Equine Sports Medicine

Diagnosis & Treatment

Glenwood Veterinary Clinic offers the premier team of horse vets on the Western Slope of Colorado. Trail riding, barrel racing, roping, rodeo, racehorse, reining, dressage, hunter jumper, cutting, western pleasure, backyard, cow horse, endurance, eventing, cross country, polo, driving and drive teams, western dressage, gymkhana.

Our team of veterinarians have advanced training in sports medicine and stay active in the rapidly changing landscape of equine lameness and soundness. When you bring your horse to see us, whether it is for non weight bearing lameness or just a bit of back soreness, our team will work closely with you to identify your goals and reach an optimal performance without pain or discomfort.

When we talk about sports medicine, we try to break it down in terms of diagnostics and treatment, acknowledging that some forms for treatment may be diagnostic as well.

Step 1: Evaluation

Step 1: Evaluation

Sports Medicine Lameness/Soundness exam

One of our doctors will perform a passive evaluation to identify areas of heat, swelling, effusion (joint fluid), tendon or ligament thickening, myofascial or muscle pain, and range of motion. We will then likely watch the horse move at different gaits (walk, trot, canter or lope) and different directions to further characterize the horse’s soundness. Depending on the results of this, we perform flexion tests to identify areas of soreness. Then we move to diagnostics or treatment.

Step 2: Diagnostics

Step 2: Diagnostics

Diagnostic Nerve or Joint Blocks

One of the primary ways we communicate with horses in sports medicine is by numbing areas on the horse using a local anesthetic (carbocaine/mepivacaine, lidocaine/novocain) to see if it eliminates their pain or soreness. This allows our veterinarians to isolate the areas of interest to reach a diagnosis and avoid wasting money on unneccesary diagnostics.

Radiographs (X-Rays)

Our hospital is equipped with mobile digital radiography machines that allow us to quickly and accurately view bony structures within the horse. In some situations, soft tissue structures are visible but for the most part, radiographs are used to view bones. We charge x rays by the joint/region at ~$100 per joint/region. In addition there is an interpretation/storage fee as we keep all x rays in a cloud based storage system so we can electronically send them to our clients, trainers, farriers and referring veterinarians.

Ultrasound

We have multiple ultrasound units along with advanced training in ultrasonography. All of our units are mobile and we can perform ultrasonography or sonograms at the farm or at the clinic. This is our primary modality for identifying soft tissue injuries.

MRI-CT-Bone Scan (Nuclear Scintigraphy)

When we can’t identify the source of a lameness through blocks, x rays and ultrasound, it’s time for more sensitive imaging. We refer these to Colorado State University.

Step 3: Treatment

Step 3: Treatment

Non-steroidal Anti-inflammatory medications (Horse ibuprofen)

*Caution must be utilized for any of these medications as overuse can damage the stomach lining and lead to gastric ulcers as well as kidney and liver damage*

  • Phenylbutazone (Bute)
    💊tablets, powder, paste
    💉injectable
  • Flunixin meglumine (Banamine)
    💊paste
    💉injectable
    *NEVER GIVE BANAMINE IN THE MUSCLE*
  • Firocoxib (Equioxx)
    💊tablets, paste
    *easier on the stomach

Muscle Relaxers

  • Methocarbamol (Robaxin)
    💊tablets

Systemics

Used to help the horse’s whole body feel better, especially their joints

  • Pentosan Polysulfate
    💉Injectable in the muscle, monthly
  • Legend
    💉Injectable in the vein, as needed
  • Adequan i.m.
    💉Injectable in the muscle, 7 doses over 4 weeks

Alternative Therapies

  • Laser Therapy
  • Mesotherapy: Similar to acupuncture, we use small needles to inject fluid into the middle layer of skin on the horse’s back or neck, called the mesoderm. Originally invented in France in 1952 to treat humans, it is excellent for back or neck pain, kissing spines (overriding dorsal spinous processes ORDSP), back or neck arthritis, and sacroiliac (SI) pain or arthritis. Excellent when combined with chiropractic, shockwave and/or joint injections. Typically recommend 2 treatments the first month, then monthly thereafter.
  • Chiropractic
  • Acupuncture or Aquapuncture
  • Shockwave (Extracorporeal Shockwave Therapy ESWT): Shockwave therapy is a noninvasive, high-energy, sound wave treatment commonly used in human and veterinary medicine. It helps the body in relieving pain, speeding healing, and improving the quality of healing. Shock wave is a much higher energy treatment and can penetrate deeper areas than many other types of modalities. “Shock wave” is a physics term to describe a rapid increase in pressure, such as the energy from an explosion or thunder resulting from lightning. “Shock wave” does not refer to electrical shock. It is actually a high-energy SOUND wave treatment. Typically can be performed without sedation. Fantastic results for tendon/ligament injuries, arthritis, soreness, myofacial and muscle pain, and AWESOME for backs and necks.

Injections

  • Joint injections
  • Back injections
  • Neck injections
  • Ultrasound-guided tendon or ligament injections

Steroids

Avoid for overweight, metabolic, Cushing’s/Pituitary Pars Intermedia Dysfunction (PPID) horses, as too much steroid can lead to laminitis or founder.

The steroids that we use in joint injections are not what the body builders use. Big muscle man steroids are called anabolic (build up) steroids while we use catabolic (break down) steroids to rid joints of painful inflammation and pressure. Steroids are the most common option that we use in joint injections as they are often the most cost effective. They will typically give a robust response by curbing inflammation within the joint. Over time, there is concern that steroids will damage cartilage within the joints. We generally do not recommend injecting a joint with steroids more than once every 3-6 months.

Regenerative Medicine

We offer multiple types of regenerative medicine at GVC. Our current options are ProVet APC, IRAP (Interleukin-1 Receptor Antagonist Protein), ProStride, PRP (Platelet Rich Plasma) and Renovo. Each of these products has excellent benefits and generally operate similarly. In all products except Renovo, we pull your horse’s blood and extract anti-inflammatory proteins, growth factors and other pain relieving cells to reinject into joints.

ProVet APC $$

  • Can be injected same day
  • 1 kit will yield enough for 1-2 joints
  • Can be performed at the farm or hospital
  • Can be put in tendons, ligaments or joints

IRAP $

  • Needs to be processed overnight
  • 1 kit will yield enough for ~10 joint injections
  • Cost effective
  • Can be performed at the farm or hospital
  • Can be put in tendons, ligaments or joints

ProStride $$$

  • Can be injected same day
  • 1 kit will yield enough for 1 joint
  • Can be performed at the hospital only
  • Can be put in tendons, ligaments or joints

PRP $$

  • Can be injected same day
  • 1 kit will yield enough for 1-2 joints
  • Can be performed at the farm or hospital
  • Can be put in tendons, ligaments or joints

Renovo $$$

  • Can be injected same day
  • At farm or hospital

Joint Lubricants

Hyaluronic Acid

Polyacrylamide Gel

“Polyacrylamide hydrogel products, although often considered equal, have clear differences in composition, manufacturing quality and injection techniques as well as their ability to interact with surrounding tissues. These characteristics determine the safety and effectiveness of each hydrogel.

Upon injection into joints, Arthramid® Vet, a uniquely cross-linked 2.5% polyacrylamide hydrogel, adheres to the synovial lining through its ability to exchange water molecules. Over a period of 14 days the gel becomes integrated into the synovial lining and its immediate surrounding tissue of the inner capsule by a combination of cell migration and vessel ingrowth forming a thick, cushion-like membrane consisting of vessel integrated gel covered by a new and hypercellular synovial cell lining.

As a result, Arthramid® Vet has an augmentation effect on both the joint capsule and synovium. It increases the elasticity and tensile strength of the capsule, improving its capacity to transfer load. It is believed that this augmentation and cushioning causes a subsequent reduction in mechanoreceptor activation in the capsule itself. It also causes the formation of a new and hypercellular synovial cell lining, improving the quality of synovial fluid within the joint itself. These actions both help reduce synovitis and its successively deleterious effects.

Unlike other hydrogels Arthramid® Vet becomes fully integrated into the surrounding tissue (rather than encapsulated) and is therefore long lasting. Arthramid® Vet does not elicit a foreign body reaction or harbour infection. Arthramid® Vet is non-pyrogenic, neuro innocuous and contains no heavy metals.”

-Arthramid Vet