In late October 2011, Piper, a sweet and friendly English Bulldog, was left at the shelter by her owner, who requested that she be put to sleep.
SCBR received a call from the shelter about the abandoned, sick bully. After speaking with the vet at the shelter, it was suspected that the owners knew something was wrong with Piper and opted to dump her and let a stranger euthanize her rather than trying to take on her medical problems. Mel, a long-time team member from SCBR, went to the shelter to pick her up that day and took her to see Dr. Kraemer immediately due to her obviously bleak medical state.
Dr. Kraemer: So, Mel, how did you find Piper when you arrived at the shelter?
Mel (SCBR): Piper was filthy, covered in feces, fleas, and dirt; she barely had enough energy to get up and walk out of her kennel. I physically had to pick her up and carry her to my car.
Dr. Kraemer: What happened next?
Mel (SCBR): I knew she was in a critical state, so I immediately drove her to see you at your animal hospital so she could be examined and treated. During the entire car ride to your hospital, which was about an hour’s drive away, Piper could barely keep her eyes open. She stayed curled up in the passenger seat with her head as close to me as possible. She was scared and clearly ill.
Dr. Kraemer: Yes, I remember seeing her for the first time that day; she was severely emaciated, just skin and bones. All you could see was this familiar bully head with two big eyes (see photo). We had her weighed (she was only 27 lbs), and then we took her to the ICU to be examined. Shortly afterward, she vomited and collapsed. We immediately placed an IV catheter and started fluid replacement. Symptomatic treatment was initiated, and lab work was ordered. In addition to the vomiting, she had explosive, non-stop, watery diarrhea that did not respond to our initial treatment.
Mel (SCBR): It was sad seeing her drifting in and out of consciousness, struggling to hold on. It’s uncertain how much longer she would have survived in the shelter without medical attention.
Dr. Kraemer: Once Piper was stabilized, she began undergoing a long series of tests and evaluations, including various lab tests, radiographs, ultrasounds, etc. Our initial workup showed low blood albumin (protein) due to her GI problems, which were causing edema (swelling caused by excess fluid collecting in the body’s cavities or tissue). She also had a high WBC (white blood cell count) and anemia (low red blood cell count).
Mel (SCBR): After you did the initial workup, what did you conclude was the likely diagnosis (i.e., the medical condition underlining her problems)?
Dr. Kraemer: IBD (Inflammatory Bowel Disease). Lymphoma was less likely, so we started her on the traditional treatment for those types of immune-mediated conditions. The treatment included immunosuppressants like pred (cortisone), a hypoallergenic diet, vitamin B injections, broad-spectrum dewormers, antibiotics, probiotics, etc.
Mel (SCBR): Did you see any improvement?
Dr. Kraemer: Unfortunately, from a medical point of view, there was very little improvement. Though the vomiting stopped, the diarrhea was as bad as before, and she continued to lose weight, which was very worrisome. The only positive was her fun-loving demeanor, which surfaced as soon as she started getting all the attention and love.
Mel (SCBR): So what was your next step?
Dr. Kraemer: After seeing no significant change, I decided to refer Piper to an internal medicine specialist whom I have known for over a decade. Dr. D added some new tests and tweaked the treatment, adding a second immunosuppressant (imuran), Tylan powder, and vitamin K.
Mel (SCBR): Was any progress made with that additional treatment?
Dr. Kraemer: None of the medications were helping; months went by and we all became increasingly frustrated and worried. Piper still suffered from the same explosive, chronic diarrhea; her body was not retaining any of the nutrients or vitamins essential for a healthy lifestyle and weight gain.
Viki, who is one of the SCBR founders, was her foster mom. She took upon herself Piper’s rigorous daily care, which included medicating, special feeding, and the unpleasant task of cleaning piles of never-ending diarrhea. I believe, at this point, I started discussing the stem cell therapy option with her for the first time. It was then decided to first seek guidance from a pet nutritionist and holistic specialist. Diet plays a key role in treating IBD, and finding the right diet that would work with Piper’s system would be a challenge. With the help of a pet nutritionist, we were hoping to find a diet that worked for Piper and would allow her body to correctly absorb the nutrients of the food so that she could gain weight.
The holistic specialist also changed the cortisone (immune suppressant) to a different kind and gave Viki a recipe for a homemade diet that Viki cooked for Piper with love and care every day. Sadly, nothing was working despite everything we tried. At this point, Piper’s weight dropped to a new low—a mere 23 lbs—and we did not think she would last long at this rate.
Mel (SCBR): Do you remember what the turning point was when the stem cell therapy option finally came to the forefront?
Dr. Kraemer: Yes, by now over a year had gone by, and the rescue had already invested large sums in countless diagnostic tests, second and third opinions, multiple immune suppressant drugs with high risks of unintended serious side effects, and various supplements and specialty hypoallergenic diets, only to see Piper wasting away to a critical state. The rescuers and Viki, who mothered her through it all with dedication, were devastated and desperate. We had discussed stem cell therapy in the past, and both Viki and SCBR were prepared to take the leap of faith. I explained that it would be experimental, but at this point, we had nothing to lose. We used regenerative therapy successfully on many patients with arthritis and orthopedic problems but never for immune-mediated diseases.
Mel (SCBR): So what made you think that stem cell therapy would succeed where traditional and holistic medicine failed?
Dr. Kraemer: First, I should explain that inflammatory bowel disease (IBD) is an autoimmune disease. For the purpose of this interview, I am going to simplify the disease process with a simple illustration. Think of our cells as “selves.”, Each one of us is born with a personal cellular marking coded by receptors unique to us and us alone. Think of those receptors as a “lock” and our immune system as the “key”. If the key and the lock are not a perfect match, our immune system would consider that cell “foreign” and attack it. In Piper’s case, the receptors (i.e “locks”) of her GI tract were altered for some unknown reason; thus, her immune system considered those cells an “enemy” and responded by going into attack mode, inflicting cellular damage, manifested by the severe inflammatory state the disease is known by. It’s easy to understand why, traditionally, we treat autoimmune disease with immune suppressant drugs, though, as you can imagine, even when we succeed, this approach possesses a possible harmful adverse effect as well as possible lifelong therapy. In contrast, adult stem cells, which we all store in our bodies (bone marrow, blood, and fat), are our own natural repair cells. They are typically used by all of us as we grow older (wear and tear) or when we get injured to replace damaged cells and fight inflammation.
Mel (SCBR): That is so interesting. I know about the controversy of embryonic stem cell therapy. But I have not heard about regenerative medicine as it applies to “adult cells”. I can now see why you thought they would benefit Piper and her IBD condition.
Dr. Kraemer: Stem cell therapy has been demonstrated to induce profound healing activity. Besides healing damaged tissues and promoting the regeneration of damaged areas, stem cells have the unique ability to modulate the immune system while preserving disease-fighting capabilities.
They produce anti-inflammatory agents to protect the dog from immunological self-attacks (as in Piper’s inflammatory bowel disease). Piper was truly a fighter. She had everything going against her, and despite that, she had made it this far.
Piper’s story (parts 2 and 3) will be posted in the coming weeks. Don’t miss this amazing, developing story of Piper’s true medical and rescue miracle.
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Dr. Kraemer is a Tufts Veterinary School 1991 graduate (Boston, MA).
He is a member of the AVMA (American Veterinary Medical Association) and the SCVMA (Southern California Veterinary Medical Association) and has been practicing veterinary medicine and surgery in Orange County, California, for over 20 years.
Dr. Kraemer has a special interest in Bulldogs, French Bulldogs, and other Brachycephalic breeds and their unique medical and surgical needs, such as
breathing and airway conditions
joint pain, ligament, and tendon injuries
ear canal disease
skin and allergy problems
eyes and eyelid abnormalities
As well as other medical conditions related to the breed.
Dr. Kraemer is also a leading provider of in-house same-day stem cell therapy and cryobanking for dogs and cats.
Dr. Kraemer has a long-lasting relationship with Bulldog Rescue; he provides shelter, medical, and surgical services to their bulldogs.