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IRAP therapy,,,Can anyone share their experience with this treatment?

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  • IRAP therapy,,,Can anyone share their experience with this treatment?

    It has been suggested to me that my young horse have this therapy for some arthritic changes in his ankle; he is just 3. I am not finding out much about it except for the details of the procedure. I would really appreciate any info.

  • #2
    I did IRAP on my QH gelding. At the time he was 10 when we did it. We decided to do it for his hocks because regular hock injections just were not cutting it. A year later, after 3 injections spaced out every 3 months, xrays showed a reverse in his arthritic changes. I am a believer in the process. It made a difference in my boy that will last long term vs hock injections every 6 months. And it was covered by insurance


    • Original Poster

      Thanks...I forgot to ask about insurance


      • #4
        ooohhh, I'll be watching this thread closely. I'm considering it as an option for arthritic changes in a coffin joint. Any other stories out there?

        Maverick-did you do the IRAP in conjunction with injections, or any other treatments? How quickly did you see improvement in your gelding?


        • #5
          In this part of the country, prp is used instead. In several vets opinions, it works better and is much cheaper. That said prp has a very small profit for vets while irap profits hundreds of dollars. Irap is still more common in regions like Texas and Oklahoma.

          Sorry that doesn't address your question, but I hope it's food for thought.


          • Original Poster

            What is PRP?


            • #7
              Star got IRAP for a collateral ligament injury in his coffin joint in 2008 and, later (2011, 2012), for neck arthritis. You can read some of the details of the first injury at the lameness blog linked in my signature. It ends in 2009, with our first show back. The lameness recurred in 2011 and he turned out to have neck arthritis which may have been driving the front end problems. I did neck injections with IRAP in the fall of 2011 and then just did a second set.

              I don't think that IRAP and PRP are the same thing. As my vet explained it to me, IRAP is more of an anti-inflammatory whereas PRP is more of a scaffolding on which to start healing. I'm not explaining it as well as she does. She does both, BTW.

              IRAP - interleukin receptor antagonist protein
              PRP = platelet rich plasma
              The Evil Chem Prof


              • #8
                PRP Platelet Rich Plasma

                They pull blood and spin it down -- remove the serum and a layer of surrounding white and red cells and inject in the injury area.

                For my horse's suspensory injury that is the course we took.

                Did it work? Don't know yet.

                I know folks who have used either IRAP or PRP with excellent results. It depends on the injury and who is doing the treatment.


                • #9
                  LOVE IRAP. Used it very successfully in a fetlock that did not respond to IA HA and steroid.

                  PRP and IRAP are definitely not analogous therapies.


                  • #10
                    Have a customer's horse we use it on. He also did not respond well to HA as we were having to inject too often. IRAP works great on him and the injections are much less frequent.

                    Hell hath no fury like the chestnut thoroughbred mare


                    • #11
                      Used IRAP on LF fetlock after surgery to remove old bone chip (occurrence unknown). During surgery vet found that the rough edges of joint had worn right through cartilage so he now was walking bone-on-bone. Prognosis: good chance of pasture sound/light-riding but probably not for competitive trail riding, which was our sport.

                      After IRAP we had about 6 months of rehab, very light riding. Now about 20 months after IRAP, we have had no lameness recurring and are back doing CTRs of 20-40 miles and completing sound. (Prior to my experience a friend had IRAP done on a fetlock also, for kind of "early onset" arthritis, and he's been sound since; it's been at least 4 years.)

                      What they say IRAP does is stop/arrest the degeneration of cartilage. I'd say it's definitely worth considering. My insurance did cover mine.
                      It's just grass and water till it hits the ground.


                      • #12
                        Success with IRAP

                        I have a good amount of experience in this, as my 15 year old Arab has DJD in both front fetlocks. We have undergone IRAP 3 times to immediate and excellent success . It usually lasts for him about a year or so before another treatment. As the price goes up and he ages though, we are now faced with whether we should retire from the show ring instead of another costly treatment sequence. I will tell you to get an experienced vet to do the procedure. Also, in no way is IRAP and PRP the same type of treatment. Also, insurance covers it ONCE and then they exclude the joints when you renew. I haven't heard of a horse that only had one treatment if they were competing. And, we've always completed 3 injections even though some of the literature says that you can inject and freeze part of it. Best of luck!


                        • #13
                          My dad's horse had fractures in three legs (yes, three) and other damage, we think from a psycho-ex-boarder but not provable. They did IRAP on him and it probably saved his life. He's sound and rideable now.

                          DH just had PRP on his shoulder. I know it hurt like hell, and still hurts (been three days), but we're hoping it works...
                          COTH's official mini-donk enabler

                          "I am all for reaching out, but in some situations it needs to be done with a rolled up news paper." Alagirl


                          • #14
                            I have had excellent results with IRAP. I have used it on my 23 year old jumper and had wonderful results. He was not being helped by regular injections anymore and he got 3 more years of jumping with a junior rider. On him we injected both front fetlocks and hocks and stifles as needed. Also used it in the hocks of my 32 year old quarter horse. He was having a hard time getting up and laying down. Hocks have terrible arthritis and I am convinced that the series of IRAP has been life extending for him. My latest experiance with is it in my daughters 11.2 hand small hunter pony. We are afraid to use steroids on him and the IRAP has been amazing for him. We put it in his stifles on a series and he has not had to have the traditional injections. I have not had a reaction on any of my horses and it was quick and easy and in these cases game changing. Make sure you use it all before it expires though! I see clients have theirs expire and have to be discarded so keep a note on your calander to keep track of number of doses left and when the clinic may dispose of them. Only thing, it IS painful on the pocketbook! But for me... Worth it!


                            • #15
                              Gotmypony and Tullymars, I am so glad to hear of your success. Gotmypony, I wanted to confirm that you were in a situation of "bone on bone" and the IRAP still helped? My "20's" Appy has bad hock arthritis in all joints - upper and lower. Most recently lame on left hind which has been puffy for months. He is sound at the walk (pasture and LIGHT trail walks) still likes to canter some (in pasture) but gimpy at the trot.

                              His lower joints are 99% fused, or about as close to fusing as my vet says they can get. But the upper left, high motion joint is almost bone on bone and one area in particular has significant narrowing. We injected last week, that one particular area and the vet said IF he shows improvement, he will be a good candidate for IRAP. At this point I feel like it's our only option. He is on every-other-week Adequan too which helped him alot in the beginning.

                              He is not a candidate for regular injections anymore - first, there isn't much left to inject. Secondly, he goes off his feed. Even with this last injection which was a low amount to be safe, and he was put on Misoprostal and Ulcerguard, he almost went off feed, but was better this time.

                              He is also on 1/4 previcox. I can move him to half but I am trying to reserve that for worse case scenario, or down the road a few years....plus, the half could be worse for his ridiculously sensitive stomach.

                              Would love to hear more IRAP stories. How long until you see effects??


                              • #16
                                Tpup: more information

                                Each time I saw a difference after the 2nd injection.
                                It works but not forever if you use it for DJD. For an injury, one course of 3 injections may be enough, I can't speak to that. I also have to use Adequan, Legend for long shows, and used Previcox in the winter until I discovered Equithrive.


                                • #17
                                  Tpup - Yes, I was told bone on bone, not all over the entire fetlock but in the area where the bone had chipped off and left rough edges; those rough edges worked against each other and wore a "groove" around part of the fetlock so it was more than just a small spot.

                                  Re the bone-on-bone, what the vet told me is that the "original" type of cartilage will not come back once it's gone, but the body does create a type of more fibrous cartilage in its place. Maybe a vet on here can comment on that. All I know is that he was still slightly lame after the surgery but not lame after the IRAP. He had 3 IRAP injections (all made from the original collection of his blood), about 2 weeks apart, IIRC. About 2 weeks after the final IRAP treatment he tested sound on the longe for the first time, then we did lots of hand-walking followed by light/short/flat rides, building up to regular rides (which around here are hilly and somewhat rocky). Now 20 months after the whole episode I've been competing in CTRs again and - knock wood! - have had no lameness. Will he need additional IRAP on that leg someday? That's possible and we'll cross that bridge at the time. The IRAP treatment (collection and 3 injections) was about $1200-1500, I think, and people I know using Adequan are paying about half that for a year's worth, with intermittent problems between their treatments. So for me it's been good so far and, knowing my friend had her IRAP done 4 years ago, I'd love to get that much out of mine before having to re-do, if at all.
                                  Good luck!
                                  It's just grass and water till it hits the ground.


                                  • #18

                                    I had a prevent check on Irish Sport Horse,everything looked very good on this 6 year old mare, except she had little inflammation in one ankle joint. The vet suggested IRAP which would stop the inflammatory response and give her years of jumping. The horse was not lame. We purchased the horse for my 14 year old and planned to do IRAP. The mare had an inflammatory response with the first injection and lameness. Also she produced a small amount IRAP(only 3 vials), so the vet put HA in with the IRAP but no steroid. One month later second IRAP treatment with HA was repeated the mare had rejection response, with increased swelling and lameness. Cultures were neg. and after each treatment received steroid injections. I was told she could never have Irap again. I was also informed by another vet that HA is not given with IRAP. She kept coming up lame for the next 6months while showing. After working with another vet and few more injections and rest(xrays and ultrasound were always neg) he recommended MRI. The MRI showed destruction of articular cartilage in LF and RF,told the 7 year old mare would be good broodmare with her blood lines. I did not have a positive experience with IRAP and still have a number of questions of everything which went wrong. Also this large vet group does there own IRAP(own lab and equipment), they do not use the IRAP from Decchra or Arthrex. I am only a show mom, but learned alot from this experience.


                                    • #19
                                      We used IRAP on our broodmare. I can't say whether the stall rest or the IRAP did more, but she looks sound now charging happily around the field.

                                      But the thing I wanted to say is to be aware that the price they say...let's say $1,000...is inaccurate since the vet needs to come out a bunch of times and for our vet it costs an arm and a leg. So my only input is that the cost is much higher than what I thought it would be.


                                      • #20
                                        Originally posted by staf01 View Post
                                        Also this large vet group does there own IRAP(own lab and equipment), they do not use the IRAP from Decchra or Arthrex. I am only a show mom, but learned alot from this experience.
                                        Their OWN IRAP?

                                        That perhaps sounds more like platelet rich plasma? I do not think you can do it on your "own" without the magic beads coated in the mystery substance that promotes the production of the target protein...