Lameness evaluations, as well as pre-purchase exams, are conducted routinely and include trotting in hand on asphalt and lunging on soft ground. Diagnostic nerve and joint anesthesia are routinely utilized for lameness diagnosis. Digital ultrasound and radiography are available to assist with diagnosis of lameness. Treatment modalities available include traditional intra-articular injections, IRAP (interleukin-1 receptor protein antagonist), stem cell, bone marrow and platelet rich plasma injections and extracorporeal shock-wave treatment.
IRAP-Interleukin-1 (IL-1) is a chemical secreted by many types of cells in the body. It acts to call in certain immune system cells and chemicals to attack infections and damaged or dying cells. IL-1 is an important part of the inflammatory response but in the case of your horse’s joints sometimes can be detrimental. IL-1 increases inflammation and accelerates the deterioration of tissues like joint cartilage. Interleukin-1 Receptor Antagonist Protein (IRAP) blocks IL-1 from binding to tissues and inhibits the damaging consequences of IL-1. The IRAP procedure begins with drawing blood from the horse to be treated into a syringe. The syringe is specially prepared with glass beads that stimulate production of the antagonist protein. The blood is then incubated for 24 hours and centrifuged to separate the plasma (abundant with IRAP) from the blood. The plasma is then collected in a sterile manner and injected into the horse’s joint. Typically, IRAP treatments are once a week for three weeks and usually, after that time, the horse can return to normal work.
Stem Cell Injections Tendon injuries are common among performance horses and can be very challenging to treat. Stem cell injections are useful to stimulate new growth of damaged tendons and suspensory ligaments. This procedure begins with harvesting bone marrow from the sternum of the horse to be treated. The bone marrow is then put into special tubes containing an anti-coagulant. These tubes are then shipped to a lab where the cells are incubated and grown up till there are enough cells present to treat the lesion. The cells are then sent back to us and injected into the damaged tissue. Often this can be done with the horse standing eliminating the need for general anesthesia.
Platelet Rich Plasma In humans autologous platelet concentrates have been successfully used to stimulate wound healing of different tissues including cartilage, bone, tendon, ligament and skin. This new and promising technology has recently spread into veterinary medicine and is being utilized to treat problems from lacerations to tendon and ligament tears. Platelet rich plasma is obtained by pulling blood from the horse to be treated into special syringes containing an anti-coagulant. These syringes are then centrifuged and the thin platelet rich layer of plasma is drawn off. This plasma is then injected into the damaged area in order to assist with healing of the lesion.
Extracorporeal Shock Wave Treatment Extracorporeal shockwaves are high-pressure, low frequency sound waves, applied to affected tissue in a site-specific manner. This type of therapy has been used to treat a range of orthopedic conditions in both human beings and animals. When the shockwaves meet tissue interfaces of different densities, the energy contained in the shockwaves is released and interacts with the tissue. The shockwaves appear to relieve pain and may accelerate healing within the injured tissue.