Mesenchymal stem cells in veterinary clinical practice: Evidence from naturally occurring diseases.

MSC therapy shows strongest evidence in equine tendon injuries and companion animal osteoarthritis, but broader use requires standardized protocols.

This review evaluates the clinical evidence for mesenchymal stem cell (MSC) therapy in veterinary medicine, focusing on client-owned animals with naturally occurring diseases. MSCs and MSC-derived extracellular vesicles (EVs) have been applied across a broad range of conditions including musculoskeletal disorders (osteoarthritis, tendon/ligament injuries, bone disease), soft-tissue and oral mucosal conditions, neurological disorders, ophthalmic diseases, and internal medicine conditions such as inflammatory bowel disease, chronic kidney disease, and respiratory disease. The strongest clinical evidence exists for equine superficial digital flexor tendon injuries and osteoarthritis in dogs and horses, supported by several controlled or prospective studies. Evidence for other indications largely derives from pilot studies, case series, or single trials. MSC-derived EV therapy remains predominantly preclinical, with limited veterinary clinical validation to date. A major challenge limiting the field is significant heterogeneity across studies in cell source, preparation methods, dosing, administration routes, and outcome measures, which prevents meaningful meta-analysis or direct comparisons. The authors call for standardized protocols, larger controlled trials, and greater regulatory clarity to advance MSC therapies from experimental use toward evidence-based clinical application in veterinary medicine.

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