1. Stem Cell Therapy in Dogs A New Treatment for a New Decade Presented by Vet-Stem 6650-0019-001

2. What are Stem Cells? Stem Cells are primitive cells present in almost every tissue Self Renewing Able to become different tissue types Signal other cells to come in and rescue and repair 6650-0019-001

3. What Do Adult Stem Cells Do? 10 million cells die in your body every minute of every day. Your stem cells replace them so you can continue living. 6650-0019-001

4. Embryonic vs Adult Stem Cells Embryonic Stem Cells Intended to form whole animal - not for repair Can form tumors – UNPREDICTABLE Ethical dilemma Maybe someday Adult Stem Cells – many sources Intended for self repair No ethical dilemma Do not form tumors when injected Available now Gruen L and Grabel L, Stem Cell 2006;24;2162-2169. 6650-0019-001

5. Why Fat as Stem Cell Source? High healing cell count – No culturing required 1000 times more stem cells than bone marrow Family of healing cells Rapid, Easy to access Over 1700 peer reviewed papers published 6650-0019-001

7. What Do Stem Cells Do? Reduce Inflammation Reduce pain Differentiation into tissue Home in on injury sites Induce healing-regeneration 6650-0019-001

8. The Injury Response Cascade Time Fibrosis Inflammation “Regeneration” Acute Injury Scar Complete Magnitude QUICK FIX Courtesy of Dr.Caplan, Case Western Reserve 6650-0019-001

9. “Regeneration” Acute Injury Scar Reduced Time Magnitude Inflammation Fibrosis Stem Cells in Injury Response Courtesy of Dr. Caplan, Case Western Reserve Stem Cells 6650-0019-001

10. Annie Annie 9 yr LabX Chronic elbow arthritis Drugs not controlling pain Stem Cell Therapy Able to jump in and out of car; took 2 hour run in the woods 90 days after stem cell therapy 6650-0019-001

11. Harley 6 yr Rat terrier Pain in hips & knees since 6 months old Pain killer medications (NSAIDS) for 12 months & still painful Wouldn’t play ball or go up stairs 2 weeks after stem cells– Dramatic pain reduction Plays ball and climbs stairs Now NSAID free for >36 months Harley 6650-0019-001

12. Blinded Clinical Trial Participant Cinnamon 10 yr Standard Poodle Arthritis in both hips Unable/unwilling to take medications Owners considering euthanasia-got a new puppy 30 days after stem cell therapy he was playing, jumping, running and taking long walks 6650-0019-001

14. Got Fat? 6650-0019-001

15. Why Use Vet-Stem? Began treating horses in 2003 Experienced-Over 3,500 horses & 2,000 dogs Safety-your pet’s own cells Strict quality standards Peer-reviewed, published controlled studies Global leader in veterinary stem cell therapy 6650-0019-001

16. Horses:7/3,359 (0.2%) Only local swelling/pain Dog: 2/1,695 (0.1%) Only local swelling/pain *probable adverse events, through 6/1/09 Safety Profile* 6650-0019-001

17. Written standard operating procedures Independent Quality Assurance Unit Routine audits of all procedures Sample release criteria Formal training systems Quality Standards 6650-0019-001

18. Service Overview 6650-0019-001

19. Vet-Stem Adipose Processing Lab 1. Immediate use 3. Lifetime supply by culture 2. Frozen for future 6650-0019-001

20. Current Supported Uses Dogs/Cats Osteoarthritis Polyarthritis Tendonitis Ligament injury 6650-0019-001

21. Pet w/ lameness or pain due to arthritis or a partial tear of a ligament or tendon Pet does not require surgery – surgery first, if needed No other major diseases (liver, kidney, heart) No major spinal disease (spondylosis, spinal arthritis) Not-responsive or can’t tolerate pain killers Realistic expectations Ideal Stem Cell Case 6650-0019-001

22. Cruciate Ligament Disease & Stem Cells Surgery – always have surgery when required With surgery – helps to reduce inflammation and scar tissue After surgery – helps to treat inflammation and encourage cartilage repair Chronic ACL inflammation and synovitis is a good case 6650-0019-001

23. Storm Storm 9yr Catahoula Leopard Dog Mix Arthritis in both hips and right stifle Unable/unwilling to take medications 3 weeks after treatment started showing improvement Later his left stifle was treated after surgical repair Storm and owners happy that he is doing extremely well 6650-0019-001

24. Real World Dog OA Cases 24 6650-0019-001

26. Conclusion: According to a 2009 Owner Survey Greater than 33% of dogs discontinued the use of NSAIDs completely Greater than 28% of dogs decreased their dependency on NSAIDs At 90 and 246 days after treatment 6650-0019-001

27. Malibu Before and After Video 6650-0019-001

28. Media Coverage of Veterinary Medicine 6650-0019-001

29. Questions? 6650-0019-001