS Disease:

Frequency: 4-6 treatments, bi-weekly intervals
Energy levels: Low-moderate (0.10-0.20 mJ/mm²)
Target areas: Paravertebral muscles, LS junction

Clinical Benefits:

Non-invasive treatment option
Minimal Side effects
Suitable for poor anesthetic candidates
Can be combined with other therapies

Long-Term Management of Canine Lumbosacral Disease

Favorable Prognostic Factors: Early diagnosis, mild-moderate signs, owner compliance, normal vertebral anatomy

Poor Prognostic Factors: Severe neurological deficits, transitional vertebrae, poor compliance

Lifestyle Modifications for Dogs with Back Injuries

Essential Changes:

Permanent weight management
Avoid high-impact activities
Ramp access for elevated surfaces
Regular low-impact exercise

Monitoring Protocol:

Quarterly examinations initially
Annual radiographic assessment
Withdrawal reflex monitoring

Canine Lumbosacral Disease: Key Takeaways

✅ LS disease is underdiagnosed – consider in all hind limb lameness cases
✅ Withdrawal reflex testing is crucial – often the earliest detectable sign
✅ Always count vertebrae – transitional vertebrae significantly increase risk
✅ Conservative management works – 60-70% success rate with proper protocol
✅ Weight management is essential – critical for long-term success

Implementing systematic evaluation protocols for dog back pain diagnosis can dramatically improve diagnostic accuracy and patient outcomes while providing specialized care that keeps working dogs operational and family pets comfortable.

For comprehensive training in PulseVet shock wave therapy protocols, explore pulsevet.com

*Dr. Matt Brunke was paid by Zomedica, Inc. to provide this webinar

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09/22/2025

ecallenCanine Health

Dog Shoulder Injury Diagnosis: Veterinary Guide to Forelimb Lameness

Based on clinical insights from Dr. Matt Brunke, DVM, DACVS-SA, DACVSMR, CCRT in his webinar, “Empowering Vets to Treat More with Less Risk”*

Shoulder tendinopathy in dogs often goes undiagnosed in veterinary practice, overshadowed by more common elbow pathology. Yet for sporting dogs and working canines, canine shoulder injury represents a significant cause of performance decline and chronic pain. Unlike obvious conditions like cruciate ruptures, shoulder problems present with subtle lameness and normal elbow examinations that can leave practitioners searching for answers.

Dr. Matt Brunke emphasizes that while most thoracic limb lamenesses are elbow in origin, when the elbow examination is completely normal and forelimb dysfunction persists, the shoulder becomes the primary suspect. This is particularly true in dogs with repetitive activity histories—agility competitors, dedicated fetch players, and working dogs whose jobs demand repetitive shoulder motion.

Understanding Canine Shoulder Anatomy

The canine shoulder presents unique challenges that differentiate it from human shoulder pathology. Dogs lack functional clavicles, meaning the entire forelimb is suspended from the trunk by muscular attachments rather than bony connections. This arrangement places enormous stress on shoulder soft tissues.

The glenohumeral joint relies heavily on muscular support for stability, with primary motion occurring in flexion-extension planes rather than the multidirectional movement seen in humans. This biomechanical difference makes dogs particularly susceptible to overuse injuries from repetitive activities.

The Big Five Tendons: The supraspinatus serves as the primary lateral stabilizer and is most commonly injured in sporting dogs. The infraspinatus, responsible for external rotation, frequently suffers damage in agility dogs making sharp turns. The biceps brachii tendon, running through the bicipital groove, is prone to chronic tenosynovitis in fetch-playing dogs.

Canine Shoulder Pathophysiology Patterns

Shoulder tendinopathy typically develops through chronic repetitive stress rather than acute trauma. Dogs engaging in high-intensity, repetitive activities gradually develop microscopic tendon tears that create inflammation cycles. Unlike acute injuries that heal with rest, these chronic microtraumas often lead to tendon degeneration.

Secondary compensation mechanisms create challenging diagnostic scenarios. When dogs develop elbow arthritis, they alter gait mechanics to avoid pain, placing abnormal stress on shoulder structures. This secondary shoulder tendinopathy won’t resolve until the primary elbow problem is addressed.

Physical Examination Protocol

Visual Inspection and History Begin by observing natural movement patterns. Dogs with shoulder tendinopathy often show subtle weight shifts and altered foot positioning. The history typically reveals gradual onset rather than acute injury, with “warm-up lameness” being characteristic—dogs appear stiff initially but improve with activity.

Complete Scapular Evaluation Start by locating the scapular spine, which should form a straight line from dorsal to ventral. Any deviation suggests fracture or deformity requiring radiographs. Palpate the entire scapular body systematically, assessing supraspinatus and infraspinatus muscle bellies for atrophy or asymmetry.

Critical Safety Point: If the scapular spine isn’t straight or painful, radiographs are mandatory to rule out osteosarcoma or fractures.

The Gold Standard: Biceps Stretch Test

This two-phase test represents the most reliable functional assessment for shoulder tendinopathy:

Phase 1 – Shoulder Flexion: Flex the shoulder to 90 degrees while maintaining neutral elbow position. This tests supraspinatus and infraspinatus tendons. Positive signs include pain response or muscle guarding.

Phase 2 – Elbow Extension: Extend the elbow while maintaining shoulder flexion to engage the biceps tendon. Dogs with biceps tendinopathy show clear pain responses. In severe cases with complete rupture, you may observe “loss of end feel” where the radius and ulna can be positioned parallel to the spine.

Safety Considerations: Avoid direct biceps tendon palpation due to bite risk. The medial insertion lies close to the dog’s face, and painful responses can be defensive. Functional testing provides better information without safety concerns.

Diagnostic Imaging Strategy

Sedated orthogonal radiographs remain the foundation of shoulder diagnosis, primarily to rule out serious conditions rather than directly visualize tendon pathology. Standard views include lateral and caudocranial projections with proper positioning being critical for interpretation.

Key Radiographic Patterns:

Biceps tenosynovitis: Mineralized bodies along the bicipital groove with osteophytes at the supraglenoid tubercle
Shoulder arthritis: Caudal humeral head osteophytes and corresponding glenoid changes
Osteosarcoma: Moth-eaten lytic lesions requiring immediate attention

Quality positioning is essential—small changes dramatically alter joint appearance. Veterinary radiologist review provides objective interpretation and catches subtle abnormalities.

Advanced Imaging Options

Musculoskeletal Ultrasound offers dynamic tendon assessment and cost-effective evaluation of fiber architecture. However, it requires significant training and experience for accurate interpretation. The learning curve is steep, but practices investing in training can achieve excellent diagnostic value.

CT and MRI provide the highest soft tissue detail but require anesthesia and may not be readily available. These are typically reserved for surgical planning or unclear diagnoses after thorough clinical evaluation.

FAQ: Shoulder Tendinopathy Diagnosis

How do I differentiate shoulder pain from elbow pain?
Key differences include pain location during manipulation, range of motion patterns, and radiographic findings. Shoulder issues show pain on shoulder flexion/extension with normal elbow ROM, while elbow problems demonstrate the opposite pattern. Both conditions can coexist in chronic cases.

What breeds are predisposed to shoulder tendinopathy?
High-risk breeds include Border Collies (agility activities), Labrador Retrievers (fetch, swimming), German Shepherds (working activities), and Golden Retrievers (sporting activities). Any dog with repetitive activity exposure can develop these conditions.

When should I refer to a specialist?
Referral indications include suspected complete tendon rupture, failed conservative management after 6-8 weeks, concurrent neurological signs, or need for advanced imaging and arthroscopy.

How reliable is the biceps stretch test?
The biceps stretch test has high sensitivity for biceps tendinopathy when performed correctly. False positives are rare, though concurrent elbow pathology can complicate interpretation. Proper technique is essential for accurate results.

Can shoulder tendinopathy be bilateral?
Yes, bilateral presentation occurs in approximately 20-30% of cases, especially in working dogs with repetitive activities. Always examine both shoulders systematically, even when lameness appears unilateral.

Treatment Integration

Treatment success requires understanding that shoulder tendinopathy represents chronic inflammatory conditions needing comprehensive management rather than quick fixes.

Initial Phase (0-2 weeks): Focus on controlling inflammation through rest, activity restriction, and appropriate NSAIDs. Cold therapy provides additional anti-inflammatory benefits during this acute management period.

Rehabilitation Phase (2-8 weeks): Controlled exercise progression, physical therapy protocols, and PulseVet® shock wave therapy become crucial. The 3-5 weekly shockwave treatments target cellular-level inflammation while promoting tissue healing and proper fiber alignment.

Multimodal Approach Benefits

Combining pharmaceutical management (NSAIDs, amantadine) with non-pharmaceutical modalities like PulseVet shock wave technology provides synergistic effects. This approach addresses multiple aspects of the inflammatory cascade while promoting natural healing mechanisms.

Prognosis Factors: Favorable outcomes depend on early diagnosis, acute versus chronic presentation, owner compliance with activity restrictions, and absence of concurrent elbow pathology. Most acute cases resolve in 4-8 weeks with proper management, while chronic cases may require 8-16 weeks and ongoing maintenance.

Key Takeaways

✅ Shoulder tendinopathy often mimics elbow disease – systematic examination is essential
✅ Biceps stretch test is the gold standard for functional assessment
✅ Always palpate the entire scapula – rule out fractures and neoplasia
✅ Radiographs are essential for differential diagnosis
✅ Early intervention improves outcomes – don’t wait for severe lameness

Implementing systematic shoulder examination protocols improves diagnostic accuracy and patient outcomes while providing valuable specialized services for your veterinary practice. For advanced training in PulseVet shock wave therapy protocols, visit pulsevet.com

* Dr. Matthew Brunke was paid by Zomedica, Inc. to provide the webinar.

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09/22/2025

ecallenCanine Health

Veterinary Rehabilitation Equipment: Shock Wave & PEMF Therapy for Senior Dogs

Veterinary rehabilitation equipment has become essential for practices treating the growing population of senior dogs. With canine osteoarthritis affecting at least one in four dogs and functional mobility decline representing a primary euthanasia factor, practices need proven treatment solutions that deliver measurable outcomes while generating sustainable revenue. The PulseVet® shock wave system and Assisi LOOP® targeted PEMF (tPEMF™) devices offer evidence-based technologies that transform geriatric care capabilities and practice profitability.

The Growing Market for Veterinary Rehabilitation Equipment

Senior Dog Population Trends

The aging canine population presents significant opportunities for veterinary practices willing to invest in advanced care capabilities. Geriatric dogs face a complex interplay of conditions requiring specialized treatment approaches:

Primary Conditions Driving Equipment Demand:

Osteoarthritis: Affects at least one in four dogs, likely much higher

Neurologic diseases: Intervertebral disc disease, degenerative myelopathy

Mobility decline: Sarcopenia, obesity, and sedentary lifestyle complications

Chronic pain management: Multi-modal treatment requirements

Market Reality: Practices without rehabilitation capabilities often refer these high-value cases to specialty centers, losing significant revenue opportunities.

Revenue Impact of Rehabilitation Services

Practice Differentiation Benefits:

Premium pricing for advanced care services

Increased client retention through comprehensive treatment

Referral generation from improved patient outcomes

Competitive advantage in aging pet population market

Client Willingness to Pay: Pet owners consistently invest in quality-of-life improvements for senior pets, making rehabilitation services highly profitable when properly positioned.

PulseVet Shock Wave System: Evidence-Based Osteoarthritis Treatment

Why Shock Wave Therapy for Veterinary Practice

The PulseVet shock wave system represents the most researched and clinically validated modality for canine osteoarthritis treatment. With multiple published studies demonstrating efficacy, shockwave therapy offers practices a proven revenue generator with measurable patient outcomes.

Technology Advantages:

Focused high-velocity soundwaves with precise energy delivery
Multiple biological effects: Neovascularization, tissue regeneration, pain reduction
Proven mechanisms: Affects nitric oxide, protects chondrocytes, recruits stem cells
Documented outcomes: Improved weight-bearing, mobility, and pain scores

Clinical Applications and Treatment Protocols

Primary Indications for PulseVet Therapy:

Hip osteoarthritis: Comprehensive pain and mobility improvement
Elbow osteoarthritis: Targeted joint-specific protocols
Shoulder tendinopathy: Soft tissue healing enhancement
Lumbosacral disease: Pain reduction and functional improvement
Cranial cruciate ligament injuries: Post-surgical rehabilitation support

Treatment Protocol Examples:

Standard osteoarthritis: 3-6 treatments, weekly intervals
Lumbosacral pain: Protocol showing 60% CBPI improvement
Progressive improvement: Continued benefits at 14, 28, and 60-day assessments

Assisi Loop PEMF Device: At-Home Treatment Solution

Market Advantage of Targeted PEMF Therapy

The Assisi LOOP tPEMF devices address a critical gap in veterinary rehabilitation: consistent at-home treatment for mobility-impaired patients. This solution provides practices with additional revenue streams while solving client compliance challenges.

Technology Benefits:

Pulse electromagnetic field therapy affects inflammatory cascades
Nitric oxide modulation provides measurable anti-inflammatory effects
Portable design enables daily home treatment
Client convenience reduces transportation barriers for senior pets

Clinical Applications

Target Patient Population:

Severe mobility limitations: Patients with transportation challenges
Chronic conditions: Long-term inflammatory management needs
Post-surgical care: Extended rehabilitation requirements
Client preference: Owners seeking at-home treatment options

Practice Differentiation:

Comprehensive care offering: In-clinic and at-home solutions
Client education opportunities: Demonstrate commitment to advanced care
Reduced clinic burden: Fewer frequent visits for chronic patients
Enhanced outcomes: Consistent daily treatment improves results

Equipment Features and Benefits

PulseVet Shock Wave System Capabilities

Assisi Loop PEMF Device Advantages

Frequently Asked Questions About Veterinary Rehabilitation Equipment

What is the typical ROI timeline for rehabilitation equipment investment?

Most practices see equipment ROI within 12-18 months with proper case volume. The PulseVet shock wave system typically pays for itself with 50-100 treatment sessions, achievable within the first year for active practices.

How much training is required for veterinary staff to operate rehabilitation equipment?

The PulseVet shock wave system requires 8-16 hours of comprehensive training, while Assisi Loop PEMF device instruction takes 2-4 hours. Zomedica provides complete training programs and ongoing support.

What are the space requirements for rehabilitation equipment in general practice?

The PulseVet shock wave system requires a dedicated treatment room (8×10 feet minimum), while Assisi Loop devices require minimal storage space. Both integrate easily into existing practice layouts.

Success Stories and Practice Transformations

Small Animal Practice Case Study:

Practice size: 2-doctor general practice
Implementation: PulseVet shockwave system and Assisi Loop devices
Results after 12 months:
- 40% increase in geriatric case retention
- $8,000 monthly revenue from rehabilitation services
- 25% improvement in client satisfaction scores
- 15% growth in senior pet wellness visits

Multi-Doctor Practice Results:

Practice profile: 4-doctor mixed animal practice
Equipment investment: Complete rehabilitation equipment suite
18-month outcomes:
- $25,000 monthly rehabilitation revenue
- 60% reduction in geriatric case referrals
- 30% increase in new client acquisition
- Regional reputation as geriatric care specialist

Client Satisfaction and Retention Benefits

Outcome Measurements:

Treatment success rates: 60-80% improvement in mobility assessments
Client compliance: 90%+ completion rates for prescribed protocols
Referral generation: 3:1 ratio of new clients from existing client referrals
Practice differentiation: 85% of clients report choosing practice for advanced care

Long-term Practice Benefits:

Revenue stability: Recurring treatment generates predictable income
Team satisfaction: Advanced capabilities improve job satisfaction
Professional growth: Continuing education and specialization opportunities
Market leadership: Recognition as innovative practice in community

Taking Action: Transform Your Practice with Rehabilitation Technology

Why Choose Zomedica’s Technology? Here are Some Proven Technology Advantages:

✓ PulseVet shockwave system:
Extensively researched with multiple canine studies
✓ Assisi Loop PEMF devices:
Convenient at-home treatment solutions
✓ Comprehensive training:
Complete staff education and certification programs
✓ Ongoing support:
Clinical protocol development and technical assistance
✓ Practice growth:
Revenue enhancement through advanced care capabilities
✓ Competitive advantage:
Cutting-edge technology differentiates your practice
✓ Measurable outcomes:
Objective assessment tools and documentation support

Comprehensive Practice Support and Resources

Discover how Zomedica’s rehabilitation equipment solutions can transform your practice revenue and patient outcomes. Our veterinary technology specialists understand the business and clinical challenges of implementing advanced care services.

Visit zomedica.com to explore our complete rehabilitation equipment solutions and discover how the PulseVet sho ckwave system and Assisi Loop PEMF devices can generate sustainable revenue while delivering exceptional patient care.

The future of veterinary practice profitability lies in advanced care capabilities—join successful practices already achieving measurable results with Zomedica technology.

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89ae91deccf8acaf843b0c1a07589add586e700d

08/08/2025

ecallenEquine Health

Groundbreaking Use of Shock Wave Therapy for Equine Pulmonary Conditions

Electrohydraulic shock wave therapy has long been a cornerstone of treating equine soft tissue injuries and managing chronic pain. Now a recent breakthrough may change how veterinarians approach complex respiratory issues in performance horses. Thanks to the pioneering work of Dr. Beau Whitaker, this established modality is now being explored for its potential in managing Exercise Induced Pulmonary Hemorrhage (EIPH) and Equine Asthma.

The Evolution of Shock wave Therapy in Horses

Shock wave therapy isn’t new to the equine world. For over 20 years, it has been a standard of care for soft tissue rehabilitation and pain management. Backed by a strong foundation of clinical research, electrohydraulic shock wave therapy has helped countless horses return to peak performance.

Challenging the Old Norms

Historically, shock wave therapy was considered unsuitable for air-filled structures like the lungs. However, that narrative began to shift in 2022–2023, when Dr. Whitaker launched a study investigating its use in treating EIPH.

Supported by an unpublished study from the University of Cordoba and clinical applications by Dr. Martin Allen on Standardbred racetracks, Dr. Whitaker’s research challenged longstanding assumptions about safety and efficacy in pulmonary applications.

Investigating Shock Wave for EIPH Treatment

Dr. Whitaker’s study focused on barrel racing horses with recent EIPH episodes. The criteria included:

Normal upper airway anatomy
Bronchoalveolar lavage (BAL) specimens confirming a bleed within the last 48 hours

These horses received targeted shock wave therapy to the lungs, and outcomes were measured 2–4 weeks post-treatment, after their next competitive run.

Results That Rival Traditional Treatment

The results were striking:

76% of horses improved by at least 1 grade on their BAL score
47% improved by 2 or more grades

By comparison, only 68% of horses treated with Lasix (furosemide), the traditional pharmacologic intervention for EIPH, showed a similar improvement of 1 grade or more.

These results suggest that shock wave therapy may offer a promising, drug-free alternative or complement to Lasix in EIPH management.

Uncovering a Link Between EIPH and Asthma

In reviewing the cases, Dr. Whitaker noted a surprising trend: every horse in the study also had concurrent asthma. This discovery raised an important question — was the improvement due to the treatment of EIPH, or was shock wave therapy addressing the underlying asthma instead?

New Study: Shock Wave Therapy for Equine Asthma

Prompted by this revelation, Dr. Whitaker launched a follow-up study focused exclusively on horses with mild to moderate asthma. These are typically horses whose owners report coughing during rest and exercise.

Promising Early Results

While data collection is ongoing, early outcomes include:

55% of horses showed 100% symptom resolution within 2 weeks
67% experienced at least 90% improvement

Dr. Whitaker has a paper currently in development to publish these findings.

New Study: Shock Wave Therapy for Equine Asthma

To support clinical investigation of this innovative approach, Zomedica has sponsored an Equine Asthma Clinical Registry. This global database allows veterinarians to track shock wave treatment results in horses with asthma, contributing to a growing body of evidence and accelerating understanding within the veterinary community.

Final Thoughts

The potential for shock wave therapy to treat respiratory issues in performance horses is an exciting frontier in equine medicine. With results showing comparable — and in some cases superior — outcomes to traditional treatments like Lasix, this could represent a paradigm shift in how we manage EIPH and asthma in horses.

As studies expand and the Equine Asthma Clinical Registry gains traction, the equine veterinary community is poised to explore a new and promising era of non-invasive pulmonary treatment.

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04/07/2025

ecallenCanine Health

Non-Surgical Management of Sporting Dog Injuries: Effective Treatment Options

Sporting dogs, from agility competitors to flyball athletes, endure immense physical strain that can lead to frequent injuries. These active canine athletes require specialized care to ensure swift recovery and sustained performance. Dr. Ariel Markley’s recent webinar, Non-Surgical Management of Sporting Dog Injuries: Effective Treatment Options, provided veterinary professionals with an in-depth look at cutting-edge therapies that can help sporting dogs recover without surgery. In this blog, we’ll explore the key takeaways from Dr. Markley’s presentation, including advanced treatments like Zomedica’s PulseVet® shock wave therapy and other non-surgical options.

Common Sporting Dog Injuries

Understanding the injuries common to sporting dogs is the foundation for effective treatment. High-impact activities often result in repetitive stress and acute injuries, with the following being most prevalent:

Agility dog injuries: Shoulder and stifle injuries caused by sharp turns and jumps.
Flyball injuries: Iliopsoas injuries and soft tissue strains from explosive running and sudden stops.
Canine shoulder injuries: Supraspinatus and bicep tendinopathies from repeated jumping or landing.
Carpal ligament injuries: Impact-related injuries from navigating uneven surfaces.
Iliopsoas injuries: Strains due to overuse or sudden deceleration during sprints.

Treatment success hinges on tailored rehabilitation plans that incorporate advanced non-surgical therapies. These options offer effective healing while minimizing downtime.

Non-Surgical Treatment Options for Sporting Dog Injuries

1. Shockwave Therapy
Extracorporeal shockwave therapy (ESWT) is one of the most effective first-line treatments for soft tissue injuries in sporting dogs. It uses high-energy sound waves to accelerate healing and improve tissue quality.

Mechanism of Action:
Targets tendons, ligaments, and muscles to enhance blood flow and stimulate collagen production.

Promotes tissue repair while reducing fibrous tissue formation.
Encourages a faster return to athletic performance.

Studies highlight significant improvements in lameness and ultrasound findings following shockwave therapy, particularly in shoulder injuries such as supraspinatus tendinopathy. Zomedica’s PulseVet® shock wave therapy is a proven option in this domain, offering reliability and effectiveness for veterinary professionals.

2. PRP Therapy

Platelet-rich plasma (PRP) therapy has gained traction for treating chronic soft tissue injuries in sporting dogs. This regenerative technique leverages the dog’s own blood to stimulate healing.

Usage and Benefits:

Often used in conjunction with shockwave therapy for enhanced recovery.
Improves tissue quality, reducing the risk of re-injury.
Provides significant relief from chronic injuries like bicep tendinopathy and carpal ligament injuries.

PRP therapy, when administered with ultrasound guidance, ensures precise delivery to the affected area, maximizing its effectiveness.

3. Photobiomodulation Therapy (Laser Therapy)

Laser therapy offers a non-invasive way to accelerate tissue repair and reduce inflammation using infrared light. Although canine-specific research is still emerging, studies on other species have shown promise.

Key Benefits:

Enhances collagen organization and reduces inflammatory markers.
Maintains flexibility and prevents stiffness during recovery.
Supports long-term healing when combined with other therapies.

This modality is a valuable tool for veterinarians looking to complement shockwave and PRP therapies.

Importance of Rehabilitation and Injury Prevention

A structured rehabilitation plan is critical to a sporting dog’s recovery and long-term performance. These plans focus on rebuilding muscle strength, improving balance, and restoring neuromuscular control.

Rehabilitation Timeline:

Initial rehabilitation (8–16 weeks): Controlled exercises like weight shifting, posture work, and balance drills.
Sport-specific retraining (8–12 weeks): Gradual reintroduction to agility, flyball, or other athletic activities.
Conditioning maintenance (ongoing): Exercises to prevent future injuries and maintain peak performance.

Owners should set realistic expectations, as soft tissue injuries can take 6–12 months for full recovery. Consistent home-based exercises and regular veterinary follow-ups are vital to successful outcomes.

Applying Injury Management in Your Practice

Offering clients comprehensive solutions for managing soft tissue injuries in their sporting dogs is of paramount importance. Advanced therapies like shockwave, PRP, and laser treatments enable faster recovery and safer returns to competition, while structured rehabilitation plans help prevent re-injury.

Sporting dogs require advanced care to meet the demands of their athletic lives. With therapies like shock wave, PRP, and laser treatment combined with structured rehabilitation, veterinary professionals can help their canine patients recover faster, stay healthy, and achieve their full potential.

To learn more about PulseVet® shock wave therapy, visit Zomedica’s website or contact your local representative.

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09/02/2024

ecallenTechnology & Innovation

How Your Shock Waves Are Generated – It Makes a Difference!

By T.J. Barclay, DVM

Extracorporeal shock wave therapy (ESWT) is a common treatment modality for a variety of orthopedic conditions in both animals and humans. In veterinary medicine, ESWT was first developed for use in horses over two decades ago. More recently, usage of ESWT has expanded to small animal species. Several different shock wave generators are marketed for use in veterinary medicine, leading to the erroneous assumption that all are equally effective in producing the desired results. Let us explore the differences between these devices, and what they mean for our patients.

Understanding Shock Wave Generation Methods

Shock waves are a specific form of sound wave, characterized by an extremely rapid, high amplitude peak followed by a slower and lower amplitude trough. Current therapeutic devices generate focused shock waves by using one of three methods:

Electrohydraulic: An electric spark within a fluid medium generates a shock wave that is then focused by a metal reflector.
Electromagnetic: These devices function similarly to a loudspeaker, wherein an electromagnetic coil produces the shock wave.
Piezoelectric: An electric current causes an array of piezoelectric crystals to vibrate, producing the shock wave.

While all these devices produce shock waves, there are significant differences in how those waves are focused into the target tissues. These different focusing methods result in varying volumes of tissue that are subjected to shock waves. The electrohydraulic method produces a focal zone that is several orders of magnitude larger than either of the other two methods. This means that for every individual shock wave (aka “pulse”), more cells are affected. Put another way, for any given volume of tissue to be treated, an electrohydraulic device requires fewer pulses to effectively treat it.

Energy Flux Density: A Misleading Comparison

The energy delivered by shock waves can be measured, and it is termed “energy flux density” (EFD). While on its face, EFD would seem to be an effective way to compare the different shock wave devices, this is a common misconception. Energy flux density is defined as the energy delivered across the focal plane and is reported in units of energy per unit of area (mJ/mm²). Total energy delivered is thus dependent on the size of the focal zone of the particular device. As stated before, electrohydraulic devices have a much larger focal zone, and therefore deliver a much larger amount of energy. Saying that electromagnetic or piezoelectric devices are equivalent to their electrohydraulic counterparts based on EFD delivered, is akin to saying that a teacup and a swimming pool hold the same amount of water!

Shock Wave Clinical Efficacy and Research

The effects of ESWT on soft tissue injuries, bone injuries, osteoarthritis, wounds, and other lesions have been extensively studied. However, given the differences in shock wave generation methods, care must be taken when extrapolating protocols and expected results from one method to another. The results seen in studies performed with electrohydraulic devices cannot be assumed to be achievable with the other devices. Ideally, the efficacy of each particular device would be proven through its own clinical trials. Keep that in mind when deciding on a shock wave device to incorporate into your practice!

You can check out a listing of scientific studies performed with the PulseVet electrohydraulic device here.

Want to learn more about PulseVet? Schedule a demo!

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09/02/2024

ecallenEquine Health

Maintaining Comfort in the Performance Horse

By T.J. Barclay, DVM

Just like their human counterparts, equine athletes are prone to experiencing discomfort or injury over the course of their training. Effectively treating injuries and maximizing the comfort of the horse are essential for the horse to realize its peak potential. The owner, trainer, veterinarian, farrier, and other supporting personnel each have important roles, and they all must work together as a team to maintain the overall health and fitness of the horse.

Common Signs of Discomfort in Equine Athletes

Discomfort can manifest itself in many ways. Some, such as overt lameness, are relatively easy to detect. Other times, it can be difficult to determine if a behavior is pain related or not. Problems such as difficulty changing leads, refusal to perform certain maneuvers, girthiness, and bucking can all be induced by musculoskeletal pain. Whenever pain or injury are suspected, the veterinarian’s expertise in managing orthopedic conditions becomes key. First and foremost, an accurate diagnosis of the problem is critical to formulating an appropriate treatment plan. A thorough examination in both static and dynamic states, combined with diagnostic analgesia and diagnostic imaging provide the necessary information.

Choosing the Best Treatment Plan for Equine Athletes

Once a diagnosis is reached, options for treatment are discussed with the owner and a plan is made. For some conditions, treatment may allow the horse to continue training with no changes. In other cases, interventions such as rest, rehabilitation, or corrective shoeing may be indicated. Today, we are fortunate to have a myriad of therapeutic options at our disposal for treatment of orthopedic conditions. Anti–inflammatories, viscosupplements, orthobiologics, chiropractic manipulation, and acupuncture are some of the viable options, and a multi-modal approach often provides the best outcomes.

PulseVet® Shock Wave Therapy for Equine Recovery

Another modality that has become a mainstay of treating musculoskeletal conditions is extracorporeal shock wave therapy, with PulseVet shock wave being the leading provider in this field. PulseVet therapy delivers high-energy sound waves focused and directed into injured tissues. These shock waves stimulate the release of a variety of different cytokines that modulate inflammation, increase blood supply, and stimulate bone growth. A typical treatment protocol using PulseVet’s system involves one to three shock wave treatments at approximately two-week intervals.

PulseVet shock wave therapy is well established in the treatment of soft tissue injuries such as suspensory ligament strains and bowed tendons. These structures are notorious for developing scar tissue that is less elastic than normal tissue and prone to reinjury. PulseVet shock wave stimulates growth of normal collagen fibrils within the lesion, resulting in a better quality of healing and a more functional structure.

Other common areas where PulseVet shock wave therapy is beneficial are the neck, back, and sacroiliac regions. Dorsal spinous process impingement (kissing spines) and osteoarthritis of the dorsal articular processes can often be effectively managed with shock wave therapy, allowing the horse to return to work in a timely manner. PulseVet technology is also useful in slowing the progression of osteoarthritis in other joints.

Maximizing Equine Athletic Performance

Maintaining peak performance in the equine athlete is a team effort involving input from multiple areas of expertise. When injuries arise, accurate diagnosis and effective treatment provide the best chances for complete healing and a timely return to work. PulseVet shock wave therapy is often a valuable tool for achieving that goal. As veterinarians, nothing is more satisfying than seeing our patients sound and competing with their owner!

By incorporating PulseVet shock wave technology into our treatment plans, we can offer our equine athletes cutting-edge care that promotes faster healing and better outcomes. Whether dealing with soft tissue injuries, joint issues, or back problems, PulseVet shock wave provides a non-invasive, effective solution that helps maintain comfort and performance in our equine athletes.

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