The Horse

FEB 2019

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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Page 43 of 51

SPORTS MEDICINE STACEY OKE, DVM, MSC 44 February 2019 The Horse | P hysically demanding careers, such as those of competitive sport horses, are inherently accompanied by injuries, whether sustained in training, competition, or an unfortunate pasture mishap. In some cases those injuries can be quite serious, resulting in long layups, lost training days, failure to return to previous athletic function, high re-injury rates, and early retirement … not to men- tion the economic losses associated with each. Not that long ago, training- and performance-related injury treatment was restricted to a few tried-and-true tricks, predominantly controlled exercise, cold hosing, and anti-inflammatory drugs. "Over the course of the past decade or so, the field of rehabilitation has evolved dramatically and now encompasses an impressive array of modalities to help in- jured horses, including stem cell therapy," says Lisa Fortier, DVM, PhD, Dipl. ACVS, professor of equine surgery at Cornell University and Cornell Ruffian Equine Specialists, in Ithaca, New York. Indeed, rehabilitation is now its own specialty in veterinary medicine, with hundreds of veterinarians worldwide certified as American College of Veteri- nary Sports Medicine and Rehabilitation diplomates; more than 120 of these focus on horses. In this article we'll describe stem cell therapy and explain how veterinarians incorporate it into their rehabilitation arsenal. Specifically, we will look at what sport horse owners need to know about this therapy and when it might be useful. Understanding Rehabilitation: Where Do Stem Cells Fit? Rehabilitation is a remarkably vast and varied specialty. Examples of rehab modalities include: ■ Exercise Controlled walking, limb and core exercises, swimming, treadmill; ■ Thermal options Cool-water circulating devices, cryotherapy, cold-water hydro- therapy, heat application; ■ Acupuncture ; ■ Electrophysical techniques Extracor- poreal shock wave therapy, transcu- taneous nerve stimulation (TENS), neuromuscular electrical stimulation; ■ Mechanical soft-tissue techniques Mas- sage, stretching, chiropractic; and ■ Biological therapies . "It is this latter group of rehabilita- tion modalities, the biologic therapies, that encompasses stem cell therapy," says Fortier. "Grouped together with platelet-rich plasma (PRP) and interleu- kin-1 receptor antagonist protein, more commonly referred to simply as IRAP, biologic therapies are among the more novel therapies included in rehabilita- tion programs." Scientists have conducted stem cell re- search predominantly on Thoroughbreds, and veterinarians use the therapies in the racing industry. The sport horse industry, however, seems to be playing things more conservatively, say our sources, and has not yet fully embraced these biologic therapies, particularly stem cells. Take, for example, a recent survey of 305 equine sports medicine or rehabilita- tion veterinarians from the United States, Europe, and Canada. Their patients primarily competed in hunter/jumper, dressage, pleasure riding, Western riding, and eventing. The most common breeds used in those activities were Warmbloods, Thoroughbreds, and Quarter Horses. Stem Cell Therapy in Sport Horses Veterinarians sometimes incorporate stem cell therapy into injured sport horses' rehabilitation programs. COURTESY UC REGENTS/DON PREISLER How, when, and why to try stem cell therapy for common athletic injuries

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