Osteoartritis canina (artrosis o artritis en perros)
OA, degenerative joint disease, DJD, appendicular osteoarthritis, arthritis in dogs
La osteoartritis es el desgaste de las articulaciones. El cartilago que amortigua los extremos de los huesos se va adelgazando, la articulacion se inflama y empieza a doler y a ponerse rigida. Es una de las causas mas frecuentes de dolor prolongado en los perros, y muchas veces se confunde con que el perro simplemente esta envejeciendo. No se cura, pero se controla muy bien: mantener a su mascota delgada, darle ejercicio regular y del tipo adecuado, y usar medicamentos aprobados para perros logra que la mayoria se mueva con mas comodidad.
Qué podría notar
- Le cuesta pararse cuando estaba acostado, sobre todo al despertar o despues de una siesta
- Cojea o esta tieso los primeros minutos del paseo y despues se va soltando
- Ya no quiere subir escaleras, saltar al carro, ni subirse al sofa o a la cama
- Paseos mas cortos: se queda atras, se sienta, o quiere regresar antes que antes
- Pierde musculo en las caderas, los hombros o los muslos, y el tren posterior se ve mas angosto
- Se pone de mal humor, se encoge o se retira cuando le tocan las caderas, los hombros o los codos
- Duerme mas y juega menos; lo saluda desde la cama en lugar de ir a la puerta
- Se resbala en pisos lisos, o camina con el tren posterior tambaleante
Estándar de atención
Get the dog lean, and treat weight as a therapeutic intervention rather than advice
Aprobado / respaldado por guíasCalculate a target weight, prescribe a measured therapeutic weight-loss ration, weigh at every recheck, and record BCS and MCS numerically. This is the intervention with the best benefit-to-harm ratio in the whole protocol and it has objective gait-analysis support. The 2021 AAHA Nutrition and Weight Management Guidelines also address the communication problem directly, because owners often hear weight advice as a judgment of their own care.
Productos nombrados: No drug. Therapeutic weight-management diets. No FDA-approved canine weight-loss drug is currently identified as marketed; do not imply a GLP-1 agonist is available or appropriate for dogs.
Open prospective clinical trial, 14 obese client-owned dogs with clinical and radiographic OA on a restricted-calorie diet over 16 weeks: significant decrease in lameness from 6.10% body-weight loss onward on numeric rating and visual analogue scales, supported by kinetic gait analysis from 8.85% body-weight loss onward. Species: dog, naturally occurring disease. Limitation: open-label, no control arm, n=14. Reinforced by a randomised (non-blinded) trial of 29 overweight dogs with OA in which caloric restriction plus intensive physiotherapy produced greater weight loss and the best improvement in mobility and ground-reaction-force symmetry at 6 months.
Start an approved anti-inflammatory analgesic: a licensed canine NSAID, or grapiprant
Aprobado / respaldado por guíasNSAIDs were used in 88.31% of cases in the VetCompass elbow-disease cohort and remain the pharmacological backbone. Grapiprant is an EP4 prostaglandin-receptor antagonist and is mechanistically distinct from COX inhibitors. Baseline bloodwork, the lowest effective dose, and scheduled recheck plus repeat bloodwork are part of the standard, not optional extras. Never combine two NSAIDs, and never combine an NSAID with a systemic corticosteroid.
Productos nombrados: FDA-approved for dogs: carprofen, meloxicam, deracoxib, firocoxib, robenacoxib (NSAIDs); grapiprant (Galliprant, NADA 141-455, Elanco). None of these may be extrapolated to cats.
Double-blind, randomised, placebo-controlled trial in 70 dogs with OA: carprofen produced significant improvement in CBPI pain severity (median 4.25 to 2.25) and pain interference (4.33 to 2.67) over 14 days while placebo did not, with a significantly greater improvement than placebo. A companion analysis in 68 dogs showed carprofen also significantly increased peak vertical force and vertical impulse versus placebo - so this class moves the objective measure, which the injectable biologics do not. Species: dog, naturally occurring disease.
Prescribe controlled, regular exercise and structured physical rehabilitation - not rest
Ensayo controlado en esta especieReplace long weekend walks with shorter, consistent daily lead exercise; add non-slip flooring, ramps in place of jumps, raised food bowls, and traction on stairs. Refer for physical rehabilitation where available. This is the modality that makes the weight-loss step achievable in a dog that hurts.
Productos nombrados: Not applicable.
Randomised (non-blinded) prospective clinical trial, 29 overweight or obese dogs with clinical and radiographic OA: caloric restriction plus an intensive physiotherapy programme including transcutaneous electrical nerve stimulation achieved greater weight loss and the best improvement in mobility and ground-reaction-force symmetry at 6 months compared with caloric restriction plus home-based therapy. Species: dog, naturally occurring disease. Limitation: not blinded, both arms received an active intervention, so the physiotherapy increment is confounded with the additional weight loss it produced. The 2022 AAHA guidelines place non-pharmacological modalities inside the tiered multimodal plan.
Consider bedinvetmab (anti-NGF monoclonal antibody) as an approved option - with informed consent and baseline imaging
Aprobado / respaldado por guíasBedinvetmab is a caninised anti-nerve-growth-factor monoclonal antibody, FDA-approved 5 May 2023 (NADA 141-562) to control OA pain in dogs, and EU-licensed 10 November 2020. It is a genuinely approved biologic and the best-evidenced injectable in this category. The effect size is real but modest, and the post-marketing musculoskeletal safety signal is now serious enough that the honest presentation includes it. Discuss it, document the discussion, image the joint first, and agree in advance on what finding would stop treatment.
Productos nombrados: Bedinvetmab (Librela, Zoetis, NADA 141-562, FDA-approved 5 May 2023). The feline anti-NGF product is a DIFFERENT molecule with a separate approval - frunevetmab (Solensia, NADA 141-546, approved 13 January 2022). Never cross-label the two.
Two peer-reviewed, sponsor-authored pivotal RCTs. EU trial: n=287 (141 bedinvetmab / 146 placebo), day-28 CBPI treatment success 43.5% vs 16.9%, p=0.0017 (Corral et al. 2021, PMID 34565678). US trial: n=272, day-28 CBPI success 47.4% vs 36.6%, p=0.0410, number needed to treat 9.3 and standardised effect size 0.3 at day 28 (Michels et al. 2023, PMID 37541934). Head to head on objective force-plate gait analysis it was NON-INFERIOR, not superior, to grapiprant: day-42 success 68.8% vs 56.3%, difference 12.5% (90% CI -37.5 to 18.8), authors concluding both are appropriate first-line treatments (Enomoto et al. 2026, PMID 41667566). Safety: FDA issued a Dear Veterinarian Letter on adverse events including neurological signs; global pharmacovigilance across 18.1 million doses recorded 9.48 events per 10,000 treated animals with lack of efficacy the most-reported term (DOI 10.3389/fvets.2025.1558222); a EudraVigilance disproportionality analysis reported ligament/tendon injury, polyarthritis, fracture, musculoskeletal neoplasia and septic arthritis approximately 9 times more frequently than the combined total for six comparator OA drugs, and an 18-member expert panel reviewing 19 cases unanimously concluded a strong suspicion of a causal association with accelerated joint destruction (Farrell et al. 2025, PMID 40417367). Species: dog throughout.
Fix the correctable lesion surgically when one exists, instead of injecting around it
Aprobado / respaldado por guíasOsteoarthritis secondary to a mechanically unstable or surgically addressable lesion is a different clinical problem. Cranial cruciate ligament rupture is the clearest case: the strongest causal evidence in canine orthopaedics favours surgery, not injectables. The same logic applies to fragmented medial coronoid process, osteochondritis dissecans lesions, and severe patellar luxation. Establish whether a surgical indication exists before any injectable is discussed.
Productos nombrados: Not applicable - surgical referral.
Target-trial-emulation analysis of 615 surgically and 200 non-surgically managed cases of canine CCL rupture in UK primary care: risk differences of -25.7% (95% CI -36.7 to -15.9) for short-term lameness and -31.7% (-37.9 to -18.1) for long-term lameness, both favouring surgery. Species: dog, naturally occurring disease, real-world primary-care data with causal-inference design.
Pegram C et al. Prev Vet Med. 2024;225:106165. PMID 38503655; DOI 10.1016/j.prevetmed.2024.106165
Add omega-3 fatty acids, from an enriched therapeutic diet or a dosed supplement
Ensayo controlado en esta especieThis is the only nutraceutical category in the canine OA literature with evident analgesic efficacy on systematic review. Deliver it as a defined dose from a quality-controlled source, not as an unspecified joint supplement.
Productos nombrados: Omega-3 (EPA/DHA) enriched therapeutic diets and marine-oil supplements. No approved drug claim.
PROSPERO-registered systematic review and meta-analysis (CRD42021279368), 57 articles comprising 72 trials across nine categories of natural health product in dogs and cats with osteoarthritis: omega-3-enriched diets and omega-3 supplements showed evident clinical analgesic efficacy; cannabidiol showed efficacy to a lesser degree; collagen weak efficacy. Species: dogs and cats pooled, which is a real limitation of the review for a dog-only claim.
Escalate multimodally under the AAHA tiered framework rather than by adding unproven injections
Aprobado / respaldado por guíasWhen an approved first-line analgesic is insufficient, work through the guideline's tiered decision tree - reassessing the diagnosis, adding or substituting modalities with the best efficacy evidence, and treating adjacent contributors such as comorbid pain sources and reduced sleep. Proactive and pre-emptive analgesia beats reactive dose-chasing.
Productos nombrados: Guideline framework; agent selection is patient-specific. Note that tramadol, despite being recorded in 19.64% of the VetCompass elbow-disease cohort, failed in a randomised blinded placebo-controlled crossover trial (see the negative-evidence step below).
Expert consensus guideline, not an RCT. The 2022 AAHA Pain Management Guidelines provide assessment algorithms for acute and chronic pain, describe owner-facing pain-assessment instruments, and give a tiered decision tree prioritising the most efficacious modalities. Consensus is not trial evidence and should be labelled as such.
Cannabidiol: a weaker but real signal, sitting on top of an unresolved regulatory position
Evidencia preliminarThe 2022 meta-analysis found cannabidiol efficacious to a lesser degree than omega-3 in canine and feline osteoarthritis. There is no FDA-approved cannabidiol product for dogs, product quality and labelling accuracy vary, and legality differs by jurisdiction. If it is used, it should be as an adjunct with an owner score measured before and after, not as a replacement for an approved analgesic.
Productos nombrados: No approved canine product. Do not present any cannabidiol product as approved or as veterinary-labelled unless a specific approval can be produced.
Same PROSPERO-registered systematic review and meta-analysis as the omega-3 step (57 articles, 72 trials, dogs and cats pooled). Cannabidiol: efficacy demonstrated, to a lesser degree. No approved product and no regulatory efficacy determination.
Barbeau-Gregoire M et al. Int J Mol Sci. 2022;23(18):10384. PMID 36142319; DOI 10.3390/ijms231810384
Stop recommending glucosamine-chondroitin, and do not use tramadol as a substitute for an effective analgesic
No se localizó evidenciaTwo of the most commonly used things in canine OA have been tested and failed. Saying so is part of the standard of care, because every dollar and every week spent on them is a dollar and a week not spent on weight loss and an approved analgesic.
Productos nombrados: Glucosamine hydrochloride / chondroitin sulphate products: negative evidence. Tramadol hydrochloride: negative evidence at 5 mg/kg PO q8h as monotherapy in canine OA.
Glucosamine-chondroitin: the 2022 systematic review and meta-analysis reports a very marked non-effect and its authors recommend these products should no longer be recommended for pain management in canine and feline osteoarthritis (PMID 36142319). Tramadol: randomised, blinded, placebo-controlled crossover trial, 40 dogs with elbow or stifle OA, 35 completing; tramadol at 5 mg/kg PO q8h for 10 days produced no significant change from baseline in vertical impulse, peak vertical force or CBPI, while carprofen in the same dogs improved all three - authors concluded tramadol provided no clinical benefit. Species: dog, naturally occurring disease, within-dog comparison.
2022 AAHA Pain Management Guidelines for Dogs and Cats — American Animal Hospital Association
Cómo se diagnostica
- History plus a validated owner-completed clinical metrology instrument at the first visit (CBPI or LOAD), because the AAHA guidelines make owner-captured assessment central to chronic pain evaluation and because it establishes the baseline that later response is measured against (Gruen et al. 2022, PMID 35195712; DOI 10.5326/JAAHA-MS-7292)
- Gait observation at walk and trot on a non-slip surface, plus body condition score AND muscle condition score recorded numerically - the 2021 AAHA nutrition guidelines call for both at every examination (PMID 34228790; DOI 10.5326/JAAHA-MS-7232)
- Systematic orthopaedic examination of every limb and joint: range of motion, pain on manipulation, effusion, crepitus, thickening and periarticular muscle mass, with the contralateral side as the within-patient comparison
- Orthogonal radiographs of the clinically implicated joints, with sedation for correct positioning; image the contralateral joint because elbow and hip disease is frequently bilateral even when lameness is unilateral
- Exclude the differentials that change the plan entirely: cranial cruciate ligament rupture (surgical), immune-mediated polyarthropathy and septic arthritis (arthrocentesis and synovial fluid cytology when there is effusion, pyrexia, multi-joint involvement or acute deterioration), primary or metastatic bone neoplasia, and neurological disease including intervertebral disc disease and lumbosacral stenosis, which mimics hip pain
- Baseline CBC, serum biochemistry and urinalysis before starting chronic NSAID therapy, and a documented plan for repeat monitoring
- Where available, an objective baseline: force-plate or pressure-sensitive-walkway gait analysis. Owner scores and force-plate measures do not correlate with each other in dogs with osteoarthritis (Brown et al. 2013, PMID 23311715; DOI 10.1111/jvim.12004), so they answer different questions and neither substitutes for the other
- If an anti-NGF monoclonal antibody is being considered, obtain and archive baseline radiographs first - the published safety critique specifically calls for baseline and follow-up imaging and documented informed consent (von Pfeil et al. 2026, PMID 42361372; DOI 10.2460/javma.26.03.0170)
Dónde encaja un biológico
Nuestro propio producto, calificado con la misma regla
Cinco ensayos clinicos aleatorizados con celulas madre mesenquimales aplicadas dentro de la articulacion, en unos 250 perros con osteoartritis natural, mostraron mejoria en el dolor y la funcion evaluados por los duenos y por los veterinarios entre la cuarta y la octava semana; sin embargo, el analisis objetivo de la marcha en plataforma de fuerza no cambio en ninguno de los tres ensayos que lo midieron. Dos revisiones independientes calificaron esta evidencia como debil. Ningun producto de celulas, secretoma o exosomas esta aprobado por la FDA para ninguna especie animal, y no existe ningun ensayo clinico publicado de exosomas ni de ninguno de los peptidos del catalogo en perros con osteoartritis. en Estados Unidos ningun producto de celulas o exosomas para animales esta aprobado por la FDA. Lo que si esta aprobado para el dolor de la osteoartritis en perros son los antiinflamatorios no esteroideos de uso veterinario, el grapiprant y el anticuerpo monoclonal bedinvetmab; y lo que mejor evidencia tiene, por encima de cualquier inyeccion, es bajar de peso al perro con sobrepeso.
Qué existe
Canine osteoarthritis is the ONE indication in this whole category where cell therapy has genuine in-species randomised evidence - and it is small, mostly sponsor-affiliated, and split between subjective and objective endpoints. MESENCHYMAL STEM CELLS, DOG, naturally occurring OA - five randomised controlled trials, roughly 250-260 dogs in total. (1) Black et al. 2007, randomised double-blinded multicentre placebo-controlled, autologous adipose-derived stem and regenerative cells, single intra-articular hip injection: significantly improved lameness and compiled lameness/pain/range-of-motion scores versus control. The abstract reports no sample size, effect magnitude or p-values, the journal is defunct with no DOI, and the sponsor was the commercial provider (PMID 18183546). (2) Harman et al. 2016, n=74 analysed, allogeneic adipose MSC versus saline, 60 days: owner Client-Specific Outcome Measurement success 79.2% treated versus 55.4% placebo, p=0.029; veterinary pain-on-manipulation 92.8% vs 50.2%; all endpoints subjective, no force plate, corresponding author at the sponsor (DOI 10.3389/fvets.2016.00081). (3) Kim SE et al. 2019, University of Florida, n=38 umbilical-cord MSC vs n=30 saline, elbow OA, 6 months: CBPI treatment success 54% vs 28% at 1 month, 50% vs 27% at 3 months, 46% vs 14% at 6 months - and, in the authors' own words, no differences in peak vertical force of the affected limb over time in either group (DOI 10.3389/fvets.2019.00474). (4) Punzon et al. 2022, n=80, multicentric double-blinded placebo-controlled, XENOGENEIC equine umbilical-cord MSC, single intra-articular injection: best results at week 8 with 63% improved on gait analysis, 77% on orthopaedic examination, 65% of owners reporting improved quality of life, and 59% of owners reporting effect duration beyond 6 months; no systemic or permanent adverse events. The abstract reports only treated-group percentages, with no placebo-arm percentages or between-group p-values, so those three numbers must never be quoted as superiority over placebo (DOI 10.2460/javma.22.06.0237). (5) Kim S et al. 2022, Colorado State, n=14, double-blind randomised active-comparator, allogeneic MSC versus high-molecular-weight hyaluronic acid: HYALURONIC ACID OUTPERFORMED MSC, with body-weight-distribution improvement significant from baseline for the HA group only and between-group comparisons favouring HA at weeks 24 and 36; self-limiting joint flare occurred in 7 of 14 dogs, 6 of them in the MSC arm (DOI 10.3389/fvets.2022.890704). TWO INDEPENDENT APPRAISALS grade this body of work weak. Olsson et al. 2020, PRISMA systematic review of hip ADSC, 1,483 records screened to 6 included studies: all positive, risk of bias high in the before-and-after studies and moderate-to-high in the randomised ones, and meta-analysis was not possible because of heterogeneity (DOI 10.1016/j.rvsc.2020.11.014). Moloney 2022, RCVS Knowledge Summary: strength of evidence graded WEAK, noting that all veterinary outcome measures used were subjective (DOI 10.18849/ve.v7i3.473). A multi-institution position statement establishes that the existing canine and equine MSC orthopaedic literature is not reported to a standard permitting comparison or pooling (Guest et al. 2022, DOI 10.3389/fvets.2022.817041). ONE AUTHORISED PRODUCT EXISTS, AND IT IS NOT AMERICAN AND NOT HUMAN-DERIVED. DogStem (EMA EMEA/V/C/005829, EU/2/22/285, authorised 30 November 2022 to EquiCord S.L.) contains EQUINE umbilical-cord-derived mesenchymal stem cells and is authorised for use in DOGS - a xenogeneic authorisation, stated as xenogeneic in its own Summary of Product Characteristics. Its SmPC records that in the pivotal field trial 51% of DogStem-treated dogs versus 5% of placebo-treated dogs met the force-plate treatment-success endpoint at 8 weeks, decaying to 39% versus 11% at 12 weeks. Dose is 7.5 x 10^6 cells in 1 ml intra-articularly, cells expanded to passage 4. Its SmPC also states that biodistribution is unknown because no proprietary biodistribution studies were conducted. IMMUNOLOGY - the finding that settles the marketing language. Punzon E, Garcia-Castillo M, Rico MA, Padilla L, Pradera A. Front Vet Sci. 2023;10:1098029 (PMID 37266387) is a randomised controlled target-animal SAFETY study in 24 young healthy police working dogs, not an efficacy study and not in osteoarthritic dogs. No product-related adverse events followed single or repeated administration - but antibodies against the administered cells were detected in 6 of 8 (75%) dogs receiving equine umbilical-cord MSC and 5 of 8 (63%) receiving allogeneic canine adipose MSC, with no accompanying CD8+ cytotoxic memory response and no clinical signs. Titres were not measured; the assay was qualitative. The authors' own conclusion is that this suggests MSCs are immune-tolerant rather than immune-privileged, which is consistent with the wider literature position that MSCs are immune-evasive, not immune-privileged (Ankrum et al. Nat Biotechnol. 2014;32(3):252-260, DOI 10.1038/nbt.2816). PLATELET-RICH PLASMA, DOG - PRISMA-compliant systematic review of 18 studies and 379 dogs using the Cochrane robvis tool: all 18 reported significant pain or function improvement, but 8 had high risk of bias from inadequate randomisation or blinding; 8 of 18 lacked platelet-concentration data, only 7 of 18 gave enough detail to classify the preparation, and objective gait analysis appeared in only 7 of 18. Adverse events in 6 publications were mild transient local pain or lameness. Authors' conclusion: protocol heterogeneity and methodological limitations preclude definitive efficacy conclusions (Cardona-Ramirez et al. 2025, PMID 40912277; DOI 10.2460/javma.25.01.0033). EXOSOMES / SECRETOME, DOG - the only in-vivo intra-articular study located in dogs with osteoarthritis is a SAFETY study with n=3. Three dogs with bilateral stifle or elbow OA received 20 mg allogeneic canine MSC lyosecretome in hyaluronic acid in one joint and placebo in the contralateral joint, twice, to day 80; the authors conclude it is safe and does not induce a clinically significant local or systemic adverse response. That is the entire in-vivo canine joint dataset (Mocchi et al. 2021, PMID 34828003; DOI 10.3390/ani11113271). Note also that lyosecretome is whole secretome - protein, lipid and vesicles together - not purified exosomes. The authoritative review states verbatim that very limited data is available on the efficacy and safety of cell-free therapy using MSCs for managing canine osteoarthritis, and that large-scale multicentric randomised controlled trials are required (Sharun et al. 2022, PMID 36336651; DOI 10.1080/01652176.2022.2145620). PEPTIDES - nothing. Searched across the MicroAmino-type catalogue (BPC-157, TB-500, GHK-Cu, KPV, LL-37, thymosin alpha-1, MOTS-c, Epitalon, Semax, Selank, IGF-1 LR3, CJC-1295, Ipamorelin, AOD-9604, SS-31, VIP, ARA-290, 5-Amino-1MQ), no controlled canine clinical trial was located for any of them in any indication. The only BPC-157 study involving dogs is a pharmacokinetic/ADME study in rats and beagles reporting 45-51% intramuscular bioavailability in beagles - laboratory pharmacology supporting human translation, not evidence of treating disease in dogs (He et al. 2022, PMID 36588717; DOI 10.3389/fphar.2022.1026182). TB-500 is additionally FEI-banned. REGULATORY. FDA states verbatim that currently no animal cell- and tissue-based products are FDA-approved, and that it is illegal to market an unapproved ACTP because it has not gone through the required FDA pre-market review and approval process. FDA names osteoarthritis explicitly as a disease whose treatment brings such a product within the legal definition of a drug.
Qué no se ha demostrado
Stated plainly, so it cannot be read the other way: 1. NO cell, secretome, exosome or peptide product is FDA-approved for any animal species for any indication. In the United States these are unapproved new animal drugs, and promoting therapeutic efficacy for one is itself evidence of the violation. 2. NO published clinical efficacy trial of exosomes or extracellular vesicles exists in dogs with osteoarthritis - or in dogs with any naturally occurring disease. The canine joint dataset is one n=3 safety study. Everything else in the canine exosome literature is in vitro, rodent, an experimentally induced model, or non-therapeutic (sperm cryopreservation). 3. NO controlled canine trial exists for BPC-157, TB-500, GHK-Cu, KPV, LL-37, thymosin alpha-1, MOTS-c, Epitalon, Semax, Selank, IGF-1 LR3, CJC-1295, Ipamorelin, AOD-9604, SS-31, VIP, ARA-290 or 5-Amino-1MQ - in osteoarthritis or anything else. 4. NO MSC trial in dogs has demonstrated a benefit on objective force-plate gait analysis. Three of the RCTs measured it; in all three it was null, and one intravenous open-label study found peak vertical force significantly DECREASED from baseline. The only positive force-plate treatment-success figure in the category belongs to DogStem's registration trial, which is not available in the US. 5. NO structure-modifying, cartilage-regenerating or disease-reversing effect has been demonstrated for any of these products in dogs. Claims to repair or regenerate cartilage, or to address the underlying cause of the disease, are the exact language FDA cited as the basis for a drug determination in an enforcement letter. 6. THESE PRODUCTS ARE NOT IMMUNE-INVISIBLE. Antibodies to the donor cells were raised in 75% of dogs given equine umbilical-cord MSC and 63% of dogs given allogeneic canine MSC. Immune-privileged, prevents T-cell activation, and near-zero rejection risk are not defensible and must not appear anywhere. Immune-evasive or immune-tolerated, with the inflammation caveat attached, are the defensible terms. 7. THERE IS NO ZERO-FLARE CLAIM AVAILABLE. Self-limiting joint flare occurred in 7 of 14 dogs in the Colorado State trial, 6 of them in the MSC arm, and DogStem's own SmPC lists marked increase of lameness and pain as a side effect. 8. DogStem does not transfer to a human-derived or US product. It is equine-derived, EU-authorised, and says nothing about human cells; there is no predicate doctrine in EU veterinary law and no US approval follows from it. Its dossier is data-protected. 9. Any chart, percentage or trajectory labelled simulated, modelled or projected on a predecessor website may not be republished. In particular, the six-point CBPI curve attributed to DogStem as reference data is fabricated - DogStem's public data are two force-plate success rates, not a CBPI trajectory - and the doses-per-donor-cord yield figures have no source.
Fuentes
- Kim SE et al. 2019 - canine elbow OA, UC-MSC vs placebo RCT; CBPI positive, peak vertical force null — Kim SE, Pozzi A, Yeh JC, Lopez-Velazquez M, et al. Intra-Articular Umbilical Cord Derived Mesenchymal Stem Cell Therapy for Chronic Elbow Osteoarthritis in Dogs: A Double-Blinded, Placebo-Controlled Clinical Trial. Front Vet Sci. 2019;6:474. DOI 10.3389/fvets.2019.00474 https://doi.org/10.3389/fvets.2019.00474
- Harman et al. 2016 - n=74 allogeneic adipose MSC RCT; note the 55.4% placebo response — Harman R, Carlson K, Gaynor J, Gustafson S, et al. A Prospective, Randomized, Masked, and Placebo-Controlled Efficacy Study of Intraarticular Allogeneic Adipose Stem Cells for the Treatment of Osteoarthritis in Dogs. Front Vet Sci. 2016;3:81. DOI 10.3389/fvets.2016.00081 https://doi.org/10.3389/fvets.2016.00081
- Punzon et al. 2022 - n=80 xenogeneic equine UC-MSC RCT (treated-arm percentages only) — Punzon E, Salgueero R, Totusaus X, Mesa-Sanchez C, et al. Equine umbilical cord mesenchymal stem cells demonstrate safety and efficacy in the treatment of canine osteoarthritis: a randomized placebo-controlled trial. J Am Vet Med Assoc. 2022. DOI 10.2460/javma.22.06.0237 https://doi.org/10.2460/javma.22.06.0237
- Kim S et al. 2022 - the trial the industry does not cite: hyaluronic acid outperformed MSC — Kim S, Elam L, Johnson V, Hess A, et al. Intra-Articular Injections of Allogeneic Mesenchymal Stromal Cells vs. High Molecular Weight Hyaluronic Acid in Dogs With Osteoarthritis. Front Vet Sci. 2022;13:890704. DOI 10.3389/fvets.2022.890704 https://doi.org/10.3389/fvets.2022.890704
- Black et al. 2007 - first canine MSC RCT; cite by PMID only, the journal predates DOI assignment — Black LL, Gaynor J, Gahring D, Adams C, et al. Effect of adipose-derived mesenchymal stem and regenerative cells on lameness in dogs with chronic osteoarthritis of the coxofemoral joints: a randomized, double-blinded, multicenter, controlled trial. Vet Ther. 2007;8(4):272-84. PMID 18183546 https://pubmed.ncbi.nlm.nih.gov/18183546/
- Moloney 2022 - RCVS Knowledge Summary grading the canine MSC OA evidence WEAK — Moloney M. In dogs with osteoarthritis, is intra-articular allogenic mesenchymal stem cell therapy more effective than placebo effect? Veterinary Evidence. 2022;7(3). DOI 10.18849/ve.v7i3.473 https://doi.org/10.18849/ve.v7i3.473
- Olsson et al. 2020 - PRISMA systematic review; meta-analysis not possible, risk of bias moderate to high — Olsson DC, et al. Administration of mesenchymal stem cells from adipose tissue at the hip joint of dogs with osteoarthritis: A systematic review. Res Vet Sci. 2020;141. DOI 10.1016/j.rvsc.2020.11.014 https://doi.org/10.1016/j.rvsc.2020.11.014
- Punzon et al. 2023 - the antibody finding that ends the immune-privileged claim (safety study, 24 healthy working dogs) — Punzon E, Garcia-Castillo M, Rico MA, Padilla L, Pradera A. Local, systemic and immunologic safety comparison between xenogeneic equine umbilical cord mesenchymal stem cells, allogeneic canine adipose mesenchymal stem cells and placebo: a randomized controlled trial. Front Vet Sci. 2023;10:1098029. PMID 37266387; DOI 10.3389/fvets.2023.1098029 https://doi.org/10.3389/fvets.2023.1098029
- Ankrum et al. 2014 - MSCs are immune evasive, not immune privileged — Ankrum JA, Ong JF, Karp JM. Mesenchymal stem cells: immune evasive, not immune privileged. Nat Biotechnol. 2014;32(3):252-260. DOI 10.1038/nbt.2816 https://doi.org/10.1038/nbt.2816
- DogStem EPAR / SmPC - equine umbilical-cord MSC authorised for dogs; 51% vs 5% force-plate success at 8 weeks — European Medicines Agency. DogStem (equine umbilical cord-derived mesenchymal stem cells), EMEA/V/C/005829, EU/2/22/285, EquiCord S.L., authorised 30 November 2022. EPAR and Summary of Product Characteristics. https://www.ema.europa.eu/en/medicines/veterinary/EPAR/dogstem
- Mocchi et al. 2021 - the ONLY in-vivo canine OA secretome study: n=3, safety only — Mocchi M, Bari E, Dotti S, et al. Canine Mesenchymal Cell Lyosecretome Production and Safety Evaluation after Allogenic Intraarticular Injection in Osteoarthritic Dogs. Animals (Basel). 2021;11(11):3271. PMID 34828003; DOI 10.3390/ani11113271 https://doi.org/10.3390/ani11113271
- Sharun et al. 2022 - authoritative statement that canine OA cell-free efficacy data is very limited — Sharun K, Muthu S, Mankuzhy PD, et al. Cell-free therapy for canine osteoarthritis: current evidence and prospects. Vet Q. 2022;42(1):224-230. PMID 36336651; DOI 10.1080/01652176.2022.2145620 https://doi.org/10.1080/01652176.2022.2145620
- Cardona-Ramirez et al. 2025 - PRP systematic review, 18 studies / 379 dogs, no definitive efficacy conclusion — Cardona-Ramirez S, et al. Platelet-rich plasma for canine osteoarthritis: a systematic review. J Am Vet Med Assoc. 2025. PMID 40912277; DOI 10.2460/javma.25.01.0033 https://doi.org/10.2460/javma.25.01.0033
- FDA - no animal cell- and tissue-based product is approved; marketing an unapproved one is illegal; osteoarthritis named explicitly — US Food and Drug Administration. FDA's Role in Veterinary Regenerative Medicine. Verbatim: currently, no ACTPs are FDA-approved; it is illegal to market an unapproved ACTP because it hasn't gone through the required FDA pre-market review and approval process. https://www.fda.gov/animal-veterinary/cell-and-tissue-products-a
- FDA CVM GFI #218 - Cell-Based Products for Animal Use, the governing guidance — FDA Center for Veterinary Medicine. Guidance for Industry #218, Cell-Based Products for Animal Use. June 2015, Docket FDA-2014-D-0634. https://www.fda.gov/media/88925/download
- He et al. 2022 - the only BPC-157 study involving dogs is pharmacokinetics in beagles, not efficacy — He L, et al. Pharmacokinetics, distribution, metabolism and excretion of BPC-157 in rats and beagle dogs. Front Pharmacol. 2022;13:1026182. PMID 36588717; DOI 10.3389/fphar.2022.1026182 https://doi.org/10.3389/fphar.2022.1026182
Seguimiento de la respuesta
Cómo saber si está funcionando
Los clínicos lo siguen con Canine Brief Pain Inventory (CBPI) as the primary owner-reported instrument, scored as Pain Severity Score and Pain Interference Score, with treatment success conventionally defined as a decrease of at least 1 in BOTH. Acceptable validated alternatives: the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire, the Helsinki Chronic Pain Index (HCPI), and Client-Specific Outcome Measures (CSOM), in which the owner names three activities their own dog has lost and rates each at every visit. Alongside the questionnaire, record body weight and body condition score numerically at every visit - that is the objective measurement every practice already owns. Where a force plate or pressure-sensitive walkway is available, use it, but do not expect it to agree with the owner score: in dogs with osteoarthritis there was no correlation or concordance between change in CBPI scores and change in peak vertical force or vertical impulse, which the authors interpreted as owners attending to behaviours other than lameness..
CBPI responsiveness: Brown DC, Boston RC, Coyne JC, Farrar JT. Ability of the canine brief pain inventory to detect response to treatment in dogs with osteoarthritis. J Am Vet Med Assoc. 2008;233(8):1278-83. PMID 19180716; DOI 10.2460/javma.233.8.1278. CBPI versus force plate: Brown DC, Boston RC, Farrar JT. J Vet Intern Med. 2013;27(1):22-30. PMID 23311715; DOI 10.1111/jvim.12004. LOAD construct and criterion validity, with head-to-head comparison against CBPI and HCPI in 222 dogs with osteoarthritis: Walton MB, Cowderoy E, Lascelles D, Innes JF. PLoS One. 2013;8(3):e58125. PMID 23505459; DOI 10.1371/journal.pone.0058125
HONEST STATUS, DO NOT GUESS: the CBPI was developed at the University of Pennsylvania School of Veterinary Medicine and LOAD at the University of Liverpool; both are third-party copyrighted instruments, and the specific licence terms for embedding either one in a commercial website or app were NOT verified in this research pass. Written permission must be obtained from the copyright holder before either instrument is reproduced, digitised or included in a PetSmartMeds product. Until that permission is in hand, ship the owner-facing check-in on the Client-Specific Outcome Measures method instead, which is a methodology rather than a copyrighted form: the owner nominates three specific activities their own dog has lost and scores each one at every check-in. That approach is free of licensing risk and is the same class of measure used as the primary endpoint in several of the canine trials cited on this page.
Frecuencia sugerida: Baseline before any treatment change. Recheck at 4 weeks after starting or changing therapy, which matches the day-28 endpoint used in the pivotal canine OA trials and in the CBPI responsiveness study. Then every 3 months while stable, with body weight and BCS at every visit and NSAID monitoring bloodwork per the drug's label and the patient's risk. Re-measure sooner on any deterioration. If an anti-NGF antibody is in use, schedule follow-up radiographs as part of the monitoring plan, not only in response to a problem.
Preguntas que puede responder en casa
- In the last week, how hard was it for your dog to get up from lying down? (not hard at all / a little hard / quite hard / could not do it without help)
- How far can your dog walk now before slowing down, sitting, or wanting to turn back - and is that more or less than a month ago?
- Can your dog still do the three things you told us mattered most (for example: stairs, jumping into the car, playing with the other dog)? Score each one from 0 to 10.
- Has your dog been stiff or limping in the first few minutes of a walk, and does it wear off or stay?
- How is your dog sleeping, and how do they greet you when you come home - from the door, or from the bed?
- Since the last visit, has there been any vomiting, diarrhoea, black or bloody stool, yellow gums, or a day with no appetite? (this is the medication-safety question and it is not optional)
- What is your dog's weight today, and how much food are you actually feeding, including treats and anything from the table?
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