Equine musculoskeletal examinations and treatment

Lameness, stiffness and lowered performance

Changes, even minute ones, in a horse’s movement, performance or behavior may be indicators of a disorder of the musculoskeletal system. Obvious lameness is one of the most common reasons for a veterinary examination. Other reasons include stiffness, lowered performance or unwillingness to move around. We are also more than happy to examine a horse’s musculoskeletal system even if there are no obvious symptoms, for example, before or after a competition season.

Clinical orthopedic examinations

During a clinical orthopedic examination, many different aspects of a horse are assessed. A veterinarian performs a detailed inspection of the horse’s muscular system and limbs manually. The movement of the horse is typically evaluated while the horse is in trot and, when necessary, also in gallop or while ridden. Regional anesthesia is a diagnostic aid used to localize problem areas as precisely as possible. We use the sensor-based analysis system Equigait, which measures gait asymmetry, to reliably evaluate the horse’s movement and how regional anesthesia affects it.

Radiography and ultrasound

After the problem area has been localized, we use state-of-the-art radiography and ultrasonic equipment to establish as accurate a diagnosis as possible, even in stable conditions. This enables us to design an individualized and effective treatment plan so that your horse is able to get back to its normal routine as a sport horse or a leisure horse with minimal problems.

Horse rehabilitation and medication

In addition to medicinal treatment, we always develop individualized rehabilitation programmes for each of our patients and monitor their rate of recovery carefully.

The methods of treatment available:

Joint injections

PRP

IRAP

Stem cells

Polyacrylamide hydrogel

Platelet-Rich Plasma (PRP)

PRP is most commonly used to treat soft-tissue injuries, such as suspensory ligament and flexor tendon injuries. Once the damaged tissue is located via ultrasound, PRP is injected into it. The primary treatment for a soft-tissue injury is rest, after which a tailored rehabilitation plan developed by a veterian is maintained. PRP injections are a good complement to rehabilitation, since the platelets in PRP contain a multitude of bioactive factors that speed up the healing process. Although no large-scale clinical trials on the efficacy of PRP have been completed, the method is widely used in equine medicine and has caused adverse side-effects only in extremely rare cases. In our treatments we use an allogeneic PRP compound, which means that the platelet-rich plasma has been taken from a donor horse before being turned into a commercially manufactured compound in a laboratory. Using allogeneic PRP has several benefits. For one, its platelet count is both known and optimal. The compound is also sterile and safe because it has been manufactured in a pharmaceutical environment. Finally, it eliminates the need to draw blood from the patient (horse) in order to create the PRP used in its treatment. PRP treatment €388.74 (Price does not include house call, mileage [travel] or sedatives.)

  Irap®

IRAP (Interleukin-1 Receptor Antagonist Protein therapy)

is a widely used joint disease treatment option. IRAP treatment alleviates the symptoms of joint inflammation caused by overtraining or mild trauma, as well as those of early stages of osteoarthritis. These symptoms include joint pain and inflammation. For the treatment, 50 milliliters of blood is drawn from the patient (horse) into a special IRAP syringe. The blood is then incubated for 24 hours. This results in an autologous serum (ACS) that is rich in anti-inflammatory neurotransmitters with regenerative properties. One blood sample typically produces enough serum to carry out three to four treatments. For one course of treatment, the serum is administered once every three weeks and consists of three to four injections in total. IRAP sample collection, processing and storage €512. (Price does not include joint injection procedures, sedatives, house calls or mileage [travel])

Stem cells

Stem cells are used for treating either joint or soft-tissue injuries. Stem cells are injected into the damaged area where they grow into normal or near-normal tissue and improve the healing of the injured area.  In our treatments we use commercially manufactured allogeneic mesenchymal stem cells. Stem cells are basically able to specialize as any cell in the body. The stem cells used in the treatment of joint diseases are chondrogenically induced, which means that they differentiate (specialize) as chondrocytes. The stem cells used in the treatment of soft tissue injuries, on the other hand, are tenogenically induced, causing them to differentiate (specialize) as tendon tissue. All allogeneic stem cells we use have been taken from donor horses before being turned into a commercially manufactured compound in a laboratory. This guarantees that its stem cell count is known and the product is certifiably sterile and safe to administer.  Stem cell treatment is tailored and the compound ordered for each horse separately. The treatment costs approximately €890.

Polyacrylamide hydrogel

Polyacrylamide hydrogel is used in the treatment of joint disorders in horses. It is a synthetic gel injection that mimics joint fluid and is injected directly into the joint. Once injected, it forms a stable, long-lasting layer that protects the joint by lubricating it, which reduces friction and protects the joint from strain. Polyacrylamide hydrogel is an especially good treatment option if changes caused by a degenerative joint disease have been detected. As it is slowly, mechanically broken down into smaller pieces, polyacrylamide hydrogel provides a longer acting, sustained effect than, for example, hyaluron, which is detectable inside the horse for only a short period of time. The hydrogel is able to reduce the pain and inflammation caused by a degenerative joint disease for longer than traditional treatments, which greatly reduces the need for frequent joint injections.
Horses have a high tolerance of polyacrylamide hydrogel, and no permanent or major detrimental side effects have been detected in research related to its use in horse treatments (McClure & Wang 2017, McClure, Yaeger & Wang 2017). The incorporation of polyacrylamide hydrogel into joints does take some time, so the treated horse should be restricted to a walking regimen for approximately three weeks after the injection. Normal training can be resumed after a month. Polyacrylamide hydrogel Noltrex €135 (Price only includes the compound.)