Zero Pain Philosophy

Stem cells are an evolving and promising option for osteoarthritis management in dogs and cats. In this podcast we talk to Dr Russell Chandler from Greenside Referrals in Scotland with all the questions you may have about stem cells. We start from the view of the vet in the consulting room with an arthritic pet in front of them. 
What do we say to clients, how do stem cells work, which cases are suitable. Listen to our discussion now and understand if stem cells are the right option for your patients.
Links
Greenside Referrals
https://www.stemcellsscotland.co.uk/contact-us
Russell’s book
https://5mbooks.com/product/regenerative-medicine-in-small-animal-musculoskeletal-conditions
Andrew Armitage’s paper on stem cells
Efficacy of autologous mesenchymal stromal cell treatment for chronic degenerative musculoskeletal conditions in dogs: A retrospective study.
This represents the first study using “real-world” data to show that cell-based therapies, injected into multiple areas of musculoskeletal pathology in a targeted holistic approach, resulted in rapid and profound positive effects on the patient's pain state and quality of life which was maintained with repeat treatment for up to 2 years.
https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2022.1014687/full

How does CBD work?
Is CBD a first line option for the treatment of OA pain? 
And where in our second line options does CBD fit? 
In this episode of the Zero Pain Philosophy podcast we are joined by anaesthesia & pain specialist Dr Leon Warne to answer these questions.
If your clients are asking you about CBD, then you need to listen to this.
References
Here is the link to the CATRAS work discussed in today’s podcast:
Warne LN, Schug SA, Beths T, Brondani JT, Carter JE, Lascelles BDX, Raisis AL, Robertson SA, Steagall PVM, Taylor PM, Whittem T, Bauquier SH. Content validation of a Critical Appraisal Tool for Reviewing Analgesia Studies (CATRAS) involving subjects incapable of self-reporting pain. Pain Rep. 2018 Jul 25;3(4):e670. doi: 10.1097/PR9.0000000000000670. PMID: 30123860; PMCID: PMC6085143.
These are the COAST guidelines:
Cachon T, Frykman O, Innes JF, Lascelles BDX, Okumura M, Sousa P, Staffieri F, Steagall PV, Van Ryssen B. COAST Development Group's international consensus guidelines for the treatment of canine osteoarthritis. Front Vet Sci. 2023 Aug 3;10:1137888. doi: 10.3389/fvets.2023.1137888. PMID: 37601753; PMCID: PMC10436090.
This is a recent review of CBD in dogs and cats
Moreno-López N, Moreno-López C, Amariles P. Cannabis-based products for medicinal use in dogs and cats: a systematic review. J Small Anim Pract. 2025 Jul 14. doi: 10.1111/jsap.13913. Epub ahead of print. PMID: 40660612.

Our latest podcast discusses the newly launched DogMA app with researchers Dr Natasha Clark and Professor Eithne Comerford. 
Mobility issues from musculoskeletal diseases, like osteoarthritis, affect around 200,000 dogs annually, posing a significant challenge to their health and welfare. Although these diseases can affect dogs of any age, owners often miss early, subtle signs of gait abnormalities, leading to late diagnosis of osteoarthritis. 
The DogMA app was developed to address this by enabling early detection of mobility problems, including subtle signs of discomfort or decline often overlooked in routine care. 
DogMA is supported by scientific research led by Dr. Natasha Clark at the University of Liverpool, under the supervision of Professors Eithne Comerford and Karl Bates, in collaboration with Dogs Trust. 
By using the app for regular assessments, users can also contribute anonymized data to ongoing research at the University of Liverpool, helping to advance the understanding of canine mobility across the UK.
References
Here is the link to the paper discussed in today’s podcast:
Clark NL, Bates KT, Harris LK, Tomlinson AW, Murray JK, Comerford EJ. GenPup-M: A novel validated owner-reported clinical metrology instrument for detecting early mobility changes in dogs. PLoS One. 2023 Dec 27;18(12):e0291035. doi: 10.1371/journal.pone.0291035. PMID: 38150469; PMCID: PMC10752556.
University of Liverpool page launching DogMA
https://www.liverpool.ac.uk/life-course-and-medical-sciences/research/dogma/
Download the app for free from your app store:
Android: DogMA in the Google Play Store
iOS: DogMA in the Apple App Store
This is the paper documenting radiographic and clinical OA in 23% of dogs less than 4 years of age:
Enomoto M, de Castro N, Hash J, Thomson A, Nakanishi-Hester A, Perry E, Aker S, Haupt E, Opperman L, Roe S, Cole T, Thompson NA, Innes JF, Lascelles BDX. Prevalence of radiographic appendicular osteoarthritis and associated clinical signs in young dogs. Sci Rep. 2024 Feb 3;14(1):2827. doi: 10.1038/s41598-024-52324-9. PMID: 38310147; PMCID: PMC10838335. 
These are the COAST guidelines:
Cachon T, Frykman O, Innes JF, Lascelles BDX, Okumura M, Sousa P, Staffieri F, Steagall PV, Van Ryssen B. COAST Development Group's international consensus guidelines for the treatment of canine osteoarthritis. Front Vet Sci. 2023 Aug 3;10:1137888. doi: 10.3389/fvets.2023.1137888. PMID: 37601753; PMCID: PMC10436090.

Do you feel like to need to play detective in your behaviour cases? How many of these cases have pain as an underlying issue? Then you will love this paper!
We have the pleasure of talking through the approach taken in this series of cases where the authors describe their approach to assessing pain in the behaviour case.

Detection of maladaptive pain in dogs referred with behavioral complaints:challenges and opportunities
https://www.frontiersin.org/articles/10.3389/fnbeh.2025.1569351

Dr Robert Trujanovic is an EBVS European Specialist in Veterinary Anaesthesia & Analgesia. In our latest podcast we talk to Robert to share his experience of using botulinum toxin A in pain management in dogs. Robert is leading the field on this subject and brings his experience of interventional pain management to our Zero Pain community.
We explore
What is the mechanism of action of BT?
What sort of pain cases is BT used for in human medicine?
Can you please tell us about some cases where you have successfully used BT in dogs (any feline experience)
Are there some practical considerations you would like to mention?

References
·      Pioneering pain management with botulinum toxin type A: From anti-inflammation to regenerative therapies. Hamta Rahmatipour, Salar Mohammadi Shabestari, Soheila Zamanlui Benisi, Hamidreza Samadikhah
 
·      Botulinum toxin for the treatment of chronic pain. Review of the evidence. Roberto Carlo Rivera Día, Mario Andrés Arcila Lotero, María Victoria Avellaneda Suarez, Sara Echeverri Saldarriaga, Manuela Gómez Martínez
 
·      Botulinum Toxin in Chronic Lateral Epicondylitis, from Tendon to Muscle Approach—A Review
 
·      Transforaminal versus Intra-Articular Facet Corticosteroid Injections for the Treatment of Cervical Radiculopathy: A Randomized, Double-Blind, Controlled Study N.J. Bureau, T. Moser, J.H. Dagher, D. Shedid, M. Li, P. Brassard and B.E. Leduc
 
·      Retrodural space of Okada in the posterior ligamentous complex region: clinical and anatomical findings relevant to lumbar interlaminar epidural injection