Denny and Charlie (and the rest)
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Stem Cell Therapy

Monday, 5 March 2012 18:55 by robbi

As promised, today I’m going to discuss one of the other treatment options we have been looking into for Denny. Today, I’ll be going over our findings on stem cell therapy.

Stem Cell Therapy This is fairly cutting-edge stuff, but not the moral minefield of Dr. Jekyll you may think of when you hear the term. This involves taking a bit of fat (adipose tissue) from a dog, running it through a series of processes which extract stem cells and then duplicate them. The resulting “stem cell soup” (I made that up, that is not a technical term) is then injected back into the same dog via an IV. The stem cells then migrate to areas of inflammation (kind of like white blood cells migrate to areas of infection) and start working to build up healthy cells.

It’s a very expensive procedure. And the IV injections are usually repeated several times, though the extraction of fat cells usually only happens once (with some cells being saved for the additional treatments.) Costs run around $5000 if the vet sends out the cells to a specialized lab to be replicated; it’s about $3000 if the vet has an in-house machine to do the replication. Very few vets actually do this procedure, as it is definitely not mainstream yet. In my research, I was only able to find 2 vets in all of Houston who have done the procedure. One does in-house and has been doing them for just over a year. The other sends out the samples and has been doing them for just about 6 months. Houston is the 4th largest city in the US. If only 2 vets do it here, I can only imagine how difficult it would be to find someone if you lived in a rural area.

MediVet is the name of the company that supplies the in-house machinery to vets.  They have some really interesting information on their website.

We spoke with both doctors about stem cell therapy as a possible treatment for Denny. This was going with the assumption that he has a degenerative disease of the spinal cord. I thoroughly researched treatment for DM and similar diseases only to find the options were pathetic. I understand what they mean when they say “no cure.” But why does that also have to mean “no real treatment?” Everything I read talked about caring for the dog as it loses its ability to walk. Mobility aids and palliative care seemed to be all anyone could offer. There’s some anecdotal information about diet changes and supplements, but nothing very encouraging. I was initially very excited about the prospect of stem cell therapy as a treatment. Firstly, it was something concrete we could try to “fix” his issue. Secondly, I kept seeing videos of dogs who had undergone the treatment and shown amazing results. I became a bit more disheartened when I would read more, as many of these dogs had suffered acute trauma leading to their conditions. These were dogs that had been in accidents; one day they were healthy and the next they couldn’t walk. Denny’s was chronic, slowly worsening over the last year. Also, there hasn’t been a whole lot of research into stem cell therapy. There are just a few studies done – almost all abroad – so there’s not much clinical data. The data I was reading seemed to suggest no more than a 50% chance of the therapy working for a dog with Denny’s symptoms.

It seemed a lot of money, a lot of pain and a lot of emotional minefields for something with a small success rate. Nonetheless, we trudged on and consulted both doctors here in Houston to see what they thought.

Our initial consultation was with the physician that pioneered the procedure here in Houston. He’s a very personable, likeable fellow – very down to earth. After dealing with doctors who have the “God complex” and who look down on us mere mortals trying to help our dogs and asking loads of questions, it’s kind of nice to meet a doctor who is so straight-talking. We took Denny in and brought copies of his MRIs for the vet to look at. I had exchanged emails with him, so he had a pretty good grasp on Denny’s situation but this was his first time seeing him in person. What happened next was a bit of a blur. He saw us as we walked in the door and greeted us himself. He took us back to a consulting room where he started to talk to us about stem cell therapy. I related Denny’s history once again, trying to not leave out any details. I wanted his honest opinion about whether or not this was the right path to take. He listened and began explaining some of the finer points of the procedure. He saw Denny walk about 2 feet on the floor of the room. He then examined him on the table, checking the proprioception on his back legs. The exam lasted about 2 minutes. He then turned back to me and continued to talk about the stem cell therapy. He explained in great detail every aspect of the procedure. He wanted to inject the first set of cells directly into Denny’s spinal cord – like an epidural. Subsequent treatments would be via IV line in his paw. We discussed Denny’s current medications (he was on a trial of steroids to try and reduce spinal cord swelling) and his activity level. He explained Denny would have to be off the steroids for a couple of weeks prior to the treatment. And that was it. Next thing I know he’s telling me that we can schedule the pre-op bloodwork in a couple of weeks and the operation to remove the fat tissue in another month. Then we were out the door, our heads spinning.

Make no mistake, this doctor definitely seems to know what he is doing with regard to the technical aspects of this therapy. And he has had amazing results with dogs suffering from arthritis – the primary patient that stem cell therapy is aimed at. But how do we know this is the right treatment for Denny? In the car on the way home, Richard asked me what I thought. The first thing that came to my mind was “I wish he had spent more time examining Denny.” Only then did we both realize that he hadn’t even looked at Denny’s MRI scans.

I received an email from the vet later that day, recapping his plan. He signed it off by telling me he was consulting some other vets about Denny’s case and that he was “getting very excited.” My heart sank a bit. Denny was an exciting case; a chance for this vet to try this procedure on a different type of patient than what he had been treating. Denny is so much more to us than a patient, or even a dog. He’s our boy. He is special. I’m not opposed to trying something experimental on him if it is our best hope. But I wasn’t convinced it was.

I decided to continue to try to get in touch with the other vet in Houston who had done stem cell therapy. I wanted a second opinion and this was the only man qualified within 200 miles to give it to me. Eventually, I was able to speak with him via phone. I described Denny’s symptoms and relayed the details of his case. As soon as I had completed telling everything, he said “I wouldn’t recommend it.” What? He explained that based upon Denny’s improvement after surgery and the subsequent deterioration in conjunction with the swelling, he believed his symptoms were probably the result of compression on the spinal cord. Yes, the swelling due to scar tissue could be a factor, but most likely there was more to it than that. It’s a bit of a vicious circle – he has swelling and pain, he can’t hold his spine straight; that causes more pressure which makes his cord even more pinched. He said it would be a waste of time and money to do the stem cell treatment. What did he recommend? Well, he just happened to have recently been at a conference where someone was demonstrating a brace for dogs which forced their spines into alignment….

We’ll make a full post on that one next, with details about all sorts of stuff you probably didn’t know existed!

In the meantime, I should state that we haven’t ruled anything out.  Denny continues on his rehab therapy.  It seems to be making him stronger, and as I wrote before he enjoys the laser therapy.  But we’re a bit frustrated because we’re not seeing much in the way of improvement in his walking.  True, it definitely isn’t any worse.  But we were hoping for more. 

Perhaps we will pursue stem cell, perhaps not.  But I wanted to share this information so that anyone thinking about it would have a little bit more information on how it works and what is involved.

Until then, I thought I’d post a random pic of Stewie. 

Please sir may I have some more?

He had finished his dinner and decided to give us his most pitiful look in hopes that he might get seconds. Silly boy!