|
|
Discussion on Severe Bone Spavin - Stem Cell Therapy??
|
| Author |
Message |
New Member:
Coomber
|
Posted on Wednesday, Nov 9, 2005 - 3:01 pm:
Good afternoon Dr. O and readers.
I have read many of the articles concerning DJD trying to understand the best treatment. My vet has recently obtained information on stem cell therapy from vets in California. My vet is an affiliate of a large equine medical center in Ocala Florida. They are experienced with race and performance horses.
My questions are:
Do you have any information on Stem Cell therapy?
Am I hearing my vet and reading the articles correctly that injecting the hocks more than twice a year will probably do more harm than good?
That pasture rest (6 to 12 months) MAY help, however some horses seem to do better with light work?
Here is part of our history:
Patrick was purchased last February. He is a six year old QH gelding that was shown successfully in western AQHA classes for three years (Several hundred points to his credit).
I was advised that he had a slight soundness problem but nothing serious. I trusted my trainer and purchased the horse without a vet examine on her advice. I now know the importance of the examine.
I show under the guidance of the trainer who boards, cares for, and exercises Patrick. I ride twice a week. I was told in March (by the trainer) the horse needed his right hock injected and this stifles 'blistered'. This was done by the barn vet and all was well until May when the Patrick became stiff on this leg and some days dead lame.
I took him to the Equine Hospital for evaluation and was given the bad news that he has severe degeneration of the right hock, so badly that they don't think surgery is an option as the pin most likely will not hold in the bone. The vet was surprised he was able to work at all.
He was put on cosequin, a bone builder supplement, surpass monthly for 10 days each month, and Lubrisyn. He rarely showed signs of lameness until July when he went lame after very little work. At that time his hocks were injected again.
My vet has recently recommended adding adequan once every 4 days for 7 treatments twice a year. Along with the other supplements listed and injections every six months.
Your advice is appreciated.
|
Moderator:
DrO
|
Posted on Thursday, Nov 10, 2005 - 8:37 am:
Taking your questions in order:
1) There are many ways in which stem cells have been proposed and experimented with in respect to arthritis. How are they using the stem cell therapy Ann? Could you relay to us the whole procedure?
2) Not necessarily, a lot depends on what you are injecting, where you are injecting, and the condition of the joint. But more frequent injection may mean too much work is being asked.
3) I would not say they do better than with just pasture but some don't seem to be hurt by light work.
DrO
|
New Member:
Coomber
|
Posted on Thursday, Nov 10, 2005 - 6:31 pm:
Greetings Dr.O and all, Thank you so much for your prompt reply. I am afraid this may not be the exact line but here is what I have so far.
1) My understanding that his stem cells (collected from fat near the tail) are injected into the hock. He will be kept on stall rest for several weeks, then hand walking for a few weeks, then light riding hopefully being able to return to light work in another few weeks. The company that provides the stem cells to my local vet has information posted on their website: vet-stem.com.
2) He is being injected with a cortisone, I believe in the inside area, The joint was described as severally deteriorated. We try to ride him very lightly, the amount of work I have done since February has caused him to be injected every four months.
3) So rest may be best.
And there is a chance with rest and good supplements and care the hock may fuse?
Thanks again,
Coomber
|
Member:
Angel77
|
Posted on Saturday, Nov 12, 2005 - 2:22 am:
Dear Ann,
What supplements did your vet recommend? I know this could be a very long shot but I use Amerdons Rapid Response T. www.amerdon.com It is a supplement that molecularly heals many problems horses face in todays world. I have spoken about it before in previous posts. So for more info got to their site posted above.
Athough I use it, my horses use it, a lot of my friends use it and celebrities in the Malibu, Pacific Palisades, Ventura, Santa Barbara areas use it. The company is out of Las Vegas. So they have gotten a lot of people who believe in this product nationally.
I will warn you though there are 25 schools of thought when it comes to horses and that is okay. Dr.O wrote to say he did not seem to think much of this product. No big deal everyone has an opinion right? We love Dr.O. This is a great website-forum.
So I hope you find the right solution to your horses problem. I feel for you.
Good Luck,
WTG
|
Moderator:
DrO
|
Posted on Sunday, Nov 13, 2005 - 12:52 pm:
When you go to the vet-stem literature review library they do not list any articles that show this type of treatment to be beneficial in DJD in any animal model. They do have one reference under the title "potential future applications" that suggests this is an area of future study. Going to the main body of scientific literature there are some encouraging reports about autologous adult stem cell use in acute arthritis but a recent review of the literature says results have been mixed. I think its use should be considered experimental with potential ill effects.
Hello WTG and thanks for the good words. Let me make my position here clear. Since they do not tell us what is in Rapid Response I cannot find any scientific support for their claims of a scientific breakthrough. Their "Scientific Summary" page reads like a freshman biology book with no good rigorous scientific support for any statements of product efficacy that they make. The page appears to me to be more of an obfuscation of this fact rather than presenting scientific support of their claims. I am always skeptical when companies make miraculous claims for unknown substances particularly when these things are "100% safe". Not even water can make that claim. I would be glad to entertain any information to the contrary.
DrO
|
New Member:
Coomber
|
Posted on Sunday, Nov 13, 2005 - 3:26 pm:
Good afternoon,
My vet told me the procedure is new for the hock so it is offered a 50% reduction ($1,250) of the normal cost. I hadn't thought of asking about the adverse effects and I didn't read about them on vet stems page.
Will you tell me the ill effects you have found?
|
Moderator:
DrO
|
Posted on Monday, Nov 14, 2005 - 9:56 am:
I have not found any experiments of this type with a horse so do not know what the full range of ill effects might be. Certainly the first that comes to mind is it causes an increase in inflammation rather than a decrease.
DrO
|
Member:
Angel77
|
Posted on Wednesday, Dec 14, 2005 - 1:37 am:
Dear Dr.O,
Yes I completely understand and respect your opinion. I am not a vet.
I took a 23 yr break from horses after being a 4 time Calif State Champion Junior Jumper Rider 1976-1980.
I was only taught horsemanship and riding. They had me on so many horses all the time(of course I loved it!) So I never got to learn feeding.
However I was into the supplements for my horses coat or whatever the vet had said they needed.
Rapid Response's Sharone currently along with her investors are in the middle of obtaining the patent needed to list the ingredients of this product. At least this is my understanding.
All I know is it works! Orally and topically.
Maybe it is like NONI juice or so many different products on the market today. Honestly I have no idea!!
Sometimes we do not know why things happen they just do, good and bad.
Of course my horse is also on Cosequin, Legend, Vit E & Selenium, E-5000, and Wheat Germ Oil, all of these for joint lubrication.
He also gets other supplements for coat, electrolyte, Neighlox, Redmond's salt(my horse will not touch salt), Strongid C2X, Vita Plus, and Focus SR. So maybe everything combined is helping?
Honestly, until I added the Rapid Response to the other supplements I had to have his hocks injected two years in a row.
It has now been three years since any injections have been required. My horse is sound. Even though he cast himself 3 weeks ago. His hind left was pretty swollen and a couple of cuts but he is back.
He was on Bute for 3 days along with hosing with ice cold water, wrapping, and hand walking.
By day 4 we were cruising around the 95 acre ranch just walking of course. By day 4 he was not lame, but still swollen, I never take any chances.
Day 5-7 we did light flat work for 15 minutes because he was high as a kite.
By day 8 we went back to jumping work. Sound as ever, jumping a foot over everything. I attribute my horses' speedy recovery to Rapid Response. I feel that somehow Rapid Response gives my horse what his body needs physically to restore his body molecularly. I do not even know if that makes sense!! That is just how I personally feel. Believe me for $279 a gallon, if I did not believe in this product, I would not waste my time or anyone else's for that matter!
Love your site. My dog stares at me longingly every time I am here but the people and their true life stories are truly healing!!! 
Thank you Dr.O. Have a great Day!!!
WTG
|
Moderator:
DrO
|
Posted on Wednesday, Dec 14, 2005 - 9:06 am:
Hello WTG,
Or maybe none of these supplements are required? How do prove that it is just not your overall good care that is responsible for this? We have managed thousands of horses over the years without many of these supplements. We do use Cosequin and we too have not had to inject our horse's hocks since starting but there is good scientific work to suggest the reason is something other than coincidence.
I don't find the progress your horse made after having been cast unusual considering the lack of serious injury which is not that uncommon with a simple cast. Do you think you would have had the same results if he had broken his leg? It is the nature of the injuries that determine the proper treatment and prognosis. By attributing the recovery to the RR you seem to imply that your treatment determined the nature of the injuries. And how do you separate out the effects of all the rational therapy you used, do you think the horse would have done as well without the bute? I can guarantee you he would have not. For thousands of years very smart and educated people followed their feelings concerning medicine and it resulted in the paramount of 19th century medicine: bleeding as a rational therapy as recently as 100 years ago. Because of the nature of biological systems it was only through scientific inguiry that we were finally able to flesh out which results were coincidental and which truly effected outcome.
Let me paraphrase a post I have made to you earlier today in another discussion that applies to some your points you make here:
Statistically 80% of disease can get well on their own. RR is a product that the company does not list the active ingredients or provide any scientific proof of efficacy, at least any that I can find. I know you think that this product has worked miracles on your horse but I am inundated with thousands of such miracle claims by thousands of similar miracle products some of them with no other active ingredients than water (homeopathic preparations). It is funny it is often those folks who are strong proponents of "natural medicine" that are quickest to discount the normal healing process and if all the claims of these type products were true I don't think anyone would ever be sick or die.
DrO
|
Member:
Angel77
|
Posted on Thursday, Dec 15, 2005 - 7:07 am:
My Goodness Dr. O,
As I clearly stated in my last post to you, I completely understand and respect your opinion. Understandably you hear of millions of products with outlandish claims. So yes, I get it. I am not asking you to endorse it. I am not that kind of person. I am merely sharing my personal experience and belief. No one else needs to believe.
I also comprehend the balance of nature and its own healing powers. What I was attempting to convey about my horse being cast was that recovery time was most likely cut in half because of the RR.
I would however like to think you have a good point that I do take excellent care of my boy.
I never would discount natural medicine.
I completely believe in natural & western medicine healing.
I am just wondering how it happened that when RR was added to my horses supplements no injections were required? Additionally whenever he has been injured over the last 3 yrs he seems to heal faster than before the last 2 yrs. I rode and got to know this horse for the previous owner for 2 agonizing years of near death colics every time I was out of town.
Anyway, maybe it is the Cosequin? The Legend? The other supplements? I am just trying to do the best I can for my boy.
I thought as horses age they were prone to break down not get better. In the example of having hocks injected. Am I wrong? Are there horses out there who have had to have their hocks injected two years in a row, and not have to continue on that regimen as the horse ages? Even though the horses work load has not changed?
Best Wishes and Happy Holidays!!
WTG
|
Moderator:
DrO
|
Posted on Friday, Dec 16, 2005 - 10:17 am:
Yes I have injected many horses hocks only to have them remain sound for many years thereafter even though they were at the same work load. My own horse was lame, had the lameness localized to the distal joint of the hock, and injected once a year for 3 years yet has not needed an injection for the last 5 years though his work load if anything has increased. Arthritis is a very complex problem and not all acute troubles become persistent chronic ones.
I think you misunderstand my position. If by Western medicine you mean what is commonly taught to and or practised by equine veterinarians you should understand that I find many of the currently accepted practises wanting of good scientific inquiry. I have made mistakes in thinking what I was doing in some cases was of benefit that turns out later to be shown beyond reasonable doubt to not of been having an effect on the situation.
As I often state, I don't think anyone should stop doing what they think is helping their horse but my job here is to educate horse owners about what experience and science teaches us of good equine care. When someone makes a recommendation on this board to someone else about a product that I think has problems I bring it to light. I am not asking you to not post your experiences, in fact I encourage it, but the critiquing of our experiences by each other is critical to the usefulness of this board.
DrO
|
New Member:
Ellieg
|
Posted on Friday, Dec 16, 2005 - 11:12 am:
Hi there
My 8 yr old dutch warmblood advanced dressage horse had one hock injection in May of this year and has since gone up a league and now works even harder with pirouettes etc.
He has mild osteo arthritis of the centro distal joint and is now on SYNEQUIN supplement. Is this like COSEQUIN ?
We hope he won't need another injection and will continue in full time work.
Ellie
Hampshire UK
|
Moderator:
DrO
|
Posted on Saturday, Dec 17, 2005 - 9:22 am:
In order to answer the question Elaine, can you tell us the ingredients, their concentration, and the dosage rate?
DrO
|
Member:
Oakfarm
|
Posted on Saturday, Dec 17, 2005 - 9:53 am:
SYNEQUIN:
<<Each 10g scoop or sachet provides:
Purified chronDrOitin sulphate (95%) 2000mg, Glucosamine HCL (99%) 5000mg,
N Acetyl D Glucosamine (99%) 500mg,
Ascorbic Acid 570mg,
Zinc Sulphate 360mg.
Loading programme - 35 days - 2 level scoops or sachets a day (horses over 500kg - 3 level scoops or sachets a day.) Transition Period - 36-60 days - 1 level scoop or sachet a day. (Horses over 500kg - 1.5scoops or sachets a day.) Maintenance - 61 days+ levels should be adjusted according to the individual requirements of each horse. >>
|
Moderator:
DrO
|
Posted on Monday, Dec 19, 2005 - 8:57 am:
Yes though the amount of active ingredients listed is higher per dosage than with Cosequin. For more on this see, Equine Medications and Nutriceuticals » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » The Joint Protective Treatments.
DrO
|
New Member:
Ellieg
|
Posted on Monday, Dec 19, 2005 - 10:34 am:
Thanks that is correct re the dosage and the ingredients. This stuff is pretty expensive approx £170 ($300) for the initial period. Dr O do you think there are long term benefits from using this product and how long will we have to stay on it if all is well with performance etc. How do you know if its done any good?
|
Member:
Angel77
|
Posted on Monday, Dec 19, 2005 - 5:59 pm:
Dear Dr.O,
Thank you for helping me understand. I had no idea there are horses who have had their hocks injected only a couple of times and then not needed to have them injected every year. I find that enlightening and encouraging.
And I wonder why? Do you have any idea why this happens? Do the injections help some horses more than others in some way? Do the injections thicken the synovial fluid sometimes forever?
Some of the show barns around my area seem to have so many horses that have their hocks injected every single year and some twice a year.
All of these horses are supposedly show quality dressage, hunters and jumpers. Do these show horses have too much of a work load and break down more often? On the other hand there are a similar ratio of horses who do not ever need injections. It is all very confusing. Why?
I have never heard of Synequin. Is it like Cosequin? Is it better than Cosequin? Do you know the manufacturer?
Happy Holidays!!
WTG
|
Moderator:
DrO
|
Posted on Tuesday, Dec 20, 2005 - 8:33 am:
Elaine, if I understand you correctly, those questions are answered in a pretty straight forward manner in the article I reference above and also the article on arthritis at Equine Diseases » Lameness » Joint & Bone Diseases » Arthritis and DJD: An Overview. Study them carefully and if you still are not sure post again.
WTG, it all has to do with the daily balance of trauma and healing. As long as the daily trauma does not exceed the daily healing the horse's joint will not become progressively inflamed and painful. There are many factors, (weight, age, conformation, amount of work, rate of change of work, miss-steps taken, genetic factors that effect healing, etc...) that effect both the amount of trauma and the amount of healing a horse experiences and this is what accounts for the differences in horse's experiences with arthritis.
Yes some trainers/riders do believe in regular intra-articular injections. Back when I was in very active practice, every month I might have a client who's trainer thinks the hocks need injection but we would decide not to because we did not see performance problems. But because of the nature of some of these folks we tell them we had and invariably the horse would go better after "treatment". Obviously I cannot speak about the work load of the horses you are seeing or whether injections are appropriate for them or not.
I am not personally familiar with Synequin.
DrO
|
Member:
Frances
|
Posted on Tuesday, Dec 20, 2005 - 9:49 am:
DrO, do we know any more about the product Tildren (made by CEVA Animal Health) as a new treatment for bone spavin (and navicular synDrOme)? It's been discussed in the past on this forum but was considered pretty experimental at the time.
Just wondered if any good studies were out yet?
Many thanks
Lynn
|
Member:
Angel77
|
Posted on Wednesday, Dec 21, 2005 - 2:10 am:
Dr. O,
Am I reading your post correctly? Vets who took the Hippocratic oath billed people for treatments never performed?
Now I am really confused. I was present both times my horse had his hocks injected. So I know for a fact my horse got done.
Definitely food for thought.
Thank you. Happy Holidays!
WTG
|
Moderator:
DrO
|
Posted on Wednesday, Dec 21, 2005 - 6:53 am:
No WTG no one was ever billed for work not done and there are definitely some horses that need to be injected.
The point was that some trainers would insist a horse needed injection when neither me nor the owner could see anything wrong so we would decide not to. However because the trainer would continue to insist on it we would tell them it was done. Then they would invariably think the horse looked or rode better if they thought the horses had been injected. But the owners were the ones making the final decisions whether to have the horses injected and they were the ones who pay the bill.
DrO
|
Moderator:
DrO
|
Posted on Wednesday, Dec 21, 2005 - 9:46 am:
LL I have not read anymore about Tildren and don't remember it being addressed in Dr McIlwraith's review of current therapy presented this month at the AAEP. I plan to edit the article on arthritis and joint disease after a thorough review of his paper probably early next month. I will look for references to it.
DrO
|
Member:
Frances
|
Posted on Wednesday, Dec 21, 2005 - 9:53 am:
Very many thanks DrO.
|
Member:
Angel77
|
Posted on Thursday, Dec 22, 2005 - 12:28 am:
Dear Dr.O,
I think I understand what you mean. Let me see if I have got this straight.
The trainers were told the horses(who really did not need injections)got injected. The trainers never saw the bill because it went directly to the owner.
So the owners never figured this out? Or did the trainers not communicate with the owners that they had this procedure done on their horse? Or did the owners or trainers think they got free injections?
I have never heard of such a thing. That's life always learning.
Happy Holidays!
WTG
|
Moderator:
DrO
|
Posted on Thursday, Dec 22, 2005 - 8:02 am:
Huh??? No WTG there was nothing for the owners of the horses to figure out as they were making the decision to not have their horses injected, aware they were not being injected, and were not paying for an injection. But the owners would then tell the folks who were complaining that the horses needed injection that they were injected and this invariably results in a pronouncement that they could tell a difference and the horse moving better, you know, a placebo-like effect.
To get back to the original point, you were asking about those horses that were injected very frequently and why. I was pointing out that there are folks who needlessly inject their horses, in my opinion, and this story is an illustration of how folks can kid themselves on the effects of such treatment.
DrO
|
Member:
Angel77
|
Posted on Friday, Dec 23, 2005 - 4:19 am:
Dear Dr.O,
Thanks I think I get it now. The owners told the trainers the horses had been injected. Then the trainers were saying how much better the horses were moving.
Dear Ann C,
How is Patrick doing? I am sending you good thoughts for a speedy recovery.
Happy Holidays
WTG
|
New Member:
Coomber
|
Posted on Saturday, Dec 24, 2005 - 3:22 pm:
Merry Christmas Eve All.
Your thoughts and input is appreciated.
I have re-read the DJD article and will continue to read up on the matter.
Patrick has not responded as well to the hock injections and blistered stifles as in the past.
I quote Dr. O, “WTG, it all has to do with the daily balance of trauma and healing. As long as the daily trauma does not exceed the daily healing the horse's joint will not become progressively inflamed and painful. There are many factors, (weight, age, conformation, amount of work, rate of change of work, miss-steps taken, genetic factors that effect healing, etc...) that effect both the amount of trauma and the amount of healing a horse experiences and this is what accounts for the differences in horse's experiences with arthritis.”
I believe this may be the most important issue I have. I am trying to get a feel for the proper amount of exercise. We worked for a half an hour this past Thursday and he was fine. Today (Saturday) he came out slightly stiff at the jog but after 4 or 5 strides leveled out and worked great.
We are riding approximately half and hour every other day. 5 min walk, 10 min jog, 10 min lope and 5 min walk. We never train over elevated trail obstacles. When we show I use the same ½ hour to warm him up for his 1st class and then 10 minute warm up for this next two. We show Trail, pleasure, and horsemanship. Some shows he isn’t sound enough for the 3rd class. We show around once a month. We are taking December, January and February off to see if he will improve with the lighter work.
The barn I am in doesn’t have turn out as everyone is on a ‘training” schedule. Dr. O I hate to move as the barn is very clean, everyone is feed on schedule with good quality hay, and great caring barn crew,.BUT, from some of the reading I am picking up that daily turn out could be helpful. What do you think?
He is getting daily double dose of Lubrisyn and regular cosquin along with the injections that were increased from twice a year in 04 to three times this year. My vet has recommended I add adequan injections to the mix.
Happy Holidays, Ann
|
Moderator:
DrO
|
Posted on Monday, Dec 26, 2005 - 8:37 am:
The proper amount of exercise is trial and error because we have no tests that measure "how much exercise exceeds the joints ability to repair" and every horse is an individual here. Most horses, even those with mild arthritis, are better off with as much pasture exercise as possible to promote strength and flexibility not to mention how much more relaxed they are.
DrO
|
Member:
Angel77
|
Posted on Sunday, Jan 1, 2006 - 5:59 am:
Dear Ann,
From your post I could not read your show warm up time properly. Are you warming up before your first class for an hour and a half or a half hour?
Yes, in my opinion the more a horse can move around freely as in a larger pen or turn out the better.
For instance my horse has not been stiff since he was moved out of a 12X12 barn stall into the 24x48 corral. Even though he spent at least 4-5 hours a day in turnout while living in the barn stall.
Unless your vet does not recommend larger living quarters in this in this particular case.
Adequan has helped my friends horse Russian Roulett+. He is a 20 yr old Arabian jumper who won horse of the year for his division two years in a row and won the Legion of Honor I think this year.
My horse an 11yr old TB 16.2 has been on Legend for three years where as Russian Roulett+ a 20 yr old 14.2 Arabian has been on Adequan for the last three or four years.
Every horse has specific needs and may have different responses to different supplements and or injections.
Upon my journey with my horse I have found that I can usually see an improvement with a new supplement within 2-4 weeks. Although after 90 days if I saw no improvement I changed our regimen.
It took me six months of experimenting before I found the supplement regimen my horse and I were happy with.
Does your vet think the stem cell therapy will improve your horse? Have you given the Rapid Response a trial?
Since your vet has recommended Adequan I would start with that to see if that helps but if it this is a degenerative condition I wonder what else could possibly be done--Dr.O?
I wish you the best in what ever you decide to do with your horse.
Good Luck,
WTG
|
Member:
Coomber
|
Posted on Monday, Jan 2, 2006 - 7:47 am:
WTG,
We warm up for a half an hour which is our work routine at home that normally doesn't cause soreness, the trail course is usually around 3 minutes to ride, then I warm up for 10 minutes before the next two classes.
Vet said they don't have any experience to say if it will help the hock, they only have history on tendons and ligaments. This is experimental for them to obtain history.
The turn out issue is giving me trouble. My trainer has an immaculate barn, the bedding is keep better than any where else I have checked, she blankets very methodically, and have years of experience not to mention that she seems work Patrick just right to keep him sound when I am not able to get to the barn. I have checked out most of the barns in my area and they just don't seem 'right'. Maybe this is just the ole human it is hard to make change and I should just try the one that seems the best fits with turn out or a corral.
Thanks for your input.
|
Member:
Marti
|
Posted on Tuesday, Jan 3, 2006 - 9:14 am:
Dr.O,
I know Ann C and her horse Patrick and I have been reading these posts. There are so many different products and treatments that it is totally confusing.
I have had my mare on Cosequine for the past 4-1/2 years, (I started Cosequine when she went into training at 3 years old) I considered it to be a preventative to possible problems.
My trainer recently suggested that my mare needed to have her hocks looked at, due to the fact that she was no longer willing to lope through on her hind end, she was trotting on the back end while loping on the front, plus she refused to move her hip over when loping. This mare has never been lame or shown any signs of lameness.
We had the hocks looked at by the Vet and he suggested injecting the hocks, blistering the stifles and also blistering the large muscles over the top of the rump on each side. My mare was very sore over her rump area when he tested her prior to any injections. She nearly sat down when he tested her through the rump area.
She has now been injected and blistered and all that. I actually see no difference in her movement. My trainer naturally does see an improvement (like you said earlier in one of the posts).
Now my questions: 1) Is Hyalun (oral hyaluronic acid supplement) the same and as good as or as effective as the hock injections?? I have purchased this supplement, but not yet used it. I have been holding off to see if I can see any change in movement from the injections. All of these injections were done the 1st part of November.
2) In the case of Ann C's horse, since he has such a degree of joint deterioration, can the injections or supplements actually be expected to solve or relieve any of the problems. If he has bone rubbing on bone what will cause the return of cushion to the joint area?
I have been hearing a lot about the human treatment of the knee joint using Rooster Crown as an injection. Any idea if this would work on our equine friends?
Marti
|
Moderator:
DrO
|
Posted on Wednesday, Jan 4, 2006 - 6:55 am:
1) No, the much greater concentrations of the articular injections provide more therapy.
2) Yes, their are two components of degenerative joint disease: acute inflamation and the chronic damage. The injections address the acute inflammantion which may slow the rate of chronic damage.
3) What is in the Rooster Crown?
Your first 2 questions and our recommended treatment regimen are discussed in greater detail at Equine Diseases » Lameness » Joint & Bone Diseases » Arthritis and DJD: An Overview.
Hmmmm..if you lack confidence in the diagnosis consider a referral and a second opinion. With vague symptoms and such a pronounced reaction over the gluteals I would be interested in muscle enzymes.
DrO
|
Member:
Marti
|
Posted on Saturday, Jan 7, 2006 - 9:50 pm:
Dr. O.,
Thanks for your information on the Hyalun and on the use of the injections for Ann's horse. I sure hope something will help him. He is an awesome performer and it is such a shame he has to have these problems. I will read up on the joint and bone diseases.
Can you tell me more about muscle enzymes? Maybe tell me where I can read up on this too.
Thanks,
Marti
|
Member:
Marti
|
Posted on Saturday, Jan 7, 2006 - 10:02 pm:
Dr.O.,
I am pasting information on the Rooster Crown (Comb). Is this the same as what the horses are now getting??
}Hyaluronic acid (HA) is a naturally-occurring substance found in the body. It is a constituent of the synovial fluid that lubricates joints, allowing them to move over each other easily; and also of vitreous humor, the clear, jelly-like substance in the eye. Hyaluronic acid made from rooster combs (the Mokawk-like crown on a rooster's head) or from bacterial cultures is used medically to treat the pain of osteoarthritis in the knee when no other treatment has helped. People with arthritis tend to have lower than normal levels of hyaluronic acid. The treatment, called "viscosupplementation," involves injecting hyaluronic acid, usually in three to five shots over several weeks time.
|
Moderator:
DrO
|
Posted on Sunday, Jan 8, 2006 - 8:39 am:
So Rooster Crown is the name brand of a hyaluronate product? Does it give the concentration, the size of the HA molecules, and recommended dosage rate. These are important questions when considering the efficacy of the product.
DrO
|
Member:
Marti
|
Posted on Wednesday, Jan 25, 2006 - 7:16 am:
Hi Dr. O,
I have no idea of the concentration or dosage. I was just wondering if this was something that would work for Ann's horse. It is being used on human knees.
Can you tell me where I can read up on the muscle enzymes or maybe tell me more about them. You had mentioned this in an earlier post (1-4-06)
Thanks
|
Moderator:
DrO
|
Posted on Thursday, Jan 26, 2006 - 7:14 am:
Probably the best explanation of test results of muscle enzymes would be at Equine Diseases » Lameness » Muscle & Tendon Diseases » Tying Up, Rhabdomyolysis, and Shivers (EPSM).
DrO
|
Member:
Angel77
|
Posted on Saturday, Feb 18, 2006 - 5:48 am:
Dear Marti,
These are all great questions. I too wonder if synovial fluid can regenerate itself. I have been told it can.
It has for my horse. For all the problems my horse has had lameness has not been an issue since the use of one supplement. A supplement that heals a horses body from the inside out.
You will need to look up in the earlier posts in this discussion for my miracle.
Ann,
How is your horse? Can you post a photo of you two from a show possibly in the show ring?
How many days a week does Patrick work ? How many hours a day is he in a stall or turn out?
Sorry it took me so long to return your message. I have been out of town
Just curious.
WTG
|
Moderator:
DrO
|
Posted on Saturday, Feb 18, 2006 - 10:49 am:
Yes joint fluid does regenerate itself and again WTG there is no evidence for the claims that RR makes for its product.
DrO
|
Member:
Pepette
|
Posted on Wednesday, Feb 22, 2006 - 1:27 pm:
I posted this on another thread started by Anne Collier.
After receiving an enquiry from one of my students who has a horse with ringbone, I decided to do some research and read some articles. I found nothing on horses, but there were some pertaining to human studies.
It seems that more studies have been reported in the medical literature on the use of stem cell therapy in rheumatoid arthritis than osteoarthritis. In one report, 34 patients with severe juvenile rheumatoid arthritis who did not respond to previous treatment, autologous (meaning the patient’s own cells) stem cell transplantation resulted in 18 achieving complete drug-free remission. Six showed a partial response (ranging from 30% to 70% improvement) and seven were resistant to the treatment. There were three cases of transplant-related mortality and two of disease-related mortality. The researchers concluded that in severely ill patients with severe juvenile arthritis, autologous stem cell treatment induces a drug-free remission or an increase in general well-being in many patients, but the procedure carries a significant mortality risk. Recommendations were made to improve safety outcomes.
The program that my student was looking into obtained the stem cells from fat. Research into fat-derived cells is still in the very early stages and many questions remain. I'm not convinced these cells deserve to be called stem cells, because I'm not sure they really do turn into other kinds of cells when transplanted into the body. Still, they do show promise for being used someday to treat disease.
Although stem cells derived from bone marrow are used with some efficacy, one concern is that these adult-derived cells may not be as effective as cord blood and placental cells. Adult stem cells, from wherever they are derived, may contain more DNA abnormalities-caused by sunlight, toxins, etc. Those that receive their own stem cells might be prone to repeat the same disease. For breaks, torn tendons, and such, I guess that would not be a concern.
So a concern with adult stem cells is the possibility the cells could form tumors, which was suggested by a paper that appeared in the April 15 issue of Cancer Research, an American Association for Cancer Research journal.
I have run across some owners that will say that this is an animal or an investment, and as such, the results (degree and longevity of successful results, rate of infection and/or mortality, etc) should not be held to human studies standards. That would be up to the owner to decide if the risks and results, as well as the cost, would be worthwhile. I guess it depends on the severity of the problem, too. My horses are my babies, and I would not make this kind of decision lightly. I think I would get a second, and maybe even a third, opinion from a qualified vet or equine hospital (the best ones for this type of inquiry tend to be hospitals associated with Universities, like the University of Maryland).
For this to be a legitimate medical endeavor, I am wondering if it would not be cost-prohibitive for all but the most expensive competition animals or the most financially healthy owners.
Here is something I found from the NIH website:
Scientists must be able to easily and reproducibly manipulate stem cells so that they possess the necessary characteristics for successful differentiation, transplantation and engraftment. The following is a list of steps in successful cell-based treatments that scientists will have to learn to precisely control to bring such treatments to the clinic. To be useful for transplant purposes, stem cells must be reproducibly made to:
Proliferate extensively and generate sufficient quantities of tissue.
Differentiate into the desired cell type(s).
Survive in the recipient after transplant.
Integrate into the surrounding tissue after transplant.
Function appropriately for the duration of the recipient's life.
Avoid harming the recipient in any way.
To summarize, the promise of stem cell therapies is an exciting one, but significant technical hurdles remain that will only be overcome through years of intensive research.
Given what I have written here, I am not saying that one shouldn’t do it. I think a vet would be a more qualified person to answer that after examining the horse and assessing the total situation (the horse's and the owner's). But I do have my reservations.
|
Member:
Coomber
|
Posted on Friday, Feb 24, 2006 - 11:21 am:
Greetings all. Thanks for your input, here is my update.
Patrick’s situation has deteriorated. I moved him from my trainers to a barn with turn out and two days later he suffered acute laminitis which he recovered from within about one week, thank heavens! . He wasn’t showing hoof tenderness four days later. But…he has remained very stiff and sore on his right hock.
Another veterinarian has recommended a surgery, facilitated ankylosis of the hock. If I am understand the process, the cartilage is joint is microscopically drilled out which cause the joint to fuse. I have been told the prognosis is pretty good with a 50% success rate for infected joints and an 80% rate for non infect joints (Patrick I hope).
Does anyone have any input on this surgery. Thanks, Ann
|
Member:
Pepette
|
Posted on Friday, Feb 24, 2006 - 12:57 pm:
Yes, my daughter's pony had this done. The surgery consisted of debridement of the bone, followed by a small bone graft, then casting. She had a resistant infection at the time of the surgery, so they did the best they could. She pulled through it and was no longer lame, but she could no longer be ridden afterwards. This was our last ditch effort to avoid having her put down. She is a happy pasture puff now.
|
Member:
Coomber
|
Posted on Friday, Feb 24, 2006 - 1:36 pm:
Dr. O, What can you tell me about this surgery?
|
Moderator:
DrO
|
Posted on Saturday, Feb 25, 2006 - 9:27 am:
Ann we call this surgery "arthrodesis" and have a article on it at Equine Diseases » Lameness » Joint & Bone Diseases » Arthrodesis and Joint Fusion for Arthritis. In it we discuss the various ways the procedure is done and outcomes.
DrO
|
Member:
Angel77
|
Posted on Sunday, Feb 26, 2006 - 2:16 am:
Dear Dr.O,
Just because you do not agree with my supplementation method I really do not think it is fair of you as a professional to continually put down Rapid Response T.
We all know how you feel about it. So get over it. Let the people decide for themselves.
Obviously you have not used it. So how can you be the judge and jury for the millions of people who do? These people have seen the miraculous healing powers of Rapid Response T.
You have not been so negative about other products. So in my opinion until you personally have witnessed Rapid Response's healing powers please do not knock it. You may be missing out on something really great. Did you ever think of that?
Last time I checked you are not the only Dr. in this world. People are allowed to have their own opinions. Isn't that why this forum exists? For people to explore new and old techniques alike?
I will provide you with your precious evidence as soon as I can get my scanner working.
Honestly,
WTG
|
Member:
Hwood
|
Posted on Sunday, Feb 26, 2006 - 3:02 am:
WTG,
After rereading the above posts to better understand your post tonight, there is nothing in Dr. O's post that says he disagrees with your supplementation methods . . . He only reiterates his previous statement that there are no scientific claims for the product's being able to "heal horses from the inside out." He has previously stated that if we feel that something is working, then we should continue . . . We often do things on faith, without scientific proof, but it is the Dr.'s job to keep us aware of the scientific basis for the causes, symptoms and treatments regarding our horses . . . which is the reason so many HA members joined The Horseman's Advisor in the first place.
Do what you believe and follow your gut, and don't get offended when other people require evidence more solid than what can be gleaned from anecdotes. As an example, in my personal experience with arthritis, and in my experience of owning horses with arthritis, no matter what folks say about the good of glucosamine or chonDrOitin, and though I have taken it myself for years and given it to a few of my horses, I can honestly say that I haven't seen any great results from it. Still . . . I spend money on it and continue to use it . . . proving the point that "hope springs eternal."
|
Member:
Angel77
|
Posted on Sunday, Feb 26, 2006 - 5:46 am:
Dear Hollywood,
I was in the middle of editing my post to Dr.O to be more diplomatic when apparently my time ran out.
What I was attempting to say nicely was until he has at least tried Rapid Response T please do not knock it.
How can any person say something does not work, or I cannot find any evidence of efficacy unless they have used the product themselves?
I was trying to edit the sentence- When I get my scanner working I will provide all the evidence I have which are mostly testimonials from various users as well as renowned vets. As well as the product ingredients.
WTG
|
Member:
Canter
|
Posted on Sunday, Feb 26, 2006 - 10:34 am:
WTG, think of it this way: One doesn't always have to try a product to know that it will or won't work simply because when the active ingredients are broken down, there is no scientific evidence that those ingredients work. Let's take a very simplistic and theoretical (and somewhat silly) example. Say my horse has a bacterial infection of some sort. I've heard that peppermint candies work to clear up the infection, so I feed my horse the candy. Of course, we know that there's no proof that the candy or individual ingredients of sugar and peppermint extract will help this infection and by not treating the horse with something that will help, I'm not doing myself or my horse any favors and indeed, the horse's condition may worsen and I'm spending money on candy instead of an antibiotic.
Silly example? Yes, but I hope that it illustrates what DrO tries to do for us. He tries to point us in the best direction he can to help our horses based on the best SCIENTIFIC evidence out there. Whatever you choose to use on your horse is completely up to you but as other's read your posts it's DrOs "job" to point out the pros or cons to other members.
All the best~
Fran
|
Moderator:
DrO
|
Posted on Sunday, Feb 26, 2006 - 11:15 am:
Hello Everyone,
This morning I returned WTG's membership fee and discontinued her membership. It had nothing to do with her postings which, though somewhat argumentive, were on the whole polite. On these boards I enjoy exploring how we decide what is good for our horses and what might not be so good. However, privately she has continued to email us accusing horseadvice.com of having cheated her because she did not receive the auto-emails of posts for several months and that we are intentionally hiding our fault. You may have seen some of those discussions on this board in other areas. While those posts were not abusive, just argumentive, the personal emails are down right rude. I think this is only about the 3rd person we have terminated in this manner in the 10 years of this site and I thought it required an explanation.
DrO
|
Member:
Hwood
|
Posted on Sunday, Feb 26, 2006 - 11:53 am:
Dr. O.,
Sorry to hear that you have been abused by one of us when you have been trying to help and maintain this sound and informative site.
I can only think that WTG has been trying to balance some stresses in her own life, and you became a convenient and safe scapegoat upon which she could vent some of her frustrations. Take heart and enjoy your Sunday . . . and let this be a lesson to the rest of us :0 . . . Dr. O. knows where to draw the line on putting up with abuse, so beware . . . and when feeling "punchy," go chop some wood! ;-)
|
Member:
Coomber
|
Posted on Monday, Feb 27, 2006 - 8:42 am:
Good Morning everyone, So sad about WTG, though I must say I felt she really had a hang up on pushing the rapid defense on people.
But back to facilitated ankylosis of the hock surgery, Dr. O what do you think? I really miss riding; I can only afford to keep one horse so I want to settle on a solution for Patrick. The options I have come up with since his worsened lameness are:
1. Spend the approx. $3,000 for the surgery and hope I have a sound horse in 3 to 6 months.
2. Keep on the same supplement program and rest and see if the hocks improve or stabilize, something two vets have now told me they don’t think will happen.
3. See if the University of Florida will take him for their program or find someone who wants a horse out in pasture and purchase another horse.
My vet took digital X-rays a month ago. I’ll see if I can get them and post them.
|
Moderator:
DrO
|
Posted on Monday, Feb 27, 2006 - 6:58 pm:
Hello Ann,
Here is one way of looking at it devoid of the personal considerations and taking into account the risk the surgery will not work:- First is the wait for post surgery healing acceptable? If not find a good home.
- Next step is too take the 3000 dollars for the surgery, divide by the prognosis (lets be conservative and say 50%) and we get 6000 dollars. Can you replace Patrick for this? If not it makes sense to attempt the surgery.
If you can replace him for less than 6000 dollars then from a cost/risk standpoint it makes sense to replace him. I completely understand the decision is more emotional but somtimes a objective look at the problem "clears the palate".
DrO
|
Member:
Marti
|
Posted on Thursday, Apr 6, 2006 - 9:27 am:
Hi Dr. O,
I see Ann C. has not been back posting any information lately. Well this is because she has been a very busy lady taking care of Patrick after his hock surgery. Actually we have both been pretty busy since his surgery.
Patrick seems to be coming around real good after the surgery. At the recommendation of the surgeon Patrick had both hocks done. He has been a pretty sore boy for the past few weeks. His recovery treatment includes hand walking only and complete stall rest. His walking seems to have improved this past week so that it is noticeably better now. I am sure that Ann will catch everyone up to date as soon as she has the time.
Dr. O your advise concerning doing the surgery or not was very instrumental in Ann's decision. There would be no way to replace Patrick for $6,000.00. He now has the chance he so deserves and hopefully he will be able to return to being the wonder performance horse he once was.
|
Moderator:
DrO
|
Posted on Friday, Apr 7, 2006 - 8:07 am:
Thank you Marti for the update and I have Patrick in my mind, sending out all the good vibes I can muster.
DrO
|
Member:
Paul303
|
Posted on Friday, Apr 7, 2006 - 10:36 pm:
Marti: This has been quite a thread! Thank you for your post and please let Ann know that Patrick's surgery and recovery has become important to many of us. She bought this horse on what she considered to be expert advice, and when things didn't turn out perfectly, she chose to concentrate her energies on the horse and move forward. I admire that and offer best wishes for a speedy recovery.
|
Member:
Coomber
|
Posted on Saturday, Apr 8, 2006 - 4:28 pm:
Hello fellow equine enthusiast,
Thanks for prodding me into an update Marti and thank you for taking the 4:30 am and 10:30 pm medication shifts for Patrick. I could not have done this without you. The short version of the narrative below is that Monday will be four weeks from the surgery and Patrick is doing fantastic!!! Yippee!!!! I may start riding him at the walk next week.
On March 13th at the recommendation of my local vet, Patrick was taken to Dr. John B. Madison, V.M.D., Diplomat, American College of Veterinary Surgeons, who performed a facilitated ankylosis procedure on both of Patrick’s hock (two of the hock joints were drilled out). The right hock was far worse than the left so special impregnated (with antibiotics?) bone cement used in human surgeries was also placed in this hock. The procedure was done in the morning and Patrick was sent home, a 100 mile trip, that afternoon.
Needless to say I DrOve extremely cautious but the trailering after the surgery took it’s toll and Patrick was in terrible pain for the next few days. 2 grams of bute was administered 2 times a day for 4 days, then 1 gram twice a day for the next 6 days. Chloramphenicol was prescibed every six hours for 28 days(Thank God for Marti's help). Hand walking was started and around day 7. The legs were swelling due to his standing around.
The hocks had to be wrapped for 16 days and the wraps produced pressure type sores which were very scary on the top of the hock at the tendon. The local vet has done an outstanding job visiting and counseling us as needed with the wound care.
The leg swelling slowly subsided but after the wraps were removed the left hock area retained fluid and swelled and caused some lameness which subsided in several days. Just before the left hock swelled I tried cutting the bute out as Patrick was walking with nice sound steps. On the 3rd day of no bute Patrick was found in great discomfort and not eating. He was returned to 1 gram of bute a day and pro-biotics were administered. His appetite and comfort level returned to normal within 12 hours.
Patrick is walking 20 minutes twice a day with fluid deep reaching steps and an occasional rear or back up when he is corrected for nipping at the leading hand. He has gained back the lost weight from the pain stress and over all appears to be more comfortable and sound the prior to the surgery. He was rated 4 of 5 lame before the surgery and now only has a slight hesitation on his right leg on occasional steps. He be lame tested by the vet next week.
Thanks so much for all of the warm wishes and support. I’ll keep you posted.
|
Member:
Coomber
|
Posted on Saturday, Apr 8, 2006 - 4:44 pm:
Hello fellow equine enthusiast,
Thanks for prodding me into an update Marti and thank you for taking the 4:30 am and 10:30 pm medication shifts for Patrick. I could not have done this without you. The short version of the narrative below is that Monday will be four weeks from the surgery and Patrick is doing fantastic!!! Yippee!!!! I may start riding him at the walk next week.
On March 13th at the recommendation of my local vet, Patrick was taken to Dr. John B. Madison, V.M.D., Diplomat, American College of Veterinary Surgeons, who performed a facilitated ankylosis procedure on both of Patrick’s hock (two of the hock joints were drilled out). The right hock was far worse than the left so special impregnated (with antibiotics?) bone cement used in human surgeries was also placed in this hock. The procedure was done in the morning and Patrick was sent home, a 100 mile trip, that afternoon.
Needless to say I DrOve extremely cautious but the trailering after the surgery took it’s toll and Patrick was in terrible pain for the next few days. 2 grams of bute was administered 2 times a day for 4 days, then 1 gram twice a day for the next 6 days. Chloramphenicol was prescibed every six hours for 28 days(Thank God for Marti's help). Hand walking was started and around day 7. The legs were swelling due to his standing around.
The hocks had to be wrapped for 16 days and the wraps produced pressure type sores which were very scary on the top of the hock at the tendon. The local vet has done an outstanding job visiting and counseling us as needed with the wound care.
The leg swelling slowly subsided but after the wraps were removed the left hock area retained fluid and swelled and caused some lameness which subsided in several days. Just before the left hock swelled I tried cutting the bute out as Patrick was walking with nice sound steps. On the 3rd day of no bute Patrick was found in great discomfort and not eating. He was returned to 1 gram of bute a day and pro-biotics were administered. His appetite and comfort level returned to normal within 12 hours.
Patrick is walking 20 minutes twice a day with fluid deep reaching steps and an occasional rear or back up when he is corrected for nipping at the leading hand. He has gained back the lost weight from the pain stress and over all appears to be more comfortable and sound the prior to the surgery. He was rated 4 of 5 lame before the surgery and now only has a slight hesitation on his right leg on occasional steps. He be lame tested by the vet next week.
Thanks so much for all of the warm wishes and support. I’ll keep you posted.
|
Member:
Mrose
|
Posted on Saturday, Apr 8, 2006 - 7:07 pm:
Ann, this sounds so good!! I'm so glad for you and Patrick! Keep us posted, please.
|
Member:
Paul303
|
Posted on Monday, Apr 10, 2006 - 2:38 am:
Oh, WOW!!!
|
Moderator:
DrO
|
Posted on Monday, Apr 10, 2006 - 7:47 am:
Got my fingers crossed hoping for the best Ann!
DrO
|
Member:
ngossage
|
Posted on Friday, May 4, 2007 - 9:02 am:
Hi, Ann. Just wondering if you could give us an update as to how Patrick is doing?
Thanks!
Nicole
|
|
|
