Inside AAHA December 2022

AAHA’s president-elect Mark Thompson, DVM, CCRP, talks about considerations for utilizing regenerative medicine. A Community highlight asks about unplanned inspections. Log in to the AAHA Community to join the conversation with other AAHA practice team members.

View from the Board

Consider Regenerative Medicine

As we search for new and innovative ways to help our patients, we should be considering regenerative medicine. Regenerative medicine is becoming increasingly popular in both human and veterinary medicine for treatment of multiple disease processes. Recent studies have demonstrated its efficacy in managing numerous orthopedic conditions in humans, dogs, and horses, including osteoarthritis and soft tissue injuries. I have used regenerative medicine in my practice for many years.

I started out using stem cell therapy but today mostly use platelet rich plasma (PRP). The reason I use more PRP today is because of the lower client cost and ease of sample collection and administration as well as its similar effectiveness with stem cell therapy. I apply a multimodal approach to regenerative medicine, using it as an adjunct to surgical, medical, and rehabilitation therapy. Our practice has a busy rehabilitation service, so combination therapy is second nature.

For our practice, PRP therapy is a staple. PRP therapy is a minimally invasive procedure that typically can be performed on an outpatient basis. It can be used as a single injection into the joint or tissue or as a series of one to three injections, with two weeks between each injection. In my experience, if PRP is being used to manage moderate to severe osteoarthritis by itself, about 50% of dogs require multiple doses. The most common side effect is discomfort associated with the injection, which can be managed with pain medications; it typically resolves within 12 to 24 hours after the injection. I try to avoid therapeutic ultrasound, electrostimulation, hydrotherapy, steroids, and nonsteroidal anti-inflammatory drugs during the two to four weeks following PRP therapy because of the lack of information on their potential interactions with PRP.

Stem cells are another important part of regenerative medicine. Almost all veterinary research has focused on adult stem cells, specifically derived from bone marrow or adipose tissue. I prefer the adipose tissue source in dogs for several reasons: ease of access, low morbidity and pain associated with collection, and high-yielding stem cell count compared to bone marrow. I have done less stem cell work recently, but I still believe in the value.

Many factors play a role in how you choose what modality, frequency, and combination of PRP or stem cells to use for each patient. Finding the balance between medicine, surgery, rehabilitation, and regenerative therapy is the art of our profession.

The business of veterinary medicine has become increasingly more complicated over the last 20 years. Finding another profit center can be a welcome addition for your practice as well as a life changer for your patients. Regenerative medicine has a low cost of entry. Getting a regenerative therapy program started at your practice requires doctor and staff training, but the benefits will far exceed the initial discomfort.

If you commit yourself to continued learning, your professional development extends to everyone around you, ensuring that your team also develops the habit of acquiring skills, knowledge, and abilities to become better at their jobs. After all, isn’t that what we all strive for?

 

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Mark Thompson, DVM, CCRP, is AAHA’s president-elect. Thompson is owner of Country Hills Pet Hospital, the 2018 AAHA-Accredited Practice of the Year winner.

 

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Benchmarking Tools for AAHA Members

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