Region 13 Show

This past week we were in Ohio for the region 13 Arabian Horse Show. It was a relatively slow show for us, but we got a bit busier at the end of the week. It was very hot at the show so we had a few horses that coliced and we tubed them and gave them fluids. There were also a few horses at the show that appeared foot sore. Dr. Hill used hoof testers to determine how foot sore the horses were, and we would take x-rays of their feet to see if any of them had rotation of the distal phalanx. Rotation is a big concern for laminitic horses, and it is important to catch it quickly so the horse has the best chance at recovery with very minimal rotation. If there is too much rotation the distal phalanx can come through the sole of the foot. After checking the x-rays we administered one liter of  IV fluids with DMSO. The DMSO is a systemic anti-inflammatory and seems to help laminitic horses. Dr. Hill recommended that the horse lose weight in order to decrease his chances of becoming more laminitic, or having problems in the future. Dr. Hill also drained a set of boggy hocks at the show. The horse had big painful hocks with a lot of increased joint fluid in the tarsocrural joint, which is the top joint space in the hock. It is common to see that kind of effusion if the horse has bone chips in the joint. This was a horse that Dr. Hill has worked on before and they have checked it for bone chips, but there weren't any present. This is why he simply drained the fluid and injected the horses hocks with some steroids and polyglycan. The most interesting case of the week was one horse we have previously seen on its farm. The horse was base line lame on its front right, and was known to have previous problems with that coffin joint. We did a nerve block and the horse blocked sound to a palmar digital block which is the lowest block on the leg and blocks that back third of the foot. We then took x-rays of the joint, and Dr. Hill was not unhappy with what he saw. He then injected the horses right front coffin joint with steroids. This all occurred at the farm at the beginning of the month. The horse was at the show for us to re-check, and her lameness had not changed. She was still base line lame on the right front. Dr. Hill wanted to do another block to ensure the horse blocked the same as it had at the farm, but he later decided he would start with blocking the coffin joint. The horse was much improved after blocking the coffin joint. The owners wanted a more aggressive treatment, and chose to have us pull IRAP on the horse. IRAP is a regenerative therapy and stands for  Interleukin-1 Receptor Antagonist Protein; it is a protein that inhibits interleukins, or inflammatory proteins. The treatment involves drawing blood from the horse, and then processing it so that you obtain the plasma that is rich in the Interleukin-1 receptor antagonist proteins. Once the plasma is obtained it must be frozen; it can then be thawed to inject into the affected joint. We injected the horses coffin joint with one syringe of the IRAP we harvested, and Dr. Hill has scheduled the horse to go in for an MRI to determine what is going on with the soft tissue structures in the hoof around the coffin joint. This will help determine the extent of the injury and the course of treatment. We are now down in Kentucky for the Region 14 horse show. I'll fill you in on that next week.

Dr. Hill filtering the IRAP plasma. 

The IRAP being injected into the coffin joint. 

A halter horse being presented in its class.