Shockwave therapy + PRP thoughts

[DressageHorses4Me]

Cowgirl: Thank you for what you said. So many people I know have said it’s silly and a waste of money to put $4,000 into a 16 year old horse that isn’t anything “special” as in not high level and I’m not a fierce competitor. And I get it. It isn’t the best use of funds … maybe. But I want to do right by my horse and give him the best chance to stay comfortable for as long as possible. So thank you for telling me your story. As for the maintenance, I asked the vet about that. He said that while we won’t know for sure, the shockwave and PRP should be a one time thing and it shouldn’t need to be done again. I know there’s another sports medicine specialist a few hours from me but that will probably run me another thousand dollars. I’m not sure if I should do it or use that money toward treatment. The MRI, no pun intended, is pretty black and white. The only opinion would be maybe treatment ideas and outcomes?

Kareen: I’ll look into induction/magnawave. I have not heard of it! Thanks!

[Scribbler]

I’ve seen several horses with arthritis improve in pasture life, meaning real pasture with grass to eat and enough room to move around, and several buddies to encourage that movement, not just a boring dry lot or a small field alone. Your horse is absolutely sound enough for that, from what you say.

I think that a horse needs to be pain free in order to be trained effectively. But a horse can be a little stiff, and be perfectly fine at pasture. They will do what they feel capable of doing, and work out a little of the stiffness just by cantering around in a group.

I don’t think there is anything you can do that will make this horse hold up to three or four more years of intensive training. But if he is not showing any pain now except when asked to work in tight circles, then he will be just fine at pasture, or on light riding.

[Kareen]

Here in Europe the units available are called Rehatron, Equitron or Theracell. There might be more to them but those are the ones I’ve come across during my research before I bought the unit for my practice. The lovely thing is that it works on a cellular level and helps restore the normal electric potential between the inside and outside of the cell which is needed for any cell to function properly. That also explains why it has an effect on inflammatory issues as well as neoplastic conditions such as equine sarcoids. I’ve even tried it on a few of my human family members (e.g. my mom has suffered with an allergic skin problem on her hands that made her life miserable and was barely controllable with the usual dermatologist approaches and desensitizing. After three sessions her problems disappeared and have since not turned up again so far (now about 13 months post treatment) which was surprising because I frankly didn’t have any hope in hell it would help.
Best of luck! If you have trouble to find a therapist or vet using the system I have a client who is using magnawave so she could probably help you find somewhere to ask.

[Scribbler]

Interestingly, this is another treatment where the efficacy is less established than I assumed. Often looking on the human medical pages for information can be enlightening. There is some evidence for shock wave treatment, but it is by no means a guaranteed cure-all. It appears to work by further stressing injured tendons, stimulating them to heal. Rather the same concept (thought a very different technique) as the old “pin firing” that you still see on some Standardbreds.

https://runnersconnect.net/running-injury-prevention/is-shockwave-therapy-an-effective-treatment-option-for-chronic-running-injuries/

[Pipkin]

If he’s worse on a hard surface that usually points to feet.

From what I have seen (and this is just personal experience) many don’t come back well from stall rest. They mess around hand walking etc and reinjure, after months of meticulous limited movement! The most miraculous recovery I’ve personally witnessed was a horse turned away in a huge field for 12 months. It was a make or break scenario I guess, but he is now fully sound and that was not his prognosis at all. Having a horse on box rest is so miserable I would probably only do it again if prognosis was a full recovery. If I was in the situation you are in I would retire this horse to pasture for as long as he is comfortable and you can comfortably afford it (maybe keep him on a low dose of bute).

My horse vet uses PRP and shockwave but my human vet (ha!), whose income is not affected by what procedures people undergo, is sniffy about its efficacy. Make of that what you will.

[DressageHorses4Me]

Scribber: I have to feel like what you’re saying is right. I agree, I don’t think anything will make him hold up against tough competitive dressage training, every day for the next few years. But maybe just staying at first level and enjoying time together? I think he’s very sound to be turned out and I worry that would be a waste since he still goes sound … just not in a flexion test on pavement. Also, very interesting article! It is questionable on shockwave treatment. Big thing I look at is that it might cause good but doesn’t really have much of a downside or risk I guess.

Kareen: Thanks for the further info! I’ll have to ask around - would love any references you could give from that is using the magnawave. See if there is anyone in my area.

It sure is tough … stall rest vs. pasture turn out. Everyone has their own ideas and opinions. I can’t quite make my mind up. It does just seem so mentally damaging to do to a horse. My horse has handled a week of stall rest okay however I come out every day and hand walk him in the arena for 20 minutes, then hand graze him, and let him have some good rolls in the dirt. I know he’d rather have a job. He looks at me quite confused as to what we’re doing and tries to get me to play with him and chase him. I’ve come up with a small turn out area where he can go during the day to at least be outside. Not as big as the field he’s used to but he isn’t much of a running, bucking, etc. horse in the first place. I think we’ll try that and see how he feels about it. I’m really having a hard time with stall rest, as great as it might be for repairing old damage. I’m just not sure if I want to spend the money on the shockwave and PRP if I’m not also going to do the stall rest. As I said before, I think my mind flips sides on this nearly once a day!

[Highflyer]

I know you don’t want to do another full workup, but maybe have another vet look over the results you already have?

[DressageHorses4Me]

Highflyer: Kind of what I’m thinking too. Just to be sure. Never hurts to get a second opinion. Hopefully another vet would be willing to give an opinion without having to do another full work up.

Spoke with vet again today. He said probably best for horse not to return to dressage. Horse needs a 6 month rest period with small (40x40) turnout allowed. We can reevaluate in 6 months. If no treatment, best if retired. Switch shoes to a wide web shoe to add more stability through quarters, good breakover, and heel support. Guess we’ll do rest, change shoes, and small turnout for 6 months and see where we are. If improvement, then maybe treatment or injections. He said Osphos wouldn’t do much to benefit this case since this isn’t navicular in nature.

[Cowgirl]

Well there is an in-between between stall rest and pasture. Mine was discharged from the hospital to a rehab facility. She was on stall rest for six weeks, while she received her PRP sequence and healed enough to remove stitches and bandages. After that time, they put her in a stall sized paddock for turnout. Gradually, over the months, they added panels to her turnout to increase the size. She went out every single day, after 6 weeks post surgery. She also received hand walking, then hand walking over cavalletti, and treadmill walking. By 9 months post surgery, she was on the treadmill for a half hour, plus 20 minutes handwork, with cavalletti some days, and carrot stretches, laser and PEMF, and theraplate. She is now 13.5 months post surgery and we are doing all the grand prix exercises and I plan to show her at the grand prix level of dressage in May…

The rehab facility was a very important component to her recovery. It was less expensive than a training barn and they gave her more attention. Additionally, she kept her wits about her because she had turnout every single day. I started riding her at the walk about 6 months post surgery and–I was 8 months post surgery myself–and she never spooked once.

I am so happy that I did this. She will live a long healthy life. I do have to say, that if I had just turned her out–she never would have come 100% sound and pain free because the chip needed to be removed and she needed some assistance getting the inflammatory process reversed (i.e. IRAP, Osphos, adequate, etc.)…

[SonnysMom]

I had a QH that had a hind suspensory with alvulsion from the bone. Initially treated with stall rest and very limited small paddock turn-out. That vet did not like full stall rest for suspensory injuries. He thought they came back too tight and that would cause recovery problems. He is considered one of the best local lameness vets. No improvement.
Went to a different practice. PRP and then shockwave therapy. Stall rest, hand walking, tack walking, he was getting better than he wasn’t. I eventually had to retire him.

[Cowgirl]

[QUOTE=SonnysMom;9013638]
I had a QH that had a hind suspensory with alvulsion from the bone. Initially treated with stall rest and very limited small paddock turn-out. That vet did not like full stall rest for suspensory injuries. He thought they came back too tight and that would cause recovery problems. He is considered one of the best local lameness vets. No improvement.
Went to a different practice. PRP and then shockwave therapy. Stall rest, hand walking, tack walking, he was getting better than he wasn’t. I eventually had to retire him.[/QUOTE]

With any of these treatments, there is always the chance that they won’t work or that the horse will not return to soundness. When I did the surgery on my horse the chance of full return to soundness (based on research at CSU) was 80%, and I thought that was pretty good.

[SonnysMom]

Cowgirl- I understood the risk of it not working. I am just stating my experience with those therapies and my horse.
If I didn’t think it had a good chance of working I wouldn’t have done it. On teh flip side I did understand that it was not a 100% guarantee that it would work. Sonny did not have insurance coverage so it was all out of pocket. I did a ton a research before I had the procedures done.