Many equine clinics have just a basic laboratory for the quick return of simple bloods. But when the clinic is in the winter equestrian sports center of the US, the facilities are a little more high-spec.
Rapid results are the key when horses are competing, and that’s the case at Palm Beach Equine Clinic (PBEC) in Wellington, Florida, which has one of the most advanced laboratory facilities in the country with onsite equipment capable of performing internal hematology, chemistry, and microbiology testing, as well as many regenerative therapies.
For starters, the most commonly used test is hematology, the study of blood, its chemistry, and components. A complete blood count or CBC determines the number and type of white and red blood cells circulating through the bloodstream. Changes in these blood cells can indicate inflammation, infection, or disease. Quick diagnosis leads to more proactive and efficient treatment plans.
A clinical chemistry is the study of the chemical composition of a sample. Typically, the liquid portion of blood (either serum or plasma) is used for testing components such as electrolytes, kidney enzymes, and muscle enzymes. The serum or plasma is evaluated to determine the efficiency and health of specific organs.
Finally, microbiology is the study of small organisms such as bacteria, viruses, fungi, and other single-celled life forms. The cultures from microbiology tests are used to identify a specific bacteria or fungus present and sensitivity tests are used to determine which treatment, such as an antibiotic, will most effectively treat the infection.
“We tend to get results so much faster in our own lab,” said PBEC veterinarian Dr Samantha Miles.
“Also, an in-house culture is much less expensive than sending the sample away. It takes 24 hours to run a culture and 24 hours after that for the sensitivity. So usually it takes 48 hours to get a full culture and sensitivity, whereas to send that away you’re looking at least at 72 hours minimum and sometimes it’s a couple days longer than that.”
While laboratory technologies are common in determining a diagnosis and identifying different infections and viruses; they can also be used to more effectively and quickly treat common equine problems such as colic.
“There has been a lot of research lately comparing blood lactate to the abdominal fluid lactate, and the difference being a good indicator of whether a colic is surgical versus medically managed,” Miles said.
“Sometimes it’s obvious, but not always so it is really helpful to have that capability. What we do is test a blood lactate sample using a lactometer, which takes about a minute. If a horse is dehydrated and has a higher lactate in the abdomen, we will rehydrate the horse and take it again. If the lactate value doesn’t decrease after rehydration we have a good indication that it is a real number and there is a surgical problem.”
Regenerative therapy capabilities include stem cells, PRP (platelet rich plasma) and IRAP treatments. These can be applied to previously difficult-to-manage joint diseases and injuries using natural-occurring proteins, cells, and other natural processes originated from within the body of the horse.
Essentially, these treatments use the horse’s own biological mechanisms to stimulate healing without the use of steroids or other drugs.
Stem cells are commonly derived from bone marrow which are cultured and multiplied into millions of stem cells. The cultured stem cells are injected into the affected tendon, ligament, or joint to encourage healing.
PRP is another byproduct that is internally sourced from blood platelets in a matter of minutes. The platelets are combined with numerous growth factors that are released upon activation and can enhance healthy inflammatory cells in areas of tissue injury, form new blood vessels, new connective tissue, and aid in the regeneration of skin when injected.
IRAP, stands for Interleukin-1 Receptor Antagonist Protein, is used to treat equine athletes that are susceptible to musculoskeletal injuries and osteoarthritis or degenerative joint disease. Joint trauma results in the release of inflammatory mediators such as Interleukin-1 (IL-1). IRAP uses a horse’s own anti-inflammatory protein found within the blood to counteract the destructive effects of IL-1 to slow the process of osteoarthritis. The process works by binding to the IL-1 receptors in the joint and blocking the continuation of damage and inflammation.
“We often see joint damage in sport horses because of the nature of their work, but we try to avoid overuse of steroids in joints because steroids can have long term effects on cartilage,” Miles said. “This is a way we can manage joint disease and stop inflammation without having to consistently use steroids every time. Some of our clients will maintain their horses on IRAP alone for joint injections.”
Most recently, PBEC has added a Pro-Stride machine, which is a new treatment that combines PRP and IRAP treatments, but provides faster results.
Pro-Stride will reduce pain associated with arthritis and deliver anti-inflammatory proteins capable of slowing cartilage damage and improving mobility through the Interleukin-1 Receptor Antagonist Protein. The process can provide pain relief for up to one year following a single injection, which includes 20 minutes of blood processing in the laboratory with no incubation period.
“I believe we are learning more about these technologies with more advanced science behind what they do and how they do it, “ Miles said. “These treatments are natural, drug free, competition safe and necessity drives the need for regenerative therapies in the sport horse world.
“The bottom line is that we have the ability to get horses back significantly faster after injury by using these therapies.”