|Sue Casale, DVM , DACVS|
by Sue Casale, DVM , DACVS of Angell's Surgery Service
Osteoarthritis (OA) is one of the most common causes of chronic pain in dogs. Studies have shown that more than 20% of dogs suffer from OA with the most common signs being pain, stiffness and loss of mobility.
Medical management with non-steroidal anti-inflammatory drugs (NSAIDs) may not provide complete pain relief in many dogs. Other sought-after modalities to augment NSAID therapy include additional pain medications, dietary supplements, acupuncture and joint injections. A new and rapidly growing area of research in the treatment of OA involves the use of regenerative medicine. Using this approach, mesenchymal stem cells are delivered to an area of damaged tissue where they stimulate regeneration and aid in repair of the damaged tissue. In addition, mesenchymal stem cells are multipotent and have the ability to differentiate into many different cell types such as tendon, bone, ligament and cartilage, which may further help in the repair of damaged tissue.
Mesenchymal stem cells are derived from the animal’s own tissue and once isolated, can be injected to provide a large concentration of the cells to the area of injury. Because the injected cells are derived from the animal’s own tissue and are minimally manipulated there is almost no risk of rejection or reaction. According to Vet-Stem, Inc., the company that isolates the stem cells, over 2,500 horses and 500 dogs have been treated with stem cell therapy in the past six years with less than 0.5% tissue reactions.
Stem cell therapy does not cure OA; the goal of stem cell therapy is to provide long-term anti-inflammatory effects, slow the progression of cartilage degeneration and initiate healing of the damaged tissue. This provides pain relief within a few days to a few weeks after the injection with further improvement as healing progresses. Additional injections may be required to maintain this improvement.
Stem cell therapy has been used in equine cases since 2003, but is just beginning to gain acceptance as a treatment for canine OA. There are currently two studies in veterinary literature that show significant improvement in lameness in dogs with hip and elbow OA following treatment with stem cells. Both studies were sponsored by Vet-Stem, Inc., and both studies have limited numbers of cases, however, the results are promising.
Several patients have been injected with stem cells at Angell Animal Medical Center with subjective improvement seen. Surgical management such as joint replacement is still the preferred treatment for animals that have advanced OA or are no longer responsive to medical management. Stem cells provide an additional treatment modality for animals when joint replacement is not an option or if owners want to try a less invasive approach prior to pursuing major surgery.
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Black LL, Gaynor J, Gahring D, et al. Effect of intrarticular injection of autologous adipose-derived mesenchymal stem and regenerative cells on clinical signs of chronic osteoarthritis of the elbow joint in dogs. Veterinary Theraputics 2008 9(3):192-200.
Black LL, Gaynor J Gahring D, et al. Effect of adipose-derrived mesenchymal stem and regernative cells on lameness in dogs with chroninc osteoarthritis of the coxofemoral joints: a randomized, double-blinded, multicenter, controlled trial. Veterimary Theraputics 2007 8(4):272-284.