Page 313 - The Veterinary Care of the Horse

so reduce that on the tendon. This treatment has been associated with a subsequent

increase in injuries to the suspensory ligament which takes additional strain as a result.
VetBooks.ir SUBACUTE PHASE TREATMENT

• Controlled exercise with regular monitoring by ultrasound examination. Monitoring is

essential to ensure that further damage is not occurring and should be done before any
step up in the horse’s exercise regime.
• Physical therapies including low intensity laser therapy, therapeutic ultrasound,

electromagnetic field therapy and extracorporeal shock wave therapy are used. These

treatments will reduce the pain and soft tissue swelling but there is little evidence that the
end result is improved when compared with conservative treatment and controlled
exercise. Regenerative Laser Therapy (RLT) is now being offered at the Animal Health

Trust, Newmarket, UK for ligament and tendon injuries. This pulsed high intensity laser
therapy is reported to increase circulation and reduce pain, inflammation and scar tissue.

It stimulates cell proliferation and production of collagen fibres and elastin, promoting
the repair of ligament and tendon tissue with recovery of elasticity. Horses are treated

two or three times a week for approximately 8–10 weeks and patients are closely
monitored to document the effect of treatment.

• Hydrotherapy spas help with healing.
• Counter-irritation including blistering and pin firing is still used on occasions if other

treatments have not been successful. There is scant scientific evidence to support their
use, which is considered unethical by many individuals and professional authorities.

Regenerative medicine

Stem cell therapy: Stem cells have the potential to develop into a number of tissue types

including tendon and their implantation into the injured area promotes healing with less scar
tissue than would otherwise be the case. They can be derived from bone marrow extracted

from the horse’s sternum or pelvis and cultured in the laboratory before being injected back
into the core lesion under ultrasound guidance. This treatment is given within the first month
after the injury occurs and is followed by a period of box rest and a strict programme of

increasing controlled exercise.

Stem cells can also be derived from fat tissue taken from the near the tail head of the
injured horse. This procedure can be carried out in the stable yard and avoids the need to
culture cells.

Platelet Rich Plasma (PRP): A blood sample is collected from the horse and filtered or