Ask EWP: Talking joint injections with Dr. B

Question: 

What are the different joint injections you offer and what is best for my horse? 

Answer:

We offer a number of options for maintaining and managing your horse's joints. One size does not fit all in this area so it is important that we consider the overall health of your horse, what job they are doing and upcoming competitions (associated drug rules). 

Before I start any joint injection protocol I will recommend radiographs, it allows us to assess and monitor any joint changes, establish a baseline  and make informed decisions about the best treatment. 

Steroid Injections 

Typically the go-to for managing arthritis, Intra-articular corticosteroids (steroids) are strong anti-inflammatories, which provide immediate and relatively long lasting symptomatic relief. 

Sometimes we use these in combination with hyaluronate which helps maintain a lubricating environment and minimize causes of joint disease. 

Many horses, in particular those with a competitive show schedule, will use steroid injections yet they are not always the best choice. For example, using steroids in a horse with metabolic disease can exacerbate the issue or if we believe that we can improve or better maintain the joint longer-term through an approach more targeted at healing, I will often recommend a different approach. 

Using the horse's body to help it heal (PRP, IRAP, and Pro-Stride)

I really like the healing results I see with PRP (platelet rich plasma), IRAP (interleukin receptor antagonist protein), and Pro-Stride and find a lot of our clients are preferring to use these methods in their horses. 

All of these products can help reduce inflammation and/or promote healing. In each, we draw your horse's blood and use specific components of it and inject that back into the joint. 

IRAP: IRAP amplifies an endogenous anti-inflammatory mediator, thereby reducing inflammation without any compromise to healing capacity. 

PRP: In PRP we concentrate platelets and inject those straight into the joint. Platelets are the first responders to injury throughout the body, capable of recruiting cells and releasing growth factors to facilitate healing. When we put them into joints, they direct the healing and anti-inflammatory responses appropriately. 

Pro-Stride:  Pro-Stride is a newer product that combines IRAP and PRP. The results of Pro-Stride last for up to a year and reduces pain associated with arthritis and delivers naturally occurring anti-inflammatory proteins. I really like that Pro-Stride Injections slow cartilage degradation and improves mobility.

Our primary goal in doing joint injections is to reduce inflammation. By reducing inflammation and giving our horses healing therapies we promote their comfort and enable them to perform at their best for years to come. I’ve seen so many horses go better and be happier as a result.