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PRP for Periostitis

Periostitis is a condition which primarily affects the limbs of young animals. There is a tendency for it to develop during the growth stage when the skeleton is extremely active.  Race horses oftentimes develop Periostitis in the shin bones. When they do, this is sometimes referred to ‘sore shins.’ It is not uncommon for horses to also develop acute Periostitis in the lower jaw area. Injuries caused by bits can lead to the development of the condition in this part of the body.

There are two forms of Periostitis, acute and subactute. When a horse suffers from an acute form of the disease, there is a possibility that the condition will spread to the bone, resulting in bone death and sloughing. When a horse is stricken with the more common form of the condition, subacute Periostitis, the periosteum will often begin to thicken and new bone may even begin to form.

Horses that suffer from Periostitis may experience poor blood circulation. This may occur when the blood vessels in the part of the body stricken by the condition, are pressed down by exuded matter. As a consequence, the underlying bone fails to get the nutrition that it needs.

The periosteum membrane is also sometimes lifted from the bone because of exudation involving the blood vessels which lie underneath the periosteum. When this occurs, the section of the corresponding bone may die, again, because it is not receiving an adequate amount of nourishment from the blood vessels. When the latter occurs, it becomes necessary to remove the dead portion of bone.

Periostitis is a condition characterized by inflammation of the connective tissue which surrounds a horse’s bones. It often occurs alongside a condition called Ostitis. Ostitis occurs when too much blood makes it way to the inflamed area. In response, an excessive amount of tissue begins to develop.

Acute Perisotitis can occur after an injury to the membrane, for instance from a nail puncture to the injured area. This condition is very painful and may result in lameness. A chronic form of the disease may also develop. This is often referred to as sore shins or splints because the shins are the part of the limbs that this condition most often develops. However, it must be noted that it can occur in any part of a horse’s skeleton.

In summary, Perisotitis is a very serious condition and one which requires immediate attention once a horse is suspected of having it. If a horses’ owner notices lameness, inflammation and lots of heat, it is imperative that he or she get the horse checked out immediately. If he or she fails to, the condition may worsen, making treatment more difficult. It may also become necessary that more intensive measures be taken. . The sooner a correct diagnosis is made and treatment begins, the better off the horse will be.

Causes

Acute Periostitis may be the result of a membrane injury, past or present. However, there may or may not be a wound present when the injured area is examined by a veterinarian. Typically, the injury is severe enough to cause the onset of Periostitis but not severe enough that the bone is fractured, though a fracture can cause the onset of the condition. Periostitis may also develop when the periosteum begins to separate from the bone beneath it.

Acute Periostitis may develop after a hard blow to the animal’s bone has occurred, for instance, a horse may have kicked against a very hard object or had its foot run over. Puncture wounds may cause the onset of the condition as well.  A case of simple, acute Periostitis will result in a thickened and reddened membrane that may eventually begin to strip away from the bone. It may even begin to take on a gelatinous appearance.

Symptoms 

A horse that suffers from Periostitis may develop the following symptoms in the injured area, inflammation, lameness, heat and pain.  If the bone dies, but is not removed, it may begin to crumble and exit the body via blood, pus and other discharge. It can also become trapped in the body. There are number of risks associated with this, including blood poisoning.

Inflammation: Inflammation is one of the most commonly occurring Periostitis symptoms. Swelling generally occurs soon after the onset of the condition.  It may initially feel firm, then soft and after awhile begin to fluctuate between the two sensations. The more severe the condition, the more severe the inflammation will be.

Once a horse’s owner notices swelling, they should rest the horse or at least cut back on its activities and schedule an appointment with a veterinarian.  If the inflammation occurs alongside lameness, heat and pain, there should be an increased sense of urgency to have the injury checked out.

Lameness: A horse with Periostitis may develop acute lameness. The animal may find it difficult move the injured area.  If it has developed in the limbs, there may be a change in gait and it may become difficult for the horse to walk or run. Lameness is a huge clue that something is wrong and that the injury warrants attention from a medical professional, i.e., a veterinarian.

Heat:  Periostitis may cause the injured area to feel warm or heated. The horse’s owner, trainer or vet after palpitating it will find that the injured area feels warm to the touch. This symptom is a common one when a horse develops an injury such as this one.

Pain: Periostitis is a very painful condition. The horse which develops it will not want to use the part of the body stricken with it. The presence of pain will also be evident upon palpitation of the injured body part by the vet. It will typically be very tender.

The Development of Abscesses:  An abscess may eventually form. If the bone dies, it will be begin to crumble and may show up in discharge or pus.  Subsequent blood poisoning is a risk as is the development of abscesses in the horse’s organs.

Diagnosis

When a horse is suspected of having Periostitis, a vet will first visually inspect the leg. He or she will then look for inflammation, changes in behavior, gait and lameness. He or she will also palpitate the injured area to check for tenderness, pain, heat and again, inflammation.

To verify his or her suspicions regarding Periostitis and to determine the extent of the condition, the veterinarian will X-ray the injured area. After the aforementioned has taken place, a diagnosis will be made. The diagnostic process is pretty straight-forward and uncomplicated. This is a common enough injury that vets know exactly what they are looking for and how to go about it finding it.

Treatment

A horse that develops Periostitis will be required to rest completely. It may even be necessary to incise the periosteum. This is done to get rid of matter, i.e., pus, blood, etc. that has accumulated because of the condition. Getting rid of the aforementioned matter lessens the likelihood that the bone will separate from the membrane. If it has already done so, the veterinarian may clean the wound with an antiseptic solution. Any dead bone will also be removed. Platelet rich plasma (PRP) therapy is a treatment that may be used alongside any of the above. It is used by some veterinarians to jumpstart and then expedite the healing process.

PRP therapy has been around for some time and has been used to treat human beings for decades. Though a lot is being made of PRPs use in dermatology, cosmetic procedures and sports medicine it was used prior for purposes aside of the aforementioned. One of its first applications was in the field of dentistry.

Because the human body and those of animals are very similar in many ways, treatments which work for human beings sometimes works for animals as well, as is the case with PRP therapy. It is thus increasingly being used to treat horses. Sometimes it may be used alongside other medical procedures, sometimes in lieu of it. In the case of Periostitis, it is used in conjunction with other forms of care. The goal of its use is to speed up the healing process. Its ability to do the aforementioned is due to procedure’s use of growth factors.

Growth factors are proteins and are key to what makes PRP therapy effective. They are found in the blood’s platelets. Blood is made up of several components, red blood cells, white blood cells, plasma and platelets. Platelets help the blood to clot. They also release growth factor proteins, which help heal the body. When used in PRP therapy, a concentrated number of them are injected directly into the wound. This concentration of platelets helps to speed up wound, tissue and bone healing.

When a horse undergoes PRP therapy, it is brought to a vet’s office, though some veterinarians may be willing to make house calls. To begin the procedure, the vet will first prep the horse. This will typically involve sedating the animal and administering a nerve block.  The horse will be standing. Blood is then drawn. On average, vets will draw 52 mLs in a 60 mL syringe that contains 8 mLs of some sort of anticoagulant solution. This blood, while in a vial, will be placed in a centrifuge machine, until all of its components are separated. As mentioned above, the blood is made up of the following components, red blood cells, white blood cells, plasma and platelets. After the components have separated, the platelets are drawn out and then re-injected into site of the injury, in this case, the site of the Periostitis.

Injection of the platelets does not typically require ultrasound guidance. If the veterinarian decides that he or she would rather not inject the platelets, for whatever reason, he or she may instead use a gel or spray. The treatment outcomes should be similar to traditional autologous PRP therapy, which is done via injection.

After a horse has undergone PRP treatment they will required to rest. This is in part because of the PRP procedure and also because of the injury which was why the treatment was administered in the first place.  Rest may also be required so that the injury does not worsen and so that it can properly heal.

PRP therapy is typically not painful, nor is it extremely invasive. The pricks of the needle where the blood is drawn and the platelets re-injected may be a bit bothersome but not necessarily painful. Some people who have had the procedure one have mentioned feeling a sensation of pressure and burning but not generally a significant amount. It is thus not very likely that a horse is experiencing much if any pain. The sedation and nerve block almost guarantees that it isn’t.

One of the best things about PRP therapy is the lack of complications commonly associated with it. PRP uses a horse’s own platelets. Therefore, the possibility of complications occurring is small. The body won’t reject its own fluids and there are few other potential complications. There is a possibility that the injections sites become infected but a horse faces this risk every time that they receive an injection or shot, so it is not considered a serious one. The potential rewards and gains associated with the use of PRP therapy outweigh any possible complications. The fact that there are potentially few of the latter is one of the primary reasons why more and more vets are beginning to use it, this is of course in addition to its effectiveness and ability to jumpstart and speed up the process of healing.

Veterinarian medicine is taking a new direction in many aspects, much like that of its human counterparts. More study and emphasis is being placed on procedures that use a body’s own ability to heal itself, whether that be a human body or an animal one. The body is quite remarkable in this regard. It is in recent years that scientists and researchers have begun to discover this, with new discoveries and insights being made, seemingly everyday. PRP therapy and the use of stem cells are two of the most promising treatments that harness the body’s natural healing power. Ongoing research is being done to maximize the healing capabilities of both the aforementioned.

Horse owners interested in having their animal undergo PRP therapy should speak to their veterinarians about its possible usage. He or she will be able to fullly explain the process, including the pros, cons and potential outcomes. Again, it is likely that PRP will be used in conjunction with traditional therapies for the treatment of Periostitis, such as rest, the use of anti-inflammatory medication, incision and possible removal of dead bone, not in lieu of the aforementioned.  Its use will be to speed up the healing process. It can not be used to treat the condition of Periostitis independent of the traditional, treatment protocols mentioned above.

 

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