“When she woke up in the morning, she couldn’t move.”
J-ARM（Hereafter J）：Today we are talking with Dr. Yamamoto, director of Mizuho Veterinary Hospital in Sennan City, Osaka, and Mr. Yamauchi, the owner.Dr. Yamamoto has been in clinical practice here for more than 30 years and introduced cell therapy about three years ago.Ms. Yamauchi was an owner who attended Mizuho Veterinary Hospital at that time, and now works at Mizuho Veterinary Hospital as an animal nurse. First of all, we would like to ask Ms. Yamauchi to briefly tell us about her family’s treatment of Riko.
Ms. Yamauchi（Hereafter Yamauchi）：Riko is a miniature dachshund girl, 5 years old.She was energetic and ran around a lot, but when she woke up in the morning, she was unable to move. I rushed to the hospital and called the doctor to see her.The cause was diagnosed as a suspected herniated disc.At that time, there is no deep pain when pinched, and the condition is generally not good for the rest of the day.The doctor suggested that I undergo fat stem cell therapy, and I underwent general anesthesia to culture the stem cells contained in the fat and extracted fat about the size of a pachinko ball.
I was told that it would take about two weeks for the cells to be harvested and increase to a certain number, during which time I was treated with medication. Two weeks later, when the stem cells had increased enough, I gave him an infusion. About three days later, he began to show some movement in his legs. A week later, he was already able to stand. After standing up, I started walking quickly, and before I knew it, I was walking normally. I was surprised that it healed so quickly because I had seen that he had no reaction to his leg at all at first. He was unable to go to the bathroom by himself and had been wearing a diaper until then, but I was impressed that he started going to the bathroom just as he was able to walk.
Now she feel a little dizzy only on the right side, but she has recovered enough to be able to run around and jump. It’s been a year since she was treated and so far there has been no recurrence.
Ｊ：Thank you very much. Next, I would like to ask you. How did you come to offer stem cell-based therapy to Ms. Yamauchi?
Dr. Yamamoto（Hereafter Yamamoto）：She has always been an active dog who moves a lot, and we had talked about the possibility of herniated discs, so we decided to try stem cell therapy at that time.
Yamauchi：I had already decided to use cell-based therapy when she had a herniated disc because he had been talking about it for a long time. In fact, when I worked at a hospital before, I had seen several cases of dogs that could not stand up recover at his hospital.
Ｊ：Was Riko mainly taken care of by Mr. Yamauchi?
Yamauchi：My husband was very fond of it and I told him about it. He was a little worried at first because it was not an inexpensive treatment, but I convinced him to make the decision. I had to care for her for two weeks before the cell therapy because she was unable to urinate and defecate for a long time. She had to wear diapers, which inevitably led to inflammation of her hips and other problems, and she had to go to the hospital because of it. I knew that it would be difficult for her to live like this for a long time, and I wanted to do something to help her stand up.
Ｊ：I am sorry to hear about the many hardships you are going through.How does Dr. Yamamoto usually suggest this treatment itself?
Yamamoto：I would recommend either monitoring the patient for about 2 weeks with medical therapy (Elaspor) and in the meantime opting for cell therapy, or opting for surgical therapy from the beginning. I have the impression that both options are about the same in terms of efficacy. On top of that, I would tell you that cell therapy is minimally invasive (the cut is mild and less harmful to the body). Cellular therapy is just anesthesia and taking a piece of fat the size of a pachinko ball. I will tell them that the response will not be good if it is done too late, so I would not wait a long period of time before doing the cell therapy. I tell them that if they are going to do it again, it would be better to do it sooner.
Ｊ：I have heard that your hospital has performed about 6 or 7 cases of cell therapy for herniated discs, and that all of them were eventually able to walk.Overall, how do owners feel about the treatment?
Yamamoto：They are satisfied with our services. No one is too concerned about the cost. I personally think it is a bonus treatment.
“Treatments with extras”
Yamauchi：Speaking of extras, Rico also started to grow hair on his nose where there had been none. It was about the same time that he was able to stand up after starting the cell therapy. I think it was an allergy or something that caused the hair to disappear, but now it is all growing back nicely. I thought something was wrong.
Ｊ：It is relatively common to hear of physical changes other than the main symptoms, such as improvement of hair loss and improvement of hair luster. In fact, we have even heard from owners of older dogs that their gray hair has disappeared and the hair of their youth has grown back, or that their behavior has returned to that of their youth after receiving stem cell therapy.
These points may be what Dr. Yamamoto is referring to.
Rico before cell therapy↑
Ｊ：I think that cell therapy is still in the category of “difficult to understand” treatment for owners, how do you explain it?
Yamamoto：The flow of treatment is explained using a panel in the reception area that shows the entire flow of cell therapy. I am not particularly conscious of this in my explanations, but I will tell you the number of cells, and I may show you the growing cells in culture under a microscope. I thought you might be interested in this because it is a cutting-edge treatment. The owner will understand that something is growing.
Ｊ：How do you think the owners react from your point of view when the doctor presents the treatment?
Yamauchi：Most of the owners accept the treatment as it is if the doctor says so. Not only for cell therapy, but also for other types of treatment, the response is the same no matter what kind of treatment is proposed. I believe that the relationship of trust between the doctor and owners is very strong.
Ｊ：I wish I could ask you as an owner, how do owners who are having problems with treatment feel about their treatment choices?
Yamauchi：After all, everyone doesn’t know about this treatment at first. I was the same way, but I think the owners are going into the treatment without understanding. No matter how many technical explanations I receive, there are some things I don’t fully understand. However, if you recommend something and there is even a small possibility, I would like to try it. That is a sense of trust between the doctor and the owner. That eliminates my anxiety.
After that, I think it is important for owners to know how much access they have to this information when making treatment choices. I think owners are interested in hearing how other dogs have been treated. I made the decision to do the treatment right away, but even so, I would have liked to hear from other owners who had received the treatment. I was unsure about some of the things I started with.
Yamauchi：When Dr. Yamamoto explains cell therapy to owners of dogs with herniated discs, I sometimes tell them about my own experience as an owner. I tell them that this is what happened in the past with this kind of treatment. I think what owners are concerned about is how things are going now.
I have a relative who has a dachshund who has had two surgeries so far with repeated recurrences. She is worried that it might recur again. I told him about this treatment because I wanted him to know about it. I would like to tell anyone who seems to be having trouble with the treatment.
Ｊ：Finally, what are your thoughts on cell therapy?
Yamamoto：We decided to introduce cell therapy because we thought it would be better to be able to present a variety of options as a means of responding to the needs of owners. We believe that the more options we can offer at the hospital, the more satisfied owners will be.
I think it is important to make the right decision in a certain period of time if you just want to get well. If time passes while you are still in doubt, then it will be too late to cure the problem.
Ｊ：I think the fact that you communicate clearly what needs to be communicated while building a relationship of trust with the owners may be a factor in their satisfaction with your treatment. Thank you very much for your time today.
Mizuho Animal Hospital
16-5, Tarui 2-chome, Sennan, Osaka 590-0521, Japan
http://mizuho-ah.jp/
<Interview date: July 2, 2015>