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Sports Medicine Evaluations

Lameness examinations are performed by Dr. Philip van Harreveld, Dr. Emilie Beaupre, and Dr. Elsa Ludwig, in the field and in the hospital.  Our thorough evaluations consist of physical examination, gait analysis in-hand and/or under saddle, flexion tests, diagnostic nerve and joint blocks, and diagnostic imaging.  Advances in equine diagnostic imaging permit us to obtain excellent quality digital radiographs and ultrasound images in the hospital and on the farm, allowing for immediate interpretation and treatment recommendations.  Please see the following list of lameness diagnostics and therapies offered at VLAC – Equine Hospital, and feel free to contact Dr. van Harreveld, Dr.Ludwig, or Dr. Beaupre for sports medicine consultations and referrals.


Digital Radiography

We have two digital x-ray units at our disposal for quickly obtaining high quality x-rays in-house and on the farm.  These powerful units have the capability of imaging most areas of the horse, including the distal limb, elbow/shoulder, stifle, head, neck, back and pelvis.  Images are immediately visible and can be manipulated, magnified, and measured for accurate diagnosis.  X-rays can also be emailed to you or your regular veterinarian in digital format following the examination.


Digital Ultrasonography

Our portable ultrasound units provide incredibly detailed images of soft tissues, bone surfaces and joints of the horse.  Ultrasound allows us to evaluate tendon and ligament injuries, which aids in determining treatment options as well as prognosis.  It is also a very valuable tool in monitoring the progress of healing during treatment and rehabilitation.  Ultrasound images can also be emailed to you or your regular veterinarian in digital format following the examination.


Extracorporeal Shockwave Therapy (ESWT)

EWST is a relatively new method of treatment for various lameness conditions in horses.  Shockwave therapy has been used in humans for over 20 years in the treatment of kidney stones and orthopedic diseases such as stress fractures, tennis elbow, plantar fasciitis (heel pain), and non-union fractures.  Shockwaves are high-energy sound waves, which are transmitted to the affected body part. There, they enhance healing by triggering natural repair mechanisms. Shockwaves have been shown to stimulate bone formation and healing of tendons and ligaments, and to produce marked analgesia (pain relief).  Shockwave is useful for a number of conditions causing lameness in the horse: suspensory ligament disease, bowed tendons, ringbone, bone spavin, splints, sore backs, navicular syndrome, and delayed or non-healing fractures. This treatment can be performed both in the hospital and in the field.


IRAP

IRAP stands for Interleukin-1 Receptor Antagonist Protein, and is also known as Autologous Conditioned Serum (ACS).  Joint inflammation, such as arthritis, leads to increased pro-inflammatory cytokines like Interleukin 1 (IL-1) which cause further damage to the cartilage and joint surfaces.  IRAP blocks the action of IL-1 and can cause significant reduction in joint pain and inflammation.  IRAP is produced from your horse’s own blood after it is drawn sterilely from the jugular vein and incubated for 24 hours.  The blood is then processed to concentrate the IRAP and separated into several doses.  These doses can then be frozen and injected into your horse’s arthritic joint every 1-4 weeks.


Platelet-Rich Plasma (PRP)

PRP uses your horse’s own blood to produce concentrated growth factors to improve the healing of soft tissue injuries causing lameness.  Blood is collected sterilely from the jugular vein in the hospital or on the farm, is processed in the hospital, and is injected back into your horse at the site of injury.  The special processing concentrates plasma and platelets, activating them to deliver high levels of growth factors.  These growth factors stimulate healthy inflammatory cells to remove damaged tissue, and induce production of new blood vessels and connective tissue.  Tendon and ligament injuries have been shown to heal with higher quality tissue using PRP.  From blood collection to re-injection, this can be performed for your horse all on the same day.


Rehabilitation Plans

At VLAC – Equine Hospital, we work together with horse owner, trainer, and barn manager to determine the best options for lameness treatment as well as rest and rehabilitation.  Some lameness conditions do not require specific rest periods or rehabilitation, but others benefit from time off from training and/or specific physical therapy and exercises.  We will make customized recommendations to provide your horse with the best healing environment, in order to get you back in the saddle as quickly as possible.


Systemic and Intra-articular Therapies

Other therapies that may be used to improve your horse’s joint health and comfort include oral joint supplements (containing glucosamine, chondroitin sulfate, hyaluronic acid, MSM), systemic joint therapies (such as Legend [hyaluronic acid], Pentosan polysulfate and Adequan [polysulfated glycosaminoglycan]), and intra-articular therapies (corticosteroids, hyaluronic acid).  These treatments may be administered on the farm or in the hospital.