Rethinking Our Approach to Canine OA: Treating synovial inflammation

By Eric Schreiber • Exubrion Therapeutics

Canine osteoarthritis (OA) is one of the most common chronic conditions affecting dogs in veterinary practice today. Traditionally, its management has centered on managing clinical signs, such as providing pain relief. This is understandable given the clear impact on a dog's mobility and quality of life. However, research findings and clinical experience indicates that taking an approach focused solely on masking pain misses the underlying source of the disease.¹

It's time to reframe arthritis not just as a painful condition, but as a disease of rampant synovial inflammation. In adopting a proactive treatment strategy that is aimed at modulating the inflammatory process, veterinarians can now provide more effective, long-term care.^1-3

A conversation with Matthew Brunke, DVM, DACVSMR (Canine), CCAT

Robert Menardi, DVM, Chief Veterinary Officer at Exubrion Therapeutics, had the opportunity to sit down with Dr. Brunke to talk about his experience treating this challenging disease.

Dr. Menardi: "Historically, OA has been thought of as a 'wear-and-tear' disease of older dogs involving the mechanical breakdown of the joint over time. But we now know it's actually a disease of relentless inflammation that's directly responsible for the pain and progression of joint degradation."

Dr. Brunke: "That's right. Many veterinarians, including myself, learned that OA is a disease of cartilage in vet school when it's really a synovial disease. We're also taught that cartilage doesn't have nerve endings… so if this is the case, how can OA be so painful? It's because it's the inflammation of the synovium, the synovitis, that drives the entire imbalance of the homeostasis of the joint. It's the synovium that has the greatest number of nociceptors and that's what makes the joint become painful in OA."

"I can't emphasize how important proper diagnosis is and that we need to shift our mindset to understand that inflammation is driving the progression of the disease if we are going to start doing better in getting these dogs the effective treatment they need."

Dr. Menardi: "I'd like to talk about your approach to treating canine OA and then get into your experience with Synovetin OA®, one of the newer treatments that's showing promise for dogs with all stages of this disease."

Dr. Brunke: "Before I discovered Synovetin OA, PRP was my standard of care followed by rehab, but we also used hyaluronic acid, steroids, and stem cells. With these modalities, we were getting several months of improvement, but that was about it. It wasn't a great system. Then, I learned about Synovetin OA from a research article about a radioisotope (tin-117m) treatment showing 12-month efficacy with just one injection.⁴ The opportunity to provide these dogs with a long duration of effect compared with other treatments really caught my attention."

Dr. Menardi: "When did you start using Synovetin OA to treat canine OA in
your practice?"

Dr. Brunke: "It's been a couple of years now. I connected with Dr. Lattimer (Jimmy Lattimer, DVM, MS, DACVR-Radiology, DACVR-RO-Radiation Oncology) at the University of Missouri School of Veterinary Medicine. Dr. Lattimer had been involved in the Synovetin OA clinical trials and what his team had found is that, in most cases, the majority of treated dogs had better results than they saw with current alternatives, so I decided to bring it on board.

"My first patient was an 8-year-old Labrador with elbow arthritis. His records showed that he was no longer responding to NSAIDs so he was recommended for amputation or euthanasia! Well, that wasn't going to fly with 'Mom' and she wanted to try Synovetin OA. The results were impressive. This dog went from being unable to walk without pain medication to experiencing 22 months of relief after just one injection–plus, he came off all other pain drugs."

Dr. Menardi: "How many dogs have you treated at this time?"

Dr. Brunke: "Since then, I've used Synovetin OA to treat nearly 200 dogs and have been seeing the effectiveness of this treatment continue for 18 months on average from just a single injection. I find that Synovetin OA is the most potent anti-inflammatory I can use, and it's less expensive than other modalities, like stem cells. We're using it in younger and older dogs. In fact, it's particularly useful for younger dogs with earlier stage arthritis, as it addresses the inflammation that's causing the disease before the damage to the joint becomes severe."

Dr. Menardi: "That's a really important point. The clinical studies of Synovetin OA showed the greatest improvement in dogs with mild to moderate OA—a 92% response rate. And while it also helped address inflammation and reduce pain in the majority of dogs with more severe disease, those results were slightly lower—71% response rate.^5-7 Those results are impressive regardless of the stage of disease, but it just underscores how important it is to realize that this is a disease of inflammation that's damaging the joint. Getting ahead of it before it becomes more severe and debilitating is important."
Dr. Brunke: "I agree. For example, we were seeing very young dogs 8 to 12 weeks after arthroscopy still limping on NSAIDs because of severe synovitis. So, we've started giving Synovetin OA at about 12 weeks out and we see they're doing remarkably well without NSAIDs. And in dogs with more mild disease, we're seeing we can get them off their meds and give them 12, 14, 18 months of relief in many cases."

Dr. Menardi: "So, is Synovetin OA an opportunity to maintain the health of the joint for the lifetime of the dog if they're treated early?"

Dr. Brunke: "Clearly, early intervention in treating OA is very important, and that's been highlighted in a recently published study demonstrating that tin-117m, the active component in Synovetin OA, has a positive disease-modifying effect in rodent models.⁸ So, with these young dogs, we're injecting them once and we're getting long-term relief. Now, owners still need to know that their dogs have to stay lean to help reduce general inflammation, not just because of weight on the joints, but because fat creates pro-inflammatory cytokines that contribute to joint damage. Intervening early, we have the chance to keep these dogs from becoming crippled at 5 or 6 years old."

Dr. Menardi: "Can you tell us about one of your recent Synovetin OA success stories?"

Dr. Brunke: "Certainly. We recently had a pet parent who brought her dog, Bodhi, all the way from Canada. He's a young Cane Corso that had been struggling with elbow OA. Everyday tasks were becoming harder and harder for him. We treated both his elbows and he went back to Canada that same day. He's doing great. His 'Mom' reports that she's already noticing improvements after just 1 week."

Dr. Menardi: "What advice do you have for other practitioners who are either thinking about becoming licensed to give Synovetin OA or considering referring these cases to specialists like you?"

Dr. Brunke: "Don't be afraid to learn a new skill and put new tools in your toolbox. Joint injections should be part of our standard of care. They're common treatments for humans and horses, and they should be more common for small animals, too. So, reach out to a colleague and find out what more you could be doing. And keep in mind that we all want to work together to help these pets live active, mobile lives."

Learn More

To find out how Synovetin OA can fit into your OA treatment strategy, visit Synovetin.com/vpn or contact Eric Schreiber, Chief Commercial Officer, at eschreiber@exubrion.com.

References

1. ACVS. Osteoarthritis in dogs. Available at: https://www.acvs.org/small-animal/osteoarthritis-in-dogs/. Accessed April 7, 2025.
2. Orthopedic Foundation for Animals. Available at: https://ofa.org/wp-content/uploads/2021/05/elbowarticle.pdf. Accessed April 7, 2025.
3. Enomoto M, de Castro N, Hash J, et al. Sci Rep. 2024;14(1):2827.
4. Lattimer JC, Selting KA, Lunceford JM, et al. Vet Radiol Ultrasound.2019;60(5):567-574.
5. Aulakh KS, Lopez MJ, Hudson C, et al. Vet Med (Auckl). 2021;12:117-128.
6. Donecker J, Fabiani M, Gaschen L, Aulakh KS. PLoS One. 2021;16(7):e0254613.
7. Donecker J, Lattimer JC, Gaschen L, Aulakh KS. Vet Med (Auckl). 2021;12:325-335.
8. Bendele A, Doerr CA, Gonzales GR, et al. Evidence of osteoarthritis disease modification with a Sn-117m microparticle device: a review and validation in mammalian models. Front. Vet. Sci. 2-25;12:1-13 doi: 10.3389/fvets.2025.1621296.

This Education Center article was underwritten by Exubrion Therapeutics.