Just curious, but if you had to choose between doing PRP alone or in combination w/ SWT which would you do? Money is an issue so basically am trying to help a friend decide if it makes sense to just do PRP. What advantage is there to doing both? This would be for a tear in the oblique distal sesamoid ligament that has not responded to time off (no stall rest, just time off).
For this type of injury any other therapy recommendations you think might be more help alone (or in combo w/ PRP)?
I could be wrong, but I do not think she should expect positive results from using either of the treatment. Both need to be used on acute injury.
How long ago has the injury happened?
For soft tissue injuries she needs stall rest. Nine months of pasture board made my gelding's DDFT injury worse than what he started with. And I did both RPR and SWT in combination with 5 months of stall rest BEFORE turning him out.
Even if she decides to go with either treatment, I think a vet would recommend stall rest.
I ended up doing a surgery last July and have been seeing very positive results since (knock on wood.)
I've had PRP done on two different horses -- one was a high suspensory and the other was a bowed tendon (superficial digital flexor tendon). For the suspensory, this was a 2nd time around -- the 1st time he was treated with shockwave only and came back great, then reinjured. Did one shockwave, vet wasn't happy with response, so we went to PRP. On the bow - he was also treated with shockwave, came back great, got kicked in the tendon and rebowed and I can't remember exactly why we went with PRP then, but we did it alone, no shockwave that time. Both horses did well with the PRP.
Both times were a couple years ago at least, and in a recent discussion with that vet, he did mention that they are now doing shockwave first then doing the PRP as they are finding that it (shockwave first) seems to really help the PRP work. No other details to offer than that - sorry! I trust this vet a lot, so would pretty much do what he tells me, but I know that isn't always the case (I have another vet that I've used a little and I always feel he steers me toward certain things that he makes a better buck off, and that is pretty much why I would rather haul an hour to the other guy that I trust!).
Thanks for the input thus far. I think the difficulty is that friend is trying to decide between three options:
1. Rest (most likely combo of field/stall) for a year and then just see what's happening.
2. PRP alone (w/ few months of stall rest)
3. PRP w/ SWT (few months of stall rest)
Each option has advantages with cost obviously playing a role in each one. I think she trusts the vet fine, but if she was going to go the PRP route it's obviously $$ w/ results that could be great or not. If SWT would appreciably increase likelihood of success then I think she could justify to herself racking up additional charges. So, if anyone else has additional insight into this canundrum then would be greatly appreciated as well.
I'm not sure what costs your friend is looking at, but for me, it was about $700 to do PRP. Each shockwave treatment was $400 or so. I guess I would want to talk to the vet to get an idea what he thinks -- is the PRP and/or shockwave kind of a last ditch try to make the area heal as it hasn't responded to just rest? Or does he think that any of the methods (do nothing, PRP, or PRP and shockwave) will end up the same, just have varying timelines -- like if you do the PRP, you will heal things faster but not necessarily better?
For me, my horses were insured so the financial aspect was rarely a factor in determining how to treat, which made it a lot easier. Anything that meant less stall rest was always preferred only because I was dealing with young, dumb warmbloods that were downright dangerous when they had to be locked up all the time! Even though the extended stall rest might be "cheaper," it sometimes isn't worth it, and you might lay the horse off for a year, find that the injury is no better, and be back to doing something (PRP or PRP/shock) and having to go through it all again. Just some things to consider!