Cooper Williams, VMD, DACVSMR, Cert. ISELP, owns Equine Sports Medicine of Maryland, serving horse owners in the Mid-Atlantic region. He focuses on diagnostics and sports medicine in equine athletes and is one of a small group of veterinarians in the world to be certified by the International Society of Equine Locomotor Pathology in advanced ultrasound imaging. We caught up with Williams to chat about what attendees can look forward to learning during his AAEP Convention Sunrise Session.
Williams was an early adopter of the 2.5% intra-articular polyacrylamide gel (iPAAG) ArthramidVet®, using it to manage joint lameness in horses since it received FDA approval in the United States. The gel acts as a “bio-scaffold” that bonds with injured tissue and strengthens the joint to provide support and better function of movement. As is often the case when new, relatively untried products hit the market, he initially reserved its use to severe cases in which nothing else was working—specifically, post-arthroscopy in racehorses with severe joint damage.
“They had significant degenerative changes and cartilage loss,” he explained, “but we were really pleasantly surprised by a number of those cases with these horses significantly improving and not seeing any problems as a result of using it. Then we were more confident in being able to use ArthramidVet® earlier in lots of different cases.”
As more research emerged revealing the benefits of this therapy, Williams could give clients science-based reasons to choose ArthramidVet®, particularly over steroids.
“Because I specialize in sports medicine and I’ve been doing this for a long time, my clients look to me for good advice, and they know that I tell someone what I tell them based on what I would do for my own animal,” he said.
But what truly guides Williams’ therapeutic recommendations for horses with joint lameness is diagnostic imaging. Because of his extensive background in ultrasound imaging, he has an intricate understanding of the cartilage and bone surfaces in equine joints—insights he will be sharing with Sunrise Session attendees.
“Ultrasound is the most accurate tool for bone surface detail,” Williams said. “Just like using sonar to map out the ocean floor, ultrasound gives you a direct view of what the bone surface looks like.”
It also allows him to be extremely accurate in determining the amount of fluid in a joint, the thickness, and any abnormalities in the joint capsule and synovial membrane.
Using ultrasound—in combination with radiographs or other imaging modalities—to visualize and evaluate the integrity of these joint structures “allows you to more fully elucidate diagnostically what’s going on in a given region, whatever joint it may be,” Williams explained. “That way, you can be more accurate about your treatment and what you may or may not be able to accomplish with that treatment. You can give the client information on the chronicity of what’s going on in that joint and give them a better idea of prognosis. It also allows you to get a really good baseline and use serial examinations to know how something evolves, devolves, or stays the same with a given case.”
When he’s teaching other veterinarians about advanced ultrasound imaging, Williams said he tries to hammer home the importance of using the diagnostic tool to its full capacity so you can get as much information as possible for yourself, your client, and the patient.
“You need an accurate, full diagnosis to be able to treat, rehab, manage, and give a prognosis,” he said.
Finally, Williams emphasized the importance of taking a multimodal approach to managing horses with joint diseases like synovitis, capsulitis, and osteoarthritis. In addition to injecting the joint space with ArthramidVet® hydrogel, this includes weight management, proper hoof care and nutrition, and the use of therapies such as underwater treadmills.
Don’t miss Dr. Williams’ presentation at 6:30 a.m. on Monday, Dec. 9.
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