.jpg)
I am the worst blogger, ever. A lot has happened in the last 5 months. Rather than go back and rehash all the ups and downs I will cut to the chase. On March 4 I took Frappe to see Dr. Carol Gillis for an ultrasound of his back/ SI joint. The ultrasound exam showed that he re-injured his right tuber sacral short dorsal ligament.
This is his third injury in the same spot in 5 years so we have decided that we are going to give it one more shot at getting him and keeping him sound for dressage work. Since this is our last try, I want to do everything within my means to give him the best chance at a full recovery and reduce the chance of re-injury.
After consulting with Dr. Charlie Scoggin at Pioneer Equine Hospital and Anne (and anyone else who would listen), I decided to try Regenerative Cell Therapy (stem cells). It was that or a new washer/dryer combo. You know, the really cool LG steam washer and dryer in cherry red.
What Regenerative Cell Therapy entails is harvesting either fat (from the tail head) or bone marrow to collect stem cells. The stem cells are sent off to a lab for processing and then the new stem cells are injected into the core lesion. I decided to go with the bone marrow-derived stem cells. Although it takes longer to receive the processed stem cells back from the lab, there is some evidence that bone marrow stem cells are slightly better than fat-derived.
On March 25 at 6:40 AM Cat, Frappe and I set off for Pioneer. We arrived shortly before our appointment at 8:30. Dr. Scoggin came out and talked with us for a few minutes and then introduced us to Dr. Jackman. Dr. Jackman is a surgeon and he performed the actual bone marrow aspiration. They reviewed the ultra sound images that Dr. Gillis had taken. They sedated Frappe and placed him in the stocks. There was a horse in there next to him getting shock wave therapy on his leg. Very noisy. They had their ultrasound specialist take their own baseline images of the injured ligament.
After they took the images they began prep work for the bone marrow aspiration. They clipped, prepped and blocked his sternum (between his two front legs). They used ultrasonography to identity the place where the needle should go in. Then they put in this huge needle. It was kind of a big metal rod with a handle on it. It looked very painful but he didn't show any signs of discomfort. He was way stoned though. Then they removed the bone marrow. That part took maybe 10 minutes. I felt like the whole clinic was in there watching. One of the assistants was taking pictures. I thought with her cell phone but Cat said it was a digital camera. Cat took pictures with her iPhone. After they collected the bone marrow, they pulled out the "spicket" and applied a pressure bandage to the area. Frappe was put in a box stall to recover. They said I could take him home in a couple of hours. That was at about 9:30.
We went to visit him and he seemed alert. He was foraging around the stall for leftover scraps of hay. At about 10:30 Charlie came out and said Frappe was doing really well and that he could go home in a half hour or so. They gave him some grass hay to munch on so he was happy. We went to visit with him some more and play with the babies before checking out.
When we arrived home Cat removed the pressure bandage and he wasn't leaking so that was good. He seemed sore in that area of course and a little agitated when she removed the bandages. She looked at the "site" and said it was scabbed over but I didn't want to look. She said it looked fine.
The bone marrow sample was shipped to VetCell's laboratory where stem cells will be extracted and multiplied. In 2-4 weeks the stem cells will be returned to Pioneer for implantation directly into the core of the lesion. Pioneer will call me when they receive word from VetCell that the stuff is shipping. We will probably have 48 hours notice and will make the appointment for him to have the stem cells implanted. . Before they implant the stem cells in the lesion they are going to perform extracorporeal shock wave therapy (ESWT) on the area. High energy waves are delivered via a focused beam to the site of the lesion. Doing so is thought to stimulate and recruit various factors to improve the healing process.
Follow-up will be 30 days after that. They will want to do another ultrasound to assess his healing and he is going to have another round of ESWT. He may get a third treatment of ESWT depending on how well he is healing.
Frappe is doing really well. In fact he is feeling quite spirited. Anne is hand walking him daily and I take him out for his hand grazing. The only remaining signs that he had anything done is the shaved spot between his front legs. I will try and do a better job of posting updates.
