Long story short, my horse is a moron and tore his right suspensory branch and strained the left branch on his right front while waking up from a nap (fell asleep, woke up, rolled against the fence, got cast and had to be rescued). Vet has suggested stem cell therapy as treatment which requires a 3 day hospital stay. What are your experiences? Good? Bad? Ugly? I want to hear it all. In addition, he will be getting shockwave treatments as well as Back on Track wraps.
I did stem cells and PRP for my guy with his DDFT tear. He went home the next day though. So far so good, he had a long layoff but is now starting back W/T work. his last US showed normal tendon tissue, you couldn't tell a tear was ever there. He had no problems with the procedures at all. I will say it didn't shorten his recovery time any.. plus I am being very cautious and slow with his rehab but the vet said the stem cells help the tendon heal stronger and less likely to reinjure
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My guy had stem cells harvested from his bone marrow injected into a SFT tear. We did careful rehab, twice, but he never came back. He has good days and bad days but is basically ornamental now. That all said, the clinic I used has an 80% success rate with this procedure and it was a very severe injury. Someone has to be in that other 20%; this time it was me.
I'd do it again though. Thankfully, my insurance covered virtually all the costs. He was in hospital for a week total. Had to have MRI to diagnose then be scheduled for surgery and recovery.
My horse was just injected with stem cells from fat two weeks ago. I'd love to hear more from people who had the procedure done and your rehab experiences ... or those of you that opted for another treatment and how things are going ...
My moms gelding had stem cell surgery done to repair a right front suspensory. His recovery time was very long and slow (18 months before he was back to working at the same level as before). He tore the left one at about month 20. Again did stem cell. The left healed quicker than the right did but the right one started bothering him again while rehabbing the left. He is now sound on the left, but the right is bad. She opted not to redo the procedure. The vet told her at the time that about 25% of horses tear the opposing one after surgery. I don't know if its a weight bearing issue or maybe a conformational predisposition in some horses?
He's a very pretty, very expensive stall ornament.
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A few years ago I had a mare with a check ligament injury. She was never severely lame, but also not quite right. We did three rounds of shockwave and then stem cell ... The kind harvested from fat cells. The rehab was slow but she came back 100% sound and my insurance paid much of the cost. So I had a good experience with it. Unfortunately about 18 months later I lost her to colic.
No personal experience, but another boarder opted to have it for her horse.They did it at New Bolton. He went one day to have the stem cells harvested and returned a couple of weeks later (I'm fuzzy on the timing) to have them injected. No hospital stay. Ultrasounds show he is healing well, and the vets at New Bolton are delighted with the way he is moving. He is still confined to the stall but doing walk/trot. I was with the trainer when she rode him yesterday, and he looked fine (fabulous). The owner is a vet herself and has been meticulous about the rehab. I think it's helped that this horse is very quiet and tolerates stall confinement really well.
for suspensory breakdown a year ago. Worked very well. No hospitalization, did it right on the farm. No layup; went right back to her normal, sedate routine. I consider it a complete success. Along with a bit of corrective shoeing, she is back living her happy retired life.
First was the tear at the attachment point or in the body of the ligament? Branch ligaments tend to tear away from the attachment point at the bone and can be much more tricky. Depending on the severity, in other words how much tore away and some other factors, the quality of the healing process can be very problematic. If in the body of the ligament after ultrasound your vet should have told you the place and size of the “hole” in mm or as a % of the ligament. Also you did not say what you use the horse for, competition, what type, race, jump, event, etc. Pleasure, are we talking trail riding, hacking, occasional showing? This is important so as to determine what to expect as a “success rate”. Unless it is a complete tear or a very large % of the ligament has been ruptured just about all horse IMO will heal on their own well enough to be pasture sound at the very least to trail and hacking sound with traditional methods. What it comes down to is the “quality” of the healing that makes the difference and the added expense of modern procedures. All ligaments and tendons will heal themselves given time. But they loose their elasticity because they do not heal/repair to the same shape and consistency as the surrounding tissue but rather with stiffer scare tissue that is prone to re-injury. If you were to take a rubber band, cut it, tie a knot (knot represents the scare tissue) in the middle and pull from both ends until it breaks. The break more then likely will always be at or near the knot. The theory and it is just that, behind stem cell and PRP (platelet rich plasma) is to promote the quality of the healing process so the ligament, tendon returns as close to its “original, natural” shape and condition as possible. IMO any clinic that says they have an 80% success rate with any and every horse is pure nonsense and self serving. If so there would be a waiting list a mile long at that clinic. Success is a subjective word. This is not an exact science as of yet. All owners are paying a lot of money for their horses to be “Ginny pigs” at this time. I am not saying that in a derogatory sense my research and discussions with some of the top people in the field made me feel it has shown merit. Again it comes down to the severity of the injury and after rehab the quality of the healing as determined by ultrasound. Any reputable vet who has performed the procedure on numerous horses will tell you EVERY horse responds differently and will never offer up false hope by stating high success rates. With competition horses more then likely at some time it will be problematic. Yes, many do return to a high level of competition with success but you still have to pick your “spots” carefully. More then likely there will be problems and “down” time. Also more then likely there will be problems with the “good” leg because the horse will be using it “that much” more to compensate for the bit of discomfort they feel in the injured leg. This had been my experience.
After my research I chose to go with PRPs over stem cell. The “success rate” of PRP seemed to be on par with the much more expensive stem cell procedure. We are in the Unionville PA area so we have access to some of the best in the business. I would be uncomfortable having it done in the barn. Blood is drawn and the platelets are spun off in the lab. Extensive time is spent on ultra sound to determine the best injection locations in and around the lesions/hole/tear. This “mapped” information is then used during the procedure. It takes 2 people, one using the ultra sound to guide the needle of the person making the injection. The whole procedure takes a couple of hours and the horse comes home with us. I am surprised an MRI was mentioned this is an expensive diagnostic approach and has never been suggested in our cases. Having been involved in several treatments I don’t see its need or usefulness. Perhaps there is another way approaching the procedure.
I have not done it with anywhere near enough horses to have anything but an empirical opinion. That being said I think PRP is worth the $1,000++. Further research and discussions makes me feel following up with a program of post-op hyperbaric chamber treatments is worth the cost.
The only horse I put to the full test is a Timber horse (steeplechase) I own and train. He injured his RT front Suspensory as a 3 year old on the track. I got him just short of 5 after a year turn out with “traditional” rehab. I picked my spots carefully and he was competitive at the highest level but re-injured it and PRP was done. It healed better then expected and he ran with the best of them. But it did take carefully management and was lightly raced. In last years VA Gold Cup two from home having lead the whole way and would have been an easy winner he bowed in the “good” leg. Did a PRP and it is looking great. He may never race again but he should be fine for hunting and showing. Here's the confusing part I have another timber horse who has had problems with the tendon below the front pastern. He finally pastern bowed real bad. The ultra sounds were nasty at least they sounded nasty they way the treating vet explained and was told he could never race again. I went with “trad” rehab on him. My horses are always ultra sounded by 2 different vets so as to get a consensus. One only does ultra sound diagnostics and the other treats. The ultra sound vet who I call “Dr. Death” because she is so “tough” and you are not sure to shoot the horse or yourself when she leaves the barn scanned him around 10 months later and said everything look GREAT and put him back in training. Go figure????
Bottom line at this time IMO it is still a crap shoot. The recovery time is still the same with/without, 12-18 months.
This long winded response was not written to directly address the OP’s question but to give an over all explanation of PRP and stem cell treatments.
Obligatory disclaimer; This is all based on my direct personal experience and research. Take from it what you want. To each their own.
Last edited by gumtree; Mar. 4, 2012 at 12:43 PM.