Who has done IRAP instead of routine joint injections?
How did you like the results, cost, etc? From what I've read recently about IRAP vets say the affects are longer lasting and there is less risk of a reaction because the serum comes from the treated animal. BUT if I read correctly, it's more expensive and a series of injections, say like once a week for 4 weeks?
Looking for experiences, I'm thinking of asking my vet about it.
Boyle Heights Kid 1998 16.2h OTTB Dark Bay Gelding
Tinner's Way x Sculpture by Hail to Reason "Once you go off track, you never go back!"
I did it... 3 series of injections spaced 2 weeks apart. I'd have to add up all the bills but I think it was around $1800. 11 year old mare with severe osteoarthritis in one hock. My vet said he didn't recommend it for older horses. Our other option was fusing or depo medrol but his opinion was that IRAP would give her the best chance of halting the progress of the arthritis and returning her to soundness. Huge improvement so far but her lameness set on acutely after a slip so I don't know how much of the improvement was due to tincture of time.
I'm not yet ready to give an assessment on the long term benefits, however I just completed a series of IRAP injections on horse's stifle. Background: felt NQR to me in the spring, made vet appt a week or so out. By the time vet arrived, said horse was off on hind leg. During the NQR stage I was thinking hock; when I watched the horse loose in round pen, thought stifle. Blocking and ultrasound showed stifle inflammation, no APPARENT soft tissue damage. Did "regular" injection, put on stall rest for 30 days. Mare was sound. Then discussed IRAP as stage one on ongoing preventive maintenance. Did that about 120 days from original injection - 3 times, 2 weeks apart, 4 days off (2 stall rest, 2 t/o ) then work again. That ended several weeks ago; horse feels fantastic ( back to 4th level/PSG work) First injection w/ steroids, etc was done to see what we had - ultrasound could not see all soft tissue and there was a risk that I had a bigger problem. As rehab progressed, vet proposed this plan - once we determined what we were working with. It is more expensive than "regular" injections - but apparently horses respond quite well and there is overall less risk - my vet says I shouldn't need to redo for sometime longer than 12 months. I would agree w/ above poster re the approx. cost. TIme will tell, but I feel way better about reinjecting horse's blood rather than steroids and other stuff..........
We don't get less brave; we get a bigger sense of self-preservation........
I suggest that while you pick your vet's brain, ask how he will mitigate damage form the TNF, Il-6 and other pathways as well as preventing over suppression of inflammation, resulting in even greater damage.
In most human treatments, IL1-ra is also treated with a TNFra but at the same time you need to know which Il-1 and TNF receptor is being targeted.
Also remember that all IRAP does is suppress inflammation but does not regenerate cartilage. In other words it does not stop the disease.
It just depends on how bad the arthritis is how much luck you have. I knew a big warmblood whom had steroid HA injected into his arthritic pastern. Three weeks no improvement what so ever. A second steroid HA injection was done and then he came sound and stayed sound showing in the hunters for two years after that without re-injecting. IRAP generally lasts longer, I had a single injection of IRAP last six months, but for what ever reason surgeon only did one injection not all three. Cost me $1700 for just the first injection and new radiographs. I have also heard of cases where IRAP was not very effective. I think you just cross your fingers and hope for long lasting results. IRAP would certainly be my first choice over steroid injections in I ever deal with arthritis again down the road.
My horse has severe arthritis in both front fetlocks and we've used IRAP 3 times. Usually lasts 12-17 months. He is older now and I won't do the IRAP again because what started out at around $1800 is now closer to $3000 total including all injections. I will say that all 3 worked awesome and kept him in the show ring so we were very happy. We never tried joint injections.
We did IRAP with my gelding when he was almost 20. An earlier poster said their vet had not recommended it for older horses - is that because the vet didnt think it would work? My horse had ringbone in both front fetlocks. The right was worse than the left. He was essentially a trail horse at the time following a long jumping and dressage career. He had become my husbands walking trail horse and was a member of our family. It was painful to watch him move around. He carefully looked where he was going and very carefully placed each front foot down, one at a time. It was painful to watch him. At the time we did the IRAP, I was thinking he shouldnt even be ridden at the walk and I was also thinking that we were approaching a time when he would need to consider putting him down. We did the IRAP over a period of weeks and I have to say, we have never looked back. My horse is 23 now and while he is stiff like an older horse who has had an active life would be, he still tells our other horses in the field what to do. He is clearly the boss. He is fairly sound (for a 23 yr old guy) and we occasionally see him out cantering around the field -- something he would never have done before the IRAP. A few weeks ago, a gate was left open and our 3 horses got out. They were trotting around, tails in the air having a fine time. Andy, my older guy was having the best time of all cantering around, his feet barely touching the ground, head up in the air. As I caught him, I thought "oh no" hes going to be SO stiff. But he never was. You would not even know he had done anything out of the ordinary. Its clearly been a lifesaver for him!
We did IRAP with my gelding when he was almost 20. An earlier poster said their vet had not recommended it for older horses - is that because the vet didnt think it would work?
I'm happy to hear of your positive results!
It was my understanding that my vet believed an older horse would be have much more progressed arthritis that would be more likely to come sound via fusing. Of course the entire conversation was about lower hock joints so he may only have meant it in that context.
Last edited by gypsymare; Nov. 16, 2012 at 02:48 PM.
I just completed IRAP number two in a series of three on my 17 year old WB show hunter. He has had regular injections in the past but was no longer responding to them. So far I've been very impressed with them as the horse is finally sound!
I've also used it in my 23 year old NZ TB show jumper for a fetlock and a hock. He still responds quite well to regular injections but can sometimes use a little help in between them.
I find it odd that a vet would say that it is not useful in older horses--I don't think you can get much older than mine as far as performance horses are concerned! That being said, neither of mine have any significant arthritis for their age and their hocks are no where near fusing.
Originally Posted by EquineImagined
My subconscious is a wretched insufferable beotch.
My horses lower joints are in the process of fusing, the center of the left joint has substantial fusing and the right not far behind. He is Cushings and IR so cannot use any steroids so IRAP was the only alternative. I am amazed at the difference, he is much more comfortable and hopefully it will keep the pain at a level he can tolerate and enable him to continue working so it will help finish fusing.