Brandon Equine Medical Center offers complete lameness examinations. These entail thorough physical assessment of the horse during static (standing), and dynamic (in motion) examinations. During the dynamic exam, the horse is assessed in hand, on the lunge line and under saddle as needed. Brandon Equine has the ability to video each lameness exam and possesses gait analysis software to more fully assess the horse in motion. This allows the clinician to observe the horse in normal and slow motion, and to assess gait motion and foot fall. This modality takes the lameness exam to the “extra level” in providing a complete and thorough evaluation of the issue at hand.
Flexion tests provide important information towards localizing the source of lameness. Diagnostic analgesia (nerve block) is performed as necessary to help in pinpointing the location of the lameness. With this information, the appropriate diagnostic imaging can then be pursued and a treatment plan formulated.
In May of 2016, our Sports Medicine Center opened at our clinic location. This center features air-conditioned diagnostic imaging and treatment rooms, image viewing and consultation room, day stalls, farrier workstation, lameness pad, and a riding ring for observing movement under saddle.
Adjunctive Therapies (Shockwave)
Extracorporeal shock wave treatment is another adjunct to the treatment of injuries in the horse. Brandon Equine has a Storz® shockwave unit that can be used on many areas of the body. This has emerged as a treatment for navicular pain, back pain soft tissue and joint injuries. This treatment incorporates a high-energy sound wave that can be given at different energy levels depending on the problem being treated. Two theories to its use have been formulated; one is that there is a prolonged analgesic effect thus relieving some discomfort, and the other is that it may improve blood flow to the affected area thereby bringing in the necessary cells to help in healing.
To optimize treatment and rehabilitation of a performance-related injury often requires a change in the bio-mechanics of the affected leg(s). (Reducing stress on the injury, improving foot balance, and improving/enhancing break over) Corrective farriery is an important part of the equation for returning the horse to performance, and in maintaining soundness. Horses that have laminitis (founder) similarly need assistance with corrective shoes and trims through all phases of their treatment and rehabilitation. The surgeons at Brandon Equine work closely with a skilled farrier at the hospital, and are happy to communicate with the farrier of your choice at any time.
IRAP (Interleukin-1 Receptor Antagonist Protein)
Interleukin-1 is an inflammatory protein that is produced in an unhealthy joint (e.g.: arthritis). The Interleukin-1 Receptor Antagonist Protein would normally “balance” this out. But when inflamed, there is an excess of the inflammatory protein produced, which then leads to destruction of the cartilage, more inflammation and lameness. IRAP is produced from the horse’s own blood through a special centrifuging and 24 hour incubation process. This creates an “anti-inflammatory soup” which is injected into the affected joint(s) on three occasions. The results following treatment into affected joints have been promising with marked improvement in the degree of lameness.
PRP (Platelet-Rich Plasma)
Plasma rich in platelets is similarly derived from the horse’s own blood through a centrifugation process. This process takes approximately 20-30 minutes to prepare and can be injected into lesions within bones, tendons and ligaments using ultrasound guidance. The theory behind this is that platelets help to create a “clot”, as well they promote important growth factors that help to stimulate repair of the injured soft tissue structure. PRP has been developed for the use in horses after initially being developed to fill in bone defects after oral surgery in humans. Again, this is very new, but has exciting potential for use in the horse, not only for soft tissue injuries, but for wounds and bone injury. Brandon Equine has had the opportunity to treat some soft tissue injuries using PRP, and we have been very impressed with the results achieved so far.
These therapies are part of an emerging and rapidly advancing field that offers treatments of musculoskeletal injuries in the performance horse. Regenerative medicine involves using the horse’s own blood or tissue, that is injected into a specific site after it has been processed. These treatments are very new to equine surgery and medicine, and while there are few scientific reports documenting their use, the available reports are favorable. The benefit to using these treatments is that the quality of repair is enhanced and improved over rest alone. (And in some cases horses return to function sooner). Another important benefit is that these therapies use the horse’s own tissue which reduces negative side effects. Surgi-Care has treated several horses using regenerative techniques with excellent results to date.
Stem cells are derived from bone marrow or from adipose tissue (fat) and are similarly used to treat lesions within tendons and ligaments as well as joints and bone. Brandon Equine uses stem cells derived from adipose tissue that are processed through Vet Stem® in California. Fat is harvested from the tail head area, is processed at Vet Stem®, and returned in specified quantities required to inject into a particular lesion. This whole process takes 3 days, which is faster than the bone marrow technique, which can take weeks to produce. Several horses have been treated at Brandon Equine using adipose-derived stem cells with good results, with horses returning to the same or higher level or performance.