Trial of erythropoietin and platelet rich plasma as adjunctive treatment in dogs with paraplegia and absent pan perception after thoracolumbar intervertebral disc extrusion and surgical decompression: A clinical pilot study

OBJECTIVE: To assess the effectiveness of adjunctive treatment with either systemic erythropoietin or local platelet rich plasma administered at the time of decompressive surgery in dogs with severe spinal cord injury (SCI). STUDY DESIGN: Prospective randomized study. ANIMALS: A total of 32 client owned dogs presented for acute onset of paraplegia and loss of pain perception after a thoracolumbar disc extrusion. METHODS: All dogs underwent a standard laminectomy within 24 h after admission and were randomly assigned to one of the following treatment groups: (1) Subarachnoid saline (controls), (2) subarachnoid autologous platelet rich plasma (PRP), or (3) subarachnoid saline plus IV erythropoietin (EPO). Examinations were performed initially at the time of admission, and 1, 3, 7-, 14-, 42-, and 84-days post-surgery. Parameters of interest included return of pain perception, motor or ambulatory function, and fecal or urinary continence. Statistical analysis was performed with SPSS for Windows 30 software with p < .05. RESULTS: The median age of the 32 dogs enrolled was 5 years (3-12.5 years). Dachshunds were the most common breed. One dog (3.1%) developed myelomalacia 4 days post-surgery and was euthanized. Three months post-surgery, 24/32 (75%) dogs regained ambulatory function whereas 7/32 (21.8%) did not. There was no overall difference among groups. Dogs treated with EPO appeared to have a trend towards a reduction in incontinence (Fisher exact test, p = .089) but a larger study is needed to verify this apparent finding. CONCLUSION: The use of EPO might be beneficial to reduce the likelihood of incontinence, but the low number of patients prohibits definitive conclusions. CLINICAL SIGNIFICANCE: There was no statistically significant clinical benefit found associated with local application of PRP and systemic injection of EPO at the time of decompressive surgery.