Here’s an interview with the folks at Vet-Stem and what they have to say on the issue of their new therapy for joint pain in pets:
Q: According to your literature, above all do no harm is Vet-Stem’s mantra in medicine. With that in mind, could you detail the major risks involved in VSRC?
A: In the Vet-Stem process, the animal’s own fat is collected by the veterinarian and Vet-Stem then isolates stem and regenerative cells. As with any anesthetic procedure, there is a risk benefit analysis for each patient. Though the fat collection is a minor surgical procedure, the patient must be a good surgical candidate. Patients with other debilitating diseases that may compromise their surgical success, or patients that have ongoing cancer would not be acceptable candidates. After the dog’s stem cells have been isolated and sent back to the veterinarian, the veterinarian then injects the cells directly into the joint or tendon. As in any joint injection, good sterile technique must be practiced to minimize the risk of infection. The cells themselves, since they are derived from the patient, are of very low risk.
Q: Are you seeking FDA approval for VSRC? Or is that a nightmare your small company doesn’t want to tackle right now?
A: Because the cells are from the same animal, the FDA does not consider them a drug, more of a tissue transplant; therefore there is not a regulatory oversight. Vet-Stem maintains a collaborative relationship with the FDA.
Q: Is the human medical establishment inclined to look positively on VSRC or is it still viewed as experimental?
A: If you look at the human companies that will be first to market stem cell applications, the majority of them are using an adult derived stem cell platform. Many of these companies are currently treating human patients in clinical trials.
Q: Horses have often been on the leading edge of new orthopedic therapies. The use of nutraceuticals immediately comes to mind. Does that to some extent explain why this technology isn’t widely available for humans?
A: Horses are very athletic animals whose injuries can be career-ending, that may be why new therapies are often used for them. The phrase “stem cell” can be a very polarizing term due to the controversy surrounding embryonic stem cells, and when used in reference to a human patient, this process will take on much more scrutiny and study.
Q: How much does this therapy cost for a horse? For a dog?
A: Vet-Stem’s patients’ health statuses vary, and the cost to the client is difficult to estimate. Vet-Stem recommends pet owners talk to their veterinarians about the costs.
Q: Are pet health insurance companies covering it yet?
A: Many of the equine insurance companies do cover the cost for this therapy for the most common types of injuries. Vet-Stem has met with the pet insurance companies and the current policy is not to cover any type of treatment for hereditary orthopedic conditions such as hip dysplasia, a malformation of the hip socket. Osteoarthritis (OA) in some instances is covered by insurance. Vet-Stem’s advice to owners is to check with their pet insurance carrier. For internal medicine cases that are covered by pet insurance, the treating veterinarian is given a stipend of which to use at their discretion on treatment. Vet-Stem is working diligently on future internal medicine applications, and at this time, Vet-Stem does not have any internal medicine treatment options. In the future, once Vet-Stem has released and trained the veterinarian on an approved internal medicine application, if that veterinarian would like to use stem cell therapy as part of their treatment process, the insurance company will honor this.
Q: How many animals have been treated so far?
A: Dogs? More than 300. Horses? More than 2500.
Q: In layman’s terms, how do stem cells work in the joint to repair injury or degeneration?
A: The current working theory on how these cells work is that they act as trophic mediators, cells that signal to other cells to come in to repair response to the environment. These cells secrete a variety of cytokines, cells that help regenerate and repair the tissue, and growth factors. A diverse population of cells with different roles help the natural healing process regenerate the tissue.
Q: What indications are you providing it for in dogs? ACLs? Hip dysplasia? Elbow dysplasia?
A: OA as a result of hip or elbow dysplasia, fracture repair, tendon and ligament damage, partial tears of the ACL at time of surgical repair and autoimmune polyarthritis.
Q: Which specific internal medicine therapies are you targeting?
A: Vet-Stem is looking into therapy for liver, kidney and autoimmune disorders.
Q: Why not VSRC for cats?
A:VSRC therapy is approved for feline OA, tendon and ligament injury. Though Vet-Stem has not run clinical trials on feline OA, Vet-Stem’s credentialed users report good anecdotal feedback that supports the use in cats. Feline OA is under-diagnosed by cat owners and veterinarians since the signs for OA is not always limping, rather more subtle such as lack of activity, jumping on the bed etc.
Q: A clinical pathologist recently informed me of the likelihood that these calls obtained from fat are not stem cells as they’re discussed in human medicine. On further consideration, I wonder if Vet-Stem is talking about a multipotent fibroblast instead of a true pluripotent stem cell. Could you guys clarify this nitpicky issue?
A: This is best answered by reading many of the recent review articles in the literature, such as that by Jeff Gimble, who has characterized adipose (fat) derived stem cells from horses. There are many review articles written and no dispute in the scientific literature nor amongst the stem cell community as to the validity of adipose derived stem cells from animals or humans.