Page 5 - Clinical Connections - Summer 2020

Advancing Practice
Stem Cell Therapy for Elbow Osteoarthritis: Clinical Trials Progress
The most commonly reported condition affecting the elbow in dogs is
1
osteoarthritis (OA) . It often develops
secondary to pre-existing elbow dysplasia and some breeds such as the Labrador Retriever are particularly predisposed.
Many will have had the abnormal fragments of bone and cartilage removed from the joint by arthroscopy at a young age. Some dogs with OA develop problems later in life, leading to pain and increasing lameness. Dogs with advanced disease are often reluctant to exercise which leads to weight-gain and worsening severity
of their condition. Many dogs are not suitable for joint replacements. Chronic medical management is commonplace and sometimes unsatisfactory.
Stem cell therapy may provide a therapeutic alternative for the treatment
of canine OA. Mesenchymal (or stromal) stem cells (MSCs) possess unique immunomodulatory properties, which can help to reduce inflammation in arthritic joints. Studies have demonstrated beneficial effects in dogs with hip and elbow OA 2, 3, which improved function foar up to 6 months after treatment. Many of these studies have been based on semi-objective outcome measures. As these studies and our own anecdotal clinical evidence demonstrate some
benefit in dogs with orthopaedic conditions, autologous stem cell therapy is now being offered as treatment option at the RVC.
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A small piece of adipose tissue is surgically taken from the canine patient
Mesenchymal stem cells isolated from this adipose tissue are expanded in the stem cell lab to the required numbers
These MSCs are then injected into the arthritic joint of the same dog around 7-10 days later
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Treatment outcome
is being measured by walking the dog over
a pressure mat before stem cell treatment to establish a baseline of gait (lameness assessment)
The patient then uses the pressure mat 2-3 further times over the following 4 months, to monitor the treatment effects
In addition, a questionnaire for owner assessment of activities of daily living will provide further evaluation of stem cell treatment
CLIENT FEEDBACK
Sherlock was one of the first dogs to receive stem cell therapy for elbow OA at the RVC. Her owner Becky states that:
“The RVC Small Animal Hospital was recommended by our vet to provide stem cell therapy to treat early onset arthritis in our nine year old cattle dog. The two rounds of transformative treatment has been excellent value. The benefit was obvious within a week of treatment, with improved gait, stamina and demeanour. In practical terms, over a period of several months, this made the difference between two five- minute walks a day and a 40 minute romp through the countryside. The team at the RVC are as knowledgeable as they are caring”
SUSCEPTIBLE BREEDS
Osteoarthritis
• Golden Retriever
• Labrador
• Rottweiler
• German Shepherd
• Border Collie
Elbow disease
• Labrador
• Rottweiler
• Golden Retriever
• German Shepherd
• English Springer Spaniel
Clinical Trials and Patient Recruitment
A clinical trial is currently underway at RVC Small Animal Hospital to monitor the effects of intra-articular injection of mesenchymal stem cells on the function of dogs with elbow osteoarthritis. The study is being led by Head of Orthopaedics Dr Richard Meeson and surgical resident Carlos Rubinos, together with the RVC Stem Cell laboratory under the supervision of Dr Jay Dudhia
and Dr Amy Brewer. Labradors that have previously been diagnosed with elbow dysplasia and or elbow osteoarthritis, and that are currently displaying symptoms of osteoarthritis, are being recruited for the study.
If you know of dogs suitable for this trial, please contact stemcelltherapies@rvc.ac.uk
References: 1 O’Neill DG, Brodbelt DC, Hodge
R, Church DB, Meeson RL (2020). Epidemiology
and clinical management of elbow joint disease
in dogs under primary veterinary care in the UK. Canine Genet Epidemiol 7, 1. https://cgejournal. biomedcentral.com/articles/10.1186/s40575-020- 0080-5
2 Cuervo B, Rubio M, Sopena J, Dominguez JM,
Vilar J, Morales M, Cugat R, Carrillo JM (2014).
Hip osteoarthritis in dogs: a randomized study
using mesenchymal stem cells from adipose tissue and plasma rich in growth factors. Int J Mol Sci. 31;15(8):13437-60. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4159804/
3 Black LL, Gaynor J, Adams C, Dhuoa S, Sams AE, Taylor R, Harman S, Gingerich DA, Harman R (2008). Effect of intraarticular injection of autologous adipose- derived mesenchymal stem and regenerative cells on clinical signs of chronic osteoarthritis of the elbow joint in dogs. Vet Ther 9(3):192-200. https://pubmed.ncbi. nlm.nih.gov/19003780/
For small animal orthopaedic referrals, please call: 01707 666399
Email:
qmhreception@rvc.ac.uk
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