Eight months ago, little Eli the donkey was inexplicably savaged by his longtime companion Watson, a jack nearly twice his size. During the attack, Watson grabbed Eli by the neck and shook him like a rag doll, injuring his spinal cord.
Five days later, as Eli’s condition rapidly declined, his treating veterinarian referred the donkey to Alamo Pintado Equine Medical Center in Los Olivos, Calif.
“We did a normal treatment of DMSO, anti-inflammatories and hyperbaric oxygen therapy, but he was deteriorating very fast right in front of us,” said Doug Herthel, DVM, the founder of Alamo Pintado.
An MRI revealed that Eli had severe trauma to the spinal cord and its blood supply. Swelling had compressed the cord, resulting in incomplete quad- riplegia, a lack of mobility but some sensory and motor function. Veterinary radiologist Travis Saveraid, DVM, delivered the diagnosis. Dr. Herthel also sought the opinion of Mike Kistler, M.D., in Cortez, Colo., a senior member of the American Society of Neuroradiology with more than 25 years’ experience in human spinal trauma.
“In a human, a comparable injury would have been sustained by diving into shallow water, and the majority of those injuries would have a poor prognosis, with paralysis,” Dr. Kistler said. He speculated that Eli’s injury was unlikely to resolve on its own, even if traditional treatment was used. Moreover, he believed that Eli most likely would not survive the injury or its complications.
Despite 24-hour-a-day intensive care and anti-inflammatory treatment to reduce the swelling, Eli’s condition worsened. Eleven days after the attack he lay paralyzed in all four limbs and could not lift his head or urinate or defecate. He had developed pneumonia and was on the verge of death.
Herthel, a pioneer in stem-cell therapy, knew of no research to support the use of stem cells for spinal-cord injuries, but in theory it made a lot of sense.
“The option to use stem cells was based on what we know adult stem cells can do—promote angiogenesis, reduce inflammation, protect the cells in the spinal cord, promote the growth of new cells and inhibit the formation of scar tissue,” he said.
Herthel presented Eli’s owner with the option of euthanizing her beloved pet or opting for experimental stem-cell therapy. She chose to give Eli one last chance.
“We had to do something fairly rapidly and it was an extreme long shot,” Herthel said. “We had nothing to lose, but still we were extremely nervous.”
There was no time to harvest and process stem cells from Eli’s bone marrow. So Herthel used donor stem cells derived from the bone marrow of an adult horse. He injected 70 million stem cells into Eli’s spinal canal at a point behind his poll and 20 million stem cells intravenously.
Within 48 hours, Eli began to show some movement, even while recumbent, though he had lost significant muscle mass and was extremely weak. Then on June 8—nearly a month after the attack—he showed the first significant response to the treatment when he stood with the help of two assistants.
Three days later Eli received a second treatment of 88 million stem cells injected into his spinal canal and 30 million intravenously. Again, within 48 hours, he became strong enough to stand and take a few steps with the help of three assistants. When the effects of the second treatment began to wear off 12 days later, Herthel administered the third and final dose of 100 million stem cells into Eli’s spinal canal and 20 million intravenously.
On July 2, Eli rolled up on his sternum without assistance for the first time, but the big moment came July 31, when attendants found Eli standing in his stall.
“We couldn’t figure out how he got up,” Herthel said. “So we went back and looked at the ICU video. It wasn’t pretty, but he got up, and that’s what counts. After that third treatment, he just got better and better, and his muscle mass came back.”
Eli returned home Sept. 15, where he continues to improve.
Herthel acknowledged that science cannot be based on a single case study, but he believes Eli’s story will stimulate research into stem-cell treatment for spinal cord injuries in all species, including humans.
One essential theory that Eli’s case has confirmed is that adult stem cells, even from a donor, do not evoke an adverse reaction.
“Each time we gave the stem cells, we took a sample of Eli’s spinal fluid, and it was normal, and that’s pretty amazing,” Herthel said. “That’s what makes these adult stem cells so useful.”
Skeptics will claim that anecdotal evidence of the successful treatment of one animal does not prove that stem-cell therapy was responsible for Eli’s cure. Kistler disagrees.
“The fact that Eli recovered after this initial injury over two to three months would indicate that the intervention is what promoted the recovery,” he said. “I think that’s a fair assumption.”