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  1. #1
    Join Date
    Jun. 27, 2012
    Location
    Phoenix/Charlotte
    Posts
    200

    Default Experiences with Stem Cell, PRP & Shockwave therapy

    Hi all,

    My very special mare whacked herself in the leg and messed up her right front flexor (through hardshell boots, mind you- she's a big girl) Vet said 4-10 months layup plus 6-12 months gradually increasing work. It's right before show season and I'm heartbroken, naturally. I gave myself this year and *maybe* next to show her before sending her back to our breeding farm in North Carolina to retire and have babies (I live in AZ) If her layup winds up being on the 10 month side of the estimate, I'll probably wind up breeding her this season.

    Vet suggested stem cell, PRP and shockwave therapy. Our lifelong vet who handles our broodmares back in NC suggested that we go through the University of Tennessee to work with universal donor stem cells, which are apparently somewhat more effective and less expensive, since the whole harvesting/culture process is skipped. Just wondering what your experiences have been like with these treatments, and what kinds of layups you experienced?

    This is what our vet in AZ sent me:

    Willow sustained a traumatic injury to her right front flexor tendon approximately 2 1/2 weeks ago. Although minimally lame the area of diffuse swelling was hot and tender on palpation at initial examination. Tendon margins were poorly defined. One week of stall rest with standing wraps over DOMOSO/Surpass eliminated the diffuse swelling, leaving a discrete (3” x 2” x 2”) enlargement distal to the midpoint between knee and ankle.

    Ultrasound examination (12/20/12) of the discrete enlargement revealed a tendon core lesion. Core lesions are characterized by a lucent area on ultrasound examination – a fluid density at the tendon core. The fluid is blood/serum. Surrounding tendon fibers are displaced and disorganized by the blood/hematoma.


    Any opinions would be appreciated! Just looking for a little bit of hope here. I've pretty much been a leaky faucet since I received the above email yesterday. Disclaimer: I've been out of horses for a long time and this is my first time dealing with tendon injuries on my own as an adult, so I know these are pretty common treatments, but I've never dealt with them.



  2. #2
    Join Date
    Aug. 27, 2009
    Posts
    32

    Default

    Mine tore a hind suspensory badly in July, had PRP initially then at 60 days he had shockwave therapy every 10 days for a total of 4 treatments. Ultrasound today shows 65% healed. He gets to get turned out on flat grass pasture for another 6 months starting next week. The vet is very pleased with the recovery at this point. I was given a 50/50 shot at best initially. I would do everything possible if it was me. Mine will start swimming in May.



  3. #3
    Join Date
    Jul. 16, 2001
    Location
    The Great White North, where we get taxed out the wazoo
    Posts
    635

    Default

    The shockwave made a big difference in 2 I have had with tendon injuries. My big Clyde X did a suspensory hunting and was back in light work after 3 months and hunted again the following season with no issues. My TB did high hind suspensories and was back under saddle in a month being ridden while medicated, quiet WTC but no turnout or jumping for about 3 more months.
    The longer you can give them rest, turnout (limited movement, no silliness) the faster they will come back.
    I have limited knowledge of stem cell therapy. Maybe some on line reading will help you decide.



  4. #4
    Join Date
    Jul. 19, 2003
    Location
    Middleburg, VA
    Posts
    12,878

    Default

    My horse responded EXTREMELY well to shockwave when he bashed into himself and damaged his tendon about 15 months ago. Originally, we planned on 3 rounds of it, a few weeks apart, but he responded so well after the first one, we didn't do the second two. Now, his injury was far less substantial than your horse's (no core lesion, just some minor trauma). If I was dealing with the extent of injury you are, I would go big on the treatment. It is my understanding that you do stem cell OR PRP, so, I would go stem cell.

    Also, realize that some horses responded differently to shockwave. My horse's body seems to LOVE it (I also shockwaved his back a few months ago, which made a tremendous difference), but I know others have not experienced the huge improvement using it that I have. I think it is a great, non-invasive therapy, though, that helps in a lot of situations. But, in your case, I would definitely consider another treatment along with it.



  5. #5
    Join Date
    Jul. 19, 2003
    Location
    Middleburg, VA
    Posts
    12,878

    Default

    Also wanted to add that I have rehabbed more than my fair share of tendon injuries (including ones more like what you're dealing with). Controlled exercise (like tack walking) has ALWAYS been part of the process. Most of mine have started tack walking almost from day one- 20-30 minutes a day, on a flat, even surface (like a ring or driveway), 5 or 6 days a week. Otherwise, they are on stall rest. The core lesions I've dealt with have been probably 8-12 months from injury to ready to compete again (my horse's was MUCH shorter but his injury was much less severe).



  6. #6
    Join Date
    Aug. 13, 2002
    Location
    RHE, CA US
    Posts
    2,159

    Post

    Tendon injuries are not a career ender anymore. With careful rehab, most horses can return to work. Time is your friend. The more you rush it, the worse the recovery chance. Breeding her this year might be the smart thing to do!

    I have a horse right now with a severely bowed front SFD tendon. In fact on ultrasound he has 2 lesion areas, one high one mid. We are taking it slow, strictly following the gills rehab protocol. I started out icing 4 x's a day, now I am down to one - after the handwalking. http://corebreeders.com/research/Gil...amentsAAEP.pdf

    We did stall side PRP injections 14 days ago, so I can't say if they have helped yet. I can tell you that PRP was definitely recommended for our injury by our clinic here, and that stem cell therapy then shockwave were also recommended in that order.

    I have been using previcox as the anti inflammatory drug. Wraps on 24/7. Luckily my horse has a small corral attached to his stall, so he does go out but can't run around too much. My horse doesn't do stall rest well, and the ability to at least go outside keeps him much saner and safer.

    There are different stem cell therapies, and in my research I wasn't overly comfortable with the lack of trials that have been done on any one of them. PRP though has been trialed quite thoroughly, and proven to be of benefit most of the time.





    Quote Originally Posted by AllEars View Post
    Hi all,

    My very special mare whacked herself in the leg and messed up her right front flexor (through hardshell boots, mind you- she's a big girl) Vet said 4-10 months layup plus 6-12 months gradually increasing work. It's right before show season and I'm heartbroken, naturally. I gave myself this year and *maybe* next to show her before sending her back to our breeding farm in North Carolina to retire and have babies (I live in AZ) If her layup winds up being on the 10 month side of the estimate, I'll probably wind up breeding her this season.

    Vet suggested stem cell, PRP and shockwave therapy. Our lifelong vet who handles our broodmares back in NC suggested that we go through the University of Tennessee to work with universal donor stem cells, which are apparently somewhat more effective and less expensive, since the whole harvesting/culture process is skipped. Just wondering what your experiences have been like with these treatments, and what kinds of layups you experienced?

    This is what our vet in AZ sent me:

    Willow sustained a traumatic injury to her right front flexor tendon approximately 2 1/2 weeks ago. Although minimally lame the area of diffuse swelling was hot and tender on palpation at initial examination. Tendon margins were poorly defined. One week of stall rest with standing wraps over DOMOSO/Surpass eliminated the diffuse swelling, leaving a discrete (3” x 2” x 2”) enlargement distal to the midpoint between knee and ankle.

    Ultrasound examination (12/20/12) of the discrete enlargement revealed a tendon core lesion. Core lesions are characterized by a lucent area on ultrasound examination – a fluid density at the tendon core. The fluid is blood/serum. Surrounding tendon fibers are displaced and disorganized by the blood/hematoma.


    Any opinions would be appreciated! Just looking for a little bit of hope here. I've pretty much been a leaky faucet since I received the above email yesterday. Disclaimer: I've been out of horses for a long time and this is my first time dealing with tendon injuries on my own as an adult, so I know these are pretty common treatments, but I've never dealt with them.



  7. #7
    Join Date
    May. 6, 2007
    Location
    Napanee ON
    Posts
    3,983

    Default

    Jessica Pheonixs old event horse Exploring had stem cell therapy done. He was sold to a young rider and is now competing Intermediate. I would say that was a major success.



  8. #8
    Join Date
    Nov. 13, 2009
    Posts
    4,529

    Default

    I used shockwave - three treatments, I *think* one week apart, on a front suspensory injury. I thought it worked very well. The horse had several months of showing no healing at all, and then immediately started showing healing on ultrasound following shockwave.

    The injury was rehabbed fully (and carefully). It took about one year before he was back in full work, including light jumping. I would absolutely use shockwave again for a soft tissue injury.



  9. #9
    Join Date
    Jan. 23, 2008
    Posts
    110

    Default

    Who is your vet, AZ Equine? I ask because I just moved my mare from AZ to Ohio and she had a mild tear on her collateral ligament and then two months into her rehab she tore her sesamoid oblique in her stall. AZ Equine (dr. Howard) was amazing, gave her a good prognosis and we threw the kitchen sink at her- stem cell, PrP, tildren (for an unrelated issue but figured if she was getting treated, go for it)... 9 months rest, but I went ahead and bred her because I've heard that whatever the time they estimate, double it. It was a huge bummer bc she was about to start first years but it actually worked out bc I ended up moving for my job. Oh and is she insured? That's another factor- they covered everything (thank Buddha) and the vet here, while surprised at how much we did and how conservative we were, said she was healed at her 6 month ultrasound- and now my goal is to keep her in enough shape to keep up with her baby due in June. Good luck but there will always be another show- if your mare is like mine, it's worth it- and they can bank stem cells so only may need one draw. Curious as to what her breeding is and where you're riding in az- as I lived there 6 years and have an alla czar as well!



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