If you trust your vet, then it might be good to heed their recommendations for preventative joint therapy.
I just did a round of IRAP II/ACS (not “branded” IRAP but the same technology; I had it processed at the Marion Dupont Scott EMC at VA Tech and they call it ACS) in my older gelding’s front coffin joints, and am now moving on to pasterns. He shows mild to moderate OA changes in both joints in radiographs.
Here in central MD, I paid $800 for the initial processing of blood–this includes the blood draw, processing, and storage by my vet. The draw yielded 10 vials of serum, which I’ve been told is more than branded IRAP processing yields. My vet said she’s had as many as 12 returned from one blood draw. They’re technically only supposed to be stored for one year, but she said she’s used samples that were in storage for 18 months-2 years and had them work perfectly.
Cost of injection varies by the joint, but it’s the price of a traditional corticosteroid/HA injection minus the cost of the steroid and HA, since the serum is already paid for. For coffins, the injection plus farm call on two joints has been around $540 per visit, and a full vial goes into each joint. Pasterns are around $100 less I believe (haven’t gotten that bill yet, ha), and only use half a vial of serum (so you can split one between two joints). The normal protocol is to do 3 injections per joint, spaced two weeks apart, but my vet has been using IRAP long enough and seen enough patients respond that she’s comfortable varying the timing and potentially stopping after 2 injections. I will say that on coffins I saw some improvement after the second injection and none after the third. Observationally, joint health did noticeable improve over the course of treatment, as the quality of the joint fluid became markedly better (inflamed joints have thin, watery fluid in them, while healthy joints have thicker, “honey-like” joint fluid and “feel” bouncier when inserting the needle, as explained by my vet.)
I honestly have avoided fully adding it all up, but suffice to say, the price is multiple times that of traditional joint injections. However, in my case IRAP was a better option, as horse is older and shows signs of a past laminitic episode (with a prior owner) on radiographs.
The other plus is that the efficacy seems to last significantly longer. My vet said that though the clinical protocol is to re-check after 6 months, the vast majority of her clients have seen noticeable results for 12 months at minimum, and many for longer than that. The patient that had a shorter efficacy was not backed off of work as recommended (radiographs showed joint changes significant enough to justify stepping down a level, which apparently the owners weren’t willing to do). From my understanding, traditional joint injections would have worn off more quickly under these types of circumstances as well.
I will say, that after watching this process, I would seriously price out and consider Prostride as an alternative to IRAP, as the results should be similar, though only one injection per joint is required. I think the price would come out on top as long as only 1-2 joints need treatment.
