PRP Treatment for CCL Injury: Platelet-Rich Plasma (PRP) Treatment for Cookie’s Bad Knee(s)

Can platelet-rich plasma treat a partial cruciate ligament tear in your dog?

When we found out that Cookie’s knee(s) were bad, we had to make a decision about what to do next. Of course, there are the surgeries … but could we try something else first?

We decided to give regenerative medicine a chance.

It’s not like the surgery option goes away. But if we could avoid it, we’d be very happy.

When I talked to Vet-Stem, they said that there is a decent chance that PRP could work. Cookie’s vet actually brought it up on her own and also felt it had a chance. And Jasmine’s vet agreed it was worth a try.

PRP Treatment for CCL Injury: Platelet-Rich Plasma (PRP) Treatment for Cookie's Bad Knee(s)
Cookie’s blood is being drawn to be processed

What is platelet-rich plasma therapy?

Cookie’s own blood is the source of the treatment. Blood gets drawn and processed. Red and white blood cells are separated out. all that is left is a concentrate rich in platelets. This then gets injected into the treated area; in Cookie’s case inside the knee joint.

We all know that platelets are involved in blood clotting. But they are also loaded with growth factors that are involved in healing. Which makes sense when you think about it. If there is an injury, the body not only needs to stop the bleeding but it also needs to repair the site of the injury. Once at the site, platelets also reduce inflammation which facilitates healing as well.

So that’s the theory behind why this might work. There is much to be learned about it but there is some clinical evidence that it indeed could help for a damaged knee ligament as well.

Some veterinarians use this combined with stem cell therapy, some use it on its own. There are dogs who were able to avoid knee surgery using PRP treatment.

Making the decision

There is a potential upside and no downside.

No downside anybody knows of anyway.

Jasmine’s vet was going to do the treatment for Cookie. He’s already done stem cell treatments as well as PRP treatments before, even though he never used PRP for knees yet.

Because of Cookie’s challenges, I wanted him to get his hands on her anyway.

His diagnostic hands have no match. I kept talking about going to see him even before we had the knee diagnosis and before we decided that we were going to try the PRP. The long ride was the only reason we were hesitating.

On the way

So hubby and Cookie got packed and ready for their journey down South to see Jasmine’s vet.

The procedure does require sedation. I had concerns because the last time Cookie was sedated for her x-rays, she had some serious ill effects. But with all the steps we took, and a different protocol, everything went smoothly and Cookie had no problems with the sedation this time around.

There was a question of whether we should treat just the bad knee or both. It was possible that some pain and discomfort could be expected after the injections. How much exactly we didn’t know. On one hand, having enough PRP to inject both, why not just do both? On the other hand, should the knees be quite uncomfortable after the treatment, would we want both knees being unhappy?

At the veterinarian

Jasmine’s vet examined Cookie thoroughly and decided that both knees would benefit from the injections.

Sleepy time

Her blood got drawn and processed. Cookie’s knees were shaved to help prevent infection. Keeping everything sterile is important particularly when injecting inside the joint. Cookie was sedated and he knees injected. Then the sedation was reversed.

PRP Treatment for CCL Injury: Platelet-Rich Plasma (PRP) Treatment for Cookie's Bad Knee(s)
Cookie’s blood before being processed
Cookie’s blood after being processed
Making of the magic potion
Space inside the joint targeted
In she goes
Wakey time
 

Both hubby and Jasmine’s vet were with Cookie as she started coming to. Her eyes opened but other than that she didn’t move a muscle. “She should be up by now,” said the vet, “perhaps we need to give one more injection.” And he went over to the drawer to get it.

Hubby turned to Cookie, saying, “You better get up, Cookie, or you’re going to get another needle.” And Cookie jumped to her feet and walked up to the vet, “Hey, put that away, I’m awake.”

I kid you not, that’s how it happened!

And just like that, Cookie was ready to go home. A little dazed but steady on her feet; nothing like last time. They lingered around for another hour just to make sure everything was okay. And then they started on their way home.

Post-treatment

Cookie was comfortable the whole time and had no problems with the sedation. When they arrived home, she was perky and full of beans.

Her knees looked like they felt a bit awkward that day.

She was walking a little funny but I think it might have just felt weird rather than painful. By the next day, everything looked good.

The platelets remain active 7 days after injection. Cookie seems to be feeling good and it’s hard to convince her to take it easy in order to allow healing to take place. And that’s while being on the Trazodone. Jasmine’s vet didn’t want to increase her dose any further so we’re doing our best to make it work as it were.

We are really hoping this might do the trick.

For now, we have to keep our fingers crossed and wait and see. Even if it should just buy us some time, it’ll still be worth it. Maybe by then, better surgical options might be available.

Post-procedure update

On Monday I got an email from Jasmine’s vet following up on Cookie’s PRP treatment.

It has been long enough, so asking the question; Was there value in the PRP for Cookie?

It was kind of weird timing. If he had asked me on Saturday, I would have only been delighted to report on how fantastic Cookie was doing. She was looking great and her physical therapist thought she was doing just marvelous. There were no signs of lameness, stiffness or favoring of any of the legs. She was happy and ready for action, even though she needs to build up to more activity gradually.

Platelet-Rich Plasma (PRP) Treatment for Cookie's Bad Cruciate Ligament Update

She was back at the underwater treadmill exercises and her joints and muscles all seemed happy.

The Cookie machine zero defects as far as anybody could tell.

A setback?

That would have been my response was I asked on Saturday. But I was asked on Monday. What has happened in between?

For a not discernible reason, Sunday night Cookie was favoring the hind left leg quite a bit when she trotted after daddy to see what he was up to in the bathroom.

Earlier that day I thought I saw her using the leg a bit more gingerly but it was subtle enough that I could have been convinced I was looking too hard. The trot, however, left no room for doubt that something wasn’t right.

My heart sank so deep it must have ended up in the basement.

What did that mean? That was the main question. Later that night the limp seemed to have gone away and Cookie looked just generally stiff in the hind end. That was kind of a good sign. But what did happen? And yet again, what did it mean?

I was quite shattered at the thought that the ligament was failing after all. Though it definitely didn’t look like a full tear to me. I wasn’t sure what I was looking at.

The next morning, things seemed fine yet again.

Cookie had another physio appointment on Monday and her therapist checked her out as thoroughly as humanly possible. She didn’t find any issues with any of the joints. The only tenderness she found was mid-back muscles.

The night before, when touched, Cookie was twitching in that area.

Could it be that just the muscles got angry? But why?

I was glad to see the PT’s report but still didn’t know what to make of all that.

The good news

I described everything in detail to Jasmine’s vet, including the fact that prior to that Cookie was looking amazing. By Wednesday, even the back muscles seemed to have quieted down and it was as if nothing ever happened. In fact, the physiotherapist said that Cookie’s muscles were never this happy since she started seeing her.

That all sounded good but I was anxiously expecting Jasmine’s vet’s thoughts on all that.

Deep down I was expecting something along the lines of having had put too much faith into the PRP treatment. But that was not what his reply was.

“Sounds like the foundation therapies did(or are doing) a good job to have her normalize so quickly,” he wrote.

That was certainly a pleasant surprise.

He’s not one to give false hope. On the contrary, he’s always very guarded about everything he says. This sounded as positive as it gets.

Of course, we didn’t really know what we should have been expecting. We didn’t know what things would look like otherwise. All I knew was what I saw. Though one way or another it did seem very temporary.

Back on track

Based on all this it seems we are still right on track.

Jasmine’s vet feels that what happened was a transient back muscle spasm. While I still keep wondering why, perhaps it just happened because Cookie hasn’t been very active for a long time and the muscles are just not ready for any extra load, such as Cookie getting angry at a passing tractor.

So that’s what I choose to believe at this point. Should it happen again, we will try giving a muscle relaxant and see what happens. If it helps, then we’ll know it is the muscles.

Cookie also has another chiropractic appointment to see whether the back needs another adjustment.

So after the big scare [for me], we will keep doing what we were doing, still hopeful that Cookie might be restored to full function. Which is what we all wish for.

Related articles:
Evaluating PRP Treatment for Dogs: Platelet-Rich Plasma Treatment (PRP) for Partial Cranial Cruciate Ligament (CCL) Tears—Would I Do It Again?

Further reading:
Platelet Rich Plasma: Its Place in Cranial Cruciate Ligament Repair

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