Prospective Evaluation of Local Sustained Release of Celecoxib in Dogs with Low Back Pain

Back pain affects millions globally and in 40% of the cases is attributed to intervertebral disc degeneration. Oral analgesics are associated with adverse systemic side-effects and insufficient pain relief. Local drug delivery mitigates systemic effects and accomplishes higher local dosing. Clinical efficacy of intradiscally injected celecoxib (CXB)-loaded polyesteramide microspheres (PEAMs) was studied in a randomized prospective double-blinded placebo controlled veterinary study. Client-owned dog patients suffering from back pain were treated with CXB-loaded (n = 20) or unloaded PEAMs ("placebo") (n = 10) and evaluated by clinical examination, gait analysis, owners' questionnaires, and MRI at 6 and 12 weeks follow-up. At 6 and 12 weeks, CXB-treated dogs experienced significantly less pain interference with their daily life activities compared to placebo. The risk ratio for treatment success was 1.90 (95% C.I. 1.24-2.91, p = 0.023) at week 6 and 1.95 (95% C.I. 1.10-3.45, p = 0.036) at week 12. The beneficial effects of CXB-PEAMs were more pronounced for the subpopulation of male dogs and those with no Modic changes in MRI at inclusion in the study; disc protrusion did not affect the outcome. It remains to be determined whether intradiscal injection of CXB-PEAMs, in addition to analgesic properties, has the ability to halt the degenerative process in the long term or restore the disc.

Comparison of Single versus Double Lateral Plating in Treatment of Feline Ilial Fractures Using Veterinary Cuttable Plates

OBJECTIVE

 The aim of this study was to compare the frequency of implant failure and the extent of pelvic canal narrowing associated with the fixation of ilial fractures in cats with a single veterinary cuttable plate (SLP) or double veterinary cuttable plates (DLP) applied to the lateral surface of the ilium.

STUDY DESIGN

 Radiographic evaluation of feline ilial fractures plated laterally using SLP or DLP. Pelvic canal narrowing directly postoperatively and at 6 weeks follow-up was objectively measured using the sacral index (SI). Radiographs were evaluated for implant failure and fracture healing.

RESULTS

 Seventy-seven cats satisfied the inclusion criteria. Twenty-nine fractures were treated with a SLP and 48 with DLP. Implant failure occurred significantly more (p = 0.001) in the SLP group (14/29) compared with the DLP group (6/48). Follow-up SI was significantly different between the two groups (p = 0.048, SLP median: 1.0 range: 0.83-2.4, DLP median: 0.98; range: 0.76-1.45). Median change in SI was -0.04 (range: -1.4-0.05) in the SLP group and 0.0 (range: -0.23-0.23) in the DLP group. This difference was significantly different (p = 0.031).

CONCLUSION

 DLP leads to significantly less implant failure and significantly less pelvic canal narrowing compared with SLP. This difference in pelvic canal narrowing was small and the clinical relevance remains unclear.