Tag Archives: doppler

Stem Cell Injections

We decided to go ahead with the Stem Cell injections through the company Vet-Stem.  Though expensive, they carry virtually zero risk, aside from a site infection, in comparison to the surgery.

Vet4 will gather the cells from his rear and stitch up the incisions made.  From there, if there are enough cells, the culture will be sent to the lab, and in about two days, they are able to be injected into the leg!

UPDATE:

There were enough Stem Cells to inject!  Chance is doing extremely well and is able to come home in a few days!!!

I asked if Vet4 could get Chance supportive back shoes before he left and he said he would.

Time to set up a trailer and get his stall ready in Sperryville!!!!

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DDFT Lesions

Text from Vet4 after ultra sound #3:

“I can see that he has a deep digital flexor tendon lesion and the medial side of the tendon sheath has improve but lateral side is about the same. The DDFT may the cause of all this in the first place and everything else is secondary. We will re ultrasound in 10 days or so just to confirm my findings. If they are correct, it would help to treat that area.”

Conversation with Vet4 :
So far, Chance has received; shock wave therapy, compression therapy and laser therapy.

Chance has a hole in his tendon. Vet4 believes that this is due to an infection/bowed tendon and severe lameness. The ultrasound, done yesterday, shows no change in size of the tendon hole after the previous two rounds of injections.

“Lymphangitis is a symptom rather than a cause and the cause was never treated.” Vet1 continued to treat it like a disorder rather than a symptom!

The swelling and infection have dissipated, as has the severity of the lameness. Though still lame, he is running around in the pasture.
Pain meds were started again due to increased discomfort and soreness.

Vet4 suggests doing one of the following:

1. Stem cell- which can take about two days if sample drawn has enough stem cells. If not, it could take about 4-6 wks to culture. Once injected he can move home. He is to be hand walked for a few days and then can go out as normal. Vet4 will come out in about a month to do another ultrasound and, depending on the size of the hole, may need to do further injections.

2. Surgery to clean out but NOT repair the tendon. This was not discussed in detail.
Payment plans may be an option. I emailed the office for payment options.

Time to make another decision!

Road blocks

 

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The first round of injections provided Chance with some relief, in his ability to move around and the swelling went down a bit, but that only lasted about a week.  At about day 8, Chance was swollen again and 3 legged lame.  Thankfully, a family friend of the farms owner called me.  She explained that the farrier was out shoeing one of the horses and saw Chance’s leg, and when he arrived to shoe her horses, he expressed his concern.  I immediately contacted Vet4 an he was out the following day.

Vet4 injected the masses again as a temporary fix, until we could make some decisions.  The ultrasound showed that the masses were the exact same as they were in the first ultrasound- they hadn’t increased or decreased in size.

Later that evening, Vet4 and I had a lengthy conversation about where to go from here.

We discussed the options again, at length.  We could do an MRI to gain more insight into what is happening with that leg, go in with an Arthroscope and clean it out, or look into Stem Cell Therapy.

Well, I wasn’t comfortable putting Chance under anesthesia…he was too old and too frail.  Plus, he could break a leg or a hip going down.  So, that ruled out the MRI (unless I could find a standing one) and the surgery.  The Stem Cells would run about $3000.00, plus he would need to goto the hospital to have the procedure done.

I took the night to think it over, and stayed up until sunrise reading as much as I could on leg issues, the different options vet4 and I had discussed, and other potential causes.

That next morning, I received a call that Chance was worse.  Vet4 was out of town due to an emergency, so I called Vet3.  She got out to the farm immediately.

Vet3 gave Chance Surpass topical to put on the leg, Banamine, Ulcer Guard, and continued with the Prevacox to keep him comfortable.

I asked her what she thought about the options- she felt, as I did, the surgery wasn’t a good idea and that an MRI should only be done without sedation.

I called Vet4 and we spoke about the current situation.  What else is going on? He suggested changing the course and trying different diagnostics.  He explained that TSMs (Tendon Sheath Masses) can cause swelling and pain, but they are usually relieved by the injections.  The ultrasounds showed that his suspensory tendon and ligaments looked good.  Could this be an infection? Soft tissue damage? A bone issue?

I asked him if he felt moving forward with more tests was a bad thing…was I being cruel keeping Chance alive like this?  Something that had been weighing on me from the start.  And what Vet4 said, empowered me to continue down the path I initially felt in my gut to be the right decision.  He said, “I am not the kind of person to ever give up on someone or something.” I asked if we were able to manage his pain adequately and make sure he was comfortable and he said, yes.  He advised me to “make a decision based on the horse” and “not to listen to the opinions of everyone else”.

The next day, I cleared my schedule, and headed to the farm.

 

Answers

Vet4 came out immediately.  I was beyond grateful!

He did an ultrasound of the back right leg and called me.  He found that Chance has Chronic Cellulitis and that there was Vascular constriction, and masses on the tendon sheath between the superficial and deep tendon sheaths.  The Doppler showed good blood flow and a thickening of the synovial lining. Hoof testers- Negative

We spoke about my opinions- MRI, Arthroscopic surgery, Regional Diffusion, Cold Compression Therapy, Nerve Block Injections, Steroid Injections

We decided  to try the Steroid Injections into the 3 Synovial masses to hopefully reduce the size and thickening.  Thus allowing us to see behind the masses to see what is actually happening.

Injections were into the Proximal Digital Flexor Tendon Sheath with 6mg Betamethasone and d100mg of Amikacon. Leg was covered with SSD and DMSO and bandaged.

Once injected, cold compression therapy for about 5 days twice a day and stall rest. Banamine daily.