Friday, May 24, 2013

Cat's Who Need Crate Rest - Really?!?

I am a vet.  I make recommendations alllll the time that I realize are being ignored.  Either completely ignored or partially ignored, but I continue to make these recommendations.  Why? Because it's the right thing to do.  And because a lot of the time my recommendations can make the difference between a positive outcome or a lot of frustration.

One example is crate rest.  The concept of the crate with dog people is pretty easy to get across.  Many dogs had crates when they were puppies or first adopted, and often they are a continued presence in the home into adulthood.  Dogs often *like* their crates, and seek them as a safe haven or stress-free zone. So if I recommend that you crate rest your dog, both you and your dog kind of understand the concept. You may not like it, but you get it.

Cats who need crate rest...that is a much more difficult concept.  Cats don't appreciate being confined, or being told what to do in any capacity, really.  Plus they go to the bathroom in a box, on their own schedule, so that box needs to live with them in the crate and get cleaned A LOT.  And while cats typically sleep 22 out of 24 hours in the day, for some reason it tugs on our heartstrings to see them sleeping in a crate all day.  Finally, people just don't understand putting a cat in a crate - it's a foreign and weird idea.  Because of these reasons, and others, I will sometimes suggest a bathroom or laundry room - somewhere small and confined but not a true crate.  And sometimes it works!  The problem with this is that it's not strict rest.  If a cat can jump onto an object (toilet, sink, washer/dryer, etc) they will; and if they can't jump onto said item because of an injury, they may still make the attempt, often with disastrous results.  And when the cat is not getting better and I have to insist on the crate we've already delayed the healing process and frustrated everyone.  The short of it?  If your vet tells you to crate your cat, listen.


The owner of a cat who needs to live in a crate for the at least 8 weeks, and the wife of a man who asks daily if she can come out yet... (At least Bina has sympathetic Trouble to keep her company!)

Regenerative Stem Cell Therapy

Let's start at the beginning - we are not talking about embryonic stem cells.  No cord blood is involved in this process.  We get these stem cells from FAT, and the patient's own fat at that (see, you knew that muffin top had a purpose).  So now that *that* is out of the way...

Stem cells are starter cells - they can differentiate into the cells that are needed, such as bone, tendon or ligament; they also act as a beacon for other healing cells to hone in on, bringing them to the areas of the body that need to be repaired.  

Stem cell therapy is an up and coming modality in veterinary medicine, and it is showing some pretty impressive results.  The gist of it is we harvest fat from your pet, process it until all we have left are the stem cells from the fat, and then reintroduce those cells into the areas that need it most.  It is most commonly used for osteoarthritis patients (creaky old joints) and other orthopaedic injuries (cruciate tears, elbow dysplasia, hip dysplasia), although there is progress in other areas of  regenerative medicine as well.

Why would you choose stem cell therapy over traditional management?  Well, traditional management for osteoarthritis includes many things, but those that tend to be the most problematic are NSAIDs (non-steroidal anti-inflammatories like Rimadyl, Deramaxx, Metacam, etc).  Many pets use these medications safely and long term, but they can cause GI upset, can affect the liver, and require blood work to monitor their use.  While stem cell therapy doesn't always allow a pet to completely discontinue these medications, it can help to reduce their dependency on them.  

Why would you choose stem cell therapy instead of surgical correction?  Depending on the surgery you're talking about, stem cell therapy is more affordable (total hip replacements can get up to $10k or more), is generally less invasive, and tends to have a quicker turn around time.  Also, if your pet has multiple joints that are affected (both hips, both hips and a knee, a knee and an elbow) recovering from a surgery that incapacitates an entire limb may cause worse damage to the other limbs.

This sounds a bit like a commercial for stem cell therapy, doesn't it?  Sorry about that, it's not my intention.  Stem cell isn't for everyone, and it doesn't have a 100% guarantee (neither does surgery, or NSAIDs, or physical therapy - there are no 100% guarantees), but it is SO exciting to have another option to treat these pets and relieve their discomfort.  And the research and medicine behind it is so freaking COOL - turning fat into ligament??? Awesome.