Canis ISSN: 2398-2942

Stem cell therapy: clinical application

Contributor(s): Vetstream Ltd, Stewart Halperin

Introduction

  • This article will discuss the use of adipose derived stem cells (ADSC) and bone marrow derived stem cells (BMAC) in the treatment of the following conditions in dogs.

Osteoarthritis

  • As a primary or adjunctive treatment for shoulder, elbow, carpus, hip, stifle, tarsus and interphalangeal joints once surgical intervention has been ruled out, often as part of a multimodal approach.

Tendinopathies

  •  Lesions of the biceps tendon, supraspinatus, subscapularis and medial glenohumeral ligament ( ‘medial shoulder syndrome’), iliopsoas, gastrocnemius, patellar tendon and flexor carpi ulnaris in the dog have all been treated successfully with ultrasound guided stem cell injections.

Ligament repair

  • Recent papers have suggested the use of stem cells in place of surgery for the treatment of anterior cruciate ligament repair where 50% or less of the ligament is damaged.
Print off the owner factsheet on Stem cell therapy to give to your client.

Uses

Advantages

  • There is a good evidence base for this therapy (see Stem Cell Therapy: overview).
  • Good quality tissue repair from available histological evidence.
  • Covered by some UK insurers under standard veterinary fees.

Disadvantages

  • There is a 2-3 week wait from sample collection to treatment while the cells are cultured to sufficient numbers by the processing laboratory when using cultured cell rather than patient - side stromal vascular fraction (SVF) or bone marrow aspirate concentrate (BMAC) techniques. 
  • Typically more costly than other available therapies.
  • Not suitable as a sole therapy for all injury types, eg where surgery is indicated.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Expectation for significant beneficial results (as measured with clinical metrics above) 3-12 months. Some cases may require repeat treatments, on a case by case basis. It should be made clear that 15% of patients are expected to show no significant improvement after treatment with stem cell therapy alone.

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • McDougall R A, Canapp S O, Canapp D A (2018) Ultrasonographic Findings in 41 Dogs Treated with Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma for a Supraspinatus Tendinopathy: A Retrospective Study. Front Vet Sci 5, 98 PubMed.
  • O'Donnell E M, Canapp S O Jr, Cook J L, Pike F (2017) Treatment of medial shoulder joint instability in dogs by extracapsular stabilization with a prosthetic ligament: 39 cases (2008-2013). JAVMA 251(9), 1042-1052 PubMed.
  • Canapp S O Jr, Leasure C S, Cox C, Ibrahim V, Carr B J (2016) Partial Cranial Cruciate Ligament Tears Treated with Stem Cell and Platelet-Rich Plasma Combination Therapy in 36 Dogs: A Retrospective Study. Front Vet Sci 3, 112 PubMed
  • Linon E, Spreng D, Rytz U, Forterre S (2014) Engraftment of autologous bone marrow cells into the injured cranial cruciate ligament in dogs. Vet J 202(3), 448-854 PubMed.
  • Other significant papers are listed at: www.stemcellvet.co.uk/the-science-of-stem-cell-therapy/.


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