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Lameness
At Arizona Equine, all of our doctors are well-versed in diagnosing and treating routine lameness causes. Our board certified surgeons also have specialized training in advanced lameness diagnostics and treatments. Lameness can result from any number of sources including joint related disease, inflammation and injury to tendons and ligaments, muscle pain, developmental abnormalities, axial skeleton injury/inflammation, and nerve-related pain.
Every lameness exam will start with a thorough conversation about each horse’s history and athletic performance requirements. An initial examination is then performed to evaluate for conformational abnormalities, muscle pain in the neck and back, pain on palpation of tendons and ligaments, and areas of heat or swelling. A gait evaluation is then performed where our veterinarians will watch the horse at a walk and trot under varying conditions (circles, straight lines, hills, etc). Joint flexions are also performed to put stress on various joints in order to evaluate for pain. Nerve blocks are another important diagnostic tool, and are used to localize the source of pain by systematically numbing specific parts of the horse’s leg with the goal of greatly improving lameness. Diagnostic imaging including x-rays, ultrasound, MRI and bone scan are then commonly performed to find an underlying cause of lameness. Based on the results of all parts of the lameness exam, our veterinarians can then tailor a treatment plan to each individual horse. Treatment plans may include any or all of the following: body work/chiropractic, oral medications/supplements, acupuncture, joint injections, shockwave, PEMF, farrier recommendations, physical therapy, regenerative/biologic therapies, and surgical treatment.
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Biologic Therapies
Arizona Equine offers multiple different regenerative or biologic treatment products. These treatments are used to help shorten healing time and improve the prognosis for returning to work. They are best used in the early stages of joint disease and arthritis where they will have the most benefit. We offer the following treatments at Arizona Equine:
IRAP
Interleukin-1 Receptor Antagonist Protein (IRAP) is an anti-inflammatory therapy. IRAP counteracts the inflammatory protein interleukin-1 that is produced in the joint during the development of osteoarthritis and synovitis. By preventing the interleukin-1 protein from binding to its receptors within the joint, IRAP will decrease inflammation and slow the progression of arthritis. IRAP is purified and concentrated from the patient’s own blood through a multi-step process that takes 24 hours. Once the purified IRAP product is obtained, it can be injected sterilely into a joint or frozen and saved for later use. IRAP is most commonly used to help decrease joint inflammation and combat the development of osteoarthritis. Horses that are most likely to benefit from IRAP are those with synovitis (inflammation of the joint capsule) or mild to moderate osteoarthritis.
PRP
Platelet Rich Plasma (PRP) is a product that contains a high concentration of platelets. These platelets will work to stimulate local release of growth factors that can help speed healing. To make PRP, a blood sample is collected from the patient and is centrifuged to concentrate the platelets naturally found in the bloodstream. The platelet rich portion of the sample is then separated from the rest of the blood and can be injected directly into a joint or, more commonly, into an injured tendon or ligament. Ligaments and tendons are very slow to heal due to poor blood supply when compared to other areas of the body. Thus, the most common use of PRP is injection directly into a lesion or injury in a tendon or ligament. The platelets then work to stimulate growth factor release and help to speed the healing directly at the site of injury. Patients often need multiple PRP injections over the course of healing.
Prostride
Prostride is a product that contains both a high concentration of platelets as well as cytokines and other anti-inflammatory agents. Much like PRP and IRAP, Prostride is made using the patient’s own blood, and involves centrifuging the blood multiple times in order to obtain the desired product – often called an Autologous Protein Solution. This whole process takes about 20 minutes, so it is a faster alternative to IRAP. Prostride is commonly injected into joints to help decrease inflammation and slow the progression of osteoarthritis. Prostride can also be used to help treat tendon injuries.
Stem Cells
Stem cells are a unique cell type that is un-differentiated, meaning that they have the potential to become different tissues at different sites of injection in the body. Stem cells are necessary to maintain tissues and organs in a healthy state and to allow for tissue regeneration after injury. The most common way to obtain equine stems cells is to perform a bone marrow aspirate, commonly on the sternum. Once the bone marrow sample is obtained, it is sent off to an outside lab for growth and preparation. The finished product is then sent back to us, where it can be used to help stimulate healing and reduce the formation of scar tissue. The most common application of stem cells is injection directly into an injured tendon or ligament to aid in healing. Stem cells can also help reduce pain at the site of injury. As the process of obtaining and preparing stem cells is much more complex, this treatment is considerably more expensive than the other options discussed above.