The Horse

DEC 2017

The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.

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50 TheHorse.com THE HORSE December 2017 Additionally, "the underwater treadmill is amazing for scar tissue in the lower legs," she says, noting that she's seen it "really increase range of motion." Joints "If I diagnose … a joint issue, depending on what I find on diagnostic X ray and ultrasound, we'll usually be look- ing at some sort of intra-articular medica- tion: steroids, polysulfated glycosamino- glycan and amikacin, hyaluronic acid, IRAP (interleukin-1 receptor antagonist protein), stem cells, or PRP," says Denton of his typical joint injury protocol. "We'll possibly perform arthroscopic surgery (where the surgeon inserts an endoscope into the joint through a small incision to look for damage), depending on what we find, which we may also use as an explor- atory measure to see if there's something that can be repaired." He doesn't usually apply laser or shock wave to joints, but does use ultrasound therapy for lower joints. "I tend to go with intra-articular medications, range of mo- tion exercises, underwater treadmill, and anti-inflammatories," Denton says. Hoof capsule For injuries below the proximal (upper) suspensory ligament that runs down the back of the cannon bone, Schlachter says she often looks to the hoof capsule for the root issue. "The hoof needs to be balanced 365 degrees: from medial to lateral (side to side) and dorsal to plantar/palmar (from the hoof wall to the sole and rear of the foot)," she says. "If the shoeing cycle is inconsistent, there are weak spots and strong spots in the hoof capsule; these pressure points can result in unnecessary inflammation." Other causes of hoof capsule problems can include changing farriers and trying different types of shoes over a short pe- riod, she says. "Luckily, the hoof capsule is elastic in comparison to the rest of body, so if there is damage, the horse can be brought back pretty easily as long as there hasn't been an underlying injury." On occasion, the hoof just needs some R and R, says Schlachter. "Two to four weeks on the underwater treadmill for horses that just need a break is amazing," she says. "They feel so much better after doing a completely different decreased- weight-bearing exercise." Timelines to Soundness Restoring the horse to soundness looms at the top of every owner's mind when looking at rehabilitation, along with just how long that might take. While slow and steady wins the race, it doesn't mean you need to keep your horse stall-bound. "We know with tendon and ligament injuries that some motion (e.g., hand- walking) needs to start fairly early if possible," says Denton. "Once the inflam- mation is down, walking will load the limb and apply light tension/stretching on the injured tendon or ligament more than standing in a stall will." Schlachter describes the protocol she typically follows in these situations: "From the moment the injury has been diagnosed, the horse goes onto a con- trolled exercise program, based on clini- cal findings. If the horse is still walking lame, they are on stall rest. If walking sound, which includes tight turns, but trotting lame, they start out at about 10 minutes of walk twice a day. "This also my hallmark for differentiat- ing between moderate and severe inju- ries," she adds. "If the horse is 4 out of 5 lame at the walk at the time of the injury, even for just a day, there's a good chance that injury is a severe injury. "The level of work depends on what's injured and how severe it is," she says. How fast the horse can progress in his recovery also depends on what the veterinarian sees on re-examination. Schlachter, for instance, evaluates and ultrasounds horses at the six- to eight- week and 12- to 16-week marks before clearing them for the next phase (e.g., tack- walking, trotting, etc.) in their rehabilitation. Once past the initial hand-walking ALEXANDRA BECKSTETT/THE HORSE Veterinarians might perform regenerative therapies such as interleukin-1 receptor antagonist protein on joint injuries. SPORTS MEDICINE WITH LAMENESS DATA, THE RESULTS ARE Learn more at equinosis.com 1-855-4-LAMENESS (1855.452.6363) Follow us on Social Media How MUCH D I D T H E THERAPY help?

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