「I’ve always wondered what animal- and owner-friendly treatment is.」
J-ARM（hereafter J）：Dr. Yokoyama is vigorously promoting cell therapy, and we have much to learn from him, not only in clinical practice, but also in his hospital approach to pet owners. Today, I would like to ask him about these matters as well.
Dr. Yokoyama（hereafter Yokoyama）：Thank you for your time.
J：After graduating from the Department of Veterinary Medicine at Rakuno Gakuen University, you worked for Nagano Prefecture before becoming the small animal clinician you are today.
Yokoyama：At first, I did not think of becoming a practitioner. Originally, my father was a veterinarian (an employee of Nagano Prefecture), and I often saw him looking through a microscope at home, and I admired his appearance, so I chose the career path of veterinary medicine. At first, I was not interested in small animal clinical practice at all. I joined the Nagano Prefectural Government and worked in food hygiene and rabies prevention.
One day, I planned and held a dog training class sponsored by a public health center and an animal welfare association. I found it very rewarding and thought, “I want to do something that provides service to people,” and when I thought about it, I realized that I was a licensed veterinarian, and that is when I decided to become a practitioner. I realized that I was a licensed veterinarian, and from there I decided to become a practitioner. I believe that being a practitioner is the best service industry that can make not only animals but also the families who live with them happy. I ended up entering the clinical world 10 years later than others.
J： How did you become interested in regenerative therapy?
Yokoyama：I was not very interested in cell therapy at first. However, as I am sure clinical doctors know, there are actually some owners who do not want to undergo surgical cutting in terms of cancer treatment. I guess you could say that they are reluctant to undergo the three major types of treatment. So I have been thinking about what “treatment that is kind to the feelings of animals and owners” should be. Then I learned that immuno-cell therapy was specifically available at my hospital. From there, I began to introduce cell therapy.
J：Could you tell us what you value in cell-based therapy?
Yokoyama：I believe that the root of any treatment is the relationship of trust between the owner and the doctor, and it is important to communicate this properly at the hospital. This is true not only for regenerative treatment but also for other treatments. It is the small things they do that cause them to fail. If you can’t do that, I don’t think you should do regenerative treatment. To be honest, I don’t think I can make a profit from cell therapy because I think it is an optional treatment (laugh). However, if you build a relationship of trust with owners there and think of it as another ripple effect, I think it should be a management tool.
And I always keep telling myself and my staff that regenerative medicine is not the best, not special, but that this is “one of the treatment options.
「We want to respect the owner’s choices.」
J：You mentioned the word “options” (choices), are such treatments very important in your clinical practice?
Yokoyama：I agree. First, the effect of increasing the number of options is that, for example, in the case of cancer treatment, it becomes a buffer between the three major treatments, and people become more willing to choose. Let’s say there is a child who can be cured by cutting the tumor. If you present a new option, immuno-cell therapy, the owner will be more inclined to choose the surgical procedure. Also, by presenting the options, the owners end up taking responsibility for what they have chosen. Our power is how we can line up these treatments. Basically, we want to respect the owner’s choice, so we explain everything in a neutral way without bias. We explain all the risks and benefits side by side, and then let them choose what they want to do.
J：When you present immuno-cell therapy as an option, what is the reaction of owners who actually choose it?
Yokoyama：To be honest, at first I was recommending immuno-cell therapy, but now I don’t recommend it as the only choice. However, there are many people who choose it. Owners also want their pets to live longer and to be able to feed them one more time. If they use a treatment that is generally considered to be bad, such as anticancer drugs, and the dog dies as a result, they may wonder if that was the cause of the death. This is where the role of treatment to ease the owner’s feelings is important. When we propose to do immuno-cell therapy in combination with surgery or anticancer agents, the owners feel relieved.
Recently, I have also started high-concentration vitamin C therapy as a means of regulating the body’s internal environment. However, I still believe that Western medicine is the best. Western medicine has evidence. I don’t think that we veterinarians should provide treatment without evidence. However, even if there is no evidence, if there is a high level of safety, such as immuno-cell therapy, I think we can put it on the chopping block as a treatment. It is not the first choice, but I tell the staff that it is a starting point for that patient’s treatment.
J：There are doctors who have various views on anticancer drugs.
Yokoyama：I don’t think chemo/surgery should be ruled out. We still have to provide an arguable treatment. However, in the case of cancer treatment, it is significant enough in treatment to think that it is possible to build up immunity a little more and increase the effectiveness to about 13 out of 10 if it is effective. There are also cases in which chemotherapy and surgery do not work. I think the significance of immuno-cell therapy will be demonstrated in these cases.