Soft tissue injuries and osteoarthritis are common conditions afflicting canine patients. Micro trauma to tendons, ligaments, and articular surfaces of joints can occur and can create an environment for arthritic changes. Once the degenerative cascade of this condition is initiated, its progression can be insidious. Therapies have focused on treating the symptoms or slowing the progression of this debilitating disease. Stem cell therapy may not only treat symptoms and slow the disease, but it also could help to induce repair of the underlying damage that initiated the cascade.
Stem cell therapy is becoming a common treatment option for osteoarthritis, auto-immune disease and a host of other conditions. As the therapy has evolved, treatment options have shifted from using an outside lab to procure stem cells from adipose tissue to on site preparation. AVCG is now prepping adipose derived mesenchymal stem cells in house and can return the live cells to the affected area within 1 hour of adipose collection. The process is simple, safe and effective for treating many difficult to treat conditions.
Mesenchymal Cells Stem cell therapy involves a minor surgical procedure to collect adipose tissue from the patient. This fat is then rendered into a single cell slurry that is centrifuged and filtered to collect the stem cells and other regenerative cells. Within one hour of surgery, the cells are injected back into the patient where they can begin the process or repair. The advantage of on site preparation is less cellular death due to transport and preparation at an outside lab. The patient does not have to return on a later day for follow up treatment and can benefit from the results of therapy immediately on the appointment day.
Conditions Treated with Stem Cell Therapy
- Hip Dysplasia
- Non-Union Fractures
- Tendon and Ligament Injuries
- Chronic Hepatitis
- Autoimmune Polyarthritis
- There are new disease processes under investigation at this time including kidney failure, systemic autoimmune disease and pancreatic disease such as diabetes.
What is the Treatment Process?
- Please withhold food 12 hours prior to the scheduled arrival time. Water may be left out overnight.
- Prior to your arrival your veterinarian should run a CBC/Chem panel, tick panel and an autoimmune panel on your pet. If they have not been done they will be collected on the day of the consultation.
- During a consultation with our veterinarian we will go over the condition to be treated, prognosis and associated risks.
- An intravenous catheter will be placed in a leg vein for the administration of anesthetic agents. Note: Preparation for the catheter requires hair clipping at the site.
- General anesthesia is administered, the pet is intubated and closely monitored with blood pressure, pulse oximetry, ECG and end-tidal CO2.
- Your pet will then be moved to the surgery suite and a sample of adipose (fat) tissue will be collected under sterile conditions.
- The tissue is immediately prepared to harvest the stem cells and other regenerative cells needed for treatment. Cells are activated with platelet rich plasma and laser light. This process takes 1-2 hours.
- The prepared cells are returned to the area of treatment and administered intravenously if appropriate.
- The normal total time for a stem cell collection and treatment is 3 to 4 hours.
How Stem Cells Work
Stem cells and other regenerative cells can be obtained from adipose tissues. Adipose tissue is a preferred source in dogs over bone marrow for several reasons including ease of access, high-yielding mesenchymal stem cell count as compared to bone marrow, and the fact that fat is a renewable source. The stem cells, along with a mix of other regenerative cells within the adipose tissue, are isolated and then injected directly into the injured tissue, joint and/or intravenously. These cells are always obtained from the intended recipient (autograft), eliminating the risk of rejection and disease transmission.
You should also know…
- Most patients will see improvement in 5-7 days from the IV injection.
- Full improvement can take 7-60 days.
- Ultimate long term results are unknown and it is not known if additional treatments might be necessary.
- Cells can be banked for use at a future date. This unfortunately requires using an outside lab for preparation and necessitates a second appointment for the treatment injections 48 hours after the collection.
Which dogs are good candidates for Stem Cell Treatments?
- Dogs that have not responded well to non-steroidal anti-inflammatory drugs.
- Dogs that cannot tolerate non-steroidal anti-inflammatory drugs.
- Dogs that are likely to need long-term medications for pain.
- Dogs that are not good candidates for orthopedic surgery due to age or health concerns.
- Dogs that have early arthritis.
- Dogs that have multiple joints afflicted with arthritis.
Platelet Rich Plasma Therapy
Platelet-rich plasma (PRP) uses a patient’s own blood components to stimulate healing response in damaged tissues. In response to an injury or tissue damage, the body naturally redirects platelets (clotting cells) and white blood cells from the blood to the injured area to initiate a healing response. Platelets store numerous growth factors that are released in response to signals from the injured tissue.
When a concentrated solution of platelets and white blood cells from the patient’s own blood is injected directly into injured tissue, the same healing response is stimulated, but in a more powerful form. By enhancing the body’s natural healing capacity, the treatment may lead to a more rapid, more efficient, and more thorough restoration of the tissue to a healthy state.
Conditions Treated With PRP
- Ligament sprains or tears
- Hip dysplasia
- Elbow dysplasia
- Muscle tears
What is involved in PRP therapy?
Platelet Therapy Blood is drawn from your pet and placed in a special processing unit, which separates platelets, white blood cells (WBC) and serum from red blood cells. The platelets and WBCs are then concentrated and collected into a sterile syringe. Some of the blood is used to create an “activator” of the PRP. The concentrated mixture of platelets and WBCs are then injected into the injured site. Depending on the location of the injection, your pet may need to be under anesthesia or heavy sedation.
Depending on the severity and duration of your pet’s injury, one to three PRP injections are recommended. About two weeks after the initial treatment with PRP, we will see your pet for a follow-up visit, during which your pet will undergo a full evaluation and examination. We will also ask you about your personal observations regarding your pet’s condition after the treatment. Depending on the findings, a decision will be made regarding the need for additional treatments. In general, chronic injuries require more than one injection. In both acute and chronic injuries, injections may be combined with an exercise or physical therapy program to enhance the success of the treatment.
Frequently Asked Questions
Following the initial injection, your pet will experience some soreness at the site of the treatment, especially if a joint was injected. This soreness is a positive sign that a healing response has been set in motion. This effect can last for several days and gradually decreases as healing and tissue repair occurs. It is important that anti-inflammatory medications such as Rimadyl, Deramaxx, Metacam or Aspirin are discontinued following PRP treatments. These medications may block the effects of the intended healing response facilitated by the injection itself. Alternative opioid drugs can be prescribed in case of severe pain. Your pet can resume normal activity, simply following our suggested rehabilitation plan. Vigorous or intensive exercise during this period is discouraged.
Research and clinical data has shown that PRP injections are extremely safe, with minimal risk for any adverse reaction or complication. Because PRP is produced from your pet’s own blood, there is no concern for rejection or disease transmission. There is a small risk of infection from any injection into the body, but this is rare, and minimized by our use of strict sterile technique. Of note, recent research suggests that PRP may have an antibacterial property that protects against possible infection.
If your pet suffers from chronic pain and anti-inflammatory drugs are not helping or can’t be used due to liver, kidney or gastrointestinal disease, then your pet is a candidate for this treatment. Please contact us to schedule a consultation at 734-713-1300.
These links will take you to external websites:
- Anitua E, S. M., Nurden A, Nurden P, Orive G, Andia I. (2006). “New insights into and novel applications for platelet-rich fibrin therapies.” Trends in Biotechnology 24(5): 227-234.
- Becker C, H. S., Drewlo S, Rodriguez SZ, Kramer J, Willburger RE. (2007). “Efficacy of epidural perineural injections with autologous conditioned serum for lumbar radicular compression.” Spine 32(17): 1803-1808.
- Mishra A, A. J., Anitua E, Andia I, Padilla S, Mujika I. (2007). “Treatment of chronic elbow tendinosis with buffered platelet-rich plasma.” Am J of Sports Med 34(11): 1774-1778.
- Moojen D, E. P., Schure R, et al. (2007). “Antimicrobial activity of platelet-leukocyte gel against Staphylococcus anreus.” Journal of Orthopaedic Research DOI: 10.1002/jor.20519.
- Sanchez M, A. E., Azofra J, Andia I, Padilla S, Mujika I. (2007). “Comparison of Surgically Repaired Achilles Tendon Tears Using Platelet-Rich Fibrin Matrices.” Am J of Sports Med 10(10): 1-7.