In this episode of Daily Vet Life, Wendy Gaddis, DVM, cVC, cVMA, of Block and Bridle Veterinary Service, in Northern Colorado, described two cases where she used regenerative therapies such as interleukin-1 receptor antagonist protein (IRAP) and platelet-rich plasma (PRP) to help return horses to soundness.
Case 1: Annie the Working Cow Horse
Gaddis said she’s had a lot of success using IRAP in her practice, with “Annie” as one of her standout cases. Annie is a 13-year-old working cow horse mare that, prior to seeing Gaddis, had been diagnosed with navicular disease, recovered from a suspensory ligament injury, and received coffin joint injections with hyaluronic acid and steroids, which worked well for about three months. The mare presented to Gaddis after her trainer noted she felt “off” in both her front and hind end. An extensive lameness exam revealed Annie was 3 out of 5 lame on her right front, 2 out of 5 lame on her left front, and 2 out of 5 lame on her right hind.
In the episode, Gaddis described her diagnostic work-up and imaging findings in detail and why she chose to treat the mare with IRAP. Annie received IRAP injections in both coffin joints, the left tarsocrural joint, and the right medial femorotibial joint. A week later, Gaddis injected the right coffin joint a second time and then performed a follow-up exam two weeks after that. Upon examination, Annie’s baseline right front lameness had resolved completely.
“She looked great longeing both directions and on the straight,” said Gaddis. “All the flexions were great except for her right hip stifle flexion, so I injected the right stifle a second time, and I also did a chiropractic adjustment on her at that time. I just touched base with the trainer, and she’s been back in work for about three months now. She’s working great.”
Case 2: Huey the Barrel Racing and Rope Horse
Gaddis shared another lameness case involving a 12-year-old barrel racing and rope horse. “Huey” was 3 out of 5 lame on his left hind, and his left hip stifle flexed moderately positive. Radiographs and ultrasound showed few abnormalities, but given the horse’s degree of lameness, Gaddis felt like he must have had a soft tissue injury in his left stifle.
Gaddis recommended injecting the stifle joint with PRP, which she said she’s had good results with for tissue healing. Six weeks post PRP injection, however, Huey was still 2+ out of 5 lame. So, they began a series of three IRAP injections.
After the second round of injections, Gaddis said Huey’s flexions had improved and lameness had downgraded to a 2- out of 5. After the third injection, he had improved to a 1+ out of 5.
“We started him back with very light riding, three days a week,” she said. “I just rechecked him again on Jan. 8 and he looks great. The owners will continue with the exercise program, and we will recheck him again in March (prior to their shows) and likely put another dose of IRAP in that stifle.”
When to Use Orthobiologics
Gaddis described what goes into her decision-making when recommending regenerative therapies for horses, aside from client finances.
“A lot of it depends on their age,” she said. “I often will recommend IRAP injections on a young horse over steroids because I just don’t want to start that cycle where they need those injections. We’re going to start damaging their joint. If they’re older and they have quite a bit of arthritis, I honestly don’t feel like they respond quite as well to the regenerative therapies such as IRAP or PRP. If financially people can afford it, I try to encourage people to use IRAP for joint injections. It’s case by case, but I’ve had such great results with it.”
About Dr. Wendy Gaddis
Wendy Gaddis, DVM, cVC, cVMA, runs Block and Bridle Veterinary Service, one of northern Colorado’s top equine veterinary hospitals. She graduated with honors from the Colorado State University School of Veterinary Medicine and honed her equine lameness skills at Colorado Equine Clinic in Littleton. She founded Block and Bridle Veterinary Service in 2002 and became certified in animal chiropractic and veterinary medical acupuncture in 2017. When not caring for patients, she enjoys traveling and team roping.
Related Reading
- Orthobiologic Treatment for Horses
- Antimicrobial Effect of Platelet-Rich Plasma and Platelet-Rich Fibrin
- Managing Arthritis in Horses Using Autologous Blood Products
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