PRP and IRAP: Where nature meets science in horse injury treatment

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Platelet Rich Plasma is injected into an injured area to encourage a more robust healing response. 
Platelet Rich Plasma is injected into an injured area to encourage a more robust healing response. © Palm Beach Equine Clinic

As sport horses become faster and stronger, veterinary medicine is often challenged to break barriers to provide the best in diagnostic and maintenance care.

Two resources that have become increasingly popular to treat equine injuries are Platelet Rich Plasma (PRP) and Interleukin-1 Receptor Antagonist Protein (IRAP), which encourage regeneration of injured or degenerative tissue.

Managing joint diseases and injuries using these methods is ground-breaking, but logical at its core. They essentially use naturally occurring proteins, cells, and other natural processes originated from within the body of the horse to put the horse’s own biological mechanisms to work stimulating healing without the use of steroids or other drugs.

What is PRP?

Platelets are among the very first cells to accumulate at an injured site, making them very important when simulating the repair process. Platelets contain granules filled with growth factors (the elements that aid in healing) and stimulate specified tissue to heal at an increased rate. To treat a horse with PRP, the veterinarians at PBEC are able to take a sample of the horse’s blood and concentrate the platelets in a high-speed centrifuge on-site. The harvest and processing procedures take approximately 30 minutes before the concentrated platelet-rich sample is injected back into the horse at the specific area of injury using sterile techniques and guided by ultrasound.

Dr Weston Davis.
Dr Weston Davis. © PBEC

Explaining the process, Dr Weston Davis, Board-Certified Staff Surgeon at Florida’s Palm Beach Equine Clinic, said that first, a large quantity of blood is harvested, anywhere from 60 to180ml.

“We process that to concentrate the segment that is very rich in platelets. We get a high concentration of platelets — we are hoping for five to eight times the concentration that you would get from normal blood. Then we take that platelet-rich extract and inject it back into an injured area to encourage a more robust healing response.

“Whenever you have an injury, platelets are one of the first cells that get there. They will aggregate, clump, and de-granulate. They release granules that are very rich in growth factors and signal the body to start the healing process.”

A high-speed centrifuge concentrates the platelets of a horse's blood for treatment with PRP. 
A high-speed centrifuge concentrates the platelets of a horse’s blood for treatment with PRP. © PBEC
What is IRAP?

IRAP 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.

Dr Bryan Dubynsky.
Dr Bryan Dubynsky. © PBEC

Palm Beach Equine Clinic veterinarian Dr Bryan Dubynsky said veterinarians often see joint damage in sport horses because of the nature of their work. “But we try to avoid over-use of steroids in joints because steroids can have long-term effects on cartilage.

“This is a way we can manage joint disease and stop inflammation without having to consistently use steroids. Some of our clients will maintain their horses on IRAP alone for joint injections.”

The goal to better serve sport horses that continue to improve athletically is the driving force behind the search for even more developed and precise techniques used in regenerative medicine.

“I believe we are learning more about these technologies with more advanced science behind what they do and how they do it,” Dubynsky said. “These treatments are natural, drug-free, and competition-safe, and necessity drives the need for regenerative therapies in the sport horse world.”

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