Stem Cell Therapy in Dogs and Cats
|Microscopic image of injected stem cells|
In 2004, Vet-Stem commercialized stem cell therapy for horses and dogs. Unlike the controversy over using embryos to obtain stem cells, these stem cells are derived from adipose or fat tissue. Vet-Stem works through a series of trained veterinarians. During a short surgical procedure, fat (typically from the shoulder) is removed from your dog. The fat is then shipped overnight to Vet-Stem in California where it is processed on day 2 and shipped back to your vet to deliver into a joint on day 3. Thus, the procedure must be planned on a Monday-Wednesday to enable delivery on Wednesday-Friday. Because the fat tissue is shipped to California where it is processed to remove unwanted fat cells and concentrate the stem and other supportive tissue cells, Vet-Stem had to seek FDA approval to market their product. Whereas fat is an attractive readily available source for stem cells in people using liposuction, the decreased fat-to-muscle ratio in our pets means they do need to undergo two surgeries for t Vet-Stem's FDA approved stem cell treatment . Fortunately, other companies have now entered the market to enable fat-derived stem cell therapy for treating orthopedic injuries or arthritis in your pet. The two biggest companies in addition to Vet-stem are Stemlogix, LLC and MediVet in the USA. The major difference between these companies and Vet-Stem is that the fat tissue is processed in your local vet's office. Thus, your pet only needs to undergo a single surgery/anesthesic episode.
|Owners report dogs that have not been able to walk or run returning to normal in days after treatment.|
How Can Fat Help My Pet?
In addition to fat cells in the fat, fat contains specialized cells that look like the original cells when your puppy was in the womb that changed into bone, muscles, cartilage, hair, and all the other organs of our body. These specialized cells are called "stem cells." In particular, these stem cells that can make up body parts, such as bones and cartilage, are called stromal or mesenchymal stem cells. In addition to stromal stem cells, fat contains cells that can support the building of blood vessels and produce other factors to enhance organ growth. A pet that has hip dyplasia or an anterior cruciate injury (sometimes called cranial cruciate injury in our pets) may have worn away the cartilage in the joint that provides the smooth surface to the bones that enables them to slip past one and another. When the cartilage has been damaged or worn, then our pets experience arthritis pain just like people. This can make them reluctant to move. While pain killers like Carprofen (Rimadyl) or Meloxicam can relieve the pain and inflammation, these pain killers will not repair the primary problem of the loss of cartilage. The hope is that these fat-derived stem cells can decrease inflammation like pain killers or actually rebuild the damaged cartilage.
Is Fat Better than Bone Marrow?
Well, all three companies applaud fat-derived stem cells over stem cells taken from the bone marrow. However, the verdict is still out as to whether stem cells derived from fat or bone marrow are better. Some companies claim that fat is easier to harvest than bone marrow. However, one can obtain bone marrow from an awake dog using a local anesthetic rather than a surgical procedure that is required to obtain fat. It is true that there are many fewer of the stromal or mesenchymal stem cells in bone marrow than fat. Thus, if you were to use bone marrow-derived stem cells, the cells would need to be cultured and expanded for several weeks to have a sufficient number to inject in a joint for therapy. Also, after culturing and expansion, you would be left with a relatively pure population of just stem cells. So if you are after stem cells and time is not an issue, bone marrow would be a better choice. Because bone marrow must be cultured and expanded, the FDA considers this manipulation of the bone marrow and these stem cells would now come under regulatory approval by the FDA. Therefore, even if bone marrow-derived stem cells are better, it will be a while before you see this as an option at your local vet.
What does Stem Cell Therapy Cost?
The good news is that because the fat-derived stem cells kits marketed by Stemlogix, LLC and MediVet America are minimally manipulated, they are not regulated by the FDA. This means the cost of developing these fat-derived stem cells kits for veterinarians is less expensive. Stemlogix and MediVet also train veterinarians how to use their kits for free. In turn, the cost to the pet owner is less too. On the other hand, VetStem maintains a level of quality control that enabled them to get FDA approval and requires veterinarians to undergo costly training to use their service. However, the vet does not need any specialized equipment in house for VetStem to process fat stem cells. StemLogix and MediVet system require the vet to purchase some equipment for in-house processing. The bottomline is that VetStem therapy can run from $1000-$3000 per animal whereas StemLogix and MediVet probably will cost closer to $600-$700 per pet.
But Do Stem Cells Work?
The jury is still out on stem cells. CBS' Sixty Minutes compared stem cell therapy to "snake oil." Close scrunity of VetStem's peer-reviewed journal article of a placebo-controlled, blinded trial in dogs that received their stem cells in their hip joints showed that the owner's perception of whether the dog improved and the vet's assessment frequently disagreed. For the most part, the owner's felt their dogs improved whether or not they were given stem cells or the sham injection. This is frequently referred to as the "placebo effect." Another study by VetStem giving their fat-derived stem cells in the elbows of 14 dogs had no control arm or blinding to the treatment. Using qualitative measurements of lameness, the vets did perceive the dogs did better, but a better study needs to be designed with appropriate control or sham injections. One take home message from VetStem's clinical trials is that they evaluated the dogs from 30-180 days after treatment. Stem cells will take time to grow and help repair cartilage. So if someone tells you stem cells made their dog 100% normal in a week, you should be skeptical. VetStem saw the greatest improvement at 90-180 days, which is a reasonable expectation with stem cells. On VetStem's website, they refer to trials in human patients, but for the most part, these stem cells were derived from bone marrow rather than fat tissue. The good news is that VetStem's product has been shown to be safe by the FDA. The vets that use the stem cells from all three companies are well trained. So if money is no object, and your pet is otherwise a healthy candidate for anesthesia, then fat-derived stem cells may work and hopefully soon we will know whether they also do some good.
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