Bob was cured of a painful oral disease through a successful clinical trial treatment.
VMTH "Case of the Month" - November 2013
Bob, a male domestic shorthair cat, was 14-years-old when he came to the UC Davis Veterinary Medical Teaching Hospital (VMTH) in October 2012. Bob had been suffering from painful feline chronic gingivostomatitis (FCGS) for about one year. FCGS is a severe oral inflammatory disease that affects the gums and back of the mouth. Bob’s owner tried several treatment options with his veterinarian, including extraction of several teeth and medication to manage the inflammation and pain. Even with those treatments, Bob continued to suffer from oral inflammation to the point he would paw at his mouth and cry out in pain.
Determined to help Bob, his owner brought him to the Dentistry & Oral Surgery Service (DOSS) at the VMTH in hopes of finding a different course of action to treat FCGS. In 60 - 80% of FCGS cases, a cure can be achieved with the standard care of a full-mouth tooth extraction. VMTH oral surgeons were also concerned that Bob’s teeth may be resorbing, which can also be painful. All four of his canine teeth were broken below the gum line, and he was very uncomfortable when surgeons touched his mouth. Bob needed immediate care; extraction surgery was set for the next morning.
The following day, Bob was placed under general anesthesia. Dental radiographs were obtained and showed that, in addition to FCGS, Bob also had root resorption and many of his teeth were fused to the underlying bone. This made his extractions more difficult than originally anticipated, but surgeons were able to complete the total extraction.
After the procedure, Bob returned to the VMTH for monthly re-check appointments, and he initially showed minor signs of improvement. By March 2013, however, it was apparent that Bob was not responding positively to the extraction and standard medical treatment. After exhausting all of the standard methods of care, but not willing to give up, Bob’s owner elected to enroll him in a clinical trial—being conducted by DOSS and the UC Davis Regenerative Medicine Laboratory led by Dr. Dori Borjesson—investigating a novel stem cell therapy to treat FCGS. Because stem cells are known to have anti-inflammatory and regenerative properties, the veterinarians were hopeful that this therapy, which involved extracting and isolating stem cells from Bob’s own fat tissue and injecting them back into Bob, would cure the disease.
Bob received an IV injection of stem cells in early May 2013 to decrease the inflammation and promote tissue regeneration. A potential complication of stem cell therapy is the formation of clots. This most often occurs within 72 hours of stem cell therapy, so Bob was hospitalized at the VMTH for three days of monitoring. Bob did very well, and showed no signs consistent with the formation of a clot sticking in his heart, lungs or kidneys. While in the hospital, Bob also ate well, so VMTH clinicians were confident to release him after three days.
Three weeks later, Bob returned to the VMTH for a second stem cell treatment. Once again, he completed the therapy with no complications and returned home. Bob returned to the VMTH for monthly re-checks, each time showing marked improvements. By the second re-check appointment, there were no signs of inflammation in Bob’s mouth. Three-, four- and five-month re-checks showed no signs of FCGS returning. With Bob’s success in helping to pioneer this stem cell therapy, the VMTH team continues the clinical trial with many other patients who have recently enrolled in the study.
Bob’s painful and diseased mouth before the treatment.
Bob’s healthy mouth after the treatment.
About the Veterinary Medical Teaching Hospital
The William R. Pritchard Veterinary Medical Teaching Hospital at the University of California, Davis—a unit of the School of Veterinary Medicine—provides state-of-the-art clinical care while serving as the primary clinical teaching experience for DVM students and post graduate veterinarian residents. The VMTH treats more than 45,000 animals a year, ranging from cats and dogs to horses, cows and exotic species. To learn more about the VMTH, please go to http://www.vetmed.ucdavis.edu/vmth. Timely news updates can be received on its Facebook (www.facebook.com/ucdavisvetmed) and Twitter (www.twitter.com/ucdavisvetmed) pages.
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