Do magnets really work for pain?

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Radiographs and Asthma in Cats

The study investigates Feline Lower Airway Disease (FLAD), encompassing feline asthma (FA) and chronic bronchitis (CB), which cause symptoms ranging from cough and wheezing to respiratory distress. Chronic airway inflammation leads to changes like epithelial edema, cell infiltration, and bronchoconstriction, resulting in airway obstruction and airway remodeling if untreated. 

Radiographic findings in cats with FLAD typically include bronchial patterns due to thickened bronchial walls and mucus accumulation, as well as other patterns like interstitial or alveolar, hyperinflation, and atelectasis, particularly in the right middle lung lobe. The standard treatment involves glucocorticoids, with or without bronchodilators, to suppress inflammation. The study aimed to assess if radiographic abnormalities in FLAD correlate with clinical signs and improve with individualized treatment. Although radiographic abnormalities showed significant improvement with anti-inflammatory treatment, there was no clear clinical correlation. Initially, all cats had radiographic abnormalities, including bronchial or bronchointerstitial patterns. Hyperinflation was more common in this study compared to previous ones, possibly due to selection bias, as only cats with clear clinical signs were included. The study found significant improvement in radiographic scores during treatment, particularly in bronchial lung patterns. However, improvement in interstitial patterns was slower, suggesting advanced FLAD might require longer treatment. Despite clinical improvements, some cats continued to show radiographic hyperinflation, indicating a possible lag in radiographic response or ongoing subclinical inflammation. No correlation was found between the severity of clinical signs and radiographic changes, highlighting the need for comprehensive evaluation beyond radiographs. Radiographic examination remains a valuable tool for monitoring treatment response, especially in cases where clinical assessment is limited. Limitations of the study included the lack of a standardized treatment protocol and potential biases due to radiographs being interpreted by a single radiologist and performed on unsedated cats, affecting image quality. In conclusion, while radiographic and clinical signs both improved with treatment in cats with FLAD, they did not correlate directly, suggesting a complex relationship between clinical presentation and radiographic findings. 

Gareis H, Hörner-Schmid L, Zablotski Y, Palić J, Hecht S, Schulz B. Correlation of clinical and radiographic variables in cats with lower airway disease. J Vet Intern Med. 2023; 37(6): 2443-2452. doi:10.1111/jvim.16874 

Bottom line — Rads and clinical signs did not always correlate directly.

Magnets and Pain in Dogs

Osteoarthritis in dogs is a common condition that leads to symptoms like lameness, stiffness, and behavioral changes due to pain. Diagnosing canine osteoarthritis typically involves a physical examination and may include radiographs. The disease is incurable, requiring lifelong management focusing on pain control and slowing progression through various treatments, including NSAIDs and nonpharmacologic approaches. Recent research has explored the use of static magnets (SMs) for treating chronic pain in dogs. SMs have shown efficacy in humans with chronic musculoskeletal pain and in animal models. This study investigated the effect of SMs on dogs with osteoarthritis by using magnetic collars. Owners assessed their dogs' pain using the Canine Brief Pain Inventory (CBPI), which evaluates pain severity and interference with function. Results showed significant reductions in pain severity and functional interference after wearing the magnetic collars for four weeks compared to placebo collars. The study also noted that SMs had a quick onset of analgesic effect, but this effect was short-lived after the collar was removed. There was no significant improvement in overall quality of life as assessed by the owners. While the study had limitations, including a small number of participants and its subjective nature, it suggests that magnetic collars could be a supplementary treatment for canine osteoarthritis. Further research is needed to confirm these findings and explore the longevity and mechanisms of SMs' effects. 

Picton, F. A., Fontaine, S. J., & McBrearty, A. R. (2024). Magnetic collars improve owner-reported pain scores in dogs with osteoarthritis in a blinded crossover study. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.23.10.0555 

Bottom line — Early results support this as a beneficial modality.

Status Epileptics and Cluster Seizures in Dogs

The consensus statement on veterinary management of seizure disorders, including status epilepticus (SE) and cluster seizures (CS), in dogs and cats provides comprehensive guidelines on treating these emergencies. These guidelines address the high mortality and morbidity associated with SE and the complexities in managing CS. 

For SE, the statement emphasizes the importance of early and aggressive treatment to prevent brain damage and systemic complications. SE is redefined as continuous seizure activity or sequential seizures without full consciousness recovery, lasting over 5 minutes. The statement categorizes SE into four stages, each with specific treatment options and drug sensitivities. First-line treatments for SE include intravenous and intranasal benzodiazepines, with midazolam preferred due to its potency and safety profile. If initial treatments fail, second-line treatments like levetiracetam, phenobarbital, and fosphenytoin are recommended. 

For more severe cases, third-line treatments involve anesthetic medications such as ketamine, dexmedetomidine, propofol, and barbiturates. The guidelines also suggest other pharmacological and non-pharmacological interventions for super-refractory cases. Throughout treatment, the statement highlights the need for supportive care and addressing underlying causes. 

Regarding CS, short-term management includes short-acting interventions like intranasal midazolam and rectal diazepam, followed by longer-acting medications such as levetiracetam. If these fail, further interventions, similar to those for SE, may be necessary. 

The statement also provides detailed guidelines on assessing treatment efficacy, the timing for initiating various treatments, and the tapering process once seizure activity is controlled. The overarching aim is to unify current practices, establish evidence-based guidelines, and offer recommendations for effective treatment of SE and CS in dogs and cats. 

Charalambous M, Muñana K, Patterson EE, Platt SR, Volk HA. ACVIM Consensus Statement on the management of status epilepticus and cluster seizures in dogs and cats. J Vet Intern Med. 2024; 38(1): 19-40. doi:10.1111/jvim.16928 

Bottom line — Consensus statement on treating dogs.

Just putting things in perspective …