Case: Platelet therapy

We see a number of cases of chronic degenerative joint disease (DJD) where surgical treatment like joint replacement or salvage surgery is not an option. When conventional treatment is not enough, we have two modern and emerging technologies that may help. These technologies can be used alongside each other, and alongside the other standard treatments (non-steroidal anti-inflammatory drugs, analgesics etc) that are described in our information sheet on DJD which can be found in the section for owners, sub-section “fact sheets”.

One option is the class IV K-laser therapy that we have been using since 2012 and which involves the application of laser light energy to the affected area(s). Another option is the injection of concentrated platelets into the affected joint(s). Platelets are present in a sample of the patients’ own blood which can be easily collected from a vein. The concentrated platelet fraction is then prepared using modern filtration technology. The injection of the platelet concentrate into the joint(s) requires strict asepsis to reduce the risk of joint infection, and so a short general anaesthetic is required. Clinical trials have shown that one treatment gives improved weight bearing, reduced lameness and reduced pain when measured objectively (using measuring equipment) and subjectively (when graded by owners and vets) 12 weeks after treatment. These trials were well designed: The trials were randomised and “blinded” (the people doing the measuring and assessing did not know what treatment the dogs had had and so could not be biased in their interpretations. The suggestion is that improvements in clinical signs last for months but this technology is so new that we don’t really know this yet. The idea is that platelets release platelet derived growth factors which in turn attract stem cells to augment repair and remodeling processes. See our links for more information.

We have done quite a few cases now, injecting platelet concentrate into elbows, shoulders and stifles (knees). We are now getting the feedback from the clients whose pets were the first to receive this treatment from us.

We have had several clients who saw marked improvement of mobility after one round of injection of platelet therapy, and then contacted us again of their own volition a year or so later, asking for a repeat injection when signs started to deteriorate again. The second injections also reportedly improved mobility significantly. We obviously recognise that this observation is anecdotal and from small number of cases rather than grounded in firm controlled studies, but it is promising and shows clients “voting with their feet”. It also gives a “feel” for how long we can expect any improvement to last after injection of platelet therapy into joints.

References:

  • A randomized controlled trial of the efficacy of autologous platelet therapy for the treatment of osteoarthritis in dogs. Fahie et al. J Am Vet Med Assoc 2013; 243:1291–1297
  • Clinical outcome using canine platelet enhancement therapy (C-PET). Fahie et al. Veterinary Orthopedic Society 39th Annual Conference 2012. Abstract reprinted in Veterinary Comparative Orthopaedics and Traumatology 3/2012, A8-9

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