Comparing extracorporeal shockwave therapy products

Sponsored my Zomedica / PulseVet

Adam Christman, DVM, MBA: I understand too. Let's talk about some other ones that are out there on the market in comparison to the one that we have here with PulseVet. Talk to us a little bit about what are some of the differences with other ones that are out there on the market today.

Leilani Alvarez, DVM, DACVSMR, CVA, CCRT: Yeah. The big one, so as I mentioned before, there are publications, just namely two publications on radial shockwave that were used to treat arthritis successfully in dogs. We actually don't have those machines on the market in the United States. I'm not even going to talk about those. The really big one that's available to veterinarians, and I think a lot of practitioners have, is the PiezoWave. The PiezoWave is a Piezoelectric shockwave that is a type of focused shockwave. The Piezoelectric, it generates shockwaves, but they are much lower in energy, lower intensity. Historically, people always thought about this machine as being the one that needed sedation because it was more focused, higher intensity, higher energy that would require sedation, and then the Piezoelectric was non-sedating. I think it appealed to a lot of practitioners to do the Piezoelectric because it is a lower intensity. The big issue that I've always brought up is, where's your evidence? Does it work? We do have this lovely publication now by Terry Kern. She's a friend and a colleague that just came out in Frontiers. It is a retrospective study. I always prefer prospective studies that have a placebo control because those dogs had shoulder injuries and they did improve on musculoskeletal ultrasound images, but there's no control and the dogs were also rested. We don't know, was it the Piezoelectric, was it the rest, was it the combo? What would a control dog look like? We have nine publications on the electrohydraulic pulse-fit machine specifically. Out of all of those studies, two of them were retrospective, but the rest were all prospective double-blind placebo controlled. The main difference between those two machines, again, I would say, is the Piezoelectric never needs sedation. If you choose not to use the X-Trode, the other Trodes, the five-millimeter and the 20-millimeter, I would recommend using sedation for them. Those have really good applications post-surgical, so your patient's already anesthetized and maybe you're worried about this fracture has had complications already and you're trying to increase bone bone healing. There were two very nice publications on this machine showing that it does increase bone healing. And so for those, your patient's already anesthetized, so you go ahead and do that.

Adam Christman, DVM, MBA: Okay. Yeah, because I was going to ask you, are there specific indications for our patients where one might be preferred over the other?

Leilani Alvarez, DVM, DACVSMR, CVA, CCRT: You know, I would say that the piezoelectric is particularly, it makes sense for its mechanism of action, which is similar, but just the lower intensity. I think it's quite good for more superficial things, like myofascial trigger points. So if you were to have, and by the way, I actually, because I lecture, I always look into, well, what does a human literature show? It does seem that it can be effective for things like spasms in the muscles, you have myofascial trigger points, those types of chronic myofascial things. I think it could be effective. I don't know that I would choose that over this because this X-Trode is wonderful for that. But where I would definitely choose this machine is if I want to go for something that is deeper. So if I'm treating bone, for example, or I'm treating a tendinopathy that's deeper, where I'm really wanting to get that higher energy, because that's going to give us bigger cellular permeability, more blood flow, a bigger response.

Adam Christman, DVM, MBA: Okay. Excellent.