Autologous adipose-derived falciform mesenchymal stem cells in the management of canine chronic hepatitis/cirrhosis: clinical audit
I’ll try to flesh out these details over the next few weeks with some more post-treatment biochem results. As yet, no post-treatment histopathology is available.
It should be pointed out that we would only consider stem cell therapy in a situation where the prognosis is, at the very least, guarded. That is reflected in the fact that we have had two patients who died from complications of their liver disease in the two-week period between harvesting of fat and the anticipated reintroduction of cultured stem cells.
One patient, Jess, was euthanased on account of aggressive mammary malignancy two years after stem cell therapy. The possibility of stem cell potentiation of neoplasia remains a concern in human and veterinary patients. However, overall, we are feeling pretty positive about our experiences with what is otherwise a condition with a poor prognosis.
In particular it seems that portal hypertension in some of these dogs may be reversible: judging from resolution of ascites (and withdrawal of diuretics). This may be the first report of such a phenomenon in dogs with severe liver disease. Resolution of portal hypertension subsequent to stem cell therapy in human medicine has been documented.
I’m not aware of any other published data for outcomes of stem cell treatment in canine liver disease.
We are very grateful to Biobest Laboratories; and particularly Kieran McDonald, for their enormous help with stem cell culture and general advice.
Latest update 3/11/19
|Patient||histopathological diagnosis||clinical signs||stem cell protocol||outcome|
|7 y.o. Springer Spaniel||chronic hepatitis||recurrent icterus, malaise||40,000,000 cells into splenic vein||no further outward signs of hepatitis. Ultimately died from mammary neoplasia 2 years later.|
|5 y.o. Giant Schnauzer||Chronic hepatitis and cirrhosis||malaise, icterus, ascites, inappetence||40,000,000 cells into splenic vein.||ascites managed for 3 months post-treatment with diuretics. Thereafter free from signs and off all treatment. Outwardly well 26 months later.|
|1 y.o, Springer spaniel||Chronic hepatitis||recurrent malaise, icterus||40,000,000 cells into splenic vein. Subsequently two more doses of 40,000,000 cells into liver parenchyma at multiple sites.||Euthanased 20 months later due to mycotic rhinitis and pneumonia. Developed multiple acquired PSS within 2 months of stem cell treatment. Has also received glucocorticoids intermittently both pre- and post-stem cells.|
|4 y.o. Cockerpoo||Chronic hepatitis||recurrent malaise, icterus||40,000,000 cells into splenic vein||Alive and outwardly well 18 months post-treatment. Liver enzymes and bile acids within normal limits. No current medical treatment.|
|5 y.o. Cockerpoo||Chronic hepatitis||recurrent malaise, icterus, ascites, multiple acquired PSS||20,000,000 cells into splenic vein. 20,000,000 cells into liver parenchyma at multiple sites||Euthanased 6 months post-treatment on account of complications of liver failure. Initial improvement in demanour, appetite. Also received glucocorticoids.|
|9 y.o. Cocker||Chronic hepatitis and cirrhosis||chronic malaise, weight loss||40,000,000 into liver parenchyma at multiple sites||post-prandial bile acids declined from 55 to 17. Outwardly asymptomatic 4 months post-treatment.|