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Mesotherapy? Has anyone used this? PRP, IRAP, Shockwave?

Horse Care
#1

As the title says. If anyone has used it, what did you use it for and what was the outcome?

I’m also interested in those who’ve used other non-chemical therapies such as PRP, IRAP, shockwave, cold laser, and whatever else is out there. I’d like to know what the dx was, and the outcome.

I am having the devil’s time trying to alleviate, fix, strengthen (call it what you want at this point) my mares stifle issues, and higher up (lumbar, possible SI and/or hip). It seems like I make progress in one area only to regress in another.

Also any shoeing protocols that have worked for you.

Anything… need to hear some ideas.

Thanks!

#2

Mine rehabbed in 2015 from an SI soft tissue injury. This summer, he basically fell apart again. We’ve been doing a lot of straightening work with him (dressage lessons) to help him carry himself better, as he was very crooked before and right after rehab. That helped a lot, but finally caught up to him again this year.

I did need to inject several areas, and do a mini rehab again, but at the end of September I got an osteopath in. She did a gait assessment (just short walk and trot on hard ground), then a full-body treatment. She did concentrate a lot on his hind end as most of his issues are from there.

He had one day off, then I rode him lightly and he felt worse. I was told to put him on a walk-only protocol for another 4 days, then add canter (no trot - for his particular issue), then add trot back. I figure he was probably quite sore, like getting a deep tissue massage.

But…after those days of walking, he felt great! Much straighter, pushing more evenly, and a noticeable difference in steering, because he was straighter behind.

I’m having her back for another appt in a week or so, then likely touch-up appts once/twice a year. She comes over from France and gets booked solid while she’s here.

I’m skeptical about some of these things but there was very clearly a difference, and this is from a long-standing issue. I feel it was the last little piece he needed to get as good as he’s going to get.

#3

15-ish years ago, we did meso semi-regularly on a few horses. More of a “can’t hurt, might help a bit” kind of thing. I never saw or noticed a significant difference myself. Plus it was hard to watch, and I’m not squeamish about needles either. However, I haven’t had any experience recently. Would be curious to talk to current sport horse vets to see if they’re still doing it regularly.

#4

I tried it. Thought my horse threw his back out as he suddenly started bucking and kicking out in canter transitions. It helped, somewhat, but in hindsight I regret I didn’t call in a specialist vet who could assess and determine if a proper SI injection would have been a better solution. The vet that recommended (and did the meso) could not do an ultrasound guided injection.

Fast forward 3 or so years, I finally had the SI injection. It pains me to say that I didn’t realize the amount of pain my guy was in until that was fixed. I wish I had done that - ultrasound guided SI injection - instead of the mesotherapy. His toppling changed, muscle came in where it was wasn’t possible previously (even though he is in less work now). Step is better, he is more comfortable and just looks better overall.

So, learn from my mistake. If they are recommending meso, ask why and confirm that ultrasound guided SI isn’t actually the better solution. I wish I had.

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#5

I tried it for a case of back soreness that we couldn’t get to the bottom of (lots of variables, horse unwilling to do his PT exercises). I opted not to use steroid in the injections. Unfortunately, it had only very short lived effect on the back muscles. But I did like the results for his neck. I am currently dealing with a very sore neck likely due to a foot lameness we can’t seem to figure out, and I would not rule it out as something to try again for the neck if we can’t manage that part with the usual acupuncture (which is much more pleasant for the horse) while we try to resolve the lameness. Horse already has neck problems, so this isn’t helping. But the vets are inclined to maybe try a course of systemic steroids first. We’ll see.

#6

I like meso, but don’t think it’s terribly useful as a stand-alone treatment. In conjunction with an SI or back or hock injection, to help ease muscle soreness caused by the primary issue, sure. I’ve mostly used it when I was dealing with an underlying issue that had caused muscle soreness, and for one reason or another we didn’t want to give the horse prolonged rest - like when the main issue requires work to fix such as weak stifles.

#7

Thanks for that. Nobody has recommended or even brought up mesotherapy yet, it was something I stumbled across and I was curious. There is a sporthorse vet local to me who does list it on his website, but that’s all I know.
I am leaning towards SI as my next culprit, altho at this point I am not sure which way is best to waste money. (Yes, I know…best/waste…LOL)

@joiedevie99 - as you say, my main issue needs work not stall rest.

What about PRP, IRAP, Shockwave?

#8

Mesotherapy is a very common treatment for backsoreness… but fixing what is causing the backsoreness would help first. I don’t see it often used for stifle injuries. I do see it used often for a horse who has a sore back caused by KS, hard work, or compensation.

I would pick meso any day over PRP/IRAP/shockwave if you’re dealing with backsoreness from a back issue… but if the back soreness is caused by something else, it may not be worth your while until you treat whatever the root cause is.

I’ve used meso a few times on my own personal horses and held plenty for the vet for it. It does look a little barbaric – but I’ve seen very good results and not seen any poor ones. With any injections there are risks, but I would be comfortable using meso for almost any horse of mine that needed it. Around here it’s not uncommon for a lot of eventers to be a bit sore coming off of the end of their season - the ground gets really hard around the summer and eventing is hard work. Lots of eventers opt to use meso late summer/fall to keep their horses in top shape and comfortable.

I used meso in conjunction with an SI injection (which is way more gristly to watch, IMHO) for a horse who had chronic back pain from a saddle that “fit” but wasn’t comfortable for him for whatever reason. I only needed to inject him once - and went with a saddle that didn’t fit on paper. He was a completely different horse post injections, and it really made a difference.

I also use meso once a year with one of my horses with mild kissing spine to stay ahead of “posturally induced body pain” as my vet calls it. It makes him far more comfortable – and as another poster noted, it also had some positive benefits on the horse’s neck - he has CA as well, so that was always interesting to me. I combine it with 2 months of robaxin. For him it is a “standalone” treatment because his discomfort is caused by kissing spine.

But back to the back pain – back pain is usually a symptom of something else rather than the back (unless KS is involved). I don’t know too much about your situation so discard anything below that you’ve already tried, sorry to hear you are going through this – here are some things that maybe might help, since you mention it is a stifle issue…

  • is she on full turnout?
  • have you tried estrone + work (hill work or pole regime)?
  • how were the stifles DDX’d - block flexion xrays?
  • is she wearing hind shoes?
  • how do her feet look?

Chronic stifles in my experience tend to either be an injury to the stifle (such as a meniscus or collateral tear) or, sometimes and very surprisingly, it’s cervical arthritis – especially if the lameness is inconsistent. Really bad angles behind can also cause stifle issues, and bringing the toe back and correcting the heel can make a horse with chronic stifle issues much more comfortable…

My personal horses if their back is sore, I check feet first. Then everything else.

Got any videos and pics of her feet?

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#9

Before recommending any pharmaceutical treatments, you need to describe what you are doing to actually develop and strengthen your horse’s muscles. Is there hill work? Trails? Proper dressage? How long is the horse ridden at each ride? Too many rides a week that prevent the inflammation/healing cycle to actually work? What type of footing/arena?

There is no point in telling you something without appropriate input as to the horse’s routine in order to actually compare apples to apples instead of a Pessoa saddle to a ford truck.

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#10

Thank you Beowulf. She’s on as much turnout as weather will allow, was 24/7. I have used estrone twice. Last summer I felt it worked ‘well enough’ but this year it seemed like everything crashed at once and because of that I think we missed out on any benefit it might have provided.
PT - YES, we do poles (lots) and hills and backing and I ride regularly always with an eye towards developing her correctly.
Films - I have filmed every bone in this mare’s body I think… When I did the PPE 2 years ago, I got as much of the spine as it could pick up, and I later did stifles and neck. EVERYTHING is clear!
BUT - her lumbar spine, has a slight roach, and from what we see on film is fused. She does have normal range of motion.

Feet. This is my conundrum. Her hind feet have negative plantar angles. My farrier and I have spent the last year working to correct this. In June I had new films taken showing her angles are now “textbook perfect”. We have finally got a heel on her, and the bullnosing is gradually diminishing. BUT… but… but… In fixing this did I aggravate something higher up?

Stifles - she drags her left hind, badly. To the point that when she was barefoot you didn’t even need to trim the toe; this improved with therapeutic shoeing. But it’s the right hind that will buckle out from under you (she has nearly fallen with me just the other day).
What I see (for example) when I’m lunging is that she’ll go around looking good for a bit then it’s like the hind just can’t do it anymore, and she starts dragging. Like it tires out too quickly. It shouldn’t. She’s fitter than that.
Based on my own person experiences with athletics, injuries, and rehab, my money is on a soft tissue injury somewhere that is old, but exercise flares it up - especially as you develop the horse and ask for more, you hit that spot where going forward is not possible.
I honestly don’t know if that’s true in her case, I would have to do a ton more diagnostics to call that.

This past spring/summer, her behavior devolved to the point that in August I took her to the vet and said - find the pain. This is not the horse I bought. Tested for EPM (negative), put her on Robaxin and ulcer treatment, injected the lumbar spine (where she was palpating sore), AND bought a new saddle (had fitter out, tried a zillion, settled on the one we both loved, in fact she actually sighs with it on, and this is a mare who holds her breath).
Then, shoer was out and since we’ve done so well correcting her angles we decided to put her in normal shoes and see if she holds them. Now I’m back to worse than before (not the angles, the other stuff) Why? Is she suddenly sore in her hind feet? From what?
I don’t have any good thoughts on that one, but I texted my farrier (who will be out next week) and told him I want to put her back into the therapeutic shoeing and see if this goes away. It will be very interesting to find out.
OTOH it really bothers me because last year she didn’t have any shoes behind and her angles were what they were (that farrier has been fired) and I rode her all over the place with nary a worry. Yes, she’d drop out behind occasionally but not anything that really worried me. But, she wasn’t in the same place work-wise as she is now. We now have another year of education under our belt. Which means I’m asking more. Which shouldn’t be a big deal as everything I’ve done has been slow, gradual, and thoughtful.

So I don’t know.

#11

Despite some soreness in the lumbar, your story does not really make me want to lean to giving mesotherapy a try. I would be looking harder for a hind limb problem, maybe a pelvis/SI problem.

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#12

Have you tested for PSSM? Your horse sounds a lot like my horse that had a shifting hind end lameness. Xrays, ultrasound, MRI and blocks from foot to stifle were all negative. He was labeled “undiagnosable” I decided on my own to do a 5 panel test and he came back N/P1 for type 1 PSSM. Diet and exercise have resolved his issues although he has bad days with the cooler weather.

#13

I used IRAP for a mare who had inflammation in stifle and was (suddenly) lame in that hind. I think it worked pretty well, due to lameness, gave her roughly a month of down time, then put her gradually back to work - 4th level. Uncertain about long term as about 6 months later she did something to her withers (flipped or got cast, never knew) causing enormous heat and pain. Took a long time to heal and in the middle she displaced the large colon, requiring surgery. After all that the stifle was still good, but 3 months out of commission and very slow back to work makes it hard to say.

I did have an old (20’s) TB that was diagnosed w/ cervical arthritis. It impacted his stifle causing one hind to drop out or buckle or whatever. Only under saddle until the arthritis got much worse, then also in the round pen.

Last story - current horse, older upper level Lusitano, was uncomfortable in hind end. less willing to sit. Injected hocks, that helped some, stifles were not the problem either. On a whim (as a non-believer) I had an accupuncture vet come and work on him. She calls it “restricted in hindquarter muscles” and OMG it has made a huge difference. And this vet throws in a few chiro adjustments in the same package.

#14

Maybe this (commercial) article could help:

https://www.platinumperformance.com/…s/connectivity

#15

Thanks Bluey. Interesting.

#16

I have used Mesotherapy for back soreness caused by suspected kissing spines. HOWEVER. This horse has a history of hind end lameness which we actively work on. Prior to my owning him, he sustained severe damage to both hind suspensory ligaments (huge holes at the origin), which he had surgery and PRP for during my ownership. His hocks are close to fusing and they get injected every 6 months. His SI is visibly unlevel, showing there was likely a previous injury there as well, so that gets treated as needed. He also gets stifle injections, but I actually don’t think there is an injury to the stifles - I think that the rest of his compromised hind limbs make his stifles sore.

This is an ex-steeplechase horse who ran quite a bit and who I have done up to Third Level dressage with. He is 16 now and we treat him symptomatically as needed. He has had all of the diagnostics including a full body bone scan, so we are very secure that we know what we are dealing with and treating.

Mesotherapy makes a difference for him, but honestly, when his hind legs are “quiet” and not painful, his back is not painful.

I’d do a workup with a very good sports medicine vet to find out what the actual problem is rather than treating everything and guessing. It’ll save you money in the long run.

#17

My mare received mesotherapy and shockwave when she was initially diagnosed with kissing spine. She tolerated the actual meso procedure very poorly, and then had a bit of an unusual reaction to it a few days later, so we we agreed to never do that again. Shockwave, on the other hand, was very effective pain management for her. She tolerated shockwave so well that we even did it unsedated once.

She also received shockwave for a suspensory injury, and that healed perfectly.

#18

I AM working with good lameness vets and we are not “treating everything and guessing”. There is more than one thing at play and it is not easy pinning it down.

Medicine is not an exact science. Bodies are very good at compensation, and when you fix one thing you cause a chain reaction that may or may not result in an unexpected or unintended consequence.

Beyond that my original question was simply if anyone had used meso before… I’d never heard of it and vets had not mentioned it and I was curious.

#19

We’ve used to in combination with shockwave to help relieve some kissing spine pain (though I found out later a lot of my horses’ back issues were from sore front feet). My vet/chiro basically told me meso is great to help break the cycle of pain. So you fix the underlying issue and then use meso to sort of reset the nerves. Without fixing/treating what’s causing it, the meso isn’t going to do a whole lot (or at least last very long).

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#20

Good lord, defensive much??? You didn’t state anywhere that you were working with a good lameness vet- you just said YOU were thinking of looking into the SI next, presumably as your vet had already r/o certain things. Everyone thinks their normal vet is a good lameness vet and based on my experience as an equine claims adjuster, that is just not the case.

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