It is always a pleasure to feature the perspective of other pet writers on Patrick's Blog. This guest blog from Dawg Business' Jana Rade is especially current as she shares her personal perspective on stem cell therapy. As a pet parent to Jasmine, Jana has seen the ups and downs of this cutting edge treatment. Thank you Lorie Huston, my fellow vet, for initially hosting this post on her excellent Pet Health Care Gazette site. Jasmine, the stem cell child Jasmine was five years old when she started limping on her hind leg in the summer of 2008. We didn’t think much of it at first, because it has happened before and resolved eventually without a diagnosis or treatment from any of her vets. Something about it was different though. Unlike in the past, Jasmine started to be reluctant to exercise and play. That wasn’t like her, quite the opposite. We always had a hard time keeping her subdued while we wanted her injury to heal. Even though we didn’t expect much from the vet visit this time either, I felt that we should at least give it a try. This time, however, the vet said he was suspecting a torn ACL and suggested an exam by an orthopedic specialist. When I looked up what a torn ACL was, I wasn’t happy at all! Surgery? On my little girl? Six months recovery? While we were waiting for our appointment with the specialist and hoping that maybe it could be something else, I started researching possible treatment options. The most common and recommended treatment, a TPLO surgery, we didn’t like the least bit. I liked the TTA a bit better, but turned out that it was not available up here at that time. The extracapsular repair looked the least invasive, but all the articles and resources I found were frowning on using it in large breed dog. We considered a brace, but felt that Jasmine was too young and too active for that. Meanwhile, the verdict from the orthopedic specialist was in and it was even gloomier that we thought it could be. Not only her left ACL was torn, but her right one was in a bad shape too. Recommendation? TPLO surgery for the left knee right away and another one for her right knee as soon as possible. Two highly invasive surgeries back-to-back and taking away a year of her life? There has to be another option!? I put my work and my life on hold and devoted all my time to researching. The more I researched, the more our hopes shrunk. Searching high and low, one vet from Australia suggested that for a partial tear would could try prolotherapy. I researched it, sounded kind of promising. Finding a vet doing this treatment in Ontario was another story. Eventually I found one. I discussed Jasmine’s case with her and she said that it could work, pending her evaluation. Not to do anything behind his back, I brought this up to Jasmine’s vet. He quickly looked it up and told us it was a horrible idea with high risk of bone infection that could result in amputation. Wow, not every day you’re told that you’re trying to maim your dog! Both the Australian vet and the holistic vet I found in Ontario insisted that the risk is minimal when it’s done properly, but I was already freaked out too much. (Interestingly, Jasmine’s new vet does this procedure sometimes for select cases) When I was sharing my desperation with the holistic vet, she said there might be another way. And that was the first time I heard the words stem cells. She said it was a new treatment that was really a shortcut to what prolotherapy is designed to achieve. Back on the computer I started researching this. When I learned what stem cells are and what they do, I got quite excited. Sounded right. Made sense. Other than theoretical information there wasn’t much to be found back then. But I found a story of Allie, the Boxer and her stem cell treatment. That was pretty much the only real-life story available at that time. But we were sold on the idea. I called Jasmine’s vet again and told him about my find. He talked about rejection. “These would be her own stem cells,” I said. “From bone marrow?” he asked? “No, from her fat tissue,” I replied. “Sounds like a scam.” he concluded. This time he didn’t even bother looking anything up! Don’t you just love being treated like an idiot? I wasn’t something I accidentally stumbled upon on the internet, I spend days researching and talked to many people, including vets. Well, at least he wasn’t talking about amputation this time … Regardless of the lack of support on his part, we still really liked the idea and wanted to find out whether or not it could be an option for Jasmine. I went on Vet-Stem’s website where they had a directory of vets certified to do the procedure. There were some in Ontario and some even within driving distance. I took the list and started calling. One of the vets seemed interested in the discussion and in Jasmine’s case. He spent a great deal of time talking to me on the phone. While he felt that surgery is probably the best solution for her, he was willing to discuss the stem cell option. He said that he wanted to try this treatment on their resident dog who had bad arthritis. While I was really taken by him, what I really wanted was somebody who had experience with this treatment. I told him that and he was cool with it. However, when I called all the other certified vets, nobody has actually done it yet. We were even willing to drive down to the states, but nobody within reasonable distance has done it either. Ok, this was clearly something new, huh? Yet, we still liked this idea better than the invasive surgery. Since finding a vet who already had some experience with the treatment turned out impossible, we decided to go with the one who took all that time to talk with me on the phone. He sounded that he cared about animals, and he sounded like a no-nonsense but open to different things guy. We booked a consultation with him. He asked to see the x-rays from the orthopedic specialist. He wasn’t happy that we had only x-rays of her knees. He wanted to see her shoulders and hips also. So we agreed that he’d take his own set. When we came in, he examined Jasmine head-to-toe, took his own x-rays and found arthritis not only in her knees, but shoulders, jaws and neck also. I will skip here the whole ordeal about him finding an abdominal mass and the cancer scare, I wrote about that earlier. The part of that which is relevant to this story is that a resulting exploratory surgery resulted in delay in dealing with her knees. And to make things more interesting, by the time we were able to schedule Jasmine’s treatment, her left ACL suddenly tore completely. That was another blow. Do we have to go with the TPLO after all? The new vet also mentioned the option of extracapsular repair. I told him about what I found on this surgery for large breed dogs, but he said he’s done it many times in large dogs successfully. It was certainly less invasive. He already had a great deal of our trust by then. It would be less invasive. And the worst that could happen would be that we end up where we started. We decided that was what we were going to do. What about the stem cells though? The treatment clearly wasn’t going to help her left knee. But maybe it could save her right one, fix her arthritis and help with recovery from the surgery. Normally, when using stem cells for ACL tear, a thorough evaluation of the damage by MRI or arthroscopy. In Jasmine’s case though, already using the treatment in combination with the surgery and for her arthritis, we eventually decided just do it and hope for the best. On the day of the knee surgery her vet also took a bit of fat tissue from Jasmine’s shoulder and sent it off the VetStem to be processed. Two days later he injected the stem cells into both knees, her shoulders and gave her one IV dose for the areas that couldn’t be injected, such as her neck. There was nothing left do to than work on her post-op rehab and hope for the best. The first month after the treatment, Jasmine’s vet looked disappointed, as he couldn’t see any difference in her recovery compare to dogs who got the knee surgery only. Two months later though, Jasmine was getting a bounce back in her step and her vet started to look excited. She was doing remarkably well! We had nothing to compare it with, but it was clear that she was feeling well. As we got accustomed to in the past two years, just when we were all happy and everything looked good, something was bound to go wrong. Three months after her surgery her right knee just went. She didn’t do anything crazy, just boom. That was really disappointing, but not really surprising. When using stem cell treatment for an ACL injury, the knee should be protected and ideally stabilized using a brace. Not only we couldn’t do all that, but the leg had to carry double the load. But at the end we were happy that her right leg got her through the post-op on the left one, which was now strong enough to take over. So there we were, back on the operating table. Given what the stem cells did the first time around, this time it was no question for us whether we should combine the second surgery with the treatment also. Her recovery the second time around was just as remarkable. Today, over two years after the surgery and the treatments, her knees and shoulders are looking great. Before, her shoulders were very wide, as they were compensating for the bad rear. Now her body has the right proportion. There a little bit of loose skin on both shoulders as a reminder of how broad they used to be. Jasmine is seven and a half years old now, but she has her life back! Even her jaws are feeling better, as she is showing interest in chewing on bones again, which she hasn’t done before. We thank Vet-Stem not only for the awesome treatment, but also for finding our amazing vet. Of course Jasmine’s odyssey doesn’t end there, and neither does her stem cell treatment experience. But more on that next time. Jana Jana Rade is a graphic designer by profession and never aspired to learning about dog health issues until she met Jasmine. Unfortunately, she received a crash course in the subject due to Jasmine’s many health issues and has since become an advocate for other pet owners and their four-legged friends. In her blog, Dawg Business, Jana shares her experiences and the lessons she has learned with others. She shares this message with all dog owners: At the end, your dog’s health is up to you!