Pentorse 100

Osteoarthritis In Dogs

• It is one of the leading joint degenerative disorders seen in dogs.
• It has been estimated that around 30-50% of dogs will be affected by osteoarthritis at some point in their lives.
• The condition causes long term degeneration of joints and involves many tissues including cartilage, bones of the joint, joint capsule and synovial fluid.
• The key signs or symptoms of osteoarthritis are stiffness, lameness and pain of the joints.

MAJOR CAUSES OF OA

• Larger breeds such as German Shepherd , Labs, Golden Retrievers, Great Danes.
• Obesity
• Age
• Repetitive stress from athletic activities
• Mechanical Injuries.
• Improper Nutrition
• Genetics

Parts of Joint

Articular Cartilage
Synovial membrane
Synovial fluid
Joint capsule
Ligament Tendon

What is Pentorse 100?

Pentorse is made of an active ingredient called Pentosan polysulfate sodium. It is a semi-synthetic polysulfated polysaccharide.
PENTORSE 100 Canine Injection aids in the treatment of non-infectious, inflammatory joint disease in dogs.

Pentosan Polysulphate is derived from a plant source called beechwood.
• Pentosan polysulfate is a semi-synthetic polysaccharide polymer which possesses anti-inflammatory, anti-arthritic and chondroprotective properties.
• Classified under DMOAD (Disease modifying osteoarthritic drug)

MECHANISM OF ACTION

∙ Loss of proteoglycans (PGs are large molecules composed of a protein core) from extracellular matrix of articular cartilage is one of the central pathological feature of OA.
The depletion of PGs maybe a consequence of declining chondrocyte viability and/or excessive catabolic activity.
∙ Inhibits proteolytic enzymes and decrease the loss of proteoglycans.
∙ Inhibits destructive enzymes like interleukin-1 and interleukin-6, TNF alpha (Tumor necrosis
factor-alpha converting enzyme)
∙ Initiates immune mediated response to the site with release of interleukins 1,6, TNF α and leucocytes thus causing inflammation, pain and redness.
Decrease in HA concentration reduces viscosity of synovial fluid which causes friction between the joints. Pentosan Increases HA concentration in synovial fluid and thus increasing viscosity in the fluid and smoother mobility.
∙ Due to heparin like nature it breaks down vascular occlusions and increases blood flow to the joints. Thus improving oxygenation and nutrition to the joints.
∙ Decreases procoagulant activities and vascular occlusions.
∙ Breaks down blood clots and increases blood flow to the joints.
∙ Due to favourable conditions made, it Initiates chondrocyte regeneration.

Glossary

∙ Chondrocytes are the cells responsible for cartilage formation
∙ Extracellular Matrix : A large network of proteins and other molecules that surround, support, and give structure to
cells and tissues in the body
∙ Anabolic reaction: synthesize larger molecules from smaller constituent parts.
∙ Interleukins (IL) are a type of cytokine
∙ Cytokines are small proteins that are crucial in controlling the growth and activity of other immune system cells and blood cells.
∙ Procoagulant activity represents the capacity of activated FXII( zymogen to serine protease) propagating down the intrinsic pathway and ultimately inducing plasma coagulation

Mechanism of action

• 1) Pentosan polysulfate is a polysulfated polysaccharide drug that acts as a chondroprotective agent.
• 2) It can retard the degradation of articular cartilage in osteoarthritis through inhibition of many enzymes that are implicated in the degradation of cartilage
• 3) PPS has a positive effect on chondrocyte metabolism, which encourage repair of articular cartilage
• 4) Stimulate the synthesis of HA (the major nonproteinaceous component of synovial fluid). The quantity and molecular weight of HA are often reduced in arthritic joints. HA is important for the maintenance of viscosity, soft tissue boundary lubrication and protection of articular cartilage from mechanical damage
• 5) Improve circulation to subchondral bone.
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CONTRADICTIONS

• Pentosan being a plant based origin it doesn’t have any side effects in the body but occasionally if a patient is hypersensitive they may show gastric sensitivity like Emesis, diarrhoea, lethargy and anorexia.
• We also need to take precautions in the following cases:
• Do not use for the treatment of septic arthritis. In this case, appropriate antimicrobial therapy should
be instigated.
• Do not use in dogs with advanced liver or kidney impairment, or evidence of infection.
• Do not use in dogs with blood disorders, coagulation disorders, bleeding or malignancy (especially haemangiosarcoma).
• Pentosan Polysulfate has an anticoagulant effect. Do not use during the pre-operative period.
• Do not use in the skeletally immature dog (i.e. dogs whose long bone growth plates have not closed).
• Do not administer in Pregnant or lactating bitches.
• NSAID and In particular Aspirin should not be used in combination with pentosan as they may affect thrombocyte adhesion and potentiate anticoagulant activity of the product.
• Corticosteroid have been shown to be antagonist to a number of action of pentosan

USP

Completely safe and no reported side effects.
Anti- inflammatory action helps reducing joint inflammation and pain.
Chondro-protective action and inhibition of loss of proteoglycans helps in terminating further destruction of the joint and initiates regeneration of the damaged tissue.
Stimulation of Hyaluronic acid increases formation of synovial fluid which helps in lubrication of the joint.
Technically the product shows a long term effect as compared to other treatment options.

CURRENT THERAPIES USED FOR OA

• NSAIDs like Meloxicam, Carprofen.
• Polysulfated glycosaminoglycan like Adequan.
• Supplements like HA, Chondroitin, Glucosamine.
• CBD oil and supplements.
• Physiotherapy and Hydrotherapy
• Acupuncture

Dosage of Pentorse 100

• The dosage for canine is 3mg/kg BW (1 ml per 33 kg BW) given subcutaneously every 5-7 days for a period of 4 weeks.
• Can be repeated again after one month rest period.
• Not more than 3 courses a year i.e 12 injections in a year.

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