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Shock Wave Therapy

Shocking News for Dogs with Arthritis

A new form of therapy offers pain relief using sound waves.

by Mary Straus

About a year ago, I was contacted by someone who wanted to know my opinion on an experimental therapy her holistic vet was recommending called extracorporeal shock wave therapy (ESWT). At the time, I had never heard of such a thing, so I set about researching it.

I was surprised and intrigued by what I found. ESWT uses a device that creates high-energy focused sound waves that travel through skin and soft tissue to act upon the body in various ways. In human medicine, shock wave has been used for over 25 years to break up gallstones and kidney stones (lithroscopy) without the need for invasive surgery (“extracorporeal” means “outside the body”). In 1992, doctors began using shock waves to treat a range of orthopedic conditions, including nonunion of bone fractures, heel spurs, plantar fasciitis(a cause of heel pain), tennis elbow and other forms of tendonitis, rotator cuff injuries, femoral head necrosis, and joint pain. New research is being done on the use of shock wave therapy to speed healing of wounds and burns, and other applications are under investigation.

History of veterinary use:

Bythe late 1990s, veterinarians began exploring the use of ESWT for horses to speed healing of broken bones (including those that failed to heal normally), treat tendon and ligament injuries, and ease the pain of arthritis.

The use of ESWT for horses has been evaluated at a number of veterinary schools, including the University of Tennessee, Purdue University, Iowa State University, Colorado State University, the University of California at Davis, and the University of Wisconsin. Clinical trials demonstrate that ESWT has been effective in treating musculoskeletal disorders that include bone spavin, stress fractures, navicular syndrome, bowed tendon, bucked shin, arthritic joints, and more.

Experimental treatment of dogs using ESWT began in 1999. Good results have been reported for treatment of various orthopedic conditions in dogs, but the number of controlled clinical studies is still very limited. Conditions likely to benefit from this treatment include osteoarthritis (shoulder, hip, back, elbow, knee, wrist and ankle), hip dysplasia, chronic back pain (spondylosis deformans, chronic intravertebral disk disease, lumbosacral instability), osteochondrosis lesions, sesamoiditis,tendon and ligament injuries, tendonitis, non-union or delayed-healing fractures, and lick granulomas. Treatment can be used alone or in combination with other therapies. Both young, athletic dogs and geriatric dogs can benefit.  One manufacturer is promoting ESWT for four weeks prior to casting on toy dogs with broken legs when it is not possible to use screws.

Most studies show significant improvement in a majority of animals treated, but this treatment is still in the experimental stage, and results are not always consistent. This may be due to a poor understanding of the mechanisms and lack of guidance about the appropriate settings on the various devices on the market and optimal treatment regimen. As use of ESWT becomes more widespread, it is likely that overall results will improve as more is learned about how this methodology is best applied.

Practitioners interviewed in 2003 reported that approximately 70 percent of patients demonstrate a remarkable response to treatment. Another 15 percent exhibit improvement that is not as significant as the first group. Some of these may improve further with a second treatment. About 15 percent show no improvement.  Shoulders, backs and hips seemed to respond best to ESWT, while treatment of knee injuries had the least response.

According to SanuWave, makers of VersaTron shock wave devices for horses and small animals, most cases demonstrate very significant improvement within a week. A second shock wave treatment two to three weeks later often improves the results further.

How does it work?

ESWT devices generate a series of focused high-pressure acoustic pulses (sound waves) that travel from the probe through the skin and soft tissue. When the waves meet tissue interfaces of different densities, such as where soft tissue, tendons, ligaments, cartilage and bone meet, the energy contained in the shock waves is released and interacts with the tissue, producing both mechanical and cellular effects.

The shock waves appear to relieve pain and stimulate healing within the injured tissue, although the mechanism for these effects is unclear. Researchers believe that ESWT stimulates the body’s own resources to speed healing, including increasing vascularization (blood supply) to the area being treated, increasing osteoblastic activity resulting in increased bone growth and cartilage synthesis, and increased osteoclastic activity resulting in absorption of unwanted bone spurs and calcium deposits, as well as other factors.

The reason that this treatment relieves arthritis pain is even less clear, but may have to do with depletion of neuropeptides that lead to the sensation of pain and can contribute to the inflammatory response. Shock waves do not appear to slow the progression of osteoarthritis, but rather reduce the pain associated with it.

ESWT devices consist of a box that generates the waves, and a wand (probe) that is used to target the waves to specific spots.

Mechanisms for generating shock waves:

Extracorporeal shock waves are pressure waves generated outside the body that can be focused at a specific site within the body. There are three types of ESWT devices, which generate high-energy, focused shock waves. They consist of electrohydraulic, electromagnetic and piezoelectric devices. All of these mechanisms convert electrical energy into a pressure wave within a fluid media (the body). No significant difference in effectiveness between these different methods of producing shock waves has yet been demonstrated. Electrohydraulic devices have been approved by the FDA for treatment of multiple conditions in humans.

A fourth type of device produces low- to medium-energy radial waves, also called ballistic or pressure waves. This type of treatment is most accurately called radial pressure wave therapy (RPWT), but is also sometimes referred to as radial shock wave therapy (RSWT) or grouped together with ESWT. RPWT utilizes a projectile mechanism to stimulate a pressure wave.

With ESWT, maximum energy is focused on a specific point,while with RPWT, energy is applied to the surface and radiates from there. More treatments with less time in between may be needed when using RPWT. Most studies in the US have been done using ESWT, which are the only devices approved by the FDA for treating humans. RPWT is widely used in Europe.

Safety Issues:

ESWT is generally considered safe, though high-intensity or prolonged treatment (beyond 1,000 pulses) might be capable of damaging tissue or bone. There are anecdotal reports of horses that have fractured bones following shock wave therapy, but the cause of the fracture is unknown. It is possible that the analgesic (pain-relieving) effect can lead to overuse, which would make injury more likely.

Care must be taken during treatment to avoid the brain, heart, lungs and intestines, as well as neurovascular structures (major nerves and blood vessels). ESWT is not recommended for dogs with clotting disorders due to the potential for bruising. Dogs that are immune-compromised may not respond as well to therapy, which is thought to rely on the body’s own immune system for healing.

With proper use, side effects are insignificant, limited to some bruising of the skin where the pulses are applied if bubbles are present or good contact with the probe cannot be achieved. 

How the treatment is performed:

Physical exam is required to diagnose musculoskeletal disorder and to rule out neurological disease that cannot be treated with ESWT. It’s important to identify all the painful areas that should be treated, including secondary issues that may have developed due to compensation for an injured or painful joint. X-rays are usually required to help determine treatment, and other standard tests such as blood work and urinalysis may be done to ensure your dog is healthy prior to anesthesia.

Treatment is done under heavy sedation or short general anesthesia, as it causes discomfort that can range from mild to severe depending on the intensity used. The machines that generate the pulses are usually quite loud, which can also be frightening to the patient. It takes only a few minutes to treat each site. The area to be treated must be shaved and a gel applied to ensure transfer of energy from the probe head to the patient’s tissues, as any air between the probe and the skin will interfere with the mechanism. The veterinarian determines the energy level used and the number of pulses delivered based on the location, type and severity of the disorder.

Treatment regimen varies, but generally is repeated anywhere from one to three times, two weeks to a month apart. The dog may be a little more sore for 12 to 24 hours following treatment, though sometimes the opposite is the case and the treatment produces a short-term anesthetic effect, during which time you must be careful that your dog doesn’t overdo it. Improvement may be seen right away, or it may take a few weeks to see the full effects of the treatment. The process may need to be repeated yearly, though it lasts much longer in some dogs.

Cost:

The cost for ESWT can vary considerably, depending on which type of machine is used, how many sites are treated, whether your dog is anesthetized or just sedated, and the tests needed before treatment. The lowest price I’ve heard of was $125 for treatment with RPWT without anesthesia (devices that generate radial pressure wave are less expensive and there fore the treatment may also be less expensive). More commonly, treatment with ESWT will run around $200 to $300 per site, plus the costs for exam, tests and anesthesia or sedation.

A Labrador tries it out:

Debbie Efron, of Manalapan, New Jersey, is the person who contacted me originally about shock wave therapy. Her vet, Dr. Charles Schenck, a past president of the American Holistic Veterinary Medical Association, recommended it for treatment of her dog, Taylor, a 13-year-old Labrador Retriever with arthritis in both hips, her spinal column, and her right hock, and who had recently torn a ligament in her right knee.

Dr. Schenck felt that ESWT would benefit Taylor’s hips and hock, and might possibly help the knee as well. He did not recommend it for the spine because he felt it works best where there is more soft tissue. He continued treating the spine with acupuncture instead. According to Efron, Dr. Schenck recommended a total of two sessions, three to four weeks apart. He told her to expect gradual improvement over a 6 to 8 week period, with some regression possible in between treatments. Ultimately, he expected 80 percent improvement that would last six to seven months. He uses the VersaTron ESWT device (see Resources for more information).

Improvements were seen within a week of the first treatment. “Taylor was greeting me at the door with a toy in her mouth, something she stopped doing weeks ago,” Efron said. “She is eager to go for walks and pulls me around the block, with no limping and her back legs no longer buckle on her. She is playful again, wanting to wrestle and play ‘steal the sock.’ She is still stiff getting up, though, and cannot make it up the stairs, though she will go up six stairs to go outside, without the need for support as we used to have to give.”

There was some regression in the next two weeks, as she became more reluctant to go up steps, and got up more slowly. This may be because of the ruptured knee ligament, as she avoided pressure on that leg when she could. A second treatment was done three weeks after the first, and the improvement gradually resumed.

Six weeks following the second treatment, Efron reports, “I am quite pleased with the results. Taylor is almost her old self.  She is happy. Walks are getting longer, up to a mile with no limping or buckling, but still quite slow. She is swimming again twice a week, which she loves. She runs in down a ramp, retrieves a toy we throw in, comes out of the water and wants us to chase her around the outside of the pool to get the toy again. She is on no medications at all.”

Taylor still has limitations. “She will never run again,” says Efron. “She won’t go up the steps in the house, but she does the steps to go outside much better now. She still gets more sore at times, such as after a long car ride.”

Four months after treatment, Efron says, “I still think that Taylor is improving somewhat. She does all of our old walks no problem, just a little slower. She even wants to chase her ball occasionally. We built a ramp off our deck, so she doesn't have to use the steps to go out, but she is doing better going up the flight inside our house at bedtime.”

Recently, eight months after treatment, Taylor has been experiencing some weakness in her back end, which her vet thinks is caused by neurological dysfunction due to spondylosis in her spine. “Taylor is having trouble standing. She is just fine walking and even tries to run at times, but when she stands still, her rear end drifts downward.” Her vet has confirmed that she is not in pain, and that her hips and knees are doing well. He is treating her with acupuncture.

“Taylor is on no medications, but she gets a lot of supplements and a raw diet,” says Efron. “I think her improvement peaked about eight weeks after the second treatment, and she’s been great on walks ever since. We went to the beach last weekend. Taylor was so energetic and she was begging me to throw a ball. I threw one five feet and she trotted to retrieve and was happy as can be. Then my husband threw a leash and she ran a little. She was so happy and like a puppy again. I had tears in my eyes. Nothing makes me feel better than to see her like this.”

While at the office for Taylor’s first treatment, Efron met a Golden Retriever at the same clinic with severe elbow arthritis, who had difficulty walking by age two. After ESWT treatment at age three, he was able to walk without a limp. He was returning a year and a half later at age five for another treatment.

Efron paid $425 per ESWT treatment for Taylor, covering multiple sites. This did not include charges for anesthesia, tests and exams. 

Piglet’s experience:

I’ve written about my dog Piglet’s severe elbow arthritis in the past (see ”Joint Decisions,” March 2007). While Piglet has done remarkably well with a homemade diet, natural supplements and prescription medications, she had slowed down several months ago and was no longer taking long walks. I wanted very much to try this new form of therapy with her, but it took me some time to track down a vet in my area who offers it. The nearest vet school uses it for horses, but had never considered it for dogs. I finally contacted two companies who make the devices and asked them for the names of any vets in my area who were using their products for small animals. One company gave me the name of two vets within driving distance.

I ended up taking Piglet to Dr. Jeffrey Smith of Middletown Animal Hospital, current President of the California Veterinary Medical Association. Dr. Smith has used ESWT to treat horses, dogs, and even a goat, with great success.

“About 80 percent of animals show marked improvement post treatment, though it may take up to 90 days to see this,” Dr.Smith told me. “Ideally re-treatment is preformed annually. Even in cases where no improvement is achieved, there are no side effects as one might experience with surgery or drug therapy."

Dr. Smith recommended two treatments for Piglet, one month apart. While he usually uses heavy sedation,we decided to use general anesthesia, due to my concern about Piglet’s noise phobias, as well as her age and breed.

The treatment went well, with only minor increased soreness for a day or two afterwards, possibly due to the long drive. Unfortunately, Piglet did not experience marked improvement, possibly because of the excessive amount of bony growth around her joints. I didn’t really see any changes following the first treatment, but about three weeks after the second treatment, Piglet went on a much longer walk than she had done in over six months. She has continued to take periodic long walks, up to an hour and a half to two hours, when she had not taken a walk over an hour in the prior months. She is also a little faster than she had been, and rarely goes for less than 45 minutes, whereas before she was sometimes cutting walks as short as 20 minutes.

Even without the marked improvement I had hoped for, I am happy with the treatment. Piglet is now 16 and doing almost as well as she was a year ago, which is remarkable at her age.

I paid $290 per treatment site (total $580 for both elbows) each time, plus costs for anesthesia, tests and exams.

One dog’s remarkable improvement:

Dr. Smith told me about another dog that he treated about a year earlier. Utah is a mixed breed (maybe Pit Bull and German Shepherd) who weighs 45 lbs and is now 12 years old.

Utah’s owner, Dr. Jane Rosett, of Kelseyville, California, gave me the details. “Utah had problems with one elbow for many years, eventually reaching the point where she couldn't put weight on the leg at all,” says Rosett. Utah was given two shock wave treatments, one month apart. "I didn’t see any improvement after the first treatment and in fact I think she got a little worse. I was disturbed, as I thought I would see improvement right away, but Dr. Smith explained that it can take some time for bones spurs and the like to be reabsorbed,” Rosett continues.

Then everything changed. “About two to three weeks after the second treatment, she suddenly began running around like a puppy again,” says Rosett. “The improvement was rapid and dramatic, and she’s been sound ever since." The improvement has lasted well over a year at this point, with only occasional mild limping during that time. She remains on Metacam, but she may not actually need it.
Dr. Jane Rosette rosett@hughes.net Kelseyville, 707-279-0188.

Search and rescue dog improves:

Tami Packham works for Toronto Equine Hospital in Toronto,Ontario, where they have been using shock wave therapy on horses for the past eight years. In the last few years, Packham began offering this therapy as a mobile service to small animal veterinarians in the area. Unfortunately, many small animal vets are still resistant to this new treatment, but have agreed to it when owners request it.

The first dog Packham treated was Zeus, a FEMA-certified urban search and rescue German Shepherd dog owned by Rob and Sherry Martin. “Zeus was x-rayed at age two, and found to have grade-4 hip dysplasia, as well as elbow problems,” says Rob Martin. “His ability to work declined, and within a year, he was in so much pain that we were considering euthanasia.”

That’s when they met Packham. She convinced the Martins to try shock wave therapy, with excellent results. Zeus returned to about 80 percent of normal function, not enough to continue to do SAR work, but fine for the loved pet he continued to be. After about six months, he began to decline again, and by the end of a year he was back to where he started, so the treatment was repeated.

“Zeus was retired at age three due to severe dysplasia in both hips and elbows,” says Packham. “We have been treating him for the last three years, one session each time. He continues to receive a treatment session about once a year.”

Martin describes Zeus’s response to treatment. “For the first three days after a session, he is like a puppy again, apparently due to the numbing effect of the treatment. During that time, we have to be careful that he doesn’t overdo it. Over the next three or four days, he gets very painful, even worse than before he was treated. He then begins to improve again, and by about the 10th day following treatment, he is zipping around with about 70 to 80 percent of normal function.”

Zeus has received treatment with and without sedation, but Martin feels he does best when sedated, which allows higher-intensity waves to be used. “The treatment seems to last longer when he is sedated,” says Martin. “It took about eight months before he began to decline again, compared to six months following the lower-intensity treatment without sedation.”

Zeus is now 5 years old and has received four treatments, with the last just a couple of months ago. “I think his response may be declining just a little, probably due to his joints deteriorating further over time. He has lost a little weight, going down from 80 to 75 lbs. Even though he can no longer do search and rescue, we are thrilled that he can enjoy a normal life as our pet.”

ESWT for spondylosis:

Packhamalso treated Hayley, an 11-year-old Golden Retriever who suffered from spondylosis (fused vertebrae) so bad that the family was considering euthanasia due to the pain. She had difficulty getting up, and controlling her rear legs.

“We noticed rather rapid deterioration in Hayley's movement last fall,” says Hayley’s owner, Christine Crooks, of Binbrook, Ontario. “She would take up to ten minutes to get out of her bed. When she walked through a door and turned, the back half of her body would not follow and she would fall. When she lay on the ground to rub her back and tried to kick her legs up in the air, only the front half would go up, while the bottom half just laid there. She had difficulty going up and down the stairs.  And she looked ‘just plain sad.’ She also had trouble lying in one place for long.”
Hayley received a single ESWT treatment in November. She experienced a lot of pain after the procedure and had to take pain medication for two or three days.

“About a week after her procedure, I noticed that she was getting up effortlessly,”says Crooks. “Throughout the next week, we noticed constant improvements -- she would walk out a door and turn and her whole body would move around. She almost ran up and down the stairs. But the day that I started crying with emotion was the day that she laid on the ground and all four legs went up in the air and she was kicking.”

Crooks says this treatment has had a remarkable effect on Hayley’s life. “Her disposition improved greatly, and we all talk about how our 12-year old dog is like a puppy again. Our veterinarian even said that we have to slow her down a bit to prevent her from injuring her spine. She tends to run in the snow and jump if we throw a snow ball, so we have to remember that she does have a condition. To date, four months after the treatment, she continues to do remarkably well.”

Packham says, "The dogs go home with pain medication because they are usually very sore for three days post treatment. By days four through seven, the owner starts to see improvement, and by day 14 there is significant improvement. On average, we see an improvement for six to eight months, and then they start to degenerate again." At that point, the treatment can be repeated. The charge is $250 (Canadian) for one hip, $350 for both hips (600 pulses per hip).

Soft-focused waves:

Packham recently began treating with a Vetwave Portable device that allows her to use either a focused or soft-focused therapy head, depending on the area being treated. The manufacturer says that the soft-focused waves are non-painful and can be applied without anesthesia, though this is not always so.

“I have treated Zeus with both focused and soft-focused waves, with and without sedation,” says Packham. “His last treatment was the soft-focus without sedation, and I would not do that again. His left elbow is the worst and he cried when treating. He is a very stoic dog and I still would not treat him again without sedation.”

Rob Martin, Zeus’s owner, felt that the soft-focus was far better than the focused in terms of Zeus' recovery and mobility. “He didn’t get as bad the few days after the treatment as he had with the focused waves,” says Martin. “He was still able to jump into the back of the car, and go up and down steps – I didn’t have to carry him anywhere, as I have had to do in the past. It will be interesting to see how long the treatment lasts this time.” He agrees with Packham that sedation is better for Zeus.

Packham continues, “The hips are also difficult to do without sedation because putting the dog on their back to treat inside the joint is a very submissive position for dogs and they won't stay there long. Sedation keeps them from struggling and from torquing the joint and creating more pain.”

Packham describes the difference between the two types of treatment. “The focused head has a band width of 6mm,while the soft-focus head has a 25mm band width. The energy level is the same but more intense coming through the 6mm band as opposed to the 25mm band. I have also treated myself with both heads and they are both painful as far as I am concerned.”

Packham is also treating dogs with cruciate ligament injuries. Used after surgery, it can speed healing. It may also assist dogs with partial tears to improve without the need for surgery. She feels it is very questionable whether ESWT would work for dogs with full cruciate ruptures, without the need for surgery.

How to find a practitioner:

Because ESWT is still considered experimental, especially in dogs, it can be difficult to find a veterinarian who offers it. The best way to find one is to contact the device manufacturers to see if they have sold any to vets in your area (contact information is listed under Resources below).

You can also try contacting veterinary schools in your area. Large-animal vets maybe more likely to offer this therapy, since it’s used more commonly with horses, so you might find one who is willing to treat your dog, maybe in cooperation with your own vet.

No regrets:

Even though Piglet’s response to shock wave therapy was not as great as I had hoped, I’m still glad that I tried it. The treatments were not hard on her, and I felt confident that they would do no harm. The improvement that she gained, while small, was meaningful and has allowed her to enjoy her walks more than before. At 16 years old, she’s still remarkably healthy other than her arthritis, including being mentally sharp, and her walks mean a lot to her and contribute to her quality of life. If I had it to do over again, I would make the same decision in a heartbeat.

Mary Straus does research on canine health and nutrition topics as an avocation. She is the owner of the DogAware.com website. She lives in the San Francisco Bay Area with her 16-year-old dog, Piglet.

What You Can Do

  • Contact a veterinarian who offers ESWT to see if your dog is a candidate for this form of therapy.
  • Have a full physical exam, including blood tests and x-rays, before the treatment.
  • Continue to give nutraceuticals, such as glucosamine, to help your dog’s joints.
  • Remember that ESWT can help with pain and inflammation, but will not cure arthritis.

Resources Mentioned in This Article

Manufacturers of ESWT Equipment

VersaTron, made by SanuWave, sanuwave.com, 866-581-6843 (US and Canada) or +41 (0)71 6868 900(Europe). VersaTron produces focused electrohydraulic waves. This appears to be the most widely available machine in the U.S., and the one that has been most studied here.

[Contact Greg McKellar, <Greg.McKellar@SanuWave.com>,director of the veterinary division, or Emily Davis,<Emily.Davis@SanuWave.com>, sr. product manager, if more info is needed]

Duolith Vet and Masterpuls, made by Storz Medical, Switzerland,storzmedical.ch, 678 354-6229. Sold in the US by FOCUS-IT, eswt.net,800-270-1141. Duolith Vet is a combination focused and radial shock wave therapy device. Only one type of wave is generated at a time. Masterpuls produces radial waves.

[contact "Gerhard Kinas"<gkinas@eswt.net> if more info is needed? I think he’s the one who called me, see outgoing email 7/2/07, but nothing in correspondence]

Vetwave140 and VetwavePortable, made by TRT Nonvasiv, Woodstock,GA, trtllc.com, (877) 966-1315. Vetwave devices produce either focused high-energy or soft-focused low-energy electrohydraulic waves, depending on the head that is used. The low-energy waves are most suitable for tendon and musculoskeletal applications, while the high-energy waves are used for treating bone injuries.

PiezoVet 100, madeby Richard Wolf GmbH, richard-wolf.com. US office in Vernon Hills, IL,richardwolfusa.com, 800-323-WOLF (9653). Sold by GHS Medical, Germany,extracorporeal-shock-wave-therapy.com, +49/77 31/1 89 89 69.

Swiss Dolorclast Vet,made by Electro Medial Systems (EMS), ems-company.com, Switzerland. North American division is located in Dallas, TX, 972-690-8382. Swiss Dolorclast Vetuses radial pressure waves.

dogaware.com/arthritis.html

The author’s arthritis web page with up-to-date information on ESWT, including a list of veterinarians offering this treatment.

[Dr. Smith, "Dr. Jeffrey J. Smith"<myvet@mac.com>,  707-987-2000.]

Tami Packham <tjpackham@rogers.com>
Toronto Equine Hospital

905-405-9500
meghan@torontoequinehospital.com   subject:  canine shockwave
http://canineshockwave.typepad.com

[Contact Tami to ask about cost]

Hip and Elbow Dysplasia/Zeus Haley (Tami, Toronto EquineHospital):

http://canineshockwave.typepad.com/shockwave_for_the_dog/2008/02/zeus.html

 Rob and Sherry Martin martin.rs@sypmpatico.ca

Spondylosis/Haley (Tami, Toronto Equine Hospital):http://canineshockwave.typepad.com/shockwave_for_the_dog/2008/01/nice-news-artic.html

http://www.sachem.ca/news/article/115083

Hayley getsnew lease on life By Tamara Botting, The Gazette News Jan 25, 2008

Vet-Stem Regenerative Cell (VSRC) therapy

Vet-Stem, vet-stem.com, 888-387-8361

REFERENCES

Shock Wave Therapy Can Help Promote Bone Healing and Reduce Pain

University of Illinois College of Veterinary Medicine,October 2005

http://www.cvm.uiuc.edu/petcolumns/showarticle.cfm?id=478

Shockwave therapy - more shock than wave?

13th European Society of Veterinary Orthopaedics and Traumatology Conference, 2006

http://www.ivis.org/proceedings/esvot/2006/SA/beale2.pdf

Advances in Extracorporeal Shock Wave Therapy for Dogs

Veterinary Practice News, 2002

http://www.animalnetwork.com/petindustry/vpn/articleview.asp?Section=&RecordNo=3605

Extracorporeal Shock Wave Therapy: What? Why? Safety?

Iowa State University College of Veterinary Medicine

http://www.vetmed.iastate.edu/departments/vcs/orthopaedic/home%20page/Shock%20Wave/GraysonFinalReport.pdf

Initial experience with extracorporeal shock wave therapyin 6 dogs

PeterH. Laverty BVSc, MACVSc and Scott R. McClure DVM, Pill, Dipl. ACVS.

From the Department of Veterinary Clinical Sciences, Purdue University

http://www.hmtjp.com/eswt%20in%206%20dogs%20-%20iowa%20state%20university%20-%20march%202002.pdf

Clinical evaluation of extracorporeal shock wave therapy for management of canine osteoarthritis of the elbow and hip joint

Francis DA; Millis DL; Evans M; Moyers T

University of Tennessee, Department of Small Animal Clinical Sciences

http://www.hmtbr.com.br/est_vet_internacionais/uni_tenn_osteoartritis.pdf

A blinded clinical study of nine dogs with osteoarthritis of the elbow and hips was performed, with five dogs receiving ESWT and four dogs receiving sham treatment. Results were evaluated using force plate analysis of gait, measurement of comfortable range of motion, and lameness at a walk and trot on days 0, 14 and 28. Significant improvement ranging from 2 to 20 percent during that period was observed for most dogs receiving ESWT.

Clinical evaluation of Extracorporeal Shock Wave Therapy to Reduce Clinical Signs and Pain Associated with Chronic Osteoarthritis in the Canine Patient

Peter H. Eeg B.Sc., DVM, Poolesville Vet Clinic LLC, Poolesville, Maryland

http://www.hmtjp.com/eswt%20for%20chronic%20osteoarthritis%20in%20canine%20patient..pdf

A clinical trial performed on 20 dogs with chronic degenerative osteoarthritis compared the effects of shock wave therapy using the VersaTron device to a control group maintained on Rimadyl (non-steroidalanti-inflammatory drug). 85 percent of the treated dogs showed a reduction inclinical signs equal to or greater than the control group after 14 days.

Extracorporeal Shockwave Therapy as a Treatment for Lameness in Horses and Dogs: General Information and Specifics about the Use of Shockwave Therapy in Orthopaedics at the University of Wisconsin-Madison

PeterMuir BVSc, MVetClinStud, PhD, Diplomate ACVS
Assistant Professor, Small Animal Orthopaedics

Ryland B.Edwards III DVM, MS, Diplomate ACVS
Clinical Assistant Professor, Large Animal Surgery

http://vmthpub.vetmed.wisc.edu/new/shockwave_news.htm

Essential Facts of Physiotherapy in Dogs and Cats

Barbara Bockstahler, David Levine, Darryl Millis

http://www.vetcontact.com/en/art.php?a=764&t=

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We are the only animal hospital in Lake County, CA to offer all of these benefits:  laser surgery, laser therapy, climate controlled boarding, separate cat reception, examination, and boarding areas, dental x-ray and dental suite, multi-modal pain management, physical therapy, underwater treadmill, shockwave therapy, PRP therapy, cryotherapy, digital thermal imaging, stance analyzer, tonopen for eye pressure, behavior services, house calls.....and much more.

Middletown Animal Hospital 707-987-2000
21503 S. State Highway 29 Middletown, CA 95461

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