Hyaluronic Acid Joint Injections in a Tiger With Elbow Arthritis
American Association of Zoo Veterinarians Conference 2009
Danielle R. Graham1, DVM; Catherine Monger1, LVT; Ramiro Isaza2, DVM, MS, DACZM
1Feld Entertainment, Vienna, VA, USA; 2College of Veterinary Medicine, University of Florida Gainesville, FL, USA


An 18-year-old intact male tiger, diagnosed radiographically with severe bilateral elbow osteoarthritis was becoming progressively lame in his front legs despite ongoing treatment with a variety of oral pain medications. The tiger was immobilized and then maintained on gas anesthesia. Twenty (20) mg of hyaluronic acid (HA) (Hylartin V, Pfizer Animal Health, New York, NY, USA), 18 mg of triamcinolone (Vetalog, Fort Dodge Animal Health, Fort Dodge, IA, USA) and 500 mg of amikacin (Amyglide-V, Fort Dodge Animal Health, Fort Dodge, IA, USA) were combined and split into two equal doses for injection into the left and right elbow joints. Both elbows were clipped and prepared aseptically using chlorhexadine and alcohol. A cranial approach was used by locating the lateral collateral ligament between the palpable lateral epicondyle proximally and the origin of the lateral digital extensor distally. An 18 g 3.5-inch spinal needle was placed cranial to the collateral ligament and the HA mixture was injected. Sterile technique was used throughout.

After recovery from anesthesia, the tiger’s lameness improved significantly. His activity level increased and he was noted playing with his toys and jumping onto perches in his enclosure. The duration of the improvement lasted 9–10 weeks before the lameness recurred. At that time, a second series of injections were administered exactly like the first. These injections were as efficacious as the first and results lasted until the tiger was humanely euthanatized for health issues unrelated to lameness 11 weeks later. Intra-articular injections are a relatively simple technique that should be considered in the management of large cats with osteoarthritis.


Speaker Information
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Danielle R. Graham, DVM
Feld Entertainment
Vienna, VA, USA

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