Retrospective analysis describes safety of therapeutic joint injections in dogs

Allison V. Miller College of Veterinary Medicine, Cornell University, Ithaca, NY

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 DVM
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Patrick C. Carney College of Veterinary Medicine, Cornell University, Ithaca, NY

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 DVM, DACVIM, PhD
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Alexandra Markmann College of Veterinary Medicine, Cornell University, Ithaca, NY

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 BS
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Christopher W. Frye College of Veterinary Medicine, Cornell University, Ithaca, NY

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 DVM, DACVSMR

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Abstract

OBJECTIVE

To retrospectively investigate the safety of canine therapeutic IA injections, describing and correlating adverse events with the number of injections per visit, joint injected, signalment, body condition score, type, and volume of injectate.

SAMPLE

There were 505 joint injections across 283 visits for 178 client-owned dogs, including the shoulder, elbow, carpus, hip, stifle, tarsus, and metacarpophalangeal.

PROCEDURES

A search was performed of the Cornell University Hospital for Animals medical records for relevant data, identifying dogs treated with therapeutic joint injections and rechecked between 2010 and 2022.

RESULTS

Minor complications were noted in 70 of 283 visits and included transient soreness (18.4%, lasting a median of 2 days; range, 1 to 20 days) and gastroenteritis (6.8%). One case of septic arthritis (1/505 joints), which possessed risks of a hematogenous source, was the only potential major complication. Soreness was not correlated with the number of joints injected per visit. Larger volumes of injectate normalized to body size were more likely to be associated with transient soreness in the stifle and tarsus. Across injectates, only stem cells had significantly increased odds of soreness. Gastroenteritis was not associated with the type of injectate.

CLINICAL RELEVANCE

Therapeutic joint injections in dogs are safe, with an extremely low risk of major adverse effects. Transient soreness is a commonly expected minor adverse event. The use of stem cells or larger injectate volumes (confined to the stifle and smaller distal joints) may be more likely to invoke discomfort.

Abstract

OBJECTIVE

To retrospectively investigate the safety of canine therapeutic IA injections, describing and correlating adverse events with the number of injections per visit, joint injected, signalment, body condition score, type, and volume of injectate.

SAMPLE

There were 505 joint injections across 283 visits for 178 client-owned dogs, including the shoulder, elbow, carpus, hip, stifle, tarsus, and metacarpophalangeal.

PROCEDURES

A search was performed of the Cornell University Hospital for Animals medical records for relevant data, identifying dogs treated with therapeutic joint injections and rechecked between 2010 and 2022.

RESULTS

Minor complications were noted in 70 of 283 visits and included transient soreness (18.4%, lasting a median of 2 days; range, 1 to 20 days) and gastroenteritis (6.8%). One case of septic arthritis (1/505 joints), which possessed risks of a hematogenous source, was the only potential major complication. Soreness was not correlated with the number of joints injected per visit. Larger volumes of injectate normalized to body size were more likely to be associated with transient soreness in the stifle and tarsus. Across injectates, only stem cells had significantly increased odds of soreness. Gastroenteritis was not associated with the type of injectate.

CLINICAL RELEVANCE

Therapeutic joint injections in dogs are safe, with an extremely low risk of major adverse effects. Transient soreness is a commonly expected minor adverse event. The use of stem cells or larger injectate volumes (confined to the stifle and smaller distal joints) may be more likely to invoke discomfort.

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