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Member
Posts: 31
| I have a 7 yr old gelding that has a stifle problem. It's been blocked so the vet is ure it's his left stifle. It was injected about a year ago but didn't improve. So the vets recommendations are as follows:
1) inject again and double nortrex(I have no idea what this is)
2) pro stride ?
3) shockwave treatments?
4) lastly if the above treatments don't work, do arthroscopic exploration and repair.
His ultrasound shows bilateral synovitis bulging left meniscus with fiber patter defect. X-rays show mild roughening left med meniscus like attachment.
The vet said none of these are a guaranteed fix. All of the above if I had to do them all, would be around 5k. Which I don't mind spending if I know I can compete on him. But to see him in the pen you'd never know he has a problem, runs, bucks, rips around. So if he's going to just be a pasture pet, he's ok like he is. Any experiences you've had with any of the above treatments that you could share, I'd sure appreciate it. |
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Defense Attorney for The Horse
 
Location: Claremore, OK | Stifle problems, especially meniscus problems can be hard to fix. If I was going to try something non invasive I would go with ProStride and time off and see what happens. You can do arthroscopy if you the ProStride doesn’t work and you want to see what the problem is. Just keep in mind that you might not be able to fix what the problem is.
Noltrex is a synthetic, 3rd generation acrylic that’s now being used in joints. My only experience with it has not been good. It’s main selling point is that it doesn’t break down like the normal HA and steroids. |
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 It Goes On
Posts: 2262
Location: Muskogee, OK | Benefits of arthroscopy would be knowing exactly what you have going on in the joint, cleaning up any fraying/tearing, and assessing how bad the cartilage damage is. You aren't going to be able to "repair" per say anything that is damaged, but they will clean up edges of cartilage erosions, fraying of soft tissue structures etc. What you need to decide is how bad do you want to know that information- also remember sometimes ignorance is bliss when it comes to knowing just how bad the lesions are. (As bad as that is for me to say as a veterinarian).
Generally speaking, when a stifle doesn't hold on traditional joint injections and repeatedly blocks there that usually means there is a soft tissue component (meniscus, cruciate ligament, etc) and secondary cartilage damage.
I had a 3 year old that we scoped the stifle, didn't find any soft tissue lesions but had extreme full thickness cartilage erosions. We ended up putting stem cells in the joint and he did go on to be "for the most part" sound. But any time there is full thickness cartilage damage this carries a guarded prognosis.
If this were my horse and you weren't wanting to do the arthroscopy I would definitely try Prostride- but realize this horse will also likely need a significant period of rest. Extended stall rest followed by controlled turnout etc. I would probably inject with pro stride, rest x 6 months and then inject with Prostride again before putting back into work. Time frame of going back to work will of course depend on how the horse responds, how sound he gets etc.
Some follow up questions: How lame is this horse actually? Did your vet put a grade on it? Have they ever mentioned any stifle effusion? Do you have x-rays to share? |
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Expert
Posts: 1207
| What is Prostride? |
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Expert
Posts: 1207
| Nevermind, I googled it. Good luck with whatever you decide. |
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Member
Posts: 31
| Out in his pen you'd never know he was lame. The only thing is, he sometimes stands with his hind left leg out behind him. He's not happy at a lope, and will break into a full blown buck if I take him around a barrel.
She didn't assign a number to his lameness, I don't have the X-rays but could get them sent to me. She didn't mention stifle infusion.
Turning him out to rest is not a problem, he's had over a year and a half off already. He's barely patterned For barrels has been ridden so sparingly. Early thought was the ulcer was causing the misbehavior so the stifle wasn't addressed.
Thank you for all of your explanation. :) |
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Member
Posts: 31
| Thank you for your input. So it looks like the pro stride is an injection then. Also by the sounds of it, and the other poster, don't get my hopes up of competing on him. I can take the truth, I just didn't have any opinions of what to expect except from you all. Thank you :) |
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It Goes On
Posts: 2262
Location: Muskogee, OK | Tnmunch - 2019-01-29 11:13 AM
Out in his pen you'd never know he was lame. The only thing is, he sometimes stands with his hind left leg out behind him. He's not happy at a lope, and will break into a full blown buck if I take him around a barrel.
She didn't assign a number to his lameness, I don't have the X-rays but could get them sent to me. She didn't mention stifle infusion.
Turning him out to rest is not a problem, he's had over a year and a half off already. He's barely patterned For barrels has been ridden so sparingly. Early thought was the ulcer was causing the misbehavior so the stifle wasn't addressed.
Thank you for all of your explanation. :)
That's the tough part about truly "resting" a horse- in order to heal soft tissue injuries a lot of the time strict stall rest is needed for an extended period of time. Unfortunately just turning the horse out is not resting them at all, because they can get to ripping and tearing around the pasture just like they would do during riding- actually they can get to doing more activity actually being turned out vs. just riding- and it only takes one joy ride around the pasture to un do any significant healing. Just something to keep in mind when veterinarians recommended "resting" the horse. |
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Member
Posts: 31
| Makes sense. Fortunately I've never had to deal with this type of injury so I don't have a lot of knowledge about recovery etc...
I just thought he must not be hurting that bad if he played that hard.
Well noted, thank you. |
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Elite Veteran
Posts: 618
Location: Northwest | I had a horse with cartilage and meniscus damage in both stifles. Did arthroscopic surgery to smooth out the cartilage and clean up the meniscus. Followed up with both stem cell and irap treatments. Horse made a full recovery and returned to a successful barrel racing career. |
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Member
Posts: 31
| That sounds promising. I'll look into the Irap treatments, that's a treatment I hadn't heard of yet, thank you. |
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Location: Georgia | Prostride is a hybrid of PRP and Irap. I’ve had it done successfully on a horse with a stifle cyst. It’s done by guided injection while the horse is under anesthesia. I highly recommend it but definitely make sure to use a GOOD vet. I’m a firm believer that there’s a difference in the outcome of any joint injection depending on who does them. |
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 Ima Cool Kid
Posts: 3496
Location: TN | have a mare with bone cyst in left stifle we did Tildren and she was sound for 9 months. wondering about prostride???? ( she is going to be a momma this spring)
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 Did I miss the party?
Posts: 3864
| I've seen Noltrex help some with low motion joints but, I've seen it actually make stifles worse on more than one occasion.
If you've got soft tissue damage, time off is going to be required no matter the treatment protocol you choose.
If it was me, based on what you've said so far, I'd go with stem cells for the soft tissue damage and time off.
Then, I'd do pro-stride when bringing the horse back in to work.
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Stifle surgery possibility