Treatment options for neck, back and pelvis related pathology

Mesotherapy

Mesotherapy involves injecting small amount of medication into the mesoderm of the skin via small needles. This technique is most commonly applied to treat the equine spine.  Via the “gate control mechanism”, the nerves responsible for pain perception are interrupted. The purpose of the mesotherapy is to stop the viscious cycle of pain and restricted mobility in a certain area (for example neck or back stiffness). By stopping the viscious cycle, the horse is able to move normally again which in combination with other therapies, like physiotherapy/chiropraxis, contributes to the recovery.

Mesotherapy was developed in 1952 by Dr.Pistor. In France, this therapy is commonly used in people. Prof.J.M. Denoix, world renowned in equine orthopedics, first applied this technqiue  in horses in the late 1990’s. The veterinarians at SMDC have been using this technique since 2002 with great success in the treatment of spine issues (neck, back and pelvis).

Ultrasound Guided Injections (USGI)

At SMDC horses with spine related issues are treated by USGI every day. Ultrasound provides an accurate diagnosis and this technique allows for optimal treatment of the specific underlying problem. The technique needs experience in guiding a needle into the right position under ultrasound guidance.

Focused Shockwave Therapy (Extracorporeal Shockwave Therapy or ESWT)

Focused shockwave is a proven treatment modality both in horse and humans. Tendons, ligaments and especially the area of transition between bone and ligaments are areas in which shockwave therapy is most commonly indicated. Our team has extensive knowledge and experience with both the indication for shockwave therapy as well as the expectant results. Research has shown us, using the UTC scan, that shockwave therapy results in increased quality of repair and decreased the chance of lesion reoccurrence.  With our focused shockwave equipment, Versatron, it is also possible to treat axial skeleton disorders.

Shockwave therapy makes use of soundwaves (energy) that gets transferred to the body part on which it is focused. This improves the blood circulation and metabolism of the area that is being treated, which stimulates the area to regenerate as well, as it also decreases associated pain. In a nutshell: it is a way to stimulate the body to heal itself.

The shockwave technology used in orthopedics is derived from the technique used in urology called lithotripsy.

At SMDC our machine uses focused shock waves which allows for precise tissue depths to receive the stimulation/energy. There are also machines available which are not focused and although these machines are considerably cheaper, they are also considerably less effective. Shockwave therapy has been used in both humans and horses for the past twenty years with proven results in treating musculoskeletal injuries. This therapy is one of the most innovative techniques available for the treatment of tendon/ligament lesions and areas of pain.

Physiotherapy and Chiropraxis

To support veterinary treatment, we regularly recommend the use of physiotherapists and/or chiropractics to improve flexibility, strength and coordination. Click here to read more about the physiotherapist team that we collaborate with: www.dd-physio.com

Treatment options for tendon and ligament injuries

The specialists of SMDC are very experienced in treating tendon and ligament injuries. After the precise diagnosis (by clinical, ultrasonographic and UTC examination) a wide variety of treatment options are available at SMDC. Experience and knowledge of the actual stage of the injury are both important aspects that will influence the best choice of treatment options.

Focused Shockwave Therapy (Extracorporeal Shockwave Therapy or ESWT)

Focused shockwave is a proven treatment modality both in horse and humans. Tendons, ligaments and especially the area of transition between bone and ligaments are areas in which shockwave therapy is most commonly indicated. Our team has extensive knowledge and experience with both the indication for shockwave therapy as well as the expectant results. Research has shown us, using the UTC scan, that shockwave therapy results in increased quality of repair and decreased the chance of lesion reoccurrence.  With our focused shockwave equipment, Versatron, it is also possible to treat axial skeleton disorders.

Shockwave therapy makes use of soundwaves (energy) that gets transferred to the body part on which it is focused. This improves the blood circulation and metabolism of the area that is being treated, which stimulates the area to regenerate as well, as it also decreases associated pain. In a nutshell: it is a way to stimulate the body to heal itself.

The shockwave technology used in orthopedics is derived from the technique used in urology called lithotripsy.

At SMDC our machine uses focused shock waves which allows for precise tissue depths to receive the stimulation/energy. There are also machines available which are not focused and although these machines are considerably cheaper, they are also considerably less effective. Shockwave therapy has been used in both humans and horses for the past twenty years with proven results in treating musculoskeletal injuries. This therapy is one of the most innovative techniques available for the treatment of tendon/ligament lesions and areas of pain.

Laser Therapy

The last decade laser therapy has proven to help significant in the healing process of soft tissue lesions in equine medicine. It activates several biological mechanisms: accelerates tissue repair and cell growth, accelerates wound healing, reduces fibrous tissue formation, is anti-inflammatory, provides pain relief and increases vascular activity resulting in a better and faster healing process.

SMDC works with the currently most powerful and state of the art equipment: the RLT (Regenerative Laser Therapy) Vet laser (Sound company). This is a class IV ND-YAG-laser. This machine is used at SMDC for treating muscle, tendon and ligament injuries and in rehabilitation programs.

Regenerative medicine

In the last decade new and innovative treatments have become available in equine medicine. IRAP, PRP and Stem Cells are natural products collected from the horse’s own body and used to stimulate the horse’s ability to heal. Currently there is a lot of research looking into these new treatments and  the SMDC stays up to date with the latest technologies.

IRAP (Interleukin Receptor Antagonist Protein) is also known as autologous conditioned serum. IRAP was developed to stop the effects of interleukin 1 which is an inflammatory mediator that gets produced by affected joints and is reponsible for the ensuing arthritis. IRAP stops interleukin-1 from binding to its receptor and thereby effectively halts the vicious inflammatory cycle.

Blood will be collected via a sterile technique from the jugular vein with dedicated IRAP syringes. These syringes will be incubated for 24 hours which allows production of  Interleukin 1- antagonists. After 24 hours, the syringe will be centrifuged and the separated plasma (enriched with IRAP) will be collected and filtered. These then gets aliquoted into multiple smaller syringes and used or they can be frozen for up to 2 years. The IRAP treatment involves multiple injections with 7-10 day intervals.

PRP stands for Platelet Rich Plasma. This is also collected from the horse’s own blood.  Platelet activation results in the release of multiple mediators. These molecules attract other  anti-inflammatory mediators in the affected/damaged tissue. Not only do they help decrease inflammation, these molecules also result in angiogenesis (formation of new blood vessels), fibroplasia (the wwwelopment of  new connective tissue), and re-epithelization (healing of the skin). PRP is used most often with ligament and tendon injuries to help improving the healing process. PRP is also sometimes used for the treatment of joints.

Blood will be collected via sterile technique from the jugular vein with dedicated PRP syringes which then get processed in a special centrifuge to separate the platelets from the rest of the blood. Several different collecting kids are available on the market.

Stem cells are undifferentiated cells that have the ability to wwwelop into a variety of cell types (cartilage, tendons, ligament, muscle, bone cells). There are two different types of stem cells: haemopoetic and mesenchymal stem cells.

Mesenchymal stem cells have the best potential with respect to regenerative medicine. These cells can be found in bone marrow, fat and the umbilical cord. In equine medicine, these stem cells are usually collected from the bone marrow or fat.

Bone marrow can be collected from the sternum or the tuber coxae. After collection, the sample gets send to a lab where the stem cells will be cultured and concentrated. This process can take a couple of weeks. The dose administered is usually between 10-25 million stem cells per treatment. After sterile preparation, the harvested stem cells are injected into the affected ligament, tendon or joint.

Fat is another source of these mesenchymal stem cells. Similarly to bone marrow, the collected sample gets sent to the lab and is cultured there into a high concentration.

Intra-articular treatments (joints)

Inflammation of the joint (synovitis/arthritis), the joint capsule (capsulitis) and/or injury to the joint cartilage can all be the reasons to  treat a joint. Before a joint is injected, the area is aseptically prepared to eliminate the chance of subsequent infection. After the treatment, a sterile bandage is applied to protect the area from the environment. This bandage can be removed after the horse gets home, or the next day.

With joint inflammation, we are talking about a reduced quality of synovial fluid and/or cartilage lesions. Due to the release of various inflammatory mediators  (which have a negative affect on the joint), a long standing synovitis can lead to decrease mobility of the joint capsule and even cartilage lesions. This process can eventually lead to arthritis of the joint. The purpose of the treatment is to halt the inflammation and to optimize the lubricative abilities of the joint fluid.

  • Antiinflammatory SAID’s (steroids) or NSAID’s (non steroids): these products interrupt the vicious inflammatory cycle by neutralizing the inflammatory mediators released by an affected joint.  The quality of the joint fluid will thereby improve as well.  The pain in the joint capsule will decrease and joint mobility will increase. We use the lowest effective dose to avoid long term negative side effects. This is possible by locally treating the joint, often ultrasonographically guided, at the right spot.
  • Hyaluronic acid: Hyaluronic acid is a vital part of synovial fluid and among other things responsible for “feeding” the cartilage. It also has a damping and anti-inflammatory effect. SMDC has a lot of experience in treating different joints with the best hyaluronic products (there are many products on the market with their own (dis)advantages.
  • PSGAG’s (PolySulfatedGlycosAminogGlycans): These are products  that protect cartilage and also have a positive effect on the production and quality of the synovia (joint fluid).
  • Polyacrylamids: these product are increasingly used for treating and preventing degenerative joint disease.
  • Regenerative medicine LINK

Orthopedic Shoeing

Orthopedic Shoeing

A good farrier is essential in the correct trimming and shoeing of your horse. The goal of orthopedic shoeing is to apply special shoes which  help relieve and/or load certain structures. In this way treatments and prevention of injuries will be optimized.

At SMDC we work with recognized farriers who are familiar and experienced with orthopedic shoeing. Farrier Ablas.

Supplements

SMDC collaborates with the wellknown companies Audevard and Global Medics. The products of these companies have been used by professionals for many years with satisfying results. SMDC recommends these products not only because of their scientific  basis but also because of their strict anti-doping policy.