What is Equine Regenerative Medicine?

Fall 2019 Newsletter

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Regenerative Medicine Moves into the Future at

Palm Beach Equine Clinic

A PRP tendon injection being performed at Palm Beach Equine Clinic. Photo courtesy of PalmBeach Equine Clinic

As sport horses become faster and stronger, veterinary medicine is oftenchallenged to break barriers to provide the best in diagnostic andmaintenance care. Palm Beach Equine Clinic is consistently on the forefrontof those advances and employs a team of veterinarians equipped with thelatest developments in regenerative medicine.

Two resources that have become increasingly popular to treat equineinjuries are Platelet Rich Plasma (PRP) and Interleukin-1 ReceptorAntagonist Protein (IRAP), which encourage regeneration of injured ordegenerative tissue. Managing joint diseases and injuries using thesemethods is ground-breaking, but logical at its core. They essentially usenaturally occurring proteins, cells, and other natural processes originatedfrom within the body of the horse to put the horse’s own biologicalmechanisms to work stimulating healing without the use of steroids or otherdrugs.

What is PRP?

Platelets are among the very !rstcells to accumulate at an injuredsite, making them very importantwhen simulating the repair process.Platelets contain granules !lled withgrowth factors (the elements thataid in healing) and stimulatespeci!ed tissue to heal at anincreased rate. To treat a horse withPRP, the veterinarians at PBEC areable to take a sample of the horse’sblood and concentrate the plateletsin a high-speed centrifuge on-site.The harvest and processingprocedures take approximately 30minutes before the concentratedplatelet-rich sample is injected backinto the horse at the speci!c area ofinjury using sterile techniques andguided by ultrasound.

PBEC’s Board-Certi!ed Sta"Surgeon, Dr. Weston Davis,explained PRP use in more detail:“We harvest a large quantity ofblood, anywhere from 60 to180milliliters, and we process that toconcentrate the segment that isvery rich in platelets. We get a highconcentration of platelets—we arehoping for !ve to eight times theconcentration that you would getfrom normal blood. Then we takethat platelet-rich extract and inject itback into an injured area toencourage a more robust healingresponse. Whenever you have aninjury, platelets are one of the !rstcells that get there. They willaggregate, clump, and de-granulate. They release granulesthat are very rich in growth factorsand signal the body to start thehealing process.”

What is IRAP?

IRAP is used to treat equine athletesthat are susceptible tomusculoskeletal injuries andosteoarthritis or degenerative jointdisease. Joint trauma results in therelease of in#ammatory mediatorssuch as Interleukin-1 (IL-1). IRAPuses a horse’s own anti-in#ammatory protein found withinthe blood to counteract thedestructive e"ects of IL-1 to slow theprocess of osteoarthritis. Theprocess works by binding to the IL-1receptors in the joint and blockingthe continuation of damage andin#ammation.

“We often see joint damage in sporthorses because of the nature oftheir work, but we try to avoid over-use of steroids in joints becausesteroids can have long-term e"ectson cartilage,” said Palm BeachEquine Clinic veterinarian Dr. BryanDubynsky. “This is a way we canmanage joint disease and stopin#ammation without having toconsistently use steroids. Some ofour clients will maintain their horseson IRAP alone for joint injections.”

Palm Beach Equine Clinic's high-speedcentrifuge. Photo courtesy of Palm Beach

Equine Clinic

The goal to better serve sport horses that continue to improve athletically isthe driving force behind the search for even more developed and precisetechniques used in regenerative medicine. And, at PBEC, the work to breaknew ground is never !nished.

“I believe we are learning more about these technologies with moreadvanced science behind what they do and how they do it,” said Dubynsky.“These treatments are natural, drug-free, and competition-safe, andnecessity drives the need for regenerative therapies in the sport horseworld.”

Have further questions about the regenerative therapy programs availableat Palm Beach Equine Clinic? Call the clinic today at 561-793-1599 to learnmore.

From The Hospital: Walking Sutures on a

Degloving Injury

Palm Beach Equine Clinic is known for trusted and knowledgeableteamwork between its veterinarians. That reputation went into motion whena horse with a degloving injury to its left hind cannon area was admitted tothe Palm Beach Equine Clinic hospital.

Photos courtesy of Palm Beach Equine Clinic

Several Palm Beach Equine Clinic veterinarians jumped into action toperform these walking sutures! The goal of this approach was to stretch theskin enough to reappose it with the walking sutures. This technique involvesa process where each suture is placed !rst in the deep dermis and then intothe deeper tissues, usually fascia, at a point closer to the center of thewound. The e"ect is to move the skin closer to the closing position witheach suture, minimize the dead space between the skin and underlyingtissue, and relieve tension on the sutures eventually placed to close thewound edges.

Prognosis? So far, this patient is recovering well!

Meet Palm Beach Equine Clinic’s Abby Berzas

Abby Berzas, 26, grew up in L’AnseMeg/Duralde, Louisiana, just 10minutes from one of the world’smost popular Mardi Grascelebrations. Aside from knowinghow to put on a great party, hercommunity was nestled deep withinfarm country. So, it’s no surprise thatAbby grew up around horses, abeginning that led her to studyagricultural and equine sciences atMcNeese State University insouthwest Louisiana beforeattending veterinary school at St.George’s University in Grenada. Shecompleted her veterinary studies atLouisiana State University and madeher way to south Florida for thewarm weather, ocean, and ofcourse, the horses! Abby works atPalm Beach Equine Clinic as anintern, and she has big plans for thefuture.

Learn more about Abby:

How did you !rst get involved with

horses?

My siblings and I grew up aroundhorses! We had quite a few pets andfarm animals, but horses werede!nitely “my thing.” We grew uptrail riding andexploring the farmland behind ourhouse. We would wake up beforesunrise, pack a lunch, and spend theentire day riding. I got involved inrodeo (barrels, poles, and goat tying)and did that through high school.

What led you to study/become

interested in equine veterinary

medicine?

It’s something I’ve always wanted todo. Regardless of the times Ithought I might practicemixed/small animal medicine, myheart has always returned to equinemedicine.

My biggest in#uences to pursueveterinary medicine were myparents. They aren’t veterinarians,but through their examples I’velearned that work needs to beful!lling. At the end of each day, Ineed to be happy with what I choseto do with my life.

What do you enjoy most about

treating horses?

I most enjoy being around them! It’salso a challenge. Every day is alearning curve, and every day is anopportunity to become better,despite the obstacles. I also reallyenjoy feeling appreciationfrom owners. It’s so nice when anowner genuinely thanks you for yourhelp. To know that what I do makesa di"erence in the lives of others is abig part of why I chose to practiceveterinary medicine.

What are your day-to-day

responsibilities at PBEC?

As interns, we take care of anyhospital patients admitted, whetherthat be surgery or medicine patients.We run anesthesia for surgeries andassist with after-hour emergencies.We are also able to take ambulatorycalls when the hospital isn’t so busy.

What do you enjoy most about

being part of the PBEC team?

I enjoy the good energy here!Everyone is cheerful, welcoming,and willing to help. I feel lucky to beable to complete my internship insuch a healthy work environment. Iam happy doing a variety of things,but I really enjoy internalmedicine. Also, I will be certi!ed inmixed-animal acupuncture soon, soI’d love to incorporate that into mypractice eventually.

What can we !nd you doing when

you are not working?

Lately, I’ve been spending days o"at the beach with my dog and!ancé. I was recently given my veryown kite and kite board, so I’ll bekiteboarding whenever the wind isgood! I also love hiking andexploring new beaches or parks. Iwould love to ride in my spare time,but my ponies are in Louisiana withmy family.

Healthcare Reminder: Equine Dentistry

Dr. Tyler Davis performing a dental exam. Photos courtesy of Palm Beach Equine Clinic

According to a study conducted by North Carolina State University,approximately 40% of horses have signi!cant dental problems. What’s theanswer to many of those problems? Prevention! Dr. Tyler Davis of PalmBeach Equine Clinic states that routine and thorough dental exams can helpprevent many issues from ever becoming problems.

On a basic level, dentistry in horses is important because the mouth is the!rst part of the horse that is taking in and processing food. Horses mustgrind their food into a !nely masticated bolus before swallowing. Thecombination of a horse’s upper jaw being larger than the lower and the factthat a horse chews by moving the jaw from side to side results in unevenwear of the teeth. This uneven wear may cause sharp edges, which hindere$cient chewing and may ulcerate or lacerate the cheeks and tongue. Thepain caused by the ulcerations or lacerations can result in incompletemastication, sometimes leading to problems like colic.

What is "oating?

Floating is the term for rasping or !ling a horse's teeth to ensure an even,properly aligned bite plane. While #oating is the physical process, thescope of an equine dental exam is much broader and examines the horse'soverall health as in#uenced by the mouth.

"You can get a rasp and without

even looking in the horse’s mouth

"oat the points o#, and you may be

getting the vast majority of the

work done,” said Dr. Davis. “But a

really good dental exam with a

speculum, a very good light

source, and a dental mirror allows

you to see possible problems and

prevent those problems from

becoming painful and a#ecting

your horse’s overall health.”

The most common signs of dental

discomfort in horses include:

head-tilting and tossingdi$culty chewingbit-chewing and tonguelolling tail-wringing and buckingdrooling and bad breath(sometimes) weight loss andspillage of grain

For sport horses, dental care becomes even more important. Much of theconnection between horse and rider comes by way of the horse’s mouth. Ifthere are problems or discomfort within the mouth, it will be evident in thehorse’s performance and disposition under tack. According to Dr. Davis,having a horse’s mouth in healthy condition allows one to immediately ruleout dental issues when trying to troubleshoot a performance problem.

How often should you have a veterinarian perform a routine dental exam

on your horse? Dr. Davis recommends every 12 months at the veryminimum.

Contact your veterinarians at Palm Beach Equine Clinic for more informationon equine dentistry or to schedule a dental exam at 561-793-1599.

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