Page 59 - Barrel Stallion Register 2017

anesthesia and routine surgery. This method has helped us diagnose a certain subset of the stifle problems and, in the future, will help us diagnose these sorts of meniscal injuries earlier,” he says.
“When we looked at the horses comparing surgery with surgery plus stem cells, we knew that the earlier we diagnosed the lesions, the better chance of treating it successfully and getting full return to performance. Ultimately, if we can diagnose them earlier, our treatment outcomes hopefully will improve,” he says.
Gradual ProGress
“Now we are starting to scope those stifles earlier so we can intervene and realize we need to do something more aggressively with some of them.” There are more options today than we had 8 or 10 years ago.
“We are holding classes here at CSU to teach veterinarians. Since developing the stand- ing technique, every year I teach a diagnostic stifle course. It combines imaging (mainly ultrasound), along with standing arthroscopy. The offering of a course that focuses on just one joint is unique. We offer an arthroscopy course, too, that is separate and focuses on this. We have another 4-day course that is more encompassing; it goes all the way from normal anatomy through diagnosis and treatment. That 4-day course deals only with suspensory ligaments and stifles, which is definitely aimed at people who are treating western performance horses,” he says.
Hock injuries are probably more common than stifle injuries in western horses, but are pretty easy to deal with when compared to the suspensories and stifle. “These injuries
are more challenging to locate the source of pain for proper diagnosis, and certainly the treatment options are not as well worked out,” he explains.
“There are not a lot of new techniques out there, but our comfort level in using the ones we have available has increased. We are more confident that we are on the right track, as time goes along. Some of these methods are starting to stand the test of time. The papers we have published are another step toward credibility—in a peer- reviewed journal,” says Frisbie.
“We are now pretty comfortable with our ability to make diagnoses and return those horses to work if we treat them. We are also more comfortable about getting more MRIs of the stifle joint.”
MrI and other dIaGnosIcs
Diagnostic capabilities have improved. “Twenty years ago, people didn’t even block stifles to try to pinpoint the source of lameness, and they rarely treated stifles. Now it is routine to block the stifle joint during the process of arriving at a diagnosis, and most people will
be treating them. Coming up with a defini- tive diagnosis for why they are treating them
is still a bit of a grey zone, but that’s how all of medicine progresses,” says Frisbie.
“The first thing is realizing there’s a prob- lem, and the next step is coming up with a way to fix it. We go through a process of defining exactly what the problem is and then engineer- ing specific treatments for those diagnoses once we have them. Today we are in the final stages of being able to do that with stifles. We are definitely progressing.”
There are several options for diagnosis. Today there are a few open-field magnets that can be used for doing MRI on stifles. “They are low-field magnets, about .3 Tesla, which isn’t very good. The state of the
art right now is either a 1.5 or a 3.0 Tesla magnet. So, the low field magnets are 10 times less than what we optimally want. Sometimes it’s better than nothing, but the resolution is so poor that I don’t know if it’s worth laying a horse down under gen- eral anesthesia, when you can do a stand- ing scope and look around in the joint,” says Frisbie.
“One of our residents, Brad Nelson, presented a paper at ACVS discussing a study where we took a group of horses and imaged them via different techniques. They had clini- cal exams, were ultrasounded, some of them had MRIs, and many of them had contrast CTs. We’ve been doing some contrast CT scans because they are a lot cheaper than MRIs and we are getting some pretty good answers from that. But again, you have to use general anes- thesia and there are only a few facilities that can do this,” he says.
louie’s story
In April 2014, Lisa Lockhart was coming home from a major rodeo where her horse Louie had just won the barrel race. On the long trip home, she stopped to give Louie a break and turned him out for a bit of exercise in a turn-out pen. While bucking and play- ing, he injured his stifle.
As soon as she got home, Lockhart took Louie to the Littleton Equine Medical Center in Littleton, Colorado, where her veterinarian, Dr. Terry Swanson, examined his injury. “We
went through a diagnostic process with ultrasound and radiographs. We wanted the best chance for Louie, so we contacted Dr. Frisbie because of his expertise in stifle surgeries and he agreed to be part of our surgical team,” says Swanson.
“His research in stem cells made us realize this would be the best shot for Louie. This kind of stifle injury is often career-ending for athletic horses.” The surgery and stem cell treatments were accomplished, and Louie had a 6-month
layoff from competition. Lisa gradually brought him back into work, and that fall they went to the National Finals Rodeo in Las Vegas where they won the average and placed second for the year. This was an amazing accomplishment for a horse that hadn’t run for 6 months.
The next year in 2015, Lisa and Louie won at the American Rodeo, the Calgary Stampede, and were runners up in the World again at the NFR in Las Vegas. Louie con- tinues to run well this year. “The work that Dr. Frisbie and his group has done indicates that the prognosis for this kind of injury is so much better with the surgery and stem cells,” says Swanson.
Interestingly enough, Lisa also had to have knee surgery this year and asked her surgeon if she could get the stem cell treat- ment like her horse did. Lisa cheered, “The talented group that put us back together and gave us another chance to do what
we love doing. Louie loves his job and he would not have been able to do it without
Lisa Lockhart and her horse Louie, both of whom had surgery and stem cell treatments. Louie injured his stifle, had surgery with stem cell treatments, and was back competing and winning barrel events with Lockhart after
a 6-month layoff.
Dr. Frisbie and Dr. Swanson and them putting their heart and soul into getting him better!”
SPEEDHORSE 57
equine health