By Stacy E. Smith and Dr. John Rowe, DVM
While it’s not quite the bionic technology that saved “Six Million Dollar Man,” Steve Austin or the “Bionic Woman,” scientific advances in veterinary medicine is giving virtually crippled pets a new lease on life.
Did you know that crippling conditions can be stopped in their tracks and the body healed by using stem cell derived from our pet’s own bone marrow? This method is now considered the “gold standard” when it comes to stem cell therapy options and it’s available to your pets.
For those of you that are long-time readers, you are often privy to a lot of what goes on at our house when it comes to our pets. You’ve followed our failed attempts at dog training, our pet’s adventures with us, the pets we’ve lost and the new additions. So, we thought we’d let you in on something we think you’ll find very interesting… our dog, Keegan’s, stem cell therapy.
Keegan is a ten year old Border Collie/Shetland Sheepdog mix (pictured above). Several years ago, we noticed that Keegan was struggling to raise his back end from a seated or lying position and had developed a sort of “bunny hop” when he climbed the stairs and ultimately when he would run.
While it didn’t slow him down (it never slowed his will to play fetch or go on lengthy walks or hikes with us), we knew that meant he was pretty uncomfortable.
As it turned out, Keegan was diagnosed with hip dysplasia. I know that term gets tossed around a lot and some of you may have a basic understanding of what that is, but some of you may not, so here’s a basic definition according to VetStreet.com:
This genetically predetermined disease that causes mild to severe changes to the inner workings of the hip joint happens when an animal (usually a large breed dog) inherits a series of genes specific to how this joint’s components (made up of the bones of the femur and pelvis) fit together. More specifically, it has to do with how the femoral head (the ball portion of the femur) and acetabulum (the pelvis’s hip socket) align to achieve the kind of smooth movement a pet requires for a lifetime of weight bearing and normal wear and tear. One or both hips may be involved.
If untreated, arthritis (often referred to as osteoarthritis) is the result in all cases. Because the bones of the joint don’t line up just right, the joint cartilage is subjected to abnormal wear and tear. Over time, cartilage damage occurs, resulting in pain and arthritis.
What can you do about it? Traditionally, your vet will work with you to control your pet’s pain by giving pain-relieving drugs, anti-inflammatory drugs, joint supplements (glucosamine & chondroitin), and weight management. Obviously, being overweight puts a lot of stress on joints, so maintaining a proper weight can help manage the condition.
In severe cases, surgery may be suggested by your vet. Surgical options include hip replacement surgery, reconstructing the hip joint, or removing the abnormal part of the joint and allowing the surrounding structures to form a “false joint” over time.
Surgical options may cost up to $5,000 per hip… perhaps more (or less) depending on where you live.
Keegan needed two new hips. That was going to cost a lot of money and require a heck of a lot of recovery time and rehabilitation afterward. At ten years old, we had a big decision to make.
Well, as all this was rearing its ugly head, Dr. John Rowe, our monthly veterinary guest host on our radio show, Paw Prints Live, and owner of Aid Animal Hospital in Kansas City, happened to mention to us that he had become certified to do stem cell replacement therapy. He went on to explain that although vets, even local vets, are doing stem cell replacement using stem cells derived from fat cells, he had been made aware of another version, one using stem cells procured from bone marrow. He described how that method is being used in horses with great success and is ultimately being called the “gold standard” when it comes to this type of treatment. And, as a bonus, the collection procedure is not major surgery as it is when fat cells are used, meaning almost no down time for the animal.
“How interesting,” we thought. The wheels began to spin and soon, we had an
appointment with Dr. Rowe to get started with Keegan’s treatment plan.
Before I tell you how thing worked out, this is a good point at which Dr. Rowe should chime in and give you the scoop from a scientific/medical perspective…
The field of health and medicine is always changing, always advancing. It is not an exact science, and many would agree that the practice of medicine is an art. The living body with all of its intricacies is an amazing and mysterious thing. We constantly work at discovering the next new drug, the next new therapy to manage an ever-increasing amount of ailments while trying to never forget… “above all, do no harm”.
Preventative medicine is the key. “Physician heal thyself”…body heal thyself. Every cell in the body is in constant communication with its surroundings and working together to maintain homeostasis and wellbeing. There is no better way to perpetuate health than to allow the body to stay in balance. People are familiar with the role of the immune system in detecting invading problems in the body and springing into action. Did you know that special cells in our tissues can respond to these signals and do the constant work of repair and healing? Stem cells are undifferentiated cells present throughout the body in muscle, tendons, joints, fat stores, and bone marrow. They are there precisely to repair ongoing injury, replace damage, and restore function. They become tendon, ligament, bone, liver, kidney, nerve, etc. They have the potential to differentiate into any tissue needed. They are instrumental in our natural healing process!
One of the newest fields in medicine is Stem Cell Therapy or Regenerative Therapy. What better way to target areas of healing than to use our own body’s mechanism? This therapy is not controversial, as these cells are adult stem cells retrieved from the individual in need, and there is also no concern of rejection by the body because they are indeed “self.” The two most common sources of stem cells used today are fat (adipose tissue) and bone marrow. While everyone would agree that sacrificing a little fat for the cause is a good thing, it usually requires an abdominal surgery to do so, and yields a relatively small number of useful cells. These cells are directly extracted from the sample in the laboratory and kept in a protein rich environment. Several hundred to several thousand cells can be retrieved in this way.
In stark contrast, bone marrow samples are taken on an outpatient basis through a simple bone needle aspirate. Only a small amount (1-5 cc) of bone marrow blood is required because this tissue is rich in stem cells. The cells are plated and specific cell lines of Mesenchymal stem cells are colonized in laboratory to develop millions of active cells. These Mesenchymal cells will have undergone division in colony and prove themselves to be strong and active in their cellular functions.
Through research on numerous species including humans, horses, dogs, cats, rats, and goats, bone marrow Mesenchymal stem cells have shown themselves to be some of the strongest, most active cells studied. They are the “gold standard” in regenerative therapy, and their record of healing in various species has been very successful.
Through regenerative therapy, we have the ability to place millions of stem cells in a targeted area of need and allow them to play their natural role in the healing process. They not only have the ability to become multiple tissue types, they actually coordinate a complex balance of inflammation and healing by using local tissues present and calling in immune cells and growth factors from the body at large. The most common applications of stem cell therapy in veterinary medicine have been osteoarthritis, tendon/ligament injury, cartilage/meniscal injury, and bone healing. This is where Keegan’s story begins.
Keegan is a ten year old, male, neutered, Border collie mix. He was diagnosed
with bilateral hip dysplasia in January of 2012 through examination and radiography. Like most patients, his symptoms were not sudden. By the age of five he began to have slow changes in his gait and stride that progressed to a decrease in his amount of play. Through the years he became slow to rise and was unable to jump into the truck anymore, even though he knew he may be going on a hike, one of his favorite activities.
Hip dysplasia is a common problem in veterinary medicine with a genetic predisposition. The hip is a ball and socket joint, and the head of the femur (“the ball”) is supposed to fit perfectly into the acetabulum (“the socket”). The joints will look normal on radiograph at a young age, but the incongruity over time as a puppy grows will manifest in pain, inflammation, and osteoarthritis. Boney changes develop around the head, and cartilage on the articular surfaces of the head and acetabulum become damaged. The joint capsule that produces joint fluid thickens and becomes painful, and the quality of the joint fluid becomes diminished. Routine management of hip dysplasia and osteoarthritis in current medicine include non-steroidal anti-inflammatory drugs (NSAIDS), weight management, controlled exercise, and a host of pain relievers. Dietary supplementation with glucosamine/chondroitin and omega 3 fatty acids are becoming more widely accepted and suggested by veterinarians across the country.
Keegan had all of these common changes in his hips, and had a familiar history of progression. Upon examination, he was painful in his shoulders, his triceps, his middle and lower back, his gluteals, his quadriceps, and his inner thigh muscles. The back of his thighs were diminished in size, and his quadriceps were hard and chronically contracted. Though his hip dysplasia was his primary problem, the changes in his gait, stride, and posture over time, caused him to have much myofascial pain throughout his body. Keegan was taking omega 3 fatty acids and NSAIDS when we met him, but he was not comfortable. A full blood panel was done to check for any underlying metabolic problems and evaluate his thyroid. He was healthy ten year old, and a therapeutic plan was developed.
We began by retrieving bone marrow blood from his right shoulder under anesthesia. His procedure was quick and Keegan was awake in no time. The sample was sent to a laboratory called Advanced Regenerative Therapies (ART) for stem cell expansion. While waiting for his stem cells to grow, we began weekly acupuncture sessions on Keegan. Acupuncture allowed us to treat his entire body. We specifically worked on relaxing his fatigued muscles, increasing circulation to his hips, reducing pain, and stimulating his immune system.
Within two weeks, ten million bone marrow Mesenchymal stem cells were ready for application. Keegan again was scheduled on an outpatient basis for his procedure. Under anesthesia, his hips were shaved and surgically prepped. Five million cells were placed in each hip – two and a half million within each hip joint and two and a half million just outside each joint capsule. One staple closed the skin incision at each injection site. Acupuncture was performed immediately post injection to stimulate circulation. He was awakened and sent home to rest.
We continued to see Keegan often for acupuncture, twice the first week, then at weekly intervals. His gait improved immediately and consistently as noted on examination and at home. At three weeks post injection we began cold laser treatments on his hips. By this time the stem cells were well established, and laser therapy was added to accelerate the healing process. A class IV, one-watt laser was used for two and a half minutes on each hip, and six sessions were performed at four-day intervals. It is common for patients to feel and move better with less discomfort through acupuncture and laser therapy alone. However, upon examination, patients with chronic boney changes and arthritic conditions require consistent treatments and usually persist with sore reactive acupuncture points even when they are performing well at home.
It was fascinating to note that not only is Keegan performing well at home; he
is no longer reactive in the acupuncture points around his hips! His back is relaxed, his shoulders are relaxed, and his posture is near normal. The process continues, the healing continues. At the time of this writing, only six weeks have transpired since Keegan’s stem cell injections and he is doing very well. His first mile marker will be his two-month evaluation and there will also be subsequent evaluations throughout the year. Acupuncture will continue at two-to-four week intervals and each step will be documented along the way.
This process will begin and end with Keegan. His stem cells are hard at work and his body is the driving force. We are simply nudging them in the right direction. “Come on Keegan, hop in the truck. It’s time to take a hike.”
OK, now back to the non-medical part of the story…
The bone marrow extraction couldn’t have been easier. One staple in his shoulder and he was back to normal the same day. We had to insist that he not play ball or Frisbee for the rest of the day, but he was really fine.
The NEXT day, we noticed that when Keegan ran to chase his ball outside, he was actually USING ALL 4 LEGS! He used to hold his back two legs together and hop, but he was actually using them within 24 hours. We were shocked, so we called Dr. Rowe to see if this was possible. He did some checking and found that the procedure itself and the fluid injected along with the stem cells were probably responsible for a reduction in inflammation. He warned us that things may not remain that way as the stem cells had not been given time to take hold.
So, long story short, Keegan received his stem cells on May 2, 2012… a couple of months have now passed and we have seen a steady progression in the right direction ever since.
He is using his back legs in a normal fashion more and more. He runs to chase his ball using all four legs quite consistently. His bunny hopping up the stairs is less and less often and we believe that as the muscles in his back end develop over time, he will be able to use his legs better and better.
We are still seeing Dr. Rowe at Aid Animal Hospital regularly for acupuncture and in addition to aiding in the ability for the stem cells to do their job Dr. Rowe is able to address any new issues we see as Keegan begins to use his body in a new way.
It is clear to us that this procedure has likely provided Keegan with not only several more years of life, but several more years of life that have a quality that, to him, will make it worth living.