What is PRP Therapy?

Platelet rich plasma (PRP) therapy has been clinically proven to treat pain and stimulate healing in the body. This procedure includes injecting a high dose of platelets, concentrated from your animal’s own blood, into areas affected by pain. This is a safe and natural way for your body to accelerate the healing process, rather than blocking or masking their pain.

What is Stem Cell Therapy?

Stem cell therapy treatments are unique because they help the body jump start the healing process. Stem cells are the body’s master cells and are responsible for cell recruitment. They are undifferentiated cells that have the ability to transform into a variety of different cells and replace dying cells, and the potential of rebuilding damaged tissue, muscles, tendons or ligaments. Stem cells are derived from your own body’s bone marrow or fat deposit (adipose).

What is Protein Concentrate therapy?

Protein concentrating kits are used to dehydrate platelet poor plasma after the collection of PRP. Protein concentrate contains the cytokines Alpha-2-Macroglobulin (A2M) and Interleukin-1 Receptor Antagonist Protein (IRAP). Protein concentrate injection therapy uses the body’s own proteins to successfully treat joint and disc disease at its source. A2M is a broad-spectrum multi-purpose protease inhibitor that captures and inactivates the three major chemicals that lead to joint breakdown and cartilage damage. Our protein concentration kits can produce a highly-concentrated injectate of A2M & IRAP. These proteins can stop the progression of painful conditions like osteoarthritis, rather than masking the symptoms of pain. Protein concentrate is also being used on soft tissue injuries because of its anti-inflammatory properties and ability to aid collagen formation.

Why choose Regenerative Therapies?

• Reduce the necessity for major surgery
• Better Healing & Faster Healing
• More effective means of treating certain conditions & injuries

Are there different kinds of PRP?

Every injury is different, as is the concentration of various cytokines in each patient’s platelets and their physiological response to those cytokines. There are also various methods and equipment available for concentrating PRP, and they produce a wide variety of concentrations. The gold standard in regenerative medicine is a platelet concentration of 1 billion/mL, or approximately 4-5x or more above baseline. The actual "dose" depends on the platelet concentration in the PRP and the volume of PRP injected to arrive at the total amount of cytokines delivered to the injury (i.e. concentration per mL x mL of PRP volume = total amount of platelets or cytokines).

What are common applications of PRP, Stem Cell and Protein Concentrate?

• Osteoarthritis / DJD

• Post-operative

What are the recovery expectations?

Most patients find themselves back in their daily routine the day after the procedure. Healing gradually happens over the course of 2-6 weeks and can continue for up to 12+ months.

PRP vs. Stem Cell?

The difference between PRP and Stem Cell therapy has been described metaphorically as the difference between fertilizing your garden, and seeding & fertilizing your garden. One factor is efficacy and the other is the duration of the healing process. High grade PRP has been shown to be highly effective for many conditions. It is generally less invasive, and has a lower cost than Stem Cell. PRP’s continued healing potential can progress for 6 to 12 months, and sometimes that’s all you need. Stem Cell therapy contains all the beneficial growth factors of PRP, but has a higher potential to heal via differentiation and MSC recruitment. Stem Cell therapy usually has a higher cost, because it is more invasive and time consuming. Studies have shown Stem Cell’s healing potential can have a 12 to 18 month duration.

PRP vs. Protein Concentrate?

When using RegenVET protein concentrate you get both PRP and a Protein Concentrate injection. Protein Concentrate is derived from platelet poor plasma. Whereas PRP is platelet rich plasma. The added value of using concentrated protein in a joint is increased regeneration and inhibiting the progression of osteoarthritis, and added anti-inflammatory mediation in soft tissue.

How much should I charge?

Take a look at our practice profitability guide. A rule of thumb for setting up your fee schedule is looking at your cost, and multiplying by two to three times. Common fees for PRP injections are $400 to $800. For Stem Cell injections $1,000 - $3,500. For Protein Concentrate $800 - $1,500. Some practices will choose a two-tiered pricing approach. When using regenerative therapy as an adjunctive measure to a surgery or treatment a lower price may be used. When using regenerative therapy as a stand-alone treatment a higher price may be appropriate to account for sedation and other fixed fees.

Which therapy(s) are recommended for various indication?

Highly concentrated PRP has been the gold standard for joint injections for decades. Stem Cell therapy can provide a more potent and longer lasting solutions in many cases. The addition of Protein Concentrate used with PRP or BMAC will improve the results in joints and other applications. Stem Cell is preferred for severe joint disease, disc disease, and ligament and tendon issues. There is more research suggesting that PRP with Protein Concentrate may be nearly as effective for these very difficult conditions.

What is the difference between Leukocyte Poor Vs. Leukocyte rich?

Leukocyte-poor PRP, or LP-PRP, is PRP with white blood cell and red blood cell concentrations reduced more than traditional PRP. Some white blood cells, including granulocytes (neutrophils) and macrophages, secrete pro-inflammatory signals in response to the injured tissue which can enhance recruitment and proliferation of healing cells, but also can increase short-term inflammation. The primary method of preparing LP-PRP is adapting your centrifuge method (by using a slower speed or multiple spins) to separate the most inflammatory white cells (which are also the densest or heaviest) from the lighter-weight platelets. Typically, platelet concentrations are higher in LR-PRP (leukocyte-rich PRP) than LP-PRP. Due to fewer granulocytes and macrophages, LP-PRP causes less short-term inflammatory pain or flare ups. Many believe the additional inflammation of LR-PRP is beneficial to long-term healing of tendon/muscle injuries by recruiting more neighboring cells (fibroblasts, endothelial cells, and progenitors) than platelet-released cytokines alone.

Can I inject multiple areas?

Yes, but limit injections to two or three sites at a time.

Should we use sedation or anesthesia?

As with any joint injection, sedation is recommended. Combinations include (Dormosedan/Butorphanol), (Xylazine/Ketamine) etc. General anesthesia is usually not needed unless utilizing the regenerative injections as part of a surgical procedure. In some cases when an animal tolerates a blood draw without sedation it may be easier to use general anesthesia to speed up the process.

Definitions

Platelet-Rich Plasma (PRP) – this is a concentration of platelets and white blood cells from whole blood prepared by centrifugation and reduction of red blood cells and platelet-poor plasma. Platelet-Poor Plasma (PPP) – this is the transparent yellow fluid that is the liquid, non-cellular component of blood and PRP. After centrifuging blood, it spans from the top of the tube to about 5 mL above the buffy coat. Buffy Coat – a biological term describing the white, cloudy or fluffy-appearing portion of a blood sample, post centrifugation, normally found at the interface between the PPP and RBCs. The buffy coat represents less than 1% of the total sample volume but contains >90% of platelets and WBCs. Differential – also called 5-part differential, is a term that describes the 5 primary cell types that make up WBC which are neutrophil, eosinophil, basophil, lymphocyte and monocyte. Enrichment – also called “times-base.” Can refer to any cell type when comparing the concentrate with the base whole blood cell count (e.g. platelets are enriched 7.5x base). Recovery – also called % recovery. The percentage of cells recovered from the base count (e.g. there are 10 billion platelets in the whole blood and a device recovers 7.5 billion or 75% recovery). Total Platelets – this is the total number of platelets available in any given sample (e.g. platelet base count is 200 million per mL in whole blood. In a 60 mL sample (9ml ACD-A) there are approximately 10.2 billion total platelets). Total Deliverable Platelets – the total platelets in the PRP, or the % recovery (e.g. 75%) multiplied by the total platelets in the starting whole blood. 10.2 billion x 75% recovery = 7.65 billion platelets total in the PRP. Note: Total Deliverable Platelets (and % recovery) generally increases with PRP volume. Cytokine – a small protein or peptide released by a cell that has a specific effect on or interaction with cells (e.g. cell recruitment, cell division, gene transcription, etc.). Cytokines include the interleukins, lymphokines and chemokines. Many growth factors are categorized as cytokines.