By Jennifer F Johnson VMD, CVPP
Fountain Hills, AZ
The 21st century veterinarian has evolved to consider appropriate pain management to be critical in achieving successful clinical outcomes. However, pharmacologic options are limited, and more veterinarians are turning to the use of adjunct therapies to create a well-rounded, effective, safe multimodal analgesic program.
Pulsed Electromagnetic Field Therapy (PEMF) has been advocated for pain reduction and improving wound healing;4 however, until recently, controlled clinical studies in veterinary medicine were lacking. The publication of new research results shows compelling evidence supporting the use of targeted PEMF for the treatment of pain in canine intervertebral disc disease.
Intervertebral disc disease (IVDD) is a leading cause of paralysis and pain in dogs. There are a few treatments for IVDD, but none is guaranteed to fix the problem. Crate rest, steroids, non-steroidal anti-inflammatories, muscle relaxers and other non-pharmaceutical therapies such as photobiomodulation (laser) therapy and acupuncture, have long been utilized for the treatment of IVDD. Most pets with severe, acute disc disease are candidates for hemilaminectomy surgery.
Dr. Leilani Alvarez is the Head of Integrative & Rehabilitative Medicine at the Animal Medical Center in New York, NY. She just completed a double-blind placebo-controlled trial to evaluate targeted PEMF administration to dogs who had undergone hemilaminectomy. In this study, 53 dogs were randomly selected to receive targeted PEMF or sham treatment post-operatively. Results showed that during the first week post-op, the need for pain medications was 1.8 times greater in the sham group than the treatment group and at 6 weeks post-surgery, wound healing (evaluated using VAS and wound evaluation scoring) was significantly improved in the treatment group.1 This exciting preliminary research has caught the attention of the American College of Veterinary Surgeons and they awarded this study first place for canine research abstract during their annual meeting in Phoenix, AZ in October 2018.
The tPEMF device used in this study was the Assisi-Loop® and Assisi Animal Health continues to support robust and independent research in the efficacy and safety of their product. It is important to note that no adverse effects were reported in any of the 53 canine study participants and at the conclusion of the six-week post-operative period, pet owners reported administration of less oral pain medication in the tPEMF dogs when compared to the control dogs1.
Dr. Natasha Olby, a neurologist at the NCSU School of Veterinary Medicine, also recently published in The Journal of Neurotrauma the results of her clinical trial, examining the effect of targeted Pulsed Electromagnetic Field (tPEMF™) therapy on post-op pain and locomotor recovery in dogs with acute, severe, intervertebral disc herniation (IVDE). Her study looked at biomarkers for spinal cord disease as well as pain assessment and neurologic function and found that in treated dogs, tPEMF significantly reduced incision-associated pain. In addition, dogs in the active treatment group had significantly lower GFAP concentrations and recovered foot placement better than those in the placebo group.2
Targeted Pulsed Electromagnetic Field therapy has been shown to promote pain relief and healing by upregulating endogenous nitric oxide. Unbound NO functions as a helpful vasodilator, but also acts as an effective signaler, activating the body’s own anti-inﬂammatory response, increasing production of growth factors that support neovascularization, tissue regeneration and remodeling, thereby speeding up the healing process3. In their recently published review article, Gaynor, Hagberg and Gurfein provide a comprehensive evaluation of the published research using tPEMF and conclude that evidence overwhelmingly supports the use of tPEMF in veterinary medicine and while multiple good clinical studies exist for the use of tPEMF in humans, we anxiously await continued clinical studies in veterinary medicine4. Not all PEMF devices are created equal and overwhelmingly the tPEMF signal provided by the Assisi Loop shows positive results, as outlined in Gaynor et al.4.
The Assisi Loop’s tPEMF signal is not only indicated for neurological inflammation. It is effective for any inflammatory condition, including internal inflammation such as pancreatitis, musculoskeletal issues such as osteoarthritis, dental issues such as stomatitis, and other conditions such as corneal ulcers and seromas following surgery. Assisi Animal Health recently published their Clinical Use Guide offering detailed, illustrated protocols for over 300 conditions (https://assisianimalhealth.com/clinical-use-guide/). Assisi Animal Health will continue to sponsor clinical research programs focusing on the treatment of pain, neurologic diseases, wound management and inflammation in animals.
The encouraging results outlined in these two studies suggest that veterinary clinicians should seriously explore the addition of tPEMF™ to their multi-modal pain management arsenal. While the device can easily be utilized for in-hospital patients, clients will appreciate being able to apply the treatments at home, in a fear-free, relaxed environment. The ease of use and the flexibility of the Loop allows application in beds or pet carriers and the PEMF signal can penetrate through bandages and wraps. As study results continue to be published confirming PEMF effectiveness, it is certainly going to be considered standard of care for surgical and rehabilitation cases.
1) Alvarez LX, McCue J, Lam NK, Fox P, Gulce A. Effect of targeted PEMF therapy on canine post-operative hemilaminectomy: a double- blind, randomized, placebo-controlled clinical trial, Journal of the American Animal Hospital Association. Accepted for publication May 21, 2018. Planned publication March/April 2019.
2) N Zidan, J Fenn, E Griffith, P Early, C Mariani, K Munana, J Guevar, N Olby. The Effect of Electromagnetic Fields on Post-Operative Pain and Locomotor Recovery in Dogs with Acute, Severe Thoracolumbar Intervertebral Disc Extrusion: A Randomized Placebo-Controlled, Prospective Clinical Trial. Journal of Neurotrauma 2018, Vol. 5, No. 15
3) Bragin DE, Statom GL, Hagberg S, Nemoto EM. Increases in microvascular perfusion and tissue oxygenation via pulsed electromagnetic fields in the healthy rat brain. Neurosurg. 2015 May; 122(5):1239-47.
4) JS Gaynor, S Hagberg, BT Gurfein, Veterinary applications of pulsed electromagnetic field therapy, Research in Veterinary Science, Volume 119, 2018:1-8.
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