This is the first of two parts on the array of treatment choices available to equine practitioners dealing with tendon and ligament injuries or joint problems in the horse. The next article will discuss why specific treatments are more likely to be chosen for specific injuries.
There are many treatment options available to equine practitioners dealing with injuries to tendons and ligaments and an equally large number of drugs, techniques and modalities that can be used to help manage joint problems in the athletic horse.
That is a benefit because somewhere in the potions and procedures is usually something that will bring at least some relief to each patient. On the other hand, the array of choices is a problem because clients and practi- tioners often are confused about which is best.
Photo 1: Endurance horses and other equine athletes are subject to repetitive compression injury and bone bruising at the joint surfaces. Treatments such as intra-articular injections, extracorporeal shock-wave therapy and IRAP can provide pain relief and improved healing. But scientists struggle with recommend- ations for the "best" therapy choice for each individual.
Clients hear about the various treatments, some only recently removed from experimental stages, or read about them on Web sites and question why their horse was treated with one drug and not another or given one procedure instead of something else.
Practitioners may find themselves debating as well — shock-wave therapy or Acell? Stem cells or platelet-rich plasma (PRS)? Tildren or IRAP? Even referral cases do not provide clarity. Equine veterinarians often find that very similar cases with the same diagnosis sent to different clinical centers or veterinary universities receive different treatments.
Photo 2: This is a thermographic scan of a horse with an injury to the inside of the right knee (the scan is taken from behind the horse). The white areas indicate more heat and inflammation, and the inside right knee shows much more heat than the similar area on the left. This horse suffered damage to the collateral knee ligaments of the inside right leg and is now a prime candidate for treatments that will accelerate ligament repair. But which treatment is best?
These instances leave DVMs and clients asking, "Why"?