Thursday, 17 August 2017

Canine Regenerative Medicine : My experience

Our Sarah was diagnosed as having chronic arthritis in her knees and wrists about a year ago with possible onset spondylosis. As such, she has been treated with maintenance Metacam, fortnightly laser therapy and fortnightly hydrotherapy. In addition, she goes to see the wonderful Tim Couzens, Holistic Vet, who makes up a personalised and tailored herbal mixture with a couple of homeopathic tablets. 

By and large, she has been OK. But with the summer, she has been stumbling, particularly on her right rear leg. We thought her knees were sore. 

I’d read about Stem Cell therapy for canine arthritis some time back, along with Platelet Rich Plasma therapy (a great video which explains how that works can be found on YouTube here) and now, more recently, a new medication called Arthramid which has been used in horses for a while but is now being offered to dogs by a few specialist vets. 

At the recent VETFest conference I attended, there was a talk about Stem Cell Therapy and I thought that I’d have a google and see if there is anyone who is offering it. I found Dr Stewart Halperin BVMS MRCVS who has several clinics in the UK, the nearest to us being in Chiswick. I gave him a call and, following a thorough and attentive phone conversation, he agreed to see our Sarah. 

On the day of our appointment we had a consultation which lasted well over an hour going through her entire history – not just the arthritis but also her general health and her liver issues – an integrative approach. He took us through the options he offers, explaining that she may not need the most expensive therapy but may be better benefitted with the PRP or Arthramid or even a combination of several. Of course, there was always the possibility that he could not help and she may need surgery or the treatment he offers may not be suitable for her condition. But all would be revealed with appropriate X-Rays. 

We left her at the clinic, as Dr Halperin aims to perform all procedures on the same day, and found a pleasant spot in Putney by the River and near a cafĂ© to wait. Mr Sam was with us and had a Dad Day although he was clearly concerned about where his sister had gone. 

At 16:30 we made our way back to the vet surgery and waited for Dr Halperin to give us the verdict. The most startling thing, for us, was to see the X-Rays. They clearly showed (even we could read them) that her wrists, elbows and knees were fine. However, her hips were not – they were shocking. Dr Halperin showed us that the head of the right thigh bone, which should have a rounded top to fit neatly in the socket of the hip, was almost flattened due to arthritic wear. He suggested there was also likely a genetic underlying cause too. Her left hip was not good, but not as bad as her right. 

Our Sarah must have been in considerable discomfort over the past few months with bone rubbing on bone. He told us that, even under anaesthetic, they hadn’t been able to extend her rear legs back more than about 30 degrees – it should go at least 180 degrees in a fit dog. It took them several attempts at X-Raying her to get a good scan. 

Incidentally, 5 years ago we had been told that their rear leg extension was restricted by Natalie Lenton of the Canine Massage Therapy Centre, when we attended one of her workshops. She had found this likely genetic issue way before any visible symptoms had been displayed. 

What did he do? Lots. He injected an analgesic into the joint, some lubrication, some Platelet Rich Plasma and finally, Arthramid. Additionally, he took out 4 of her teeth which he noticed were badly damaged and would also be causing her discomfort, maybe even adding to her known liver enzyme issues. 

We were given quite a few medications to keep her comfy during her recovery until the therapy settles down, including Amantadine. A survey by Lascelles et al (2007) showed that Amantadine in a multimodal analgesic regimen can help alleviate osteoarthritis pain in dogs. 

Dr Halperin suggested that taking this drug with the NSAIDs she is already on might be a useful adjunct therapy for managing her arthritis. By the next morning she was already refusing her sling, preferring to walk by herself. Dr Halperin told us to continue with the physiotherapy and massage we give her daily and to concentrate the acupressure we also give her, to areas and meridians that will benefit the hips. We also booked her in for a course of intensive hydrotherapy at the House of Hugo, plus a new diet regime. 

Interestingly he also told us we needed to go out and buy a Bio-Flow collar for her. I was rather surprised that a vet surgeon would recommend this but I guess it all goes with his multi-approach to managing canine arthritis. 

It’s been 6 weeks now. She is not ‘fixed’…she has good days and she has not-so-good days. What she doesn’t seem to have is bad days. She is moving more freely, she gets up from her bed easier, she has a great wiggle in her spine, she lifts her knees higher, she does a h-u-g-e stretch immediately after her acupressure and generally seems more relieved. What we need to concentrate on now is her muscles. She hasn’t been using her thigh muscles in a while. Twice a week hydrotherapy at the House of Hugo is making a lot of difference. Her Auntie Tel, the hydrotherapist, gets her to use those rear legs in their 10 m length pool. Gradually the muscle tone is coming back. 

How long will it last? I don’t know. But if she doesn’t feel that she’s got bone crunching on bone for a few days, weeks or even months, then that will have made it all worthwhile. 

Of course, this is just our own experience. It’s not a cure-all, not every dog will respond in the same way and, for some, this type of therapy may not be suitable. It may be, like our Sarah, that they don’t immediately get back 100% fitness. But I’ll happily settle for any relief from bone on bone crunching. However, if you’ve got a dog who has arthritis and you’re open to try options, check out the StemCell Vet webpage – it’s full of useful resources and explanations of what he does. If you know of anyone who would benefit, please feel free to share this page. 

Hopefully, with all these innovations for veterinary options, we’ll soon not have to accept a diagnosis of “It’s just arthritis”.

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