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  Discussion on Stem Cell Therapy for DJD in Hocks...Better than fusion?
Author Message
Member:
dr3ssag3

Posted on Wednesday, Apr 25, 2007 - 3:29 pm:

Greetings, all.
I've been looking into stem cell therapy for Contessa and am wondering if anyone has had any recent experience with it (the existing posts being from 2005).

We've been doing everything to keep her comfortable for light work, inlcuding non-steroidal injections in all 4 joints of each hock, alternate-day bute therapy, Legend once monthly, Adequan twice monthly, supplements galore, ice therapy, heat therapy...the list goes on.

Her hocks were last injected 10 January, 2007, and 1 February I moved her to a barn with a double-wide stall and all day turnout with the hope that having more room to move would help. At first it appeared that I'd discovered just the thing, but as the months wear on I'm realizing that we're looking at quarterly injections instead of twice yearly.

My vet stated that he's not ready for her joints to fuse, but has mentioned stem cell therapy as a possibility. While I realize it's still pretty new, is there any reason to discount this procedure? The information found on vet-stem.com is almost too good to be true. I hate to use my horse as a guinea pig, especially if it's overly risky, but seeing as she's only 12, I'm desperate to keep her sound enough to avoid retirement, especially since I can't afford a second horse and simply cannot part with my "baby."

Any and all input is appreciated!

Dawn}
Member:
ngossage

Posted on Thursday, Apr 26, 2007 - 8:38 am:

Hi, Dawn. Wow-sounds like you're doing everything you can for your girl. I don't have any input, but found your thread very interesting, since my boy has DJD in his hocks as well. I give him an Adequan shot every 4 weeks and started him on a glucosamine, HA, supplement about 2 months ago (Nimble Supreme by Adeptus). I'm hoping we can manage with once a year IA injections.

I went on to the vet-stem.com website and did some reading on using stem cells for DJD. I'd done some reading on the site last year when my boy tore his deep digital flexor tendon. I talked to my vet about it, and she said it was being used primarily in high level performance horses and told me the cost would be prohibitive (she knows I'm on a tight budget). Looks like you can request information off of the site.

I'll be interested to see what you decide.
All the best for you & Contessa,
Nicole
Member:
dres

Posted on Thursday, Apr 26, 2007 - 10:05 am:

Nicole, off topic.. could you PM me re your boys torn DDFT,.. As you know I am rehabbing a filly with this type of injury.. SPOTSROCK@SKYHIBROADBAND.NET

thanks

On the first day God created horses, on the second day he painted them with spots..
Moderator:
DrO

Posted on Thursday, Apr 26, 2007 - 10:39 am:

Hello Dawn,
There are several procedures described so I do not know how this applies to your situation but in this well conducted experiment where the cells are actually injected into the articular defects short terms benefits were noted but no long term benefit was found.
DrO

J Orthop Res. 2007 Apr 2;
Enhanced early chonDrOgenesis in articular defects following arthroscopic mesenchymal stem cell implantation in an equine model.

Wilke MM, Nydam DV, Nixon AJ.
Comparative Orthopaedics Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, C3-187, Ithaca, New York 14853.

Mesenchymal stem cells (MSCs) provide an important source of pluripotent cells for musculoskeletal tissue repair. This study examined the impact of MSC implantation on cartilage healing characteristics in a large animal model. Twelve full-thickness 15-mm cartilage lesions in the femoropatellar articulations of six young mature horses were repaired by injection of a self-polymerizing autogenous fibrin vehicle containing mesenchymal stem cells, or autogenous fibrin alone in control joints. Arthroscopic second look and defect biopsy was obtained at 30 days, and all animals were euthanized 8 months after repair. Cartilage repair tissue and surrounding cartilage were assessed by histology, histochemistry, collagen type I and type II immunohistochemistry, collagen type II in situ hybridization, and matrix biochemical assays. Arthroscopic scores for MSC-implanted defects were significantly improved at the 30-day arthroscopic assessment. Biopsy showed MSC-implanted defects contained increased fibrous tissue with several defects containing predominantly type II collagen. Long-term assessment revealed repair tissue filled grafted and control lesions at 8 months, with no significant difference between stem cell-treated and control defects. Collagen type II and proteoglycan content in MSC-implanted and control defects were similar. Mesenchymal stem cell grafts improved the early healing response, but did not significantly enhance the long-term histologic appearance or biochemical composition of full-thickness cartilage lesions. (c) 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
Member:
mrose

Posted on Friday, Apr 27, 2007 - 11:44 am:

When I first took Libby down to Santa Ynez, she went to Dr. Van Snow's clinic and we discussed stem cell. It would not work in her case since her tendon was so destroyed there was no tissue left for a matrix for the cells to grow on. He said he has had good success with some types of injuries and it depended on the injury, how severe it was, where it was, how old it was, etc. If you would like to talk with him about it I could email you his phone number if you'd like.
Member:
dr3ssag3

Posted on Friday, Apr 27, 2007 - 6:41 pm:

Thanks, Nicole. Contessa and I have been together since she was 3. We've been through a lot together, and this DJD issue is just heartbreaking, as Contessa has so much talent and heart. I really don't think she'd do well with retirement...she loves to work and was downright depressed when I spent 3 months recovering from an injury and was unable to work with her. I had to recruit the help of some neighborhood kids to keep her occupied.

Dr. O it'll probably take me a couple of days to decipher the article you referenced...I was the kid at the back of science class creating great works of art rather than listening. ;) Is there any documentation that goes beyond the 8 months cited in the study? Or is the technology too new to really note a longterm benefit? You mention many different procedures...how do they differ? Sorry for all of the questions, but my many google searches haven't pulled up much.

Sara: I'd love any and all information I can get! Thanks!
Member:
mrose

Posted on Friday, Apr 27, 2007 - 7:18 pm:

Send me your email address, Dawn, and I'll send you his address and phone number.

I'm at: mrosearabs@meadowrose.com
Member:
dr3ssag3

Posted on Wednesday, May 2, 2007 - 6:43 pm:

I thought I'd provide an update. My vet cited the same data Dr. O provided, stating that the long term benefits of stem cell therapy are too negligible to warrant such an exorbitant cost.

So, he decided to provide shock wave treatment today, in the hopes that we'll be able to keep her comfortable until her next scheduled injections in July. We will then try using the IRAP method, keeping our fingers crossed that it will last us a year.

Meanwhile, he's upped her bute from alternate-day to 2 grams per day, and wants to keep her on the twice monthly Adequan and once monthly Legend schedule.

Thanks for all the support! Wish us luck! :-)
New Member:
mydove

Posted on Wednesday, May 2, 2007 - 8:08 pm:

Hi, my mare who is almost six was diagnosed with DJD in her hocks. Since then I've been doing some research and I came across a treatment either on this website or on thehorse.com. The research came out of Colorado and seems to work. It is joint injections with Interleukin( some numbers and the word protaganonist). The injection contains nanobeads which release the medicine that stops the joint from becoming inflammed. My vet said they work but are around $800 a shot and my mare's case isn't that bad yet. I hope this helps maybe Dr. O knows something about this. Sharon
Moderator:
DrO

Posted on Thursday, May 3, 2007 - 7:57 am:

IRAP stands for Interleukin 1 Receptor Antagonist Protein so I think you are talking about the same thing. We have had involvoed discussions about this and several members report on its use. Run a search on IRAP.
DrO
Member:
dr3ssag3

Posted on Wednesday, Aug 27, 2008 - 3:09 am:

I feel compelled to resurrect this thread and provide an update on what IRAP has done for my girl. We just completed our second treatment. The first treatment took place in July of 2007. That's right, the IRAP lasted OVER ONE YEAR! Considering that we were looking at quarterly injections of the non-steroidal stuff, I am just thrilled!

Even more exciting to me was how sound she was with treatment. Her movements were free and fluid; I could tell she was comfortable and happy. She was, for all intents and purposes, SOUNDER than she'd ever been with other forms of injections. And when we decided to repeat the process one year later, she was still sound, but moving a little stiffer than she had been. I could probably have pushed the treatment back a couple of months, but I didn't want to press my luck.

Still, I think it's important to report that her radiographs showed significantly less degeneration than the year prior (we do yearly xrays). She actually had some synovial fluid left in her right hock (not much, but usually it's bone dry ... pun only slightly intended), and had a substantial amount in the left hock.

As far as I'm concerned, this highly innovative procedure has given my lovely little mare a new lease on life!
Member:
dres

Posted on Wednesday, Aug 27, 2008 - 9:29 am:

Dawn great news.. Can you tell us more about the process of it.. and the costs per hock? Is it done just like a normal hock injection??

On the first day God created horses, on the second day he painted them with spots.
Member:
paul303

Posted on Thursday, Aug 28, 2008 - 5:49 pm:

Dawn: Wonderful!...and thank you for getting back to us. It's so encouraging to hear about actual experiences.
Member:
dr3ssag3

Posted on Friday, Sep 19, 2008 - 1:09 am:

I'd have to check my records, but the cost wasn't horrible compared to how much I'd be spending if I'd be doing the non-steroidal 4x yearly. I'll post the actual breakdown tomorrow. Last year was more expensive, as he came out for 3 injections. This year he came out once for one leg and twice for the other (as it has far more degeneration). But for all intents and purposes it's worth every cent, as my baby's sound and happy. Even the chiropractor noted that she's been showing less soreness in the lower back area (where they often compensate for hock pain) in the last year compared to previous years.
Member:
dr3ssag3

Posted on Saturday, Sep 20, 2008 - 2:41 am:

Ok so for the first treatment (which includes 3 visits), I have a breakdown of the following:
IRAP Draw $75.00
IRAP Syringe $300.00
Spin & Transfer $175.00
Injection of IRAP into hocks + sedation etc ($293.00) x 3 visits = $879
Total for first treatment: $1429.00

This year the costs were the following:
IRAP Draw: $75.00
IRAP Syringe $385.00
Spin & Transfer: $175.00
Injection to both hocks + sedation etc: ($226.00) x 2 visits = $452.00
Total for this year's treatment: $1087.00

Note that these prices are for the IRAP & sedation only, not the farm call and radiographs (which were $75.00 per visit for the vet call and $480.00 for the radiographs).

Hope this helps!
Moderator:
DrO

Posted on Saturday, Sep 20, 2008 - 10:14 am:

Dawn thank you so much for this update. Have you had time to review the new article on IRAP therapy? If not it is at Diseases of Horses » Lameness » Treatment Methods » IRAP Therapy for Arthritis in Horses.
DrO
PS I will move this post under the article in the next week after I know you have had a chance to see it.
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