lameness - Shotter & Byers

IRAP Treatment

Degenerative joint disease or osteoarthritis is a very common disease in both young and old horses. It presents as lameness, joint swelling and inflammation caused by cartilage damage and inflammation of the joint synovium. This damage results in the release of inflammatory mediators, notably Interlukin-1 (IL-1) which in turn leads to further cartilage damage.

IRAP or Interleukin-1 Receptor Antagonist Protein prevents IL-1 from binding to its receptor, stopping it from causing further inflammation and joint damage.

IRAP is produced by your horse’s blood cells and this treatment allows us to harnesses its anti-inflammatory protein and directs it to where it is needed. We take approximately 50mls of your horse’s blood and transfer it into a container designed to stimulate the production of IRAP. The container is incubated for 24 hours while this process takes place. The blood is then centrifuged to remove the cells leaving behind the now IRAP rich plasma.

This plasma is injected into the diseased joint every 7-10days for 3-5 treatments.

IRAP treatment is ideal for horses with mild to moderate radiographic signs of joint disease. It is not recommended in those with joint fragments but can be a useful tool to speed up recovery following their surgical removal and is considered low risk with few complications have been noted.

IRAP can be a great maintenance therapy for competition horses. It can reduce the need for steroid joint medications and can be used in conjunction with routine joint injections throughout the competitive season.

Please get in touch to discuss this treatment with us.

IRAP Treatment Read More »

Digital Radiography – X-RAYS

Accident & Emergency Care, Lameness / Michael Byers

Digital Radiography

At Shotter & Byers we are proud to own five top of the line wireless Eklin digital x-ray machines. These allow us to take exceptional quality images that can be viewed instantly beside your horse without the constraints of wires.

We also have a wired system that displays the images instantly and a number of x-ray generators to be used with more traditional digital x-ray plates that are developed at our office.

This array of x-ray equipment allows us to provide you and your horse with an exceptional and fast veterinary diagnostic service.

Digital Radiography – X-RAYS Read More »

Diagnosing Lameness

Horse Health, Lameness / Michael Byers

Diagnosing Lameness

All cases of lames are different but this post gives a general breakdown of some of the steps that may go into a lameness workup.

Review of Medical History

Your vet will ask you questions about your horse and gather any information they may feel is relevant to the current situation.

Visual Examination at Rest

By visually examining your horse at rest your vet can note its conformation, balance, weight-bearing and look for any signs of injury.

Examination in Motion

Your vet may wish to see your horse in motion. It may be required to be seen moving in a straight line, in circles, in hand or on the lunge. Occasionally your vet may also request to see your horse under saddle to get a more compete view of the presenting lameness.

Hands on Exam

Your vet will palpate your horse, checking joints, bones, muscles, tendons and ligaments for any signs of injury or abnormality.

Application of Hoof Testers

This piece of equipment allows your vet to apply pressure to areas of the foot to look for abnormal sensitivity or pain.

Flexion Tests

Your vet will hold a leg in a flexed position for a period of time before evaluating your horse in motion once more. Your horses’ response to flexion tests can help identify the cause of the lameness.

Nerve and Joint Blocks

Local anaesthetic can be injected into joints or around nerves to numb certain areas. Blocking is a very useful diagnostic technique for identifying the location of a lameness.

Imaging

Imaging is a further step towards identifying the cause of lameness. There are two main imaging techniques that can be brought to your horse, x-ray for bony structures and ultrasound for soft tissues. Other methods such as MRI, CT and scintigraphy are available but often require sending your horse to a hospital facility.

We offer state of the art digital x-rays which can be viewed instantly on a computer beside your horse and diagnostic ultrasound.

Diagnosing Lameness Read More »

Extracorporeal Shock Wave Therapy (ESWT)

Alternative Therapy, Lameness / David Turley

Extracorporeal Shock Wave Therapy (ESWT)

ESWT has been used for many years in human medicine to treat many orthopaedic conditions such as tennis elbow, shoulder and heel injuries etc and is now a commonly used and effective treatment in equine medicine.

Some of the conditions commonly treated using ESWT include:

Osteoarthritis
Wounds and Chronic Wound Care
Acupressure Points
Non-union or delayed-healing of Fractured Bones
Joints
Bone
Large Muscles
Tendon Injuries
Chronic Back Pain
Ligament Injuries
Painful Scar Tissue
Trigger Points
Connective Tissue
Cosmetic Applications

Specific equine pathologies that have successfully been treated with Shock Wave Therapy include:

Insertional desmopathies such as proximal suspensory ligament desmitis, suspensory branch desmitis, suspensory avulsion fractures, inferior check ligament desmitis, distal sesamoidean ligament desmitis, nuchal ligament, and other ligament injuries
Tendinopathies with & without calcification such as superficial & deep digital flexor tendon injuries, e.g. bowed tendons.
Metacarpal Stress Fractures & dorsal metacarpal disease such as bucked shins
Fractures & stress fractures of splints, coffin bone fractures
Tibial & humeral stress fractures, and Bone Exostosis
Angular Limb Deformities (ALD) in Foals
Sesamoiditis & Sesamoid fractures
Navicular Syndrome (Caudal heel pain)
Osteoarthritis such as pastern degenerative joint disease (DJD), Ringbone, and hock degenerative joint disease, Bone Spavin
Osteochondrosis lesions (OCD)
Soreness/Stiffness in muscles and gluts
Sore back problems such as dorsal spinal process, sacroiliac problems, and Kissing Spines

The shock waves are created, emitted and directed onto the injured area. When the shock waves meet different types of tissues with differing make ups (i.e. bone/soft tissue interface) changes within the tissue are created.

Biologic Effects:

Vasodilation and new vessel growth
Stem cell activation
Anti-inflammatory effects
Release of growth factors
Release of neurotransmitters

Clinical Effects:

Increases blood supply
Regenerates soft tissue
Regenerates bone
Reduces pain
Promotes faster healing

Essentially, shockwaves work by marshaling the natural healing response and can be applied safely and easily without the risk of any side effects.

The treatment can be useful in cases of chronic pain that have been unresponsive to conventional treatment and typically involves three treatments at two week intervals.

Extracorporeal Shock Wave Therapy (ESWT) Read More »

Acupuncture Case Study

Alternative Therapy / Francisco Tirado

ACUPUNCTURE CASE: MUSCLE RUPTURE AND NERVE DAMAGE

This 6 year-old polo pony was presented to us with a very severe left hind lameness. She was found not weight bearing and quite distressed in the stable. After our examination and supportive treatment it was decided to refer her to the Equine Referral Hospital at the RVC for further diagnosis as we suspected a possible fracture.

After a few days in the hospital and a complete diagnostic assessment including “Bone scan??? and ultrasound examination, a rupture of the vastus medialis muscle was identified. A period of rest and anti-inflammatories was advised for some weeks.

The prognosis was fairly good but after a few weeks the owner reported a significant muscle waste above the left stifle. This atrophy was getting worse and worse and the pony was still quite lame.

The client had already been using the services of a physiotherapist but the pony was still quite sore at walk. At that stage, I recommended acupuncture and I was very pleased when the client called me back to update me after the first session. She was already moving more comfortably but still not pain free.

We noticed that the pain was reducing but the muscle waste was not. The lack of muscle above the stifle was getting so severe that the joint was losing stability and becoming also a mechanical lameness. By this time, it was obvious there was a neurological involvement during the muscle rupture. This means that the nerve was also affected and without a healthy and functioning nerve, the muscle was going to keep wasting.

I decided that this polo pony really needed some extra help in the form of electro-acupuncture as horses with nerve damage and muscle waste are the best candidate for this technique.

As a member of the Shotter&Byers team I was very proud that the partners were supportive once again considering integrative therapies as an option for restoring and preventing injuries. They purchased an Electroacupuncture machine and therefore this polo pony became my first electroacupuncture patient.

After a couple of sessions, the owner started noticing that the muscle was recovering its volume and the biomechanics of the stifle joint was improving significantly.

Currently, we are just waiting for this young polo pony to start training gradually and she will hopefully be playing this 2017 season.

In conclusion, this is one of the examples of how Acupuncture can help restore your horse´s health.

Please feel free to contact the office on 01 306 627 706 if you would like to discuss or arrange an acupuncture treatment for your horse.

Fran Tirado BVSc MRCVS CertVetACU (IVAS)

Acupuncture Case Study Read More »