Proud to be Diplomate of the American College of Veterinary Sports Medicine and Rehabilitation. Examination was very hard, but the learning process has been really worth it. New perspectives and projects ahead!

Dr. Peter Wehling using autologous conditioned serum (Orthokine /IRAP)

Dr. Wehling is a neurosurgeon in origin, but now famous after solving long standing orthopedic problems in top athletes like Koby Bryant and even the Pope Jean Paul II. He insist about patient selection for the most suitable technique depending on. He uses the ACS for joint, tendon and Spine problems. 

In joints he recommends four treatments, 2 per week. But when a player comes to his clinic from abroad he can squeeze it all in one week. 

In tendons he makes the  difference between acute and chronic stage. In the acute stage he spreads the product around the injured tendon. In case of a core lesion he recommends ultrasound guided intralesional injection. 

New perspective while dealing with tendinopathies in the horse

In last July 13 issue of EVJ, an interesting article questions the use of aniinflamatory drugs in tendon pathology. A lipoxin A₄ receptor,  FPR2/ALX and also resolvins, protectins and maresins have been studied as “resolving pathways” for inflamation.

“Studies suggest that whilst the endogenous resolution response of tendons to inflammation is initiated, it is insufficient or dysregulated such that inflammation is not adequately ‘switched off,’ perpetuating chronic inflammation and favouring fibrogenic repair”

Age can be another factor reducing the ability to the tissue to cope with inflamation due to inmunosenescence. We all know how older horse´s tendinopathies are more difficult to manage.

The paper says that while it is considered appropiate the use of antinflamatory drugs to relieve the clinical symptoms of the excessive early acute inflamation, the long term use of these drugs may be associated with adverse effects on tendon mechanical properties and propensity for rupture.

Future therapeutic goal would be modulating rather than suppresing the inflamatory process.

Tendinopathy of SDFT in a 16 y.o. mare. Lateral is to the right 

Hyperinsulinemia leads to increased vascular resistance in an isolated digit model

Dr Gauff from Austria and col. from UK have studied the effect of hyperinsulinemia on vascular resistance.

They conclude that with the insuline increase, there is a marked increase of vascular resistance and overexpression of endotelin 1. It is only an ex-vivo study, and more work needs to be done to extrapolate to in  vivo situation, but this is a step forward to try to explain the relationship between insuline and laminitis.
Here is the link to the paper:

https://www.dropbox.com/s/e1o7ape7rjtgnrh/evj12040-%20Hyperinsulinemia.pdf

Round table about regenerative therapies in the summer camp of UCM in El Escorial (Madrid)

Very interesting round table about regenerative therapies with Dr Chamorro from Real Madrid FC , Dr. Guillen, from Clinica Cemtrum and Dr. Paloma Fores from Universidad Complutense. Dr. Guillen stated that no regenerative therapy except condrocite transplant could possibly regenerate cartilage. Althoug a good number of scientific publications are pointing at Platelet Rich Plasma as effective therapy for orthopedic injuries, Dr. Gillen also doubt that PRP (wich he said a colleage calls "put on a show",  "paripé"in spanish), is useful.

The FEI sais that Meloxicam has a detection time of 72 hours

Consulting for Barbuda horses

I am glad to help with advice to horse owners in Barbuda about their horse veterinary problems. Thanks to Claire Frank for seting up and advertise in Brabudafulnet web page http://www.barbudaful.net/sport.html