SPORTS MEDICINE & COMPREHENSIVE LAMENESS EVALUATION:
Abnormalities in gait are some of the most common causes of decreased athletic performance and discomfort among our patients. The diagnostics of a lameness evaluation may include:
- Hoof-tester application
- Observation at different gaits in hand/under saddle
- Flexion (stress) tests
- Diagnostic anesthesia (regional and joint blocks)
- The theory behind these tests is simple... Your horse can't tell us where it hurts. BUT, if we make sections of the limb "numb" in a systematic fashion we may be able to tell
- When the horse feels better as evidenced by an improvement in gait - and that's "where it hurts"!
- Once the origin of the pain is isolated, further diagnostics can be performed, such as:
- Digital radiographs
- Digital ultrasound
Depending upon the specific site and cause of injury, the choice of therapy varies GREATLY from horse to horse. Our veterinarians have the privilege of choosing from an arsenal of treatments including:
- Joint Injections: Reduce inflammation and pain within an affected joint (i.e.: corticosteroids, Hyaluronic acid, antibiotic)
- IRAP: This is also used to reduce pain and inflammation within a joint but this "IRAP" fluid comes directly from the horse's own blood. A small sample of blood is harvested from the horse and incubated over 24 hours. With special chemical and physical manipulation we can trick the white cells in the blood sample to make a large amount of anti-inflammatory particles called IRAP (Interleukin Receptor Antagonist Protein). This fluid is then injected in to the affected joint(s). One benefit to this therapy is our ability to attain several doses (3 - 7) for injection from only one blood sample so if your horse only needs one joint injected, the rest of the doses can be frozen for future use!
- Stem cell therapy: If we should discover a lesion within your horse's tendon or bone where tissue LOSS is a problem, Stem Cell therapy is an optimal way to "Fill" this void of tissue and help the body rebuild healthy structures. Tendon tears and bone cysts are examples of pathology where this treatment can be of great use. The procedure includes harvest of fat from the horse's rump, followed by special manipulation to separate the fat cells from undifferentiated "Stem Cells". This remaining fluid can then be injected directly into the lesion where these stem cells can be "tricked" into becoming mature tissue matching that of their surroundings.
- PRP: Platelet Rich Plasma is the result of processing whole blood to obtain the blood fraction that has the highest concentration of platelets. Platelets contain growth factors that are released when the cells are activated. Platelet derived growth factors, transforming growth factors, insulin-like growth factors, epidermal growth factors and others act to enhance access of healthy inflammatory cells to the area of tissue injury, angiogenesis, fibroplasias, and re-epithelialization. PRP is used in new tendon and ligament injuries as well as chronic injuries that have not healed despite traditional rest and rehabilitation. The injection is performed in the standing horse under sedation and local anesthesia. Whole blood is obtained from the horse, processed, and the PRP is injected into the injured region. The limb is bandaged for a determined period of time and the horse returns to a controlled exercise program depending upon the severity of the injury and lameness present. Ultrasonographic re-evaluation is performed ever 30 days for the first 2 months, then every 60 - 90 days during the remaining rehabilitation period. In general, only one PRP injection is necessary for healing. PRP research is ongoing, but shows promising results.
- Medical therapy: Include one or more drugs from several different classes of medication.
- Surgical intervention: Some lameness may require an operation to attain the most optimal recovery and best prognosis for future athleticism.
- Nutraceutical supplementation: The addition of products including Glucosamine, Chondroitin, Hyaluronic acid, and PSGAG's may help ease the pain of ongoing pathology as well as slow the disease's progression.
- Rehabilitation: Many lameness cases require a period of rest to reduce inflammation and allow for tissue healing. The time of confinement may range from a few days to several months and may require intermittent re-evaluation with a veterinarian to help determine when and how much work the horse is capable of.