by Veterinary Practice News Editors | April 5, 2012 1:02 pm
It’s easy to spot Brian Voynick, DVM, CVA, at a lecture or conference–especially one of the holistic veterinary meetings he regularly attends.
“I’m the kind of student,” he said, “who is a pain in the neck.”
What he means is he asks a lot of questions, during and after the presentation. He can’t help it if he has an inquisitive nature and he wants to explore all options in providing leading-edge care for his patients and clients.
So when Dr. Voynick, owner and director of American Animal Hospital in Randolph, N.J., attended a lecture on veterinary stem cell therapy in 2005, he went into full brain-picking mode.
“I was really intrigued,” he said. “I love the science of it. I don’t practice all that I look into, because some of it is not yet science based. But this seemed to be.”
Voynick became an early convert, and seven years later he remains an ardent advocate of stem cell therapy. These days he sees more benefits than ever in a procedure he says can often bring a big boost to quality of life for patients suffering from painful joint ailments.
The latest stem cell technology in his pain-management arsenal comes from MediVet America of Nicholasville, Ky. The system doesn’t require practitioners to send harvested cells to an outside lab to be cultured.
A simple procedure allows Voynick to harvest 400 million to 600 million stromal cells simply by extracting a little more than a tablespoon of a patient’s adipose tissue. A staff technician can then break down the fat tissue with an enzyme wash and isolate the stem cells with a centrifuge.
The next step uses light-emitting diode technology to “activate” the cells and ready them for injection along with platelet-rich plasma. The whole process takes about two hours.
Voynick said he has seen strong evidence that by combining the platelet-rich plasma with photostimulation, the activated cells can greatly reduce pain. But more than that, he said, cell division allows for the replacement of tissue such as bone and cartilage that has disappeared with age.
“A lot of people come to me for acupuncture, which can be effective for pain,” the doctor said. But acupuncture and other therapies don’t offer an opportunity to regenerate tissue “and rebuild the joint,” he added.
Like Voynick, Chris Payton, DVM, believes in exploring all options, including alternative therapies such as acupuncture and chiropractic. He, too, recently added stem cell therapy to his armamentarium.
“A lot of clients are looking for anything they can do to try to increase longevity and make their pets more comfortable without medications that cause secondary side effects,” said Dr. Payton, who practices at Western Veterinary Clinic in South Bend, Ind.
Adding the system meant incurring an up-front expense, he noted. But the investment has brought efficiencies that make the procedure more cost-effective for the clinic and more attractive for clients.
Using an outside lab would mean charging $3,000 or more per procedure, Payton figured. With the in-house system, the clinic is able to offer stem cell therapy for $2,200 on average, he said. Once clients learn that his success rate is about 90 percent, price tends to be less of an obstacle. But he is careful not to oversell the procedure.
“The biggest thing is that they understand this isn’t a magic bullet,” Payton said. “I don’t want them expecting that their dog will be a puppy again. Some do [see that kind of change], but every case is different.”
Conversely, a particularly memorable case showed Voynick that he shouldn’t underestimate the potential of the procedure.
Molly was a 12-year-old golden retriever whose X-rays showed severe hip dysplasia and secondary arthritis. Her owners were taking turns sleeping downstairs because she could no longer climb up to the bedroom. Voynick thought the dog's case was too advanced for stem cell therapy to make a difference.
“The clients said, ‘But isn’t it a better alternative than euthanasia?’” he recalled. “They were more courageous than I was. Sometimes we put ourselves in the owner’s pocketbook when we shouldn’t.”
Two days after the procedure, Molly was able to bound outside and do her business without help for the first time in more than a year. The clients were so thrilled that they took video and sent it to Voynick. For a while, Molly was completely off dexamethasone, and for about five months, she enjoyed more mobility than she had known in years.
As the dog's pain returned, Voynick performed a second injection, using stem cells the clients had banked from the first procedure. This injection was less effective than the first, and eventually Molly had to be euthanized. But those extra months with their beloved pet free of crippling pain meant the world to her owners.
“Dr. Voynick said he didn’t know how long the effects would last–it might be a month, maybe a year or two,” said Janet Moore, Molly’s owner. “In the end, we were able to give her a really good five months. And in our hearts we were able to know we had done everything we could for her.”
The case was a valuable lesson for Voynick, as every case is. From his work with stem cell therapy, he has discovered the importance of communication, explaining the technology to clients as well as sharing the message via posters in the clinic, through his website and on his weekend TV show “The Pet Shop” on News 12 New Jersey.
“There’s still a general ignorance about the opportunities for this procedure,” Voynick said.
One client all but accused him of unethical practices, hearing “stem cell” and immediately thinking they were embryonic. Voynick made it clear the stem cells would be harvested from and reinjected into her own dog.
He and Payton also make it clear to the curious—from clients to colleagues—that the procedure is not complicated or risky.
“There really isn’t a steep learning curve,” Payton said. “Harvesting is something many veterinarians do regularly—just maybe not for this reason yet.”
Voynick does have a suggestion for practitioners considering adding stem cell therapy to their practice. Before investing in the equipment, extract the fat from an ailing patient and mail it to MediVet America for processing. The stem cells will come back two days later.
“Walk before you run,” he said. “Just try it on a straightforward case and see what you get. It’s always best to judge for yourself.”
This Education Series story was underwritten by MediVet-America of Nicholasville, Ky.
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