By Malinda Osborne

The equine industry has been abuzz over new and alternative ways to further aid in the successful treatment of common injuries incurred by equine athletes.

Two methods that have shown much promise are stem cells and interleukin receptor antagonist protein, or IRAP, therapy. Sharon L. Kaiser-Klinger, a veterinary technician at Premier Equine Veterinary Services, Sadler, Texas, gave a presentation Saturday on her experience with the treatments.

According to Kaiser-Klinger, stem cells can maximize the strength, range of motion, and performance of the tissue, and they also can reduce scarring, pain, and the likelihood of possible reinjury. In equine medicine, stem cell treatments are mostly limited to use in bone, muscle, tendon, and ligament tissue.

The two major sources of stem cells are bone marrow and adipose tissue, she said, but adipose tissue is preferred for a number of reasons. Kaiser-Klinger said fat tissue has a relatively high percentage of stem cells, it is easily accessible and renewable, and fat floats, making it easy to separate the cells.

Fat tissue can be retrieved from any part of a horse, and the most recent development for collection techniques is the use of liposuction.

Stem cells have been used to treat soft tissue disorders, osteoarthritis, osteochondrosis, fractures, and other degenerative processes. In Kaiser-Klinger's practice, she said they routinely use adipose-collected stem cell therapy for tendon, suspensory ligament, or suspensory branch injuries.

"We, on a case by case basis, use stem cells for osteoarthritis and navicular disease as well as osteocondrosis. In our experience, the results are not as positive in bone and joint applications as they are in treatment of soft tissue disorders," Kaiser-Klinger said.

On the other hand, IRAP is most effective when it is used as a periligament injection of the suspensory ligaments, especially the proximal suspensory ligament in the hind limb, she noted.

IRAP injection alone or in combination with other therapies has been able to return some horses to participation in their sport when they have not responded to other treatments.

IRAP is also used in joints for preventative measures.

"Veterinarians with patients that have problem joints sometimes keep IRAP doses stored frozen in their hospital for use before and after major events," Kaiser-Klinger said. "Combining IRAP therapy with traditional joint injections has proven to prolong injection intervals and produce healthier joints overall."

IRAP was first used in human joints after arthroscopic surgery in the treatment of osteoarthritis. She explained that the theory behind its use is that cytokines and growth factors are produced in the joint tissue and then released into the synovial fluid.

In many instances, Kaiser-Klinger said, stem cell or IRAP therapies can speed up the healing time of soft tissue lesions. She also noted their expense, however, and cautioned that these alternative therapies can and should be offered to clients, but not without a frank discussion of the cost. That said, stem cell and IRAP therapies are covered by many of the insurance policies available for major medical, Kaiser-Klinger said.