My eventing horse had an ultrasound on Monday and has a subacute core lesion at the middle third of the LF tendon (aka bilateral tendonitis or core lesion on the superficial flexor tendon). I need to decide if I want to treat this injury with PRP or stem cell therapy - any advise? Since the scan I have spoken to 3 different vets and a few horsie friends and the consensus seems to be that stem cell therapy is not proven or doesn’t have much better results than PRP, plus it is much more expensive. The vet that scanned recommends stem cell therapy but my research so far pushes me towards doing PRP therapy. I owe it to my horse to do what is best for his recovery so for the moment lets ignore the price difference - does anyone have experience with this type of injury and what type of treatment was most successful? Thank you!!
IMHO, PRP is currently the gold standard if you intend to use an injectable therapy. The downside of PRP is that the horse needs to be on strict stall rest for 30-45 days, with minimal hand walking at first, increasing over time.
You can consider doing shockwave or therapeutic ultrasound in addition to the PRP as well.
My vet gave the analogy that PRP was like the framework of a house and stem cell was the filler. Not sure how helpful that is to the OP.
[QUOTE=joiedevie99;8119915]
IMHO, PRP is currently the gold standard if you intend to use an injectable therapy. The downside of PRP is that the horse needs to be on strict stall rest for 30-45 days, with minimal hand walking at first, increasing over time.
You can consider doing shockwave or therapeutic ultrasound in addition to the PRP as well.[/QUOTE]
At AAEP convention, at sessions on regenerative therapy this year, stem cells, were the consensus as the gold standard for soft tissue injuries. I have never heard longer than 5 days of strict stall rest after prp or stem cells. The OP would need to ask his or her vet about their protocol. Some preparations suspend the stem cells in prp. I think is the best of both worlds and isn’t more expensive.
That said, sdft’s have a long history of excellent healing without regenerative therapy, so I’m not convinced doing something is a must for all sdft lesions. If insurance is paying or money is not an issue, then by all means go for stem cells. Otherwise, prp is a good option too.
A controlled exercise program is the most important element of a good treatment plan for the sdft. I’d spend the money on two months of underwater treadmill before stems cells if this were my own horse.
Hi, thanks for the info. My horse has “severe tendon tears” so I am not sure if the stem cells are what is necessary for fibers to grow back or if PRP and rest is enough to make his legs healthy enough for galloping and jumping. I wanted to take him swimming but he wont go in the pool (looks too long to jump!!) so I plan to start with a treatment from the vet followed by a good rehab plan (maybe walking him in the sea in the future).
My story is also a bit complicated because last year the same horse cut his LF extensor tendon and although it healed very well, his pastern is very stiff - almost no flexibility when you pick up his hoof, so this is probably what ultimately created the last injury. This horse is too talented to give up hope but is PRP going to be enough to get him going again?
My horse sound like he had similar injury to yours. I did the PRP with him and a long slow rehab. If you want I could send you the rehab schedule my vet made for us. We’re now dealing with an annular ligament issue after he bolted on me but the tendon itself is 100%. After the PRP he went right back into his normal tack walk schedule so didn’t lose anything there. We had been back to jumping 3’ courses, starting our gallop sets again and he was quite happy maintaining a 6 day/week training schedule. So vets and specialists are a bit baffled by recent injury! But I think the PRP did a great job helping tendon heal and would recommend it for where it did get us.
Hi! I would be interested to see your rehab schedule - thank you 
And thanks for the info, I guess I wanted to hear that stem cell therapy is the way to go since in the end that is what my vet thinks is the way forward but other vets and owners with experience mostly say PRP is good or has the same results so I suppose I will stick to my gut feeling and try that method. If I were rich I would probably do both - start with stem cell help and then finish with the PRP - I just hope whatever I do that my horse will be ok in the end.
