Have you ever heard the old fairy tale about the princess and the pea? Long story short, there is this princess, and some fussy queen wanted to check that she was a real princess and not an imposter. They made the princess sleep on top of 20 mattresses stacked one on top of the other with a pea hidden under the bottom one. Apparently only a real princess would be sensitive enough to feel the pea under all those mattresses, so when the princess comes down in the morning moaning about how uncomfortable the bed was and what a bad night of sleep she had, the queen decided she was good enough to marry the prince. Lucky guy???

Why, you ask, do we give a meow about this silly story? Well, it turns out horses are real princesses too! But the pea under their mattress is the balance, conformation, and health of their hooves. Tiny changes in hoof angle can have huge implications to the soundness of your horse. They are sooo sensitive to changes in their feet, for better or worse. That’s why I want to talk to you today about taking routine X-rays of your horse’s feet.

I don’t mean just taking X-rays when you know there is already a lameness problem. Yeah, of course you will do that. My goal is to help you prevent lameness. My docs advocate a preventative approach, looking for subtle issues with hoof balance that may not yet be causing a problem, but if left untreated can worsen and cause lameness. Long toes, negative palmar/plantar angles, incorrect hoof pastern axis, under-run heels, and medial-lateral imbalance are just a few of the subtle problems that can be assessed by foot radiographs. Some of these issues are evident on a physical exam if they’re bad enough, but why wait until they’re really bad? Mild to moderate imbalance can still be present on a relatively normal looking foot. The best way to diagnose them precisely is to evaluate the position of the bones within the hoof through X-rays.

What will X-rays show?

For routine preventative X-rays of the hooves, my docs take two views of each foot – one from the side (the lateromedial view) and one from the front (the dorsopalmar view). These images show the bones inside the hoof and pastern in relation to the outer hoof wall and sole. Some of the structures that can be seen include the coffin bone and coffin joint, the pastern bones and pastern joint, the navicular bone, and the hoof wall and sole. My doc can get a sense of the health of the bones, look for early arthritis, and check the depth of your horse’s sole.

If your horse already has a lameness problem, X-rays can help to optimize management. Horses with caudal heel pain (navicular syndrome), laminitis, and other lameness problems benefit from regular checks to make sure the hoof care is appropriate for the disease process. For example, a long toe and a negative palmar angle can exacerbate pain coming from the heel area, so a horse with navicular problems will be very sensitive to these measurements. Likewise, a horse with a tendon injury will benefit from a trimming and shoeing plan that will help to protect the tendon as it heals.

The individual structures of the foot aren’t the only focus – also critically important is how they are positioned in relation to each other and the outer hoof wall. Think about the size of the horse versus the size of his limbs and how much weight his relatively small feet and legs have to carry. Very small abnormalities in the positioning and angle of the structures in his feet can cause a lot of extra stress and wear.

My doc can check how your horse is distributing his weight and make sure he’s not putting extra stress on the bones, tendons, and ligaments of the limb. Hoof imbalance is a really common factor on the road to lameness. It can be caused by your horse’s natural conformation – for instance if he naturally has a club foot, a low heel, or his hock angles are relatively straight (post legged). It could also be attributable to the hoof trim, shoeing, or the time between farrier visits.

Medial-lateral imbalance causes uneven loading across the hoof as well as the joints of the lower limb. In a normal horse, weight is borne evenly across the whole hoof and up the limb, but an imbalanced horse carries more strain on one side, predisposing him to injuries and wear on the joints. Abnormal patterns of growth can also give insight into impending foot problems.

When should I have X-rays done?

It’s really useful to have X-rays taken when you purchase a new horse so that you’ll have a baseline to be able to compare to later on. Ideally, these will be done as part of a full pre-purchase exam, to help you avoid any unpleasant surprises in your horse-purchasing experience. After that, we generally recommend taking x-rays every 6 months. If your horse has had lameness problems or tricky conformational issues, they might be needed more frequently. We can do the X-rays at the clinic or right on your farm!

My docs work closely with farriers so that your horse has the best team to help him stay sound and happy. They can review your horse’s X-rays with your farrier and make a plan together. Certainly, they’ll do this if a lameness problem comes up, but the best time is before your horse ever takes a bad step. Your farrier can use the X-rays to optimize the trim and correct any imbalances. This is especially useful when horses have conformational issues or sensitive feet, but any horse will benefit from the best possible trim to extend his soundness and athletic career.

It’s easier to make necessary changes to maintain soundness than to reverse years of wear and tear that have already caused lameness issues. This also makes long term sense for your wallet. Preventative care is usually a lot cheaper (and more successful) than trying to fix long term problems. So treat your equine princess to some foot X-rays so you both can spend years of happy, sound riding!

Until next week,

~Tony

This hind foot has a negative plantar angle (meaning the coffin bone is tipped backwards a few degrees from where it should be) and a broken-back hoof pastern axis, causing extra stress on the upper limb.

If you are still looking for more information, head on over to our podcast page. The humans work tiressly on their podcast, it is filled with so much useful information. Click here to head that way.

Not One More Vet

Not One More Vet: You may have seen this saying, or NOMV floating around on social media recently. Forewarning for all my readers, this week’s blog is a little more intense than usual and does contain topics including suicide, depression and mental health.

 In the month of March there have been 4 suicides in the veterinary field. 3 veterinarians and 1 veterinary technician. Second only to police officers, veterinarians have the highest suicide rate of any industry. My hope, and the hope of all those on social media, is to bring an understanding to the public of what veterinarians go through on a daily basis and how you can be a part of the change and reduce the number of suicides per year.

 The veterinary community is a small one. Whether small animal, large animal, zoo animal or lab animal, veterinarians are all a part of one big family, and when a veterinarian or veterinary staff member takes his or her life, it is like losing a member of their family. Research, and you all know how much I love my research, has shown that veterinarians are 3.5 times more likely to commit suicide than the general population. There is a real mental health crisis in the veterinary field. Why is this, and why does the number of suicides continue to increase?

Educational Debt

I have known my whole life what I want to be when I grow up, and thus far I must say, I am doing a darn good job at it. Most veterinarians dream of being a vet from the time they are very young. This means that after high school, it’s straight to College/University and then Vet School, assuming all the stars align. At the very least, it takes 8 years of higher education to become a veterinarian.

 Along with schooling comes tuition. Veterinary school alone can cost upwards of $250,000-$300,000. That’s a lot of cat treats. That also leaves veterinarians with one of the largest debt-to-income-ratios out there. A common misconception is that veterinarians make a lot of money or that they are only in it for the money.  Take if from this old cat, that’s the furthest thing from the truth. Did you know that the interest rates on student loans range from 6-8% and that the average salary of an equine veterinarian is $60,000-$70,000 a year? That’s some pretty complicated math but even I can see how it would be nearly impossible to catch up and pay off student loans. Student loan payments can be as much as a mortgage and can make buying a house next to impossible.

Cost of Care

While in vet school, students are taught the gold standard of veterinary medicine. The gold standard comes with a price however, a price that the general population often can’t afford. This leaves veterinarians playing a balancing act between what’s best for the animal and what the owner can afford. Vets want to help every animal that they see. However, when an owner responds with, “if you really cared about my animal you would do this for free”, a little part of the vet dies.

 Take it from me, my docs care about each and every one of your horses just like their own. They love them, their hearts break with you and they rejoice with you. That being said, remember that vets have student loans to pay, animals and families of their own to care for, and deserve to make a fair living just like everyone else. Guilt-shaming veterinarians into providing services for free has got to stop.

Emotional Burnout and Compassion Fatigue

Unlike typical 9-5 jobs, veterinarians work 24/7/365. Even if they do not have a patient in front of them, they’re working. Whether it is working on clinical records, making phone calls, replying to texts, or researching different ways to treat your horse, veterinarians are working constantly. Based on the number of times I’ve heard stories about my docs dreaming about your horses and how they can treat them, I’m thankful I don’t have to dream about anything other than napping.

 Beyond the life of constant work, vets go into their career knowing that almost all of their patients will die before they do, with a large portion of those patients leaving this world with the aid of their veterinarian. It’s a blessing to end the suffering of an animal, but I’m also sure that it can’t be easy to have to say goodbye over and over again to a patient they have come to know and love. The empathy they share with you when your pet crosses the rainbow bridge is genuine, and the compassion they feel is real. So when they have euthanized 5 pets in 5 days, it’s exhausting and absolutely leads to burnout and compassion fatigue.

 So the next time your vet is running late, or has an emergency come up where they may have to reschedule your appointment, remember it could be you they are spending those extra few moments with while you say goodbye to your beloved family member. It could be you they are rushing to help with an emergency while rescheduling someone else. It’s always better to be the one being rescheduled and not the one with the emergency! 

Work-Life-Balance

My docs here at Springhill Equine have it really good. They work 4 days a week and split the on-call schedule 3 ways.  That’s a very rare scenario for the majority of equine veterinarians. I can only speak for equine vets in this matter, as I’ve only ever been the manager of this equine practice. But from what I have heard, not all veterinarians have it as good as my docs do. Some work 6 days a week or are on call for weeks at a time. And do you know how many text messages, Facebook messages and phone calls my docs get after hours, and on their days off from people who do not have an emergency?

 If you have an emergency, definitely call them. The docs are always there for you when you have an emergency. But if you text your vet after hours with a question that isn’t urgent, don’t get mad at them if they don’t answer until normal business hours. Work-life-balance is essential for your veterinarian’s mental health and well-being.

Life

On top of their profession, veterinarians have a life. Well, they try to, anyway. Many veterinarians have significant others, families, and pets of their own. Just like you, they have things happen in their lives, both good and bad. Sometimes those things are the breaking point, and sometimes they are the icing on the cake. Either way, life adds stress to your vet every day, just like it does for you. They give you and your pet their undivided attention despite what is going on in their life because of the love they have for the animals. I’m just asking you to remember that they’re humans, not cats, so they have feelings.

 This is just a small insight into the life of a veterinarian. They are some of the most compassionate, loving and caring people in the world. They are also faced with some incredible emotional challenges as part of their job, although you would probably never know it. So give them a break once in a while. Heck, give everyone a break once in a while! It’ll make the world a better place. And give your cat a treat, that’s important too.

 Until next week,

~Tony

P.S. – If you would like more information about Not One More Vet, please click here to be taken to their website. 

Hanging around the clinic, I hear a lot about backs. My Docs will see sore-backed horses for spinal manipulation and acupuncture, along with lameness evaluations to figure out why they’re back sore in the first place. Often after a long day of treating sore horses, I hear the Docs go on about their own sore backs. This is why I stick to laying in the driveway, sleeping on my comfy chair, and holding the front counter down. No sore back here. Unless you count the time last week I lept for the hood of one of the vet trucks and missed, but we’re not going to mention that incident ever again. It’s like it never happened. Anyway, moving on! Much like exercises are available to help human back pain, there are some great exercises for horses with back pain. These exercises also help strengthen the back, decreasing the future pain potential. 

Balance Pads

If you’ve ever hurt your ankle, knee, or hip, and sought out a doctor’s advice (something you horse people aren’t so great at) you may have gotten exercises involving balance pads. These are squishy foam squares about 2” thick. For humans, you will be asked to stand on one of these pads and do fun things like stand on one leg, or touch things with the toes of the leg you have raised. These exercises improve your balance, and the little muscles around the joints that stabilize them. They also help you increase core strength, and responsiveness. 

As it turns out, these exercises are great for horses, too! Many back injuries occur when sudden change happens. Think about that reach out for something on your desk, or down to pick up something off the floor. Then BAM! your back is in massive pain. Core exercises help prepare your back for that sudden need to pick a pencil up off the floor. They prepare your horse’s back for that moment when the footing changes as you ask for a change in gait, or their foot slips on a slick spot on the trail. 

Any horse can do these exercises. In fact, they’re so easy, even a dog could do them. There are horse-specific balance pads, but regular old human ones work too (and they are a lot cheaper). Start by having your horse stand with either both front feet, or both back feet on the pads. Have them do this for about 5 minutes. You can increase the difficulty by doing all four feet, or diagonal pairs, or even by giving the shoulder or hip a tiny push to make balancing harder. My Docs have some advanced exercises as well that they will assign for homework to help specific problems. 

Stretches

Everyone knows stretches. Heck, we cats are masters of the good stretch. Back sore horses can benefit greatly from a daily stretching routine. Each horse is different when it comes to timing, but you will most likely get the best stretching after exercise. This is when the muscles, joints, tendons, and ligaments have warmed up a bit and are most receptive to pushing their boundaries. The three big stretches my Docs recommend are nose toward stifle, chin to chest, and the butt tuck. 

Nose toward hip: For this stretch, ask your horse to stand still while turning their neck and head toward one stifle. The key to this one is to keep the tips of the ears parallel to the ground. If your horse starts to turn their head a bit, try helping them with some gentle pressure on the side of the head to correct things. If they continue to tilt their head, go back to the furthest spot they can go without tilting, and hold the stretch there for a count of 5-7. Repeat three times on each side. Keep this up, and your horse will be able to turn further and further.

Chin to chest: Just like it sounds. Ask your horse to touch their chin to their chest. Hold for a count of 5-7, repeat three times. Then ask them to do the same thing but lower. Ask them to bring their chin between their fetlocks.

Butt tuck: There’s a spot about a hand width out from the tail that when itched will make any horse tuck their booty. That’s the magic spot for this stretch. Keep the scratching up to keep the butt tucked for a count of 5-7. Repeat three times. 

Resistance Bands

If you’ve ever had the joy of being tortured by a personal trainer or physical therapist with resistance bands, then you know they can really take the work up a notch! While I haven’t experienced these things personally, and will use my claws on anyone who tries, I know they are fantastic at increasing workloads in a pretty safe fashion. 

Work on the horse version of these, known as Equibands, has shown them to build some serious topline muscle. It’s a pretty easy system to set up. Ask my Docs! They can show you how. Using a band under the abdomen and one around the hind quarters, you can really get that core engaged. The key to resistance bands is to start with very short work sessions! Five minutes is often a whole lot of work in one of these. Consider holding a crunch or plank for a few minutes and you’ll get the idea. You can ride in resistance bands, but be very, very cautious about how long!!!

You humans know having back pain is no fun! Incorporating these simple things into your daily routine can help your horse avoid back pain. If they’re already experiencing pain, these can really, really, really help improve the pain, and strengthen the right muscles to minimize future pain. Want a program to help your horse? Ask my Docs! They’ll help you come up with a custom program to keep your horse performing for years to come.

Until next week,
~Tony

P.S. If you haven’t checked it out already, the humans did a podcast episode called Pain In The Spine, which covers a lot of stuff that I didn’t get into here. You can find it over on the Podcast Page right here on my website, or download it on your phone with your handy-dandy podcast app. You should really be subscribed already. It’s an amazing amount of free access to your veterinarian’s brain!

Tuesday with Tony – Joint infections

Have you noticed that when my docs and techs do a sterile scrub on your horse’s joint prior to an injection, it feels like 5 hours of scrubbing for about 15 seconds of actual injection? And have you noticed that my docs get a lot more uptight about a half inch wound over your horse’s hock than a big dramatic looking wound on his chest? Like with real estate, location is everything, and this week we are talking about infections in a location that we take very seriously – joints.

In its most basic sense, a joint is a place where 2 or more bones meet, along with the cartilage that covers the bone ends, and a joint capsule with a synovial membrane that secretes fluid to lubricate the joint. Most types of joints have movement of some sort – hinging like your knee or moving in multiple directions like your shoulder. It’s the same for your horse. Think about the joint capsule like a protective balloon around the joint. It’s a really important place, sealing the joint space and providing nutrition and lubrication to the cartilage. When infection gets inside that space, there can be career ending or life-threatening consequences. That’s why my docs don’t mess around when a joint infection is on the line.

These locations that are surrounded by a fluid-secreting synovial lining are called synovial cavities. There are so many synovial cavities in a horse, especially in the legs! And it’s not just joints, but tendon sheaths and bursae too, which are similarly worrisome if they get infected. That’s why my docs’ knowledge of anatomy is so important. A wound in one spot might not be that big of a deal, but a wound an inch away could be in a synovial cavity. The treatment and prognosis could be vastly altered by just a tiny difference in location.

How do joint infections happen?

The answer is a bit different depending on whether it’s a mature horse or a foal. In foals, bacteria usually get into the joint through the bloodstream. The infection starts somewhere else in the foal, like the umbilicus or the lungs, and then bacteria travel in the blood until they arrive in the joint. This is especially problematic when foals don’t get enough immunity by suckling high quality colostrum right after birth, causing failure of passive transfer.

Adult horses most commonly get joint infections from wounds that enter the joint space, bringing debris and bacteria inside. Since it’s the same for a tendon sheath or bursa infection, we’ll just use joints as our example from here on. The wound could be an obvious laceration leaving little doubt that the joint has been compromised, but it could also be a tiny puncture wound that leaves no evidence of the injury.

Joint infection can also rarely be seen as a complication of joint surgery or joint injection. That’s why you see all the scrubbing we do before joint injections. It’s not common to have a problem, but my docs will still be very careful with sterility.

Signs of infection

The first and most important thing is if your horse has a wound anywhere near a joint, call my doc immediately. This is not the time to take a wait and see approach – it could turn into a real CATastrophe. Besides the wound itself, you might see lameness starting within hours to days, swelling in and around the joint, or sometimes fluid draining from the wound. It’s important to remember though, that if the joint has an open wound and is draining fluid, it may not show lameness or swelling yet. That doesn’t mean it’s not a big problem, so don’t put off calling my doc! If it’s been going on a while, the horse may have a fever. In a foal, the fever may be the first thing that occurs even before the joint swells up. No matter which of these you see first, the moral of the story is to call my doc and not mess around trying home remedies.

How we diagnose a joint infection

When there is a wound near a joint, my doc will clean the wound and then explore it to find out if it communicates directly with the joint. She may put on a sterile glove and feel within the wound itself. She may insert a sterile instrument into the wound to track which direction it goes. An x-ray can be used to look for bone abnormalities caused by infection or to help with determining if the wound communicates with the joint.

A fluid sample can be collected from the joint to test for infection. Normal, healthy joint fluid is clear, pale yellow in color, and somewhat stringy rather than thin like water. Fluid from an infected joint may turn cloudy, watery, and sometimes change color. There are several lab tests that can be used to determine normal from infected joint fluid.

My doc may inject the joint with sterile saline from a site distant from the wound to pressurize the joint. If there is communication between the wound and the joint, the pressurized fluid will leak from inside the joint out through the wound. If there is no current communication, no leakage will occur.

If any of these methods determine your horse has an infected joint, you’ll have to start treating quickly and aggressively.

How an infection is treated

Your horse will need his joint flushed out with large volumes of sterile fluid. This is best done under general anesthesia at a hospital. The gold standard is to use an arthroscope to inspect the joint surfaces, look for debris, and deliver a high flow of fluid to rinse out infection. He’ll also need powerful antibiotics given through his vein. Antibiotics are often injected directly into his joint or the region of infection as well. It’s important for the horse to be comfortable enough to bear weight on his injured leg and prevent too much stress on his other legs, potentially causing laminitis, so he’ll receive anti-inflammatory medication to reduce swelling and pain.

A joint infection can be difficult to treat, especially if the infection has been present for a while before treatment begins, or the bone or soft tissue structures are involved. So when there’s a wound on your horse’s leg, calling my doc quickly will give your horse the best chance to get the treatment he needs.

Until next week,

~Tony

P.S. Don’t forget to head on over to our podcast page to learn more about joint infections and so much more. Click here to go to the podcast page.

You know I occasionally climb up on my soapbox on really, really important issues that horses and their humans face. Today is one of  those days. Let’s talk about people doing procedures on horses they shouldn’t be doing. I’m mostly talking about floating teeth, spinal adjustments, and acupuncture. These procedures should only be done by veterinarians. There, you have the short version. Now let’s talk about why it is imperative for your horse’s health, and good for your wallet, to have these procedures done by Doctors.

Bright lights, a Speculum, and Sedation

Let’s pretend for a moment that you’re a horse. This means you have a really, really long oral cavity, with a relatively tiny mouth. When I yawn, you can see everything. When your horse yawns next time, take a good look. You can’t see a darn thing in the back. My Docs manage this by giving a little bit of sedation, placing a full-mouth speculum to hold your horse’s mouth open, then put on a bright light to see all.the.way.to.the.back. I’m going to warn you that if I hear “My horse doesn’t need sedation to have their teeth done,” someone may feel my claws. That’s like saying you don’t need novocaine when the dentist does a root canal on you. 

If your horse isn’t sedated, they will chew and gnash on the speculum with all the might they’ve got, not to mention wiggle their tongue around everywhere. This leads to very sore TMJs, and can lead to injury when the tongue gets in the way. If you aren’t a veterinarian, it is illegal for you to administer sedation. This would be like letting the produce manager at the grocery store anesthetize you for surgery. And what are they going to do if something goes wrong? Never let anyone who isn’t a veterinarian administer sedation to your horse. There are a hundred things that can go wrong, and only one thing that can go right. Don’t risk it! 

Too Much, Too Little, Just Right

Teeth are persnickety when it comes to floating them just right. I see all kinds of mumbo jumbo about making the left side and right side exactly even, getting the incisors to line up perfectly, and even evaluating the angle of the TMJ to determine how much tooth to take off. If you hear these things, you are talking to a snake oil sales-human. Run the other way, and do NOT hand your horse over to this person. You see, horses will never be symmetrical right to left, just like you aren’t. Heck, even cats aren’t, and we’re practically perfect. Attempting to make your horse symmetrical from side to side will result in way too much tooth being removed. This can do horrible things to a mouth, including cause teeth to die, create infections, and cause extreme pain. This is one of my 8,322,498 reasons why you need someone who understands all the veterinary things. Seriously, do you want the tire store people doing work on your teeth? No, you want someone who knows all the important medical things so they don’t cause horrible things to happen. 

Saving You Money

The #1 complaint I hear about dental work: the cost! Know what costs untold amounts of money? A badly done dental float. One that doesn’t involve a light, sedation, and a speculum. Important things in the back of the mouth can be missed. Imagine a sharp point from the top tooth in the back growing so long it pokes into the lower jaw. My Docs saw this recently on a horse who had been receiving “dental work” every 6 months. This person had spent thousands of dollars over this horse’s lifetime trying to make sure they were doing the right thing. Who knows how many classes were lost, bad rides happened, and pain this horse suffered. 

Good dental care from my Docs is money well spent. Overall, it would have been far cheaper, and far better for this poor horse and human. Complete soap box moment: This is ALWAYS true. I see people spend all kinds of money trying to avoid calling my Docs. If they had only called us first, even for a conversation, they would have saved so, so much money. In some cases they would have saved their horse’s life, or extended it by several years. I know this sounds cat dramatic, and I wish I could say it was. However, this is a weekly occurrence around here. 

Horses are expensive. There’s no two ways about it. But think about this: a Wellness Plan from Springhill Equine provides a dental float and all the vaccines your horse needs for a year for about $500, which you can make monthly payments on. When you look at what you spend on your horse in a year, this is actually one of the lowest costs you have. It’s cheaper than your feed and hay, your farrier costs, your trainer, fuel in your truck, all of it. Getting rid of those unnecessary supplements will more than cover the cost of real medical care. And our Wellness clients don’t pay an emergency fee if something bad happens! This is the smartest way to spend your healthcare money. Trust me. I’m a cat.

Until next week,

~Tony

P.S. Check out all the details of our Wellness Plans on our Wellness Page. And then go listen to the Supplements episode of our podcast to learn why you’re throwing your money away with most of them! You’re welcome. 

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