Alternative Use of Platelet-Rich Plasma (PRP) in Pet Treatment

"The Use of Platelet-Rich Plasma (PRP) as an Alternative Treatment for Pets"
By Assoc. Prof. Dr. Sompoch Veerakun and the Phoenix Lab Team

The use of self-plasma therapy has been around for a long time and is supported by research, even in pets. It is a natural self-healing process that accelerates healing by increasing platelet concentration, which enhances platelet function in restoring health. Platelet-rich plasma is injected into the injured area or lesion to speed up recovery. It has been used to treat damaged tendons, ligaments, muscles, bones, joints, and chronic wounds. Platelets release various growth factors that are crucial for stimulating the production of new cells, increasing cell numbers to repair damage, and promoting the activity of white blood cells and other cells involved in wound healing. These factors also help stimulate collagen production through fibroblasts and endothelial cells to repair blood vessel walls, among other processes. As a result, healing occurs more quickly and reduces the expression of pro-inflammatory cytokines such as IL-1 and TNF-a, while promoting anti-inflammatory cytokines like IL-4 and IL-10, which helps maintain a balanced healing process. Moreover, it also plays a role in reducing pain and injury, minimizing the need for drugs such as anti-inflammatory and analgesic medications. Additionally, plasma is well known as a source of electrolytes, plasma proteins, and hormones, aiding in the formation of fibrin networks during wound healing, from fibrinogen and fibronectin cells.

Examples of growth factors found in platelets include TGF-ß (Transforming Growth Factor Beta), which stimulates collagen and blood vessel production, and PDGF (Platelet-Derived Growth Factor), which also promotes collagen and blood vessel formation. These two factors are crucial in the repair process and help reduce inflammation by inhibiting the action of pro-inflammatory cytokines at the injury site. Other factors include FGF (Fibroblast Growth Factor), which stimulates fibroblast growth, and EGF (Epidermal Growth Factor), which stimulates fibroblasts, VEGF (Vascular Endothelial Growth Factor), which promotes blood vessel formation, HGF (Hepatocyte Growth Factor), and IGF (Insulin-Like Growth Factor), which stimulate the production of new cells. These factors, along with various chemokines and other cytokines, play a critical role in the body's natural healing process, assisting in stem cell stimulation or the creation of new cells and tissues. Thus, PRP is widely used in medicine for surgical, orthopedic, and aesthetic treatments, as well as for skincare, hair loss prevention, and hair thinning.

Application in Veterinary Medicine
In veterinary medicine, there have been various studies on PRP, such as its use in ophthalmology in forms like drops, injections, and clot forms. It is commonly used for corneal ulcers, with varying forms applied depending on severity. Drop formulations are effective for mild cases (Grade II), showing good results in dogs (Mishra et al., 2021). Both drop and clot forms have been proven effective in both dogs and cats (Farghali et al., 2021), and it has also been used to reduce inflammation (Farghali et al., 2021; Vatnikov et al., 2020). In dermatology and wound healing, studies have shown positive results consistent with human research, leading to its use in aesthetic treatments. In animals, it is mostly used for wound healing (Kim et al., 2009), typically in gel or drop form (Chung et al., 2015; Crovetti et al., 2004).

PRP has also been used in reproductive medicine to enhance ovarian function, treat endometrial inflammation, improve follicular development, oocyte capability, and the uterine environment for embryo implantation. It is also used to restore testicular function and treat mastitis. In veterinary practice, it has been applied to livestock and the treatment of prostate disease in dogs (Bigliardi et al., 2018; Borş et al., 2022; Perego et al., 2022). PRP is often used for tendon injuries, arthritis, and degeneration, with most studies conducted on horses due to the prevalence of sports-related injuries. Use in other animals has been increasing, but further research is needed for more accurate data. Early studies, such as on eight dogs with patellar tendon lesions, showed that PRP did not improve healing. However, in another study with 12 dogs suffering from Achilles tendon tears, PRP led to a reduction in lameness and improved histopathological healing scores. Other studies have demonstrated the benefits of PRP in musculoskeletal injuries, such as in fractured bones, where it accelerates healing, even in non-union fractures, promoting blood vessel formation and bone healing. It has also been successfully used in conjunction with other orthopedic treatments (Andersen et al., 2021; López et al., 2019; Shafieian et al., 2017). Moreover, clinical research on dogs with osteoarthritis comparing PRP with corticosteroid and hyaluronic acid injections into the joints showed similar results, with the combination of hyaluronic acid and PRP proving more effective than hyaluronic acid alone (Lee et al., 2019). PRP is also being used in other surgical fields.

In summary, PRP is used in veterinary medicine primarily for conditions such as corneal ulcers, corneal erosion, alkali burns, keratoconjunctivitis sicca, burn wounds, chronic wounds, cutaneous ulcers, acute traumatic bone fractures, tendinopathies, cartilage pathologies, and osteoarthritis (Sharun et al., 2021).

Dosage
While the exact platelet and WBC concentration for effective treatment is still unclear and may depend on the type and chronicity of the injury in the patient, the choice of treatment should be a joint decision between the veterinarian and the pet owner. PRP is believed to be beneficial as it reduces the need for other medications, such as anti-inflammatory drugs and painkillers. In some human cases, concentrations more than 17 times higher than normal have been used. However, some studies in dogs show that very high platelet concentrations (more than three times that of whole blood) may not be more beneficial than modest concentrations (2-3 times that of whole blood), depending on the type of injury. Additionally, plasma with high white blood cell concentrations may still affect inflammation, so reducing WBC levels is just as important as increasing platelet concentrations. This article provides an overview of the topic and does not go into detail on specific conditions, so further research on dosage and application methods is necessary.