Page 314 - The Veterinary Care of the Horse

centrifuged to produce plasma with high levels of platelets. This is injected back into the

damaged area of tendon where growth factors are released, which promote tissue repair and
VetBooks.ir aid the healing process.

Both stem cells and PRP improve the rate and quality of repair and are used for the
treatment of a variety of tendon, ligament and joint injuries. These treatments are known as

autologous therapy as the cells and plasma are derived from the patient.

Gene therapy

Research first published in 2017 has shown promising results from injecting DNA directly

into the injured area of the superficial digital flexor tendon or suspensory ligament in the
period 2–3 months after injury. The genes within the DNA stimulate production of growth

factors, which in turn promote proliferation of blood vessels and fibroblasts, leading to
reduced healing time and faster return to work. Only two horses were used in this study so
further work must be done with a larger number of animals to ensure the safety and efficacy

of the treatment before it is available in practice.

REMODELLING PHASE
During this phase which can continue for 15–18 months following a severe injury, type III

collagen is slowly being converted to type I. The healing process should be closely
monitored by ultrasound examination. If at any stage there is an increase of more than 10%

in the cross-sectional area of the tendon, the exercise is cut back. At each stage it is hoped
that there will be an improvement in the tendon density and fibre pattern.

Exercise programme

This will be tailored to the individual horse. It will depend on:

• the severity of the initial injury
• the progress already made

• the temperament of the horse

• the facilities available

• the experience of the rider
• the state of the ground.

It is not possible to give guidelines to suit every horse. As a general guide, walking exercise
should be initiated as soon as possible in all but the most severe cases. Consult your own vet