Prolotherapy Case Studies from Veterinarians

JUST LUIGI’S LUCK


Things were going very badly for the tiny, five pound poodle. At just under one year-old, Luigi had been surrendered to the Humane Society because his family could no longer afford the care he needed. He had been diagnosed with hip dysplasia and was now profoundly lame, unable to bear any of his weight on the right hind leg. Palpation showed that both the knee and the hip were implicated. Further physical examination found that Luigi had palpable laxity of the right hip as well as moderate draw at the right knee. Both areas were extremely painful.

Luigi, a tiny five pound poodle.

Medical staff at the Humane Society gave the go-ahead for a course of Prolotherapy treatment. Luigi’s initial course included Prolotherapy treatment started at the hip only, along with therapeutic ultrasound three times a week, and Adequan® Injections. Within 10 days of starting this program, Luigi was able to touch his toe to the ground. It was intermittent, but it was a good start. There was also a diminution of pain at this time. Luigi received his second Prolotherapy treatment a month after the first, and this time it was administered to both the hip and the knee. Again, the treatment produced results in about 10 days. Now, Luigi could touch his toe to the ground and bear a little weight on the leg. Although he exhibited mild pain in the hip joint on examination, he was no longer favoring the right hind leg and holding it off the ground.

Luigi received two more Prolotherapy treatments to the hip and knee, after intervals of two weeks and one month. By now, he was able to bear normal weight on the right hind, and pain was only evident when the hip was pulled back. The joint laxity had resolved and Luigi, clearly in better spirits, was able to start a physical rehab program that included balancing exercises and long walks on a harness. It was very apparent that Luigi was regaining muscle strength.

Despite Luigi’s progress, the orthopedic surgeon assigned to his treatment remained concerned about the little dog’s radiographs. (See Figures 1a & 1b.) There was visual and clinical evidence of improvement, but the radiographs of his hip remained unchanged. It was determined that an FHO (Femoral Head Osteotomy) was necessary, although he would still be supported by Prolotherapy treatments. As of writing, Luigi had his first post-surgery Prolotherapy treatment. This will be followed up with a course of Acell, the attenuated pig bladder cells that act like stem cells, and we will report on his progress.

Figure 1a & 1b. Luigi’ s before and after Prolotherapy X-rays. Luigi has shallow hip sockets and a femoral head luxation, which is more pronounced on the right hip. Luxation refers to the misplacement of the top of the femur out of the hip socket. Many small dogs are prone to this type of disorder.

In summary, Luigi received a total of five Prolotherapy sessions two to three weeks apart. The solution injected was equal parts of 2% lidocaine, 50% dextrose, vitamin B12, and Heel’s liquid Traumeel. A total of 7cc was used during the procedure. Luigi was injected at the dorsal and lateral aspect of the hip in four locations into and around the articular capsule surrounding the femoral head. He was also injected three different times at four injections sites: the lateral tibial collateral ligament, under the infrapatellar bursa, into the tendon of long digital extensor, and deeply into joint space under the patellar ligament.

NINE STORIES, ONE CAT’S LIFE


In a freak accident, Precious, the cat, fell nine stories from her high-rise home and was lucky to survive. Unfortunately, another crash—of the economy—meant her family could not provide the medical care she needed. She was taken to the Humane Society where she was examined and found to have escaped the incident without internal injury. Her left front paw, however, had obviously taken the brunt of the impact. It was swollen to about two inches in diameter and the metacarpal bones looked, on X-ray, like broken crockery in considerable disarray. (See Figures 2a & 2b.) Although her injuries could have been much worse, it was still a very painful and debilitating condition for this domestic shorthair cat. Despite receiving excellent acute medical care, the poor cat’s pain from the injury persisted, and she remained unable to bear weight on the paw for several months. About seven months after the fall, those in charge of her care scheduled laser and therapeutic ultrasound for her. These treatments were administered three times a week with Adequan® injections. After the regimen, Precious seemed more comfortable with less swelling in her paw, but she was still non-weight bearing on the limb.
At her next Prolotherapy session, a month later, Precious’ left front wrist and elbow were treated, as well as her paw. This time, the subsequent improvement seemed more pronounced with Precious exhibiting less pain on palpation.

Figure 2a. X-ray of Precious’s front paw six months before the accident, during an exam.
Figure 2b. X-ray of Precious’s front paw after the accident, before treatment. You can see the bones look like broken crockery.

Precious received two more Prolotherapy treatments, each one producing further improvements. In fact, after the third follow-up session, Precious could occasionally bear weight on the limb. Radiographs were taken three weeks later. These films showed improvement and bone healing with the exception of the total non-union of the middle metacarpal.

Precious received her most recent Prolotherapy treatment 10 months after her fall. Following her session, it was apparent her level of pain had dramatically subsided, as had the swelling. Her paw was now back to a normal size of about one inch in diameter. After another four weeks, Precious received injections of Acell in the paw, wrist, elbow, and shoulder area. On physical examination a few days later, Precious was pain free in all the injected areas, showed no pain on palpation and had no swelling. She was moving freely, coping with stairs and jumping up, but not down. She had started to bear full weight on the injured paw, although still limped slightly.

In total, Precious received five Prolotherapy sessions two to four weeks apart. The solution injected was equal parts of 2% lidocaine, 50% dextrose, vitamin B12, and Heel’s liquid Traumeel. A total of 5cc was used during the procedure. Precious was injected in the joint spaces between the proximal phalanges and the metacarpal bones as well as the joint spaces between the distal carpals and the metacarpals and in between the actual metacarpal spaces. All injections were done dorsal to palmar. The intent was to cause ankylosis, but actual healing did occur as seen on X-ray. (See Figure 3.)

Figure 3. Precious’s X-rays showed that there was normal bone healing after the Prolotherapy sessions were started. After the last Prolotherapy treatment, all but one metacarpal bone had healed. That bone was a classic non-union, which will probably never heal.

Three injections at the elbow were done on the lateral aspect of the olecranon, two below and one above. The shoulder was injected at the lateral gleno-humeral junction. Precious has made an almost complete recovery from her traumatic experience.

Precious is back to her old self again, thanks in large part to Prolotherapy.

Both Luigi and Precious were anesthetized for all Prolotherapy treatments with very small amounts of Telazol 0.3 to 0.4ml intramuscularly. They were woken up by administration of acupuncture after the procedures.

SUBMITTED BY ROGER L. DEHAAN, DVM


Pet owner John Lee drives his two Bernese mountain dogs almost 60 miles one way from his Greer, S.C., home to see Dr. DeHaan. He found out about DeHaan’s practice as one would a speakeasy in the 1920s, through word of mouth, after dozens of vet visits and thousands of dollars of surgery didn’t alleviate the genetic hip problem that made it hard for five year-old pooch Mack to walk.

Mack, who weighs 140 pounds, couldn’t make it up the stairs at home and the pain he suffered made it difficult to go in and out of the house to use the bathroom. He took medication that masked his pain, and his playful personality, but didn’t treat it. So, Lee tracked down DeHaan and brought his beloved family pet to A Holistic Veterinary Office, where DeHaan utilizes unconventional methods like chiropractic, acupuncture, bio-magnetics, and Prolotherapy to treat a wide variety of animal issues. During a recent Prolotherapy treatment at A Holistic Veterinary Office, Mack sat patiently without the slightest bark or whimper as DeHaan injected a non-drug Prolotherapy solution at the sites of pain and weakness.

The intent of the injections was to stimulate the animal’s own natural healing mechanism to repair and rebuild injured tissue and alleviate pain. “It’s worked for Mack,” his owner said. “He’s been getting around a lot better. He’s upstairs on a regular basis and he’s much more mobile. It’s not cheap­­—some visits can run in the neighborhood of $150—and some treatments require a significant time investment, but it’s worth it,” said Lee. “We want to do everything we can non surgically to improve (his) quality of life. If we can extend his life and make his life more comfortable and enjoyable, then that’s what we want to do.”

Dr. DeHaan’s Prolotherapy solution consists of 50% dextrose diluted down to 15% plus equal amounts of lidocaine, vitamin B12, Sarapin and a homeopathic German solution named Discus Comp by HEEL. In Mack’s case, this was injected into the left ACL as well as the first and second lumbar vertebrae, the sacrum, and both hip joints.

Response was gradual because the problem was chronic. At one year of age, by X-ray, Mack was diagnosed with bilateral hip dysplasia. Months later he dislocated one hip so the ball of the hip joint was surgically removed. He also developed arthritis on his left front elbow. Although a well built 140 pound dog, one could also say he was a bag of rickety bones, or in professional terms we call Mack “ligamentous.” Ligamentous signifies chronic ligament degeneration as a result of genetic and dietary predispositions.

In Mack’s case, the plan was to give six Prolotherapy treatments. The first three were scheduled a week apart, and the final three were approximately monthly. Supportive treatments were Mega C Plus, a form of buffered vitamin C for ligament health; Thyro Plus, a raw thyroid glandular to support his thyroid; plus a homeopathic combination for pain, arthritis and kidney support, to facilitate detox and regeneration. Mack’s recovery was nothing short of miraculous. Immediately he was happier, stronger and more active. By the forth treatment, Mack was off all pain medications and was going up and down 13 steps in the home.

It is important to treat every pet as an individual. Diet is a huge key because the average commercial diet is pro-inflammatory. In other words, corn, wheat, soy and dairy and their by-products are all proven pro-inflammatory ingredients that cause or aggravate inflammatory conditions. In fact, Mack has more recently been transitioned to a “raw” meat BARF diet with benefit.

Dr. DeHaan has treated hundreds of dogs and given thousands of Prolotherapy injections over the past 15 years. He considers Prolotherapy one of his “silver-bullet” treatments. Because of the success of Prolotherapy, clients often drive great distances, like Mack’s owner, for relief that has evaded them by all other means.

SUBMITTED BY SHAUN FAULEY, DVM


“Skipper” is a 12 year-old, male, 60 pound, mix-breed Shepard with a six month history of acute lameness on the right rear leg. The original vet diagnosed a partially torn ACL, discussed surgery, and dispensed anti-inflammatory medication. The lameness progressed over the first several months then seemed to “level out” over the final two to four months before the owner decided to pursue other options. Skipper’s owner called my office to discuss the benefits of Prolotherapy. I pinioned that Prolotherapy could strengthen the joint capsule sufficiently that a fully-ruptured ACL could probably be avoided. They agreed to try and Skipper was scheduled for his first treatment.

Skipper, a 12 year-old, male, 60 pound, mix-breed Shepard.

To help minimize movement and the mild discomfort the Prolotherapy injections may cause, Domitor was used for sedation. This was then reversed with Antiseden when the procedure was finished and the sedation was quickly neutralized. A total of four procedures were performed three to six weeks apart. During each treatment the joint capsule was infused with the Prolotherapy solution on both sides of the stifle. By the third treatment, much thicker tissue was evident surrounding the joint, which one could clearly feel with the syringe as each injection site was penetrated. Skipper made great improvement in his mobility and endurance by the fourth treatment, with the greatest changes noticed after the second and third. My experience is that improvements can still happen even with the fifth or sixth treatment, but the “jumps” are not as great and may not justify the cost.

We finished Skipper’s program after the fourth visit, at which time he was doing much better with minimal discomfort and a much stronger and secure gait. The owners understand the ACL could still rupture at any time without warning but hopefully we have made that a more remote possibility. I still recommend periodic Prolotherapy injections to maintain a strong joint capsule and minimize recurrence. The owners will check in regularly and we will perform injections as needed, but so far Skipper is doing quite well.