Case Study - Raider
Michael Sterns, DVM
The Kush Canine particles for intra-articular injection is a medical device designed to prevent the occurrence and reoccurrence of joint pain from loss of cartilage or tissue-bone mechanical malfunction caused by joint dysfunction not associated with infection (e.g., lameness, osteoarthritis). The injected Kush particles are micro-sized lubricious cushions that provide an artificial cartilage effect to protect the joint's natural tissue during joint articulation.
There is an unmet need to treat canine osteoarthritis (OA) that is safe, affordable, easily administered, efficacious, and without adverse side effects. At Alta View Animal Hospital we see arthritic dogs daily. The canine patient population represents 65 percent of our revenues. Our current treatment for canine OA relies on NSAID’s, including Cox-2 inhibitors, plus or minus tramadol or gabapentin to reduce pain and inflammation. These pharmacological treatments have several problems, including limited effectiveness and difficulty with owner/patient compliance. There may also be a large unmet need for injection of particles at the time of TPLO surgery, including their use in the contralateral stifle joint to delay or prevent further degenerative changes.
Breed: Labrador Retriever
Sex: Male, Neutered
Age: 12 years
Weight: 60 lbs.
Condition: Probable Ruptured R CCL
House Call: 4/2/16 Muscle atrophy bilateral rear, sore over T-L spine, positive drawer sign RR. Lame 3/5. Treated with 4.5 mg triamcinolone SQ, 1cc Adequan IM, and put him on 100mg Rimadyl daily.
Dog became more comfortable on flat surface, but still unwilling to do stairs without encouragement.
Follow Up: Dog returned to Rescue Agency Veterinarian for Dental Work, No X-Ray taken, no mention of lameness issues, and unwilling to opt for TPLO surgery.
Current foster regained possession of dog in 6/16. Wanted a second triamcinolone injection. Dog was still Limping. Difficulty negotiating inside and outside steps. Instability, hind quarter muscle atrophy and drawer sign R stifle still present. Goal is to inject Kush material for any improvement in a non-surgical candidate.
Treatment: July 12 th Kush Canine intrarticular injection, one syringe plus 4mg triamcinolone
Same Day, Day 5 & Day 9:
Immediately post injection, dog walked up and down outside concrete stairs. Greatest hesitation was walking down stairs prior to injection.
Day 5 Follow Up:
“He is much changed. Primarily, he seems to have more confidence, and is rapidly becoming the alpha dog in the house. Interestingly, what seems to hold him back is his OCD/anxiety. For example, he will run up the stairs, like he didn't use to, but he still won't go down the stairs. We have seen him lift his left leg to pee a few times. This is new. He also has taken a bit more risk on running. A couple times he tried to run up the stairs a bit fast and leap over multiple steps and his paws betrayed him and he slipped quite badly. But he didn't seem to mind it much.”
Day 9 Follow Up:
“Raider continues to rejuvenate daily. It is no exaggeration to say this is a different dog. He is so much happier, bossier and playful. Rather than dragging himself behind Madden, they are now playful buddies.
His latest thing is to shake. Wants to lift his front right paw and shake frequently (which I think he can now do b/c the back paw can hold him). Also he has begun to jump up with both front paws, like a puppy. Today we saw him try to sit 3 times, but didn't quite get there. Also he struggles less to get up -- it is done in a much more symmetrical way. This is true both from the bed (where he has more traction) as well as from the hardwood floor.
The owners consider this incremental improvement a great success.
3 moths post injection owner noted:
“Our friend Raider continues to thrive. It is not just movement. It is personality.”
Overview of initial results and observations:
The Kush canine treatment device is delivered via intra-articular injection with a local anesthetic block. The particles inject easily and smoothly into the synovial space using a 22 gauge, 1.5” needle. This is a straightforward procedure to perform. The proposed pricing structure for the product makes it economical to use, and no special equipment or instruments are required. If consistent long-term efficacy is seen after treatment, then drug therapy can be reduced or potentially eliminated in some cases.
Michael J. Sterns, DVM
After graduating from the UC Davis School of Veterinary Medicine in 1984, Dr. Sterns began his career as an Equine Veterinarian. He earned his MBA from the Haas School of Business at UC Berkeley in 1990, and spent the next twenty-three years building small companies in human therapeutics, medical devices and research tools. Dr. Sterns returned to clinical practice in 2012, and now practices general small animal medicine and surgery at Alta View Animal Hospital in Mountain View, California. He is now accompanied on calls by his sidekick, Casey, a six-month old Brittany Spaniel.