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Osteochondrosis (OC)Tips for diagnosing and treating OC

Reese Hand, DVM, DACVSEquine Sports Medicine & Surgery, Weatherford , Texas

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High-energy, focused sound wave healing - Extracorporeal Shock Wave Technology (ESWT)

For more information, visit PulseVet.com

Osteochondrosis (OC)Tips for diagnosing and treating OC

Reese Hand, DVM, DACVSEquine Sports Medicine & Surgery, Weatherford , Texas

Brought to you by:

High-energy, focused sound wave healing - Extracorporeal Shock Wave Technology (ESWT)

For more information, visit PulseVet.com

Makers of:

TIPS FOR DIAGNOSING AND TREATING OCSOUND ADVICE FROM FELLOW PRACTITIONERS

Diagnosing/Managing Osteochondrosis • Osteochondrosis (OC) is an orthopedic disease commonly seen in young, growing horses (late yearlings-2 years), as

well as performance and racing horses, that may have long-term performance limiting effects and significant financial impact to the horse owner if not properly diagnosed and treated

• Horses should have radiographs for OC at a young age (4-6 months) in order to accurately diagnose and enhance the likelihood of treatment success and to resolve OC for sales radiographs

• With OC, bone is formed from a cartilage matrix which becomes ossified or hardened. Failure of ossification may lead to osteochondritis dissecans (OCD), also known as lesions

• Proper bone formation is stalled , and the lesions are formed within the cartilage layer of the joint• Cartilage fractures or detaches from the joint, leading to pain, inflammation, and subsequently lameness• While the exact cause of OC lesions is unknown, suggested factors include: genetics; rapid growth and weight gain;

nutritional intake; mineral imbalances; and stressed joints• Most common joints affected are the stifle, hock, and fetlock

Shock wave therapy for treating Osteochondrosis • May be used exclusively or as part of multi-modal treatment plan• High-energy, focused sound waves penetrate to heal (up to 110 mm)• Shown to release proteins (cytokines) that reduce inflammation and proliferate growth factors (VEGF, eNOS, IGF1,

PCNA, BMP – result in neovascularization and increased bone growth)• Shock wave therapy most commonly used for treating OC:

− Subchondral bone cyst of the distal medial femoral condyle − Lateral trochlear ridge OCD of femur and lateral distal trochlear OCD of talus − Sagittal ridge of distal third metacarpal

Treatment recommendations for shock wave healing• Preparation: Clean the area of debris and trim, wipe the skin with alcohol, and apply ultrasound gel to the area or trode• Radiographs are critical to identify and localize lesions• Extremely important to place trode perpendicular to the lesion• Recommended protocols:

− Stifle and Hock: medial femoral bone cyst treated with horse standing in flexion. 1,000 pulses weekly at energy level E6, alternating the 5 mm and 20 mm trodes

− Fetlock: sagittal ridge OC treated standing in flexion. 1,000 pulses weekly at energy level E5 with 5 mm trode − Treat all lesions once a week for 5 weeks. Repeat radiographs. If improvement is noted, continue weekly treatments for an additional 4-6 weeks or until resolved. No improvement, do not continue treatments.

• Retrospective evaluation and radiographs of horses treated with shock wave had 85% resolved or significantly diminished OC at 6-8 weeks.*

©2011 PulseVet Technologies* Unpublished data.

“In my experience, shock wave can significantly reduce or completely resolve radiographic OC lesions,” — Reese Hand, DVM, DACVS, Equine Sports Medicine & Surgery, Weatherford, Texas

©2017 PulseVet Technologies