Ep 18 - Regenerative Medicine in Veterinary Practice – Stem Cells, PRP and the Future of Osteoarthritis Treatment

May 31
5 min read

For a long time, regenerative medicine felt a bit… sci-fi.

Something futuristic. Something experimental. Something happening in expensive laboratories somewhere far away from real-world general practice.

But after sitting down with Russell Chandler on the podcast recently, both Charlotte and I came away thinking the same thing:

This isn’t “the future” anymore. It’s already here.

And perhaps more importantly — clients already know about it.

Increasingly, owners are arriving in consult rooms asking about stem cells, platelet-rich plasma (PRP), and regenerative therapies for arthritis and chronic pain.

And if we’re honest, many of us in general practice probably still feel slightly uncertain about what these treatments actually involve, what evidence exists, and when we should be thinking about referral.

This episode completely changed how we think about regenerative medicine.

So… what actually is regenerative medicine?

At its core, regenerative medicine is exactly what it sounds like:

Using the body’s own biological healing systems to try to repair, regenerate, or modify disease processes — rather than simply suppressing symptoms.

In veterinary orthopaedics, the two main “orthobiologics” currently being used are:

Platelet-rich plasma (PRP)
Mesenchymal stem cells (MSCs)

And the most common indication?

Osteoarthritis.

The Big Shift: From Symptom Control to Disease Modification

One of the biggest take-home points from Russell was this:

Most of our current osteoarthritis treatments are symptom modifying.

NSAIDs help pain.

Weight loss helps mobility.

Hydrotherapy helps muscle strength.

Librela may help comfort.

Supplements may support joints.

But none of these treatments truly alter the underlying disease process itself.

That’s where regenerative medicine becomes interesting.

The goal is no longer simply making the patient more comfortable.

The goal becomes:

reducing inflammation,
improving tissue healing,
slowing disease progression,
and potentially improving the biological environment within the joint itself.

That’s a very different conversation.

Platelet-Rich Plasma (PRP) – What Is It?

PRP is surprisingly simple in principle.

Blood is collected from the patient and centrifuged to concentrate the platelets.

Those platelets are packed full of growth factors and signalling molecules involved in healing and tissue repair.

The resulting concentrated platelet-rich plasma can then be injected directly into:

joints,
tendons,
ligaments,
muscles,
surgical sites,
and even used as a gel in some situations.

One of the fascinating things Russell discussed is that platelets are far more biologically active than most of us probably appreciated at vet school.

They don’t just help form clots.

Once activated, they release a whole “secretome” of growth factors, proteins, RNAs and signalling molecules that help initiate tissue healing.

Why PRP May Appeal to Clients

One reason regenerative medicine may become increasingly popular is that many owners perceive it differently from traditional medication.

PRP is:

autologous,
minimally manipulated,
and derived directly from the patient’s own blood.

For owners worried about “lifelong medication” or wanting a more “natural” approach, this can be extremely appealing.

And unlike some futuristic concepts, PRP is already being used widely in both human and veterinary medicine.

Stem Cells – The Bit That Sounds Like Science Fiction

Stem cells are where things get really interesting.

The type discussed in the episode are mesenchymal stem cells (MSCs).

Rather than being harvested from bone marrow, these are commonly collected from fat tissue — specifically the falciform fat during a small surgical procedure.

That fat is then processed in a specialist laboratory where the stem cells are isolated, cultured, expanded and cryopreserved.

Several weeks later, the stem cells are returned ready for implantation into affected joints or tissues.

Importantly, the lab can also store additional stem cells for future treatments.

What Do Stem Cells Actually Do?

This was one of the most interesting parts of the discussion.

Stem cells are not simply “replacement cells”.

Instead, they appear to act as biological signalling centres.

They:

modulate inflammation,
influence immune responses,
encourage tissue repair,
and alter the healing environment within damaged tissues.

Russell described them as a form of “living medicine”.

And unlike traditional drugs acting on one receptor or pathway, MSCs appear capable of responding dynamically to the tissue environment they enter.

That’s a very different therapeutic concept from conventional pharmacology.

The Huge Orthopaedic Point Most of Us Probably Miss

One of the most valuable clinical discussions in the episode was this:

Most lame dogs probably have far more pathology than we identify in first opinion practice.

And honestly… this probably rings true for many of us.

A dog presents with elbow osteoarthritis.

We radiograph the elbows.

We identify arthritis.

We treat the elbows.

But Russell explained that many of these dogs also have:

shoulder pathology,
muscle strain,
compensatory tendon disease,
iliopsoas injury,
lumbosacral pain,
or secondary soft tissue problems.

And unless we identify those too, we’re often only treating part of the picture.

This is where musculoskeletal ultrasound becomes incredibly valuable in regenerative medicine practices.

It allows:

identification of tendon and muscle injuries,
real-time ultrasound-guided injections,
and far more targeted therapy.

The phrase “shelbo lameness” (shoulder + elbow pathology together) genuinely stuck with me.

Earlier Referral May Matter More Than We Think

Another major theme was timing.

We often think about referral for regenerative medicine when:

NSAIDs are failing,
arthritis is severe,
or owners feel they’re running out of options.

But Russell repeatedly emphasised that outcomes are likely far better when intervention happens earlier.

Particularly in young dogs with:

elbow dysplasia,
hip dysplasia,
cruciate disease,
or early osteoarthritis.

The earlier the disease process is influenced, the greater the potential long-term benefit.

That’s probably an important mindset shift for many of us.

Could This Become More Common in General Practice?

Honestly… yes.

Stem cell therapy will likely remain referral-based for most practices due to:

tissue harvesting,
laboratory processing,
imaging requirements,
and case complexity.

But PRP feels different.

PRP feels genuinely achievable for motivated general practitioners with:

training,
appropriate case selection,
centrifuge systems,
and confidence with joint injections.

And I suspect we’ll see more of this entering first opinion practice over the next few years.

What About Evidence?

As always, evidence matters.

Russell referenced work from Greenside Referrals showing significant improvement across multiple clinical outcome measures in dogs that had previously failed conventional therapy.

As with much emerging medicine, more long-term evidence is still developing.

But what’s striking is that regenerative medicine is rapidly moving beyond being a fringe concept.

The volume of research in both human and veterinary medicine is growing quickly.

The Bit That Really Changed My Thinking

Probably the most important thing this episode changed for me personally was this:

Clients already think regenerative medicine is real.

Many vets still think of it as futuristic.

But owners are already asking about it.

AI searches are already recommending it.

That gap between owner awareness and veterinary confidence is probably only going to widen over the next few years.

And that’s exactly why conversations like this matter.

Final Thoughts

Whether regenerative medicine ultimately becomes:

routine,
niche,
transformational,
or something in between…

…it’s clearly no longer theoretical.

And for chronic pain patients — particularly osteoarthritis cases — it potentially offers something genuinely different:not simply palliation,but biological intervention.

That’s exciting.

Huge thanks again to Russell Chandler for such an eye-opening discussion.

And as always, we’d love to hear your thoughts: