Sensational Stem Cells:  The New Frontier in Veterinary Medicine

Written by Tracy Douglas, Published in Pulse Magazine

                Bart has always been an intense retriever.  He’s the kind of dog who lives his life solely to retrieve.  That’s why it broke owner Kim Williams’ heart to see the pain he was experiencing due to osteoarthritis in his elbow after only a short period of playing fetch.  The pain became so severe that she stopped his daily routine of retrieve training and turned to her veterinarian to discuss options to help Bart recover.

                Her veterinarian recommended a revolutionary treatment using Bart’s own stem cells to help his elbow heal.  Since the surgery Bart has displayed a “rapid improvement in his mobility and attitude,” Ms. Williams happily reports, “We have recently been able to re-institute short retrieving sessions with him.”

                Bart’s unusual story of relief and recovery from osteoarthritis is one that is going to become more and more common as the usage of stem cells becomes more widespread.

                History of Fat-Derived Stem Cell Usage

                At the forefront of this ground-breaking treatment is Vet-Stem, Inc, the world leader in Veterinary Regenerative Medicine.  Formed in 2002, this privately held company works to create therapies using regenerative technologies that stimulate animal’s own inherent natural healing properties.

                It was actually the experience of seeing humans’ own natural healing properties after plastic surgery that served as the catalyst for research into fat-derived cells.  What happened was that plastic surgeons used a patient’s own fat to tuck into face lifts and subsequently noticed a lot of good wound healing.  The fat eventually dissolved, but the healing was beautiful; and that caused researchers to dig a little bit deeper.  At the University of Pittsburgh, they realized that there were a bunch of stem cells in fat, as a matter of fact, a whole lot more than there are in bone marrow. 

                Human or animal, using fat-derived stem cells for healing, eliminates a whole host of problems.  First of all, it greatly reduces the possibility of rejection.  As Dr. Julie Ryan-Johnson, Vice-President of Marketing at Vet-Stem, Inc says, “If I was to use my own dog’s stem cells on your dog, that’s going to be considered as foreign, and there’s the possibility of rejection.”  An animal’s own cells would not meet with such resistance.

                By using these fat-derived stem cells, it also takes away the debate of ethics regarding the use of embryonic stem cells; no one need worry about using dog or horse embryos for research.  “As a matter of fact, “ notes Dr Ryan-Johnson, “It’s very non-controversial, and it’s actually very holistic, because what you’re doing is you’re concentrating stem cells from your own animal and putting them back into an area of injury for them to help regenerate that area.”

                Currently, Vet-Stem, Inc has successfully treated more than 2,500 horses for tendon and ligament injuries.  And after some early pilot programs in Southern California, they officially launched stem cell usage in small animals, mainly dogs, in January of this year at the North American Veterinary Conference.

                What is the Procedure?

                The treatment procedure itself is actually pretty simple, while the process of how the stem-cells work is really fascinating. 

                The procedure begins with a veterinarian really weighing the risk vs. benefit aspect of each case.  They have to ask, “Is this animal a good surgical candidate?” because the dog, horse or cat does have to go through a minor surgical procedure to have about 50 grams of fat removed, which is approximately the equivalent of two tablespoons.  Once the animal is deemed fit, the veterinarian goes about collecting the sample of fat.  It is indeed a minor procedure, but does require an anesthetic episode.

                The fat is then sent to the Vet-Stem, Inc lab in a special validated box by FedEx overnight, using special packaging so the company knows exactly how everything’s going to come in.  Once in the lab, Vet-Stem basically digests away the fat in order to isolate the stem cells.  The stem cells get put into syringes for the vet, in such a manner that if the vet is treating two bad elbows, it’ll come in two syringes, and so on.  Those isolated stem cells are Fed-Exed back to the vet overnight and then the vet injects the syringes contents directly into the joint.

                Administering the cells by injection right into the area of injury or disease seems to be the most effective way to treat the condition.  In contrast, by delivering the stem cell treatment intravenously, if an animal has multiple areas of arthritis or a number of conditions to be treated, like a liver problem or a kidney problem, the treatment could be diluted by all of the various cells signaling that there’s a problem. 

                Which leads us to the heart of how this treatment actually works.

                How Does it All Work?

                At first, researchers thought that stem cells would literally turn into the various cells necessary for healing.  Now they realize that what comes back in those syringes processed by Vet-Stem is much more complex than they thought and contains more than fat-derived stem cells; indeed, as Vet-Stem reports, along with the stem-cells comes “a variety of cells that help to regulate inflammation, cause revascularization,  modulate immune function, and regenerate tissue.  Several of the important cell types that are involved in healing are:

·         Mesenchymal stem cells:  cells that can differentiate into many cell types to help regenerate tissues.

·         Other progenitor cells:  cells that produce over 30 growth factors that help to speed the healing process.

·         Endothelial progenitor cells:  cells that help in re-vascularization (formation of new blood vessels).

·         Cells of the Immune System:  such as lymphocytes to help maintain normal immune function.

This balanced cell population is responsible for cell-to-cell communication and thought to be the cause of the profound outcomes resulting from Regenerative Cell therapy.”

                The stem cells themselves seem to be a multipotent, and can differentiate themselves into bone, cartilage, cardiac, nerve, muscle, blood vessels, fat and liver tissue in addition to being tropic mediators.  As Dr. Ryan-Johnson explains, the current working theory is that these cells “the stem cells home to the injured tissue through a signaling process.  These cells secrete a variety of cytokines, cells that help rejuvenate and repair the tissue, and growth factors.  A diverse population of cells with different roles helps the natural healing process regenerate the tissue.”

                In layman’s terms, what happens is that the stem cell goes into this micro-environment, and these cells have many different functions.  Some of them may be anti-inflammatory, some of them may be there to turn off cell death, some of them may be there to regenerate tissue.  So, it’s not just that the stem cells go into say, the liver and rebuild a liver.  It’s about bringing in the neovasculariztion, bringing in more blood vessels.  It’s calming down the inflammation that might be in place, it’s turning off the cells from dying off from whatever it is that they’re dying off from.  A lot of different things are going on, and it’s a lot more complex then previously thought.

                Animal Recovery and Efficacy

                While these myriad amazing processes are taking place within the animal’s body, a period of rest and rehabilitation is required.  With horses, the rehabilitation is more a matter of course.  Vets, trainers, and owners are more acquainted with rehabbing horses, so they’re used to knowing how to do the lay up and bringing them back more slowly.  Since dogs are more of a relatively new industry, educating the vets and the owners about rehabilitation is necessary.

                Once the treatment is done, quiet rest is required for the dogs.  They usually feel pretty good pretty fast after the treatment; but, say for example a dog was treated for a problem in her elbows, although she may be feeling frisky and ready to go, she may not have used her elbows in three years.  So a concentration on physical therapy rehab is essential. 

                The usual prescription is that the dog is restricted to three minutes of physical therapy a day for the first couple of days, which then builds up to five minutes the next week, and then tack on another five minutes after that to gradually build up tone and strength.  As they’re building up their muscle strength, keeping the dog on a leash for the first 3-6 weeks is recommended in order to avoid injury. 

                Costing between $1500 and $2500 a procedure, Vet-Stem, Inc’s revolutionary technology is money well-spent.  Almost 3,000 horses have been treated since 2003 with no systemic adverse events reported, and <0.5% local tissue reactions.  The Vet-Stem Regenerative Cell therapy has demonstrated efficacy in horse and dogs as illustrated by case studies, retrospective studies, a Cornell University double-blind, placebo controlled study, and most recently a randomized, double-blinded, multi-center, controlled trial. 

                Vet-Stem, Inc. as the first company in the world to offer fat-derived stem cell services for veterinary use, has certified almost 400 veterinarians across the country and has close to 1000 more currently in training.  In order to become certified, the veterinarian needs to complete a three to four hour online training course conducted on the website.  After the completion of several tests, they are able to perform cases.  Because of the course’s accessibility, veterinarians are able to learn and finish the training at their convenience.

                Future of Stem Cell Usage

                Using stem cells to treat injuries and diseases is the brightest and most exciting new frontier of veterinary medicine.  Dr. Ryan-Johnson marvels, “It’s going to become a very interesting and quickly expanding area of veterinary medicine.  Just as dentistry has evolved and rehab is evolving, now it’s regenerative medicine’s turn.  Now veterinarians will have new ways to treat diseases that previously they could only sort of palliatively treat.  There are actually going to be cures for diseases!”

                Right now, Vet-Stem is working on multiple areas of promise by conducting a liver study, a kidney study, and several autoimmune disease studies.  And they’ve begun banking stem cells for future use. 

                In fifty years, Dr. Ryan-Johnson predicts that it’ll become standard for a veterinarian to collect stem cells when a puppy or kitten is spayed or neutered.  Then those cells will be banked, and by the time that cat or dog is ten years old and they’ve got bad kidneys or a bad liver, those stem cells that were taken when the pet was younger will be used for treatment.  As she says, “It’ll be like his or her own little pharmacy.”

                Treatments for humans are following hot on the heels of current veterinary uses.  As a matter of fact, Dr. Ryan-Johnson says, “Basically, the human side is really watching what we’re doing because we’re actually able to treat clinical patients now. There are some really neat things going on with the human side, and for once, as veterinarians we’re actually on the forefront of this and we’re actually helping the human side understand this a little bit better.”  Some of the studies involving humans include vascularization, spinal cord fusion, and liver disease.

                For now, animals and their owners remain the greatest beneficiaries of stem-cell usage.  As Ted Robinson, seven-time winner of the NRCHA Open Snaffle Bit Futurity and Two Time World’s Greatest Horseman Champion raves, “I wasn’t sure what to expect when I first used the stem cells, so I was shocked to see how rapidly the new tendon tissue filled what was lacking there just 30 days prior…Hearsay is one thing, but it’s hard to argue with results.”

                In addition to Vet Stem, Inc., some universities, Vet Cell Bioscience and Vantus Veterinary Stem Cell Laboratories offer similar stem cell technology although mostly for equine patients at this time.