A novel regenerative approach to treating canine lumbosacral disease: a role for adipose derived mesenchymal stem cells?

Abstract

Lumbosacral disease is a common condition affecting older dogs and also younger dogs, such as Border Collies, that are involved in agility work. The disease causes a variety of symptoms from back pain, hind limb weakness, reluctance to jump and ataxia to neurological deficits causing incontinence. The condition is usually progressive and management involves drug therapy (anti-inflammatories and analgesics), exercise management, weight control, and physiotherapy. Surgical options such as decompressive surgery (laminectomy) and distraction and stabilization surgeries are very invasive techniques with potential complications. A private independent veterinary practice has treated a variety of orthopaedic conditions with stem cell therapy (SCT) and laser therapy. Whilst SCT is mainly used for joint osteoarthritis cases, reports in human lumbar conditions makes this an interesting minimally invasive potential therapy for canine lumbosacral disease. Five dogs presenting with a history of severe back pain and radiographic evidence of lumbosacral disease attending the veterinary practice have received SCT with laser therapy in this small case series. All were being treated with a non-steroidal anti-inflammatory drug and some were also receiving one or more analgesics. Subcutaneous adipose tissue was harvested from each dog under a short general anaesthetic and blood taken for cell culture. Cell Therapy Sciences Ltd isolated the adult adipose-derived mesenchymal stem cells from the tissue and culture-expanded them. These were then shipped in sterile vials cryogenically frozen in the dog's own serum. The autologous stem cell treatment was given intravenously and by epidural injection at the lumbosacral junction under sedation. Immediately following implantation, the lumbosacral region was targeted with laser therapy using a class IV laser with appropriate settings for each animal. The laser treatment was repeated three times a week for 2 weeks and then monthly for 3 months. Efficacy of treatment was monitored by veterinary physical examination, pet-owner assessment using validated questionnaires (canine brief pain inventory (CBPI) and Liverpool osteoarthritis in dogs (LOAD) questionnaire) and repeat radiographs at 3 and 6 months after treatment where possible. All treated dogs became pain free at the lumbosacral region, were able to come off all analgesics and regained full activity. The CBPI and LOAD scores were significantly reduced in all treated dogs. The author concludes that SCT combined with laser therapy is a very effective, minimally invasive, drug free treatment option for lumbosacral disease and warrants further investigation.