The pain relieving effect of the gold bead implantation in the canine hip dysplasia in comparison with other studies and the palliative effect of non-sterodial-anti-inflammatory drugs
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Canine hip dysplasia (CHD) is a common inherited degenerative disease of the hip joint mostly affecting large sized dogs. The degree of pain due to CHD is highly individual with some dogs showing no signs of pain while others show severe locomotive disorders with a high degree of pain. In the past the only possible treatments consisted of surgical interventions or life-long pharmacological therapy with drugs usually from the family of the non-steroidal anti-inflammatory drugs (NSAIDs). The gold bead implantation (GI) is a relative new alternative palliative treatment possibility for CHD. The aim of a GI is to reduce the amount of pain caused by CHD. While the acupuncture in the human medicine has a long tradition, acupuncture in veterinary medicine, and therefore also the GI, has become more famous in the last decades. Acupuncture elicits the pain relieving potential by releasing neurotransmitters acting as agonists on opioid receptors, increasing the threshold for pain, and by modulation of the activity of cytokines. The way of action of the gold is via the inhibition of the I-κ B kinase and subsequent binding of NF-κ B to the DNA in the nucleus. Through the non-activation of this protein the production of pro-inflammatory cytokines as TNF-α, IL-1-β, IL-6 etc. is inhibited. Without the stimulation of the cyclo-oxygenase-2 (Cox-2) by theses cytokines no prostaglandins, responsible for the inflammatory process, can be produced. The NSAIDs inhibit the stimulation of Cox enzymes directly. New developed highly selective NSAIDs have the Cox-2 as main target and are able to spare the Cox-1 responsible for different physiological functions within the body. In the past the effect of the GI treatment was compared in several double-blinded studies which came to quite different results. Therefore, in the scope of this thesis the effectiveness of the GI therapy should be compared with the effectiveness of two NSAIDs (carprofen and firocoxib). The trial with the GI therapy was an open study over two years and the trials with the NSAIDs were double-blinded trials. The results showed that the GI had a significant effect after one week which was increasing significantly over six months and staying then more or less constant. In comparison with the results of the NSAIDs it was shown that the GI therapy had a greater effect than carprofen. But it was equal with the effectiveness of firocoxib. However, the results also showed that in the trail with NSAIDs several dogs were suffering from the typical adverse effects caused by NSAIDs. Even in the group treated with firocoxib, a relative safe drug, some dogs suffered from stomach ulcers, whereas no dogs of the GI group had any adverse effect.