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Ultrasound Guided Injections

Cavallo Veterinary Services is proud to offer a variety of ultrasound guided injections.  Dr. Sotela has undergone advanced training in ultrasound with ISELP.  This has allowed her to increase her accuracy of diagnosis and treatment of the equine athlete.  Using ultrasound when treating certain synovial structures and soft tissues allows for increased accuracy and efficacy of treatment.  

 

Ultrasound guidance can be used in the following areas:  

  • Joint Injections including hip, shoulder, elbow, and stifle

  • Navicular Bursa Injections

  • Cervical Facet Injections

  • ThoracoLumbar Facet Injections

  • Interspinous Injections

  • Lumbosacral & Sacroiliac Injection Techniques    

  • Tendon & Ligament Injections

Ultrasound Guided Injections

Cavallo Veterinary Services proudly offers Pro-Stride and PRP therapies for your horse. 

Pain and inflammation in your horse's joints can cause damage to the cartilage and other intra articular structures over time. Pro-inflammatory cytokines including interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF-alpha) are to blame. If not treated, they bind to the cell surface receptors on cartilage and start the degradation process.  Your horse has several naturally occurring inhibitors (anti-inflammatory proteins) to block the pro-inflammatory cytokines.  Pro-Stride highly concentrates these inhibitors to help reduce pain and protect the cartilage.  

Pro-Stride can be used to treat joint inflammation and arthritis. It is an autologous, steroid free treatment with no drug withholding times for horses competing in USEF or FEI events. Horses with a history of laminitis or metabolic conditions in which steroid use is contraindicated can benefit from intra-articular Pro-Stride therapy. This stall-side treatment is convenient and efficient and does not require an incubation period or is never frozen. This portable process is immediately available to use with fast processing times in less than twenty minutes.

Please view this video for an informative and visual explanation of Pro-Stride therapy. 

Platelet Rich Plasma (PRP) is a regenerative medicine treatment that delivers a high concentration of platelets in the form of blood plasma to a lesion increasing the amount of growth factors at the site to aid in healing. Platelets are filled with beneficial growth factors that help repair connective tissues and stimulate tendon and ligament injury repair. Additionally, PRP is used to speed the natural healing rate of wounds in horses. PRP is very safe as it is autologous, using the horse’s own blood, and is administered with ultrasound guidance into soft tissue injuries to help with healing, repair, and regeneration of tendons, ligaments, and muscles. It is often used in conjunction with shockwave therapy to promote faster recovery. Conditions treated with PRP can include tendon lesions, suspensory desmitis, check ligament injuries, collateral ligament injuries, and wounds.

Prostride & PRP

Prostride & PRP

Equine Chiropractic

Chiropractic focuses on the relationship between structure (primarily the vertebral column) and function (as coordinated by the nervous system) and how that relationship affects overall health.  Chiropractic adjustments can help restore the spinal column’s normal movement to promote healthy neurologic activity, which in turn supports biomechanical and musculoskeletal function and overall health. Chiropractic care centers on detecting abnormal or decreased motion of the individual vertebra and helping to restore that normal function found in healthy horses. 

Equine Chiropractic is a form of manual therapy that uses short lever, high velocity, low amplitude, controlled thrusts. Forces (“adjustments”) are applied to specific articulations or anatomic regions to induce a therapeutic response.  Chiropractic treatment does not replace traditional veterinary medicine; however, it can provide an additional means of diagnosis and treatment for a variety of musculoskeletal disorders and performance problems.  It can also be used to detect subclinical conditions (those not yet causing clinical signs) or abnormal biomechanics, that untreated, may progress to more significant lameness issues.  

Equine Chiropractic

Cavallo Veterinary Services uses shockwave therapy for a number of injuries in the equine athlete. Extracorporeal shockwave (ESW) aims highly concentrated and powerful acoustic (sound) pressure waves at the area of interest.  These sound waves promote healing by stimulating the release of growth factors and increasing circulation to the area being treated.

Treatments are typically administered every two to three weeks for three treatments along with rest and controlled return to exercise. Depending on the injury or tissue being treated, healing will be monitored with serial ultrasound examinations and or radiographs.  Shockwave therapy provides a temporary analgesic, or pain relieving effect. Therefore, its use on the distal limbs is prohibited within the 36 hours prior to competition.  Shockwave therapy is however permitted to be used on the axial skeleton (back/SI) up to 12 hours prior to competition.

Shockwave

Shockwave

Mesotherapy

Cavallo Veterinary Services offers mesotherapy as an alternative treatment option for pain management. It consists of multiple injections into the mesoderm, which is the middle layer of the skin. Small bleb patterns are made utilizing a mixture of appropriate medications with very fine needles directly over or near the affected sites. 

French Veterinarian and founder of ISELP, Jean-Marie Denoix, introduced mesotherapy to equine practice based off of its human applications dating back to 1952. Mesotherapy is based on the theory of gait control of pain, originating from the dorsal horn of the spinal cord. Nerve fibers coming from the skin have collateral fibers that conduct pain signals in major nerve tracts. Using mesotherapy, this feedback is halted, decreasing the transmission of painful information from deep structures to the brain. 

Mesotherapy is a minimally invasive procedure and has many benefits including reduced drug dosages, minimal side effects, and does not require significant time away from competition. The technique is performed without NSAIDS, steroids, or numbing agents and therefore does not interfere with drug withdrawal requirements such as those used by USEF and FEI. Conditions that have been shown to benefit from mesotherapy include muscle soreness and spasm, generalized back pain, kissing spine, osteoarthritis of the neck and back. sacroiliac pain, and stiffness of the neck and back. Mesotherapy is often used in conjunction with chiropractic and shockwave to manage the equine athlete.

Mesotherapy

Stem cell therapy is a regenerative therapy offered by Cavallo Veterinary Services. Our use of this technology is adapting over time as research into stem cell therapy continues to progress. 

Stem cells are thought to improve the quality of the repair and reduce scar tissue formation but are not proven to speed up the rate of healing. Ongoing research shows that in areas such as tendons and ligaments where scar formation can be detrimental to future athletic function, it is important to encourage the number of stem cells and growth factors at the site of repair, so the body will rebuild with more normal tissue rather than relying on fibroblasts which make a permanent scar. 

Stem Cell

Stem Cell

Polyacrylamide

Polyacrylamide Gel - (Noltrex-Vet/Arthramid-Vet)


Cavallo Veterinary Services uses intra articular polyacrylamide gel to treat non-infectious causes of joint lameness in horses.


Once injected into a joint, polyacrylamide hydrogel adheres to the synovial lining through its ability to exchange water molecules. Over a period of 14 days, the gel becomes integrated into the synovial lining by a combination of cell migration and vessel ingrowth. This forms a thick, cushion-like membrane consisting of vessel integrated gel covered by a new and hypercellular synovial cell lining.


As a result, there is an augmentation effect on both the joint capsule and synovium. It increases the elasticity and tensile strength of the capsule, improving its capacity to transfer load. It is believed that this augmentation and cushioning causes a subsequent reduction in mechanoreceptor activation in the capsule itself. It also causes the formation of a new and hypercellular synovial cell lining, improving the quality of synovial fluid within the joint itself.
These actions both help reduce synovitis and its successively deleterious effects by increasing lubrication and cushioning. It is believed that these products remain in the joint over time unlike traditionally used Hyaluronic Acid (HA) products.

 

Conditions that can respond to treatment include acute and chronic synovitis, capsulitis, meniscal tears, osteoarthritis and subchondral bone cysts.

Polyacrylamide
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