Platelet Rich Plasma (PRP)

In my recent blog about tendinitis, I told you about a really cool tool my docs have to treat your horse’s tendon injury – Platelet Rich Plasma (PRP). Today, we’ll talk about how that stuff works and how we use it to treat not just tendon and ligament injuries, but joint disease and even wounds. PRP has the amazing ability to deliver molecules that optimize healing for faster, and more importantly, better quality repair tissue. The best part about using PRP is that it’s a product from your horse’s very own body helping him heal…specifically, the platelets in his blood.

Horses (like you and I) have little cell fragments called platelets that zoom around in the bloodstream along with the red blood cells that carry oxygen and the white blood cells that fight infection. Platelets form blood clots when an injury occurs and help during wound healing. They contain large amounts of growth factors – molecules that send signals to form new blood vessels, bring in cells, and stimulate tissue regeneration. These growth factors are the reason we want the platelets – they give your horse the healing boost.

Sometimes, there are downsides to using medications. For example, steroids come with risks and may not be right for every horse with an arthritic joint. Platelets, on the other hand, are a super powered healing force your horse already has inside him. What my docs do is make a super-concentrated version called PRP and inject it right where your horse needs it! It’s minimally invasive, can usually be done right at your farm, and is free from any chance of allergic reaction since it comes from your horse.

What do we treat with it?

PRP was developed and tested out on humans before being tried on higher forms of life, like cats (and horses, I guess). It was first used in the 1970’s to improve healing after maxillofacial surgery. Since then, lots of clinical trials and research have been performed, both in people and in animals. Equine studies indicate that tendon and ligament injuries treated with PRP have faster tissue healing times and reduction in lameness compared to untreated injuries. The chance of the horse re-injuring the tendon after he goes back to work decreases as well. My docs use PRP to treat tendon injuries (bowed tendons), suspensory and other ligament injuries, arthritis, joint inflammation, stifle soft tissue injuries like meniscus tears, and certain wounds.

How do we make PRP?

My doc will take a sample of blood from your horse’s neck and put it in some special tubes. Back at the clinic, the blood goes through a centrifuge process to remove most of the red and white cells. This concentrates the platelets in the plasma (the liquid part of the blood without the cells) and gives us the platelet-rich plasma product (PRP). This is all done in a sterile way. We often get several doses of PRP out of one sample of blood. The doses we don’t need immediately are stored in the freezer for future use.

How is it injected?

Now that we have the PRP ready to go, the next step is to get in into your horse. If your horse’s joint is the target, the process is just the same as if we were injecting it with steroids. My doc and her tech do a super sterile scrub to reduce the risk of infection.  They don’t lick the spot clean like I would, they just use surgical scrub. Then my doc injects the PRP right into the joint.

If it’s a tendon or ligament that your horse has injured, my doc will inject the PRP right into the damaged part, where the growth factors get to work stimulating regeneration of the fibers. First, my doc scrubs your horse’s leg to make sure it’s really clean (again, no licking). She puts in a little numbing agent so he doesn’t mind the injection. This next part looks really fun – kind of like playing a video game. She uses her ultrasound to place several needles into the injured tendon. She can watch on the ultrasound screen as she moves the needles right into the defect in the tendon. That way she can make sure the growth factors are going right where your horse needs them. (video here) She will place a bandage on your horse’s leg and talk to you about what kind of activity restriction and rehab he needs. That will depend on the kind of injury your horse has, so it will be tailored to his individual situation.

For more info about PRP and to talk about whether using your horse’s own super powered PRP would help him out, give my doc a call!

This is an ultrasound of an injured superficial digital flexor tendon. See the black hole on the left side? That’s the injured part where the tendon fibers are torn – it should look more like the right side.

The needle is being placed in the tendon. It’s the bright white line entering at the top left. My doc can direct the needle right where the injury is.

The PRP has been injected into the hole in the tendon. See those little bright white specks? Those are tiny air bubbles from the PRP injection. The PRP has filled the tendon injury nicely and the growth factors are getting to work!

 Until Next week,

~Tony

Wow, wow, wow, what a year it has been! Can you believe we are only 3 days away from a New Year? Where has the time gone? That’s an easy answer for me: I have spent the last 8,349 hours sleeping, the remaining 363 hours I have been eating. Surprisingly, time really does fly when you are having fun. I figured this week we could recap 2020 and talk about some New Year’s Resolutions for 2021. I have heard over and over again from my minions what a crazy year 2020 has been for everyone. I sincerely hope for the sake of my sanity that 2021 is a little quieter so I can get my full 23.5 hours of sleep in each day!

2020 started off mild, just some buzzing around about the Royal Family when Prince Harry and Meghan Markle elected to quit the Royal Family. Why anyone would quit being royal, I do not know. Being a cat automatically makes me royalty, and personally, I wouldn’t give it up for the world. But alas, to each their own. I haven’t heard much more about Harry and Meghan the rest of the year, and can do nothing but wish them well.

One day, probably around mid-March, I was basking on the roof of one of my doc’s trucks when I saw a client pull in.  Nothing new, nothing surprising. Clients come to see me all the time. This time it was different though. This time before the client got out of her car, she put on a muzzle.  I have heard of dogs and cats being muzzled because they don’t like the vet, but I have never seen a human in a muzzle.  This person piqued my interest, so I followed them inside. 

My mind was racing. How do I protect my minions from this vicious person? What if they come after me, can people get rabies, and can they give rabies to cats or other people if they bite? Needless to say, I was very anxious about allowing this person into my clinic. I kept my distance while planning my attack but close enough to follow them into the clinic. Much to my surprise, I was greeted by my staff who are also all muzzled. No one seemed ill though. No foaming at the mouth, no growling, no obvious signs of any problems among the staff or the clinic. So why would they all be muzzled? I had to delve further into this situation. I confided with Teenie, who lives inside at all times. She told me everything has been status quo around the clinic, and since she can’t see, she really could tell if someone was acting a little off.

In order to obtain more insight into the situation I pretended to sleep quietly in my usual chair. This is when I heard my staff and the client talk about Corona and how they have to help stop the spread of Corona.  Well, I was even more confused now.  Why prevent people from drinking beer? Is there something wrong with a particular batch of Corona beer, and how would a muzzle prevent the spread? Hoping to find out more about this odd behavior I continued my stealthy plan of “sleeping”. This is when I found out that they were not talking about Corona the beer but Corona Virus, or Covid-19. I listened further and learned that they were not in fact wearing muzzles but that the masks they were wearing were to prevent the spread of the virus.  Now it all made sense. 

Things changed pretty significantly around the clinic. Everyone was wearing masks, there was hand sanitizer on every surface, and clients were asked to remain outside the building. My minions have certainly done their part on preventing the spread, and so have all of you. I am bursting with pride at how well all of you have embraced the changes we made at the clinic and during appointments. You all have been remarkably understanding and welcoming of the changes which has allowed my docs and staff to continue to treat your horses with the best care possible. For this I thank you. We have not let the Corona virus prevent us from treating your horses and we will continue to do whatever is necessary to keep everyone safe while providing top veterinary care to your equine companions.

I am pretty sure we have heard enough about the Corona virus. But what about those Murder Hornets? What a short-lived fright to give us all just a brief distraction from the pandemic mayhem.  I guess avoiding hornets is significantly easier than avoiding microscopic virus particles. Nevertheless, Murder Hornets cannot be forgotten and I remind you all to stay diligent and avoid wasps and any kind of stinging insects. 

Speaking of stinging insects, there were plenty of outbreaks of Equine Encephalitis and West Nile Virus that affected horses all over the country this year. Those pesky mosquitos really took advantage of the warm humid weather. Reports of EEE and West Nile were made in our own back yard in Alachua County. Even though we have had freezing cold temperatures the last few days, mosquitos are still all around and can still spread these viruses. Here is your reminder to get your horses vaccinated twice a year to help prevent them contracting one of these deadly viruses.

The rest of 2020 has not been all fun and games either. From the presidential election to numerous protests, there has not been a lack of news out there. We have seen wildfires out west and deaths of many famous people including Kobe Bryant, Eddie Van Halen, and Alex Trebek.  Now we are witnessing the release of the first Covid-19 vaccines. 2020 is sure to go out with a bang leaving everyone hoping that 2021 brings a bright future with health and happiness for all. 

I am sure you all have your ideas of New Year’s Resolutions heading into 2021. I have one more that I want you to add to your list.  Sign your horses up on the 2021 Wellness Plan. This is the best way to keep your horses happy and healthy. Help me, help you, to help my docs, help your horse.  My Wellness Plans will keep your horses up to date on vaccines and routine dental examinations and flotations. In my opinion, the biggest perk of the Wellness Plan is that any horse who is enrolled on a Wellness Plan will not be charged an emergency fee should the need to call my docs after hours arise. 

Needless to say, 2020 has been an interesting year. You and your horses have all been amazing as usual.  I speak not only for myself but for everyone here at Springhill Equine: we are looking forward to a bright New Year in 2021 with you all!

Until next week/year,

~Tony

For reasons unknown to me, horses simply love to injure their legs. Yet more proof that us cats are superior to horses, am I right? And they are so creative about it! Lameness or lacerations, tendonitis or trailer rides…there are many reasons why my docs might ask you to bandage your horse’s leg. If you don’t know how to do it, it can be a bit intimidating. And though bandaging is really useful, if done wrong it can actually do more harm than good. This week, I’m going to go through two of the most common bandages and the materials you’ll need for them. My doc will direct you on which one to use when she sees your horse, but if you follow my instructions, you’ll be well prepared!

Standing bandages

This is the most common type of bandage, applied around the horse’s lower leg from the top of the cannon bone down to the fetlock or pastern. The basic materials are a thick padding and a compressive bandage on top. A standing bandage is great for covering a wound, supporting an injured tendon, or controlling swelling. It’s also a good option for protecting your horse’s legs when trailering. Keep in mind, this is not the same thing as a polo wrap that you might ride a horse in. Let’s look at the layers first so you know what to have on hand.

 The quilt or “cotton” layer: It’s a thick, cushy padding. Even though it may be called a “cotton”, I do NOT mean the kind of cotton roll that pulls apart into bits. My doc uses that stuff for cleaning sheaths. She hates it for leg wraps, because it bunches up and causes pressure points or the little cotton fibers stick to the wound. You have 2 options for this bandage layer. One is a disposable product such as a combine roll that is commonly used in a hospital to cover a wound. This is only meant to be used once and can’t be washed.

The other option is a fabric wrap like a quilt or “no-bow” bandage. These can be washed and reused indefinitely and are really useful to have around the barn. In my not-so-humble opinion, all horse people should own them. Don’t try to cut corners and use a thin padding or a towel for this purpose – you’re more likely to cause a skin or tendon injury if you don’t have sufficient padding.

The outer compressive layer: This holds your quilt in place. You can use a disposable product such as Vetrap or a reusable stable bandage.  You may be tempted to use a polo wrap, but it really doesn’t work very well.

Optional: If your horse has a wound, you may also be using a thin bandage underneath the standing bandage, made up of a non-adherent pad and some white roll gauze. This can cover the wound without sticking to it and keep wound ointment in place.

Tips for putting on a standing bandage

• Despite what you have probably heard, it doesn’t actually matter which direction you wrap in! The convention is to wrap clockwise on the right leg and counterclockwise on the left, but you don’t have to. I know, I know, other horse people may judge you if they think you’re going in the wrong direction. But really, it’s a habit, rather than a medical necessity. You can be a rebel if you want to.
• When you buy a stable bandage, it will be all wrapped up nicely in the package with the Velcro on the outside. That’s useless for actually putting it on the horse. You will have to unroll it and re-roll it the right way. **This part is important to avoid much frustration and potential curse words**. When you roll the bandage, fold the Velcro ends towards each other and then roll the wrap with the Velcro towards the inside. That way, when you get to the end of your beautiful bandage, you won’t find that the Velcro is on the inside of the wrap and hence, not at all useful for securing the bandage.

• Pull firmly but not excessively. It’s helpful to practice this to get the right tension. Too loose and the bandage could slip down, but too tight and it can injure the skin or tendons. If your quilt layer is nice and thick, injury is less likely to happen.
• Smooth out the wrinkles as you apply the layers, so they don’t cause pressure points.
• For the compressive layer, each layer should overlap the last one by about 50%.
• Leave about an inch of the white padding layer exposed on the top and the bottom
• For safety, don’t sit on the ground when applying the wrap, just in case your horse objects. Horses wearing hind limb bandages will frequently lift their back legs high on the first few steps. Just keep him moving for a few steps and he will usually get over it.

Check out this video of one of our awesome Springhill technicians applying a beautiful standing wrap.

Hoof bandage

This bandage is really useful if your horse has a hoof abscess and you need to poultice his foot or protect it once the abscess has drained.

 The materials you will need:

• A diaper. Not tiny baby sized, unless you have a tiny horse. A size 4 is about right for most horses.
• Some duct tape (gorilla tape works even better and won’t wear through as easily)
• Scissors

The steps:

• First, make a duct-tape patch. Tear off approximately 6 strips of duct tape roughly 12 inches long and place them side by side vertically. Then tear off another 6 strips and place them side by side horizontally, on top of the vertical strips. So you will have 2 layers of tape, going in different directions. It helps to stick the pieces of tape to a surface as you are making the patch, and then peel the patch off when all the layers are on. Pro tip – don’t do this on a surface you would be upset about peeling the paint off. In a pinch, your thigh will do.

• Make a 2-inch cut on each of the corners

• Hold your horse’s foot up and apply whatever poultice or dressing is being used under the bandage (if any)
• Place the middle of the diaper on the bottom of the hoof and fold the top of the diaper around the pastern. Many diapers will have Velcro ends you can use to secure it.
• Place the middle of the duct tape patch on the bottom of the hoof. You may then find it easier to allow him to place his foot down and do the rest with him standing on the patch
• Fold each side upwards and overlap the cut corners snugly to fit the shape of his hoof. You should still have diaper extending further up than the duct tape reaches. This will protect the skin.

• Take the roll of duct tape and wrap it around the hoof so it secures the patch in place. Don’t pull too tightly over the heel bulbs. Make sure the diaper is high enough that the duct tape doesn’t contact the skin.
• Check the bottom of the hood bandage a couple times a day, as your horse will eventually wear through the bottom of the duct tape, depending how actively he is walking.

There are several other types of bandages you may need in specific situations, but my docs can show you those if your horse needs them. If you have a good handle on the standing wrap and the hoof bandage, you’ll be well prepared for most situations and will earn this cat’s nod of approval!

Until next week,

~Tony

P.S. Want more step-by-step videos? Check out my YouTube Channel! If you watch every video on there, you will be as smart as this cat. Well, almost.

Checking Vital Signs

In my recent column about colic, I talked about taking your horse’s vital signs as a good way to help your vet manage an emergency. Today I’ll go over how exactly I want you to do that, because it’s YOUR horse, right? So, you really should know how. I’ve enlisted some help to show you exactly what I’m talking about, so make sure you look at the pictures and watch the videos.

Heart rate

First of all, go buy an inexpensive stethoscope. You can get one for as little as $20! Amazon, CVS, Walmart, they’re not hard to find. Sure, my doc probably uses a fancier one to hear all the subtle things, but a basic one will let you count the heartbeats just fine. Then practice ahead of time, don’t wait for an emergency to happen. Put the stethoscope ear buds in your ears so they point forward. Listen for the heartbeat on the left side, just behind your horse’s elbow, about where the girth rests. It’s helpful to have him stand with his left leg forward a bit so you can push the stethoscope forward under the muscle and get good contact with his chest. Try pressing more or less firmly until you can hear the heart clearly.

A horse’s normal heart rate is around 26-46 beats per minute (much slower than yours). Since it’s so slow, you will probably be able to hear both heart sounds. It will sound like “lub-DUB”. Be careful that you don’t accidently count double – “lub-DUB” just counts as one beat. Set your stopwatch for 15 seconds and count the beats in that time. Then multiply by 4 to get his actual heartrate. For example, if I listen for 15 seconds and hear “lub-DUB” 10 times, I multiply 10×4 and his heartrate is 40 beats per minute.

There are places you can feel the pulse with your fingers to count the heart rate, but these are usually trickier to master than just listening with a stethoscope. When my doc comes out to vaccinate your horse, or whatever, you can ask her to show you the technique for listening to the heart or feeling the pulse.

Respiratory rate

Counting your horse’s breaths can be done in a couple of different ways. You can listen with your stethoscope, but it’s usually just easier to look at his flanks moving in and out. If he’s breathing hard, you can watch his nostrils flare, but if he’s breathing normally this might be harder to see. Remember that inhale + exhale = one breath. Count for 30 seconds and then multiply the number of breaths by 2 to get the respiratory rate. The normal respiratory rate of a horse at rest is 12-20 breaths per minute.

Gut sounds

Gut sounds are what you will hear when your horse’s intestines are moving normally to push food through. A normal horse has active rumbles all over his belly, and you shouldn’t have to listen for much longer than 15 seconds to hear some. Your horse’s gut sounds can be heard on both sides of his belly, high and low, in front of his hips. Again, practice ahead of time to get used to his normal.

Digital pulses

Digital pulses are a good indicator of the amount of inflammation in your horse’s feet. My doc’s favorite place to feel them is at the fetlock (your horse’s “ankle”). Using your thumb and middle finger, feel on either side at the widest part of the fetlock, towards the back. You will often feel a “squishy” area that is the artery and vein on either side – that’s the right spot. Use light pressure and feel for the pulse. It’s usually a light movement against your fingers and may be a little hard to find at first. Get to know what it feels like in a normal horse so you can tell if it’s more prominent than usual. My doc says if there is inflammation in the foot, the pulse will feel stronger than usual. She calls it a “bounding digital pulse”. It’s kind of like the throbbing feeling you would get if you hit your thumb with a hammer.

Temperature

Get yourself a plastic digital thermometer like my docs use. They’re quick and easy to use. Keep it just for your horse’s use of course! To take his temperature, it’s safest to have someone holding him for you in case he objects to it. If your horse strongly objects or you just don’t feel safe, it’s okay to give this one a pass.

Stand close to your horse’s hindquarters on one side, not right behind him. I know you might feel safer to stand farther away, but actually you’re usually safer if you’re right up against his side. Gently move his tail up a little and to the side, then slowly insert the thermometer into his anus a couple of inches, almost up to where the digital display is. Press the thermometer’s button to turn it on. It will beep again when it has finished reading the temperature.  A normal horse’s temperature is between 98.5-100.5 Fahrenheit. Take your horse’s temperature on different days to see what his normal temperature usually runs.

Mucous membranes

Take a look at the gums above your horse’s upper teeth. They should be pink or pale pink. Any colors besides that are a problem, so call my doc. They should be moist to the touch and not dry or “tacky”, which can be signs of dehydration. Next, press your finger onto the gum firmly. The pressure should be firm enough that when you lift your finger away, you see a white spot where your finger was. Count the number of seconds it takes for the spot to fill back in with color. In a normal horse, it should be less than 2 seconds. If it’s longer than that, it could indicate shock or dehydration.

Being able to take good care of your horse’s health is a critical part of good horsemanship. Practice taking your horse’s vital signs frequently, so that it’s second nature by the time you really need to do it. I guarantee that my doc will be happy to show you her technique when she’s next at your barn. There’s few things the docs at Springhill Equine like more than helping to educate owners on good care for their horses!

Until next week,

~Tony

P.S. If you want to learn more, you should really check out the Podcast the humans do. They are way more energetic than this cat, and they actually talk for thirty or forty-five minutes sometimes to teach you things. It’s really good stuff. And Patrons of the podcast get even more: their own Facebook group with videos, and they can ask questions about their horses, and all kinds of good stuff. Sometimes I feel like they’re trying to show me up, but it’s more than I’m willing to worry about this close to nap time. Anyway, you can find all the details here on the Podcast Page of my website.