A few years ago, I spoke with a colleague at a veterinary
conference about a new procedure she was involved
in testing. It sounded too good to be true – isolating stem
cells from an animal’s own tissues and injecting them back
into diseased tissue to promote healing. At the time, it
was commonly thought that stem cells were found only
in embryos, and that adult animals didn’t have any. The
researchers were getting excellent results with preliminary
studies using stem cells to treat arthritis. Wow, I thought. If
this study’s final results live up to the promising early work, this is
going to revolutionize veterinary medicine.
Well, the studies have proven its effectiveness and stem
cell therapy is now available for dogs, cats and horses.
It is used in dogs and cats with arthritis (both osteoarthritis
and rheumatoid arthritis), fractures and tendon or
ligament injuries. To date, over 5,000 animals have had
regenerative stem cell therapy.
What is a stem cell?
Within every animal’s body is a resource that has an
incredible capacity to heal – the stem cell. These cells
are present in small numbers in all tissues, and patiently wait for the chemical and biological triggers that arise from
injury to get to work. They can differentiate into just about
any cell type, such as tendon, ligament, bone, cartilage,
cardiac, nerve, muscle, blood vessels, fat, and organ tissue.
Their job is to quickly produce the correct cell types needed
to repair the damage.
What is regenerative medicine?
Regenerative medicine refers to the use of stem cells to
repair injury. When stem cells are isolated, concentrated and
placed directly at the site of injury, we can “supercharge” the healing response and even begin to heal previously
untreatable conditions. It is now known that fat tissue
contains enough stem cells to make it a good source for
collection and isolation. And most of our animals (and us
too!) have a bit of spare fat tissue “hanging around”.
The San Diego-based company Vet-Stem holds exclusive
rights to fat-derived stem cell therapy in veterinary medicine.
The current approved uses of Vet-Stem Regenerative
Cells (VSRCs) are for osteoarthritis (of the leg joints),
osteochondritis dessicans (OCD), partial tears of tendons
or ligaments, and fractures.
Cats always have to do things a bit differently, so they need to
have a blood sample sent to the lab as well as the fat tissue.
Because the stem cells are the animal’s own cells, there is no
concern with tissues being rejected and no need for harsh
anti-rejection drugs.
How does it work?
Like the conventional mainstay of arthritis relief (non-steroidal
anti-inflammatory drugs or NSAIDs), stem cell therapy
reduces inflammation. But unlike NSAIDs, stem cell therapy
actually rebuilds healthy tissue so the joint improves.
During a day surgery procedure, a small amount of fat is
collected from the animal, immediately placed in a special
sterile transport fluid, chilled, and express shipped to Vet-Stem in San Diego. There, the cells are isolated under strict
aseptic conditions to prevent contamination. The number
of cells required to treat the patient are portioned out, and
any extra are frozen and banked for later use. The treatment
syringe is express shipped on ice back to the clinic, where
it is injected into the joint to be treated. Most animals will
require a light sedative to ensure they are comfortable and
relaxed for the injection into their painful joints.
When should stem cells not be used?
In some cases of severe degenerative joint disease, the body produces
extra bone around the joint and in the ligaments and tendons.
This may make an injection into the actual joint space difficult or impossible.
If the joint is completely unstable, as in the case of a knee
ligament (anterior cruciate) rupture, or if there are bone or cartilage
fragments inside the joint, these need to be corrected with surgery
prior to stem cell therapy.
There are certain other situations when VSRCs are not recommended.
These include cancer of all kinds, severe infection and topical wounds.
What’s next?
I am very excited about the future of regenerative medicine. Research
into stem cell therapy continues and further development and refinement
are ongoing. Vet-Stem is able to grow more stem cells in their
laboratory, resulting in a virtually endless supply from only one collection
procedure. Some anticipated uses of VSRCs to watch for include
neurological, heart, kidney, liver and immune mediated diseases.
I feel privileged to be able to offer stem cell therapy to my patients,
and look forward to using it even more as exciting new applications
are unveiled. |
Setting the record straight
A lot of false rumors surround stem cell therapy.
Myth: Stem cells come from aborted fetuses or embryos.
Fact: The stem cells used in veterinary regenerative medicine are not of embryonic
origin. They come directly from the animal to be treated, and are used only in
that individual.
Myth: Regenerative medicine is much more expensive than
conventional therapy.
Fact: When costs of surgery such as hip replacement, medications, monitoring blood
tests and treating side effects is taken into account, regenerative medicine may
actually be less expensive than other options. Some animals may not be able to
have conventional treatments or drugs due to other disorders. It is impossible to
put a dollar value on a happy, comfortable mobile animal doing the things she
loves to do with you. Be aware, though, that no two animals are the same. It
is best to discuss individual care options and cost estimates with a veterinarian
experienced in regenerative medicine. Expect to pay between $3,500 to $4,750
for the initial diagnostic testing, collection surgery and implantation. Vet-Stem’s
fees include cell banking for one year; additional banking is currently billed at
$250 USD per year.
Myth: Regenerative therapy cures arthritis.
Fact: Regenerative therapy is an arthritis treatment that decreases pain and inflammation
and promotes healing. Most patients pursuing this therapy already have
joints that are significantly damaged. They may also have had prior growth/conformational
abnormalities, surgery or traumatic injuries that cannot be reversed.
Stem cell therapy can be repeated when the effects wear off, typically from four
to 12 months.
Myth: Stem cells can cause cancer.
Fact: This is a justified concern if a therapy involves embryonic stem cells because
these cells actually do divide at an extremely fast rate, and have already been
shown to have cancer-causing potential in animals and humans. However,
VSRCs are adult cells, and have not been shown to form tumors unless the
patient already has cancer. VSRCs should not be used in animals with cancer.
Myth: Regenerative medicine is only available in the US.
Fact: Vet stem regenerative medicine has also been available to Canadian veterinarians
since November 2008. |
