Dr. Steven D. Garner DVM, DABVP is an innovator. When a cutting-edge veterinary treatment is introduced, he is known for setting his sights on mastering the technology if it will benefit his patients. That is why the veterinarian uses stem cell therapy to keep IVDD dogs walking. He is one of a handful of professionals who perform this procedure in a private clinic.
When Dr. Garner founded Safari Veterinary Care Centers, near Houston, TX in 1984, his goal was to give pets the level of care they would receive at a top veterinary school hospital. He put together a skilled team and incorporated advanced diagnostic and surgical procedures into his practice. In 2011, Dr. Garner became interested in holistic medicine for his patients. So, with his innovator spirit, he became certified in Canine Rehabilitation. His care centers now include rehabilitation therapy, underwater treadmill therapy, laser treatments, acupuncture and more.
Two years ago, his interest in rehab led to a curiosity about stem cell therapies for animals. Dr. Garner researched studies that were going on in the US and in Europe. Then he took a course from a major veterinary stem cell laboratory. He became certified in clinical stem cell procurement and treatment. In 2015, he turned research into realty when he built a state-of-the-art stem cell lab.
One of the main goals of Stem Cell Safari is to treat and cure dogs with IVDD (Intervertebral Disc Disease). IVDD is the most common cause of back pain, herniated or ruptured discs, and hind end paralysis in dogs.
How Dr. Garner uses stem cell therapy to keep IVDD dogs walking
Dr. Garner kindly answered questions about the stem cell treatments he performs and how it is helping his patients.
Could you give an overview of how IVDD stem cell therapy works?
Intervertebral discs are cartilage filled with glycoprotein matrix like a jelly donut is with jelly. Stem cell therapy involves injecting live stem cells into the degenerating disc. The degenerating disc is physically collapsed and the disc matrix material is bulging or leaking from the disc causing spinal cord damage. So, there are two diseases; one is the degenerating disc and the other is the damage to the spinal cord. Stem cells produce more matrix in the disc which holds water re-hydrating the disc cartilage and re-inflating the disc structure. This reverses the degeneration process for the disc.
We use autologous fat derived stem cells (also called adult stem cells, mesenchymal stem cells, stromal vascular fraction stem cells…) which are from the pet itself so there is little likelihood of any untoward reaction. It is like a skin graft taken from one part of the body and placed on another. There should be no reactions and we have not seen any.
Dr. Garner wants everyone to know that he does not use embryonic stem cells. They are associated with tumor formation and are not being used in animals or humans for therapy.
Spinal cord injury from IVDD has 4 stages that are treated differently depending on the stage. Stem cells injected into the spinal cord or into the fluid surrounding the spinal cord enhance regeneration of damaged nerves through many pathways.
Describe the perfect candidate for the procedure?
The perfect candidate is one that does not yet have spinal cord disease. A pet that is just painful, reluctant to jump or go up or down stairs. Injection of these discs will reverse these changes and prevent or lessen the severity of the disc disease.
How far after a spinal injury can you do the procedure?
The ideal time after an insult – assuming surgery is not an option – is seven days after the injury. Spinal cord compression causes significant inflammation in the spinal cord and this inflammatory response is fatal to stem cells. So, research has shown that day 7 to day 14 after the event is best for an injection into the spinal cord at the area of compression.
Because the stem cell procedure has to be done 7 – 14 days after an IVDD injury to lessen inflammation, how can he be sure it is the stem cells helping and not the crate rest which is typically prescribed for a dog?
The short answer is that you can’t. However, research has shown that stem cells administered in conjunction with surgery actually doubles the pet’s chances of a full recovery.
Your website says the stem cells injected build tissue. Does that mean it grows disc material?
In the disc the stem cells build matrix and the stem cells secrete proteoglycans which are the main constituent of the disc matrix. In the spinal cord, stem cells replace dead neuron support cells and give “life support” to otherwise dying nerves. The nerve support cells (astrocytes and oligodendrocytes) that are replaced make myelin and help regenerate axons.
How do you know where to inject the cells?
Degenerated discs are narrow and can usually be identified on radiographs but MRI is the gold standard. Spinal cord compression is diagnosed with a myelogram in about 90% of the cases. Many times all the discs are injected.
How long have you been using stem cell therapy for IVDD dogs?
Over 2 years.
How much improvement can people expect to see?
Depends on how much damage. Dogs that are painful, have an arched back and just have disc disease are expected to be cured. (Physical therapy is important as well.)
Is your work part of a clinical study?
No not a formal study. We do keep medical records and do results analysis and use this to adjust our therapy. It was explained to me that Dr. Garner practices his stem cell usage based on current studies.
One of those studies was conducted by researchers who mimicked IVDD damage to the spinal cord of dogs. A balloon catheter was used to pinch off the spinal cord. Half of the dogs were given stem cells and half were not. All of the dogs that received stem cells walked again. The other half did not.
A second study found that dogs who received surgery and stem cells for an IVDD injury were twice as likely to have a better outcome than dogs who received surgery alone.
Have any of the IVDD dogs you treated with stem cell therapy developed the disease later in life?
It was explained that none of the dogs have had future episodes. Not many have returned for MRI’s or other follow-up diagnostics.
Dr. Garner describes the disease process of IVDD
In general, we have two diseases at play, disc disease and spinal cord disease. Signs of disc disease are pain, hunched back, reluctance to jump, pain when touched and so on. These signs are treated by treating the disc itself. Injections of stem cells into the disc reverses the degeneration, re-inflates the disc, moderates the inflammation and is a potential cure for the disease. The sooner the better with the stem cell application. Spinal cord disease on the other hand has four stages.
- The Per-Acute stage which is the first 24 to 48 hours where surgery to decompress the spine is aimed at preventing nerve death.
- The Acute stage which is the first week after the injury where the damage is done and the nerves are dying or degenerating due the initial insult causing poor blood flow, inflammation, swelling, hyperexcitability and release of harmful toxic chemicals. This phase is best treated with cage rest and anti-inflammatory medications such as NSAIDS, DMSO, Minocycline, cold packs, and laser therapy.
- The Sub-Acute stage is the stage of healing and starts 7 days to 2 weeks after the initial injury and is where stem cells are most beneficial at restoring the nerve function. This stage lasts for about 6 weeks. Physical therapy is very important during this stage as is electrostimulation, acupuncture and so on.
- The Chronic stage starts at 6 weeks and goes on for up to 2 years. This stage is where the surviving nerves take over the function of the dead nerves. This relearning has a lot to do with rehab, water treadmill and so on. Stem cells therapy along with chondroitinase ABC does improve the outcome of these pets as well. (This is a study from Iowa State University School of Veterinary Medicine)
Dr. Garner and his staff invite pet owners to visit the IVDD Answers Facebook page to learn more or ask questions.
Here is a video of Scout who was helped by Dr. Garner and stem cell therapy.
Note: Stem cell therapy is more commonly used as a treatment for pets with arthritis, kidney disease, and some heart conditions. Dr. Garner is a speaker, teacher and consultant. He was a featured speaker at the AAHA Annual Meeting and at many veterinary schools and conferences.
Photos courtesy: Stem Cell Safari