McKee-Pownall Equine Services | Lameness Services

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Lameness Services

McKee-Pownall Equine Services offers cutting edge technology and quality service in the diagnosis and treatment of equine lameness:

Shockwave Therapy

Extra-Corporeal Shockwave Therapy (ESW) was originally used in human medicine as a non-invasive means of breaking up kidney stones. In recent years the technology has been applied to treat a number of orthopaedic conditions in horses.

The actual shock wave is not an electrical shock; it is a pressure wave that moves through the tissues in a similar fashion to how an earthquake moves through the earth. The pressure wave can be generated in two ways: the lower intensity radial wave provides the greatest intensity at the skin surface while the focused technology allows the user to select a specific tissue depth for the maximum intensity wave.

At McKee-Pownall we have two fully portable focused shockwave units available for treatments. Clinically, ESW relieves pain while stimulating and accelerating the healing process. The precise mechanism of action of ESW remains unclear, but research indicates that it upregulates tissue metabolism on a cellular level, stimulates blood vessel development, and new bone formation.

"(ESW)"
 

The most common applications of ESW include treatment of acute soft tissue and bone injuries in combination with rest, and for non-invasive treatment for sore feet and joints in working horses. There is a mandatory four-day withdrawal time for ESW therapy in racing horses.

Typical applications of ESW include:

  • Sore feet
  • Navicular disease
  • Suspensory desmitis
  • Bowed tendons
  • Splints
  • Hock spavin
  • Sesamoiditis

Joint Injections

What Joint Injections Do

Injecting a joint with medication to lubricate, protect, and prevent further deterioration is one of the most commonly performed therapies in sport horse and lameness practice. While this done very frequently at McKee-Pownall, it is not a decision we make lightly and the utmost care is taken during the procedure to reduce any chance of complication.

Purpose of Joint Injections

The goal of joint injection is not to conceal pain or to allow a horse to compete when it should be rested.

Joint injections may be performed in cases of acute joint damage in order to reduce the inflammation and harmful substances released into the joint a the time of injury, as well as provide substances that promote and supply material for the healing process. Rest is a critical part of this treatment program.

In other cases, joint injections can be performed on horses to relieve problems of stiffness and poor lubrication that are part of the normal wear and tear of aging and performance. Oral and intramuscular joint therapies are often used in addition to the articular injections with the goal of prolonging the interval between treatments.

Other situations where this procedure is performed include post-joint surgery situations, and in younger horses who get sore while going through difficult developmental and training phases.

Individualized Therapy

We choose the medication on an individual basis to provide maximal benefit for each horse's unique circumstances. This is usually a combination of hyaluronic acid, adequan, and certain steroids that have been proven to protect cartilage. In addition, drug withdrawal times must be carefully considered in competition horses.

If the decision is made that intra-articular injections will benefit your horse, we will discuss what medications are appropriate, what to expect from the therapy, and provide instructions on how to manage your horse in the days after injection.

Ultrasound/Fluoroscope Guided Injections

Advanced lameness therapy can involve the diagnosis of problems in areas that are very deep within the body. These structures are impossible to reliably inject for therapeutic treatments without some kind of imaging technology.

At McKee-Pownall, we use the ultrasound and fluoroscope machines to monitor the placement of the needle, ensuring the medications are delivered to a precise location.

Advantages

Using our imaging equipment, we are able to treat a variety of conditions that could not be performed with traditional blind injection techniques, including:

  • Fluoroscope guided injection of the navicular bursa for navicular disease
  • Ultrasound guided injection of the sacro-iliac joints and lumboscaral joints for back pain and disc disease
  • Fluoroscope guided injections of bone cysts (OCD) in joints
  • Ultrasound guided injection of cervical facet joints for neck pain and arthritis

IRAP

What is IRAP?

IRAP is a substance naturally created by white blood cells that has a powerful anti-inflammatory effect in the body.

Damaged tissues release a molecule called "Interleukin-1 (IL-1)" that stimulates severe inflammation, pain, and further tissue destruction. IRAP attaches to the IL-1 molecule and prevents it from activating these other pathways.

We create the product by drawing a blood sample from your horse in a specially designed tube that stimulates the white blood cells to produce great quantities of IRAP. After a twenty four hour incubation period, we usually have enough serum for several joint treatments, and the remainder is frozen for future use.

IRAP Therapy

In horses, we use IRAP most commonly for arthritic joints and tendon/ligament injuries. In the case of joint disease, IRAP is a good choice for horses with lameness problems that are not responding well to other treatments including injection with more traditional joint medications and shockwave therapy. With ligament injuries, our goal is to reduce painful and destructive inflammation without slowing the overall healing process.

IRAP is also a good choice for horses competing under strict drug testing rules, as there are no foreign substances present in the serum. The standard course of treatment is a series of three injections, one every two weeks, with a long-term follow up injection several months later.

"IRAP Therapy"
 

PRP (Platelet Rich Plasma) Therapy

PRP therapy allows us to harness the inherent healing properties of the blood platelet. Blood is composed of three major constituents: plasma (the liquid portion), red and white blood cells, and platelets. While most of us associate platelets with the formation of clots, these tiny fragments also produce growth factors and anti-inflammatory substances to facilitate healing of damaged tissue.

This therapy has been used widely in human athletes and has recently shown a lot of promise in the treatment of equine soft tissue and joint disease. PRP is created from the horse’s own blood, placed in a special centrifuge that separates out the platelets and suspends them in a small amount of plasma. The final sample is then injected directly into the injured area using ultrasound guidance.

The process takes about 20 minutes so the horse can be diagnosed and treated during one in-clinic appointment, and on farm treatments can be arranged, usually within 24 hours. PRP therapy is indicated for the treatment of suspensory ligament injuries, bowed tendons, and joint disease.

"PRP Therapy"
 

Mesotherapy

What is Mesotherapy?

Mesotherapy is a technique traditionally used for relief of myofascial pain, although today it is most commonly seen in human plastic surgery clinics for diminishing cellulite.

The procedure involves injecting miniscule amounts of medication just beneath the skin using tiny needles mounted on racks. The medications administered are typically a combination of anti-inflammatories, local anesthetics, and homeopathic preparations.

It is well tolerated in lightly sedated horses and only takes a few minutes to perform.

Purpose of Mesotherapy

We use mesotherapy for the relief of back and neck pain in equine athletes, commonly in combination with other lameness therapies. For example, a horse with neck pain could be treated with a combination of ultrasound-guided cervical facet injections and local mesotherapy over the tense neck muscles.

We also occasionally employ mesotherapy to alleviate inflammatory conditions of the lower limbs.

Cryotherapy

Cyrotherapy is the localized application of liquid nitrogen.

Cryotheryapy is useful in minimizing the effects of splints and curbs. It can also be used in the treatment of skin tumours.