Marion duPont Scott Equine Medical Center uses innovative lameness treatment

LEESBURG, Va., Jan. 7, 2009 – Virginia Tech's Marion duPont Scott Equine Medical Center is now offering an equine lameness therapy that prevents further degeneration of the affected joint and offers a longer-lasting benefit than traditional steroid treatment.

“While I can show you the ‘after’ photo of my horse, Captain Archer,” said Mike Hillman, “I wish you could see the ‘before’ photo.”

Captain Archer, otherwise known as “Archie,” is a thoroughbred afflicted with lameness, a common malady in horses. Hillman brought Archie to Virginia Tech’s Marion duPont Scott Equine Medical Center to undergo an innovative treatment — and the results were remarkable, according to Hillman.

The treatment, Interleukin-1 Receptor Antagonist Protein therapy (IRAP™) has only been available for a few years, but faculty veterinarians at the equine medical center are experts in its use.

“The first step of IRAP therapy consists of using a special syringe containing glass beads to draw 50 milliliters of blood from the affected horse,” explained Dr. Nat White, Diplomate ACVS, Jean Ellen Shehan Professor, and equine medical center director. “The blood mixes with the beads during a 24-hour incubation period, then it’s spun in a centrifuge to separate serum from red blood cells,” he added.

The result is an enriched serum which contains anti-inflammatory proteins that block the harmful effects of interleukin-1, an inflammatory mediator that accelerates the destruction of cartilage. Lameness results when cartilage is destroyed.

The serum is administered into the horse’s affected joint once a week for three to five treatments. Because the serum is autologous, which means it is derived from the horse’s own blood, it carries minimal risk of an adverse reaction.

Previously, Archie — along with many other equine patients diagnosed with lameness — had undergone treatments that involved injections of corticosteroid and hyaluronic acid (a combination of a steroid and an anti-inflammatory lubricant). While this therapy has merit — both from a medical and financial perspective — IRAP can offer certain benefits that steroid injections cannot.

“For instance, while steroid injections do reduce inflammation, they block a wide range of inflammatory mediators — not just the ones needed to be targeted,” White explained. “An IRAP treatment appears to be very specific in blocking the inflammation caused by interleukin activity. Therefore, this treatment helps to eliminate further damage to the joint,” he said.

Not only does IRAP therapy help prevent further degeneration of the joint, it also offers a longer-lasting benefit. While the cost for an IRAP treatment is higher than the cost of a steroid injection, the effects of the IRAP treatment can last a full year. “I compared the cost of one IRAP treatment to the total cost of the quarterly steroid injections Archie had been undergoing and the cost/benefit equation began to even out noticeably,” Hillman said. “On top of the economic value, when I took into consideration that the joint would be injected once per year rather than four times, I saw clearly that IRAP was the way to go,” he added.

As for Archie, Hillman says the improvement in his horse’s gait was nearly immediate. At Archie’s baseline lameness evaluation, Hillman said that the staff at the equine medical center could readily see that the horse was in obvious pain. “And, since Archie would be the first horse that received IRAP treatment at the center, it was evident to the center’s staff that he probably represented the ‘worst case’ scenario in proving the effectiveness of this treatment,” Hillman said.

After just the first injection, Archie showed remarkable improvement and by the third injection, Hillman said that Archie was trotting more comfortably than he ever had before. “Gone was the limping horse I had known for three years,” Hillman remarked. “I couldn’t have been more thrilled with the results,” he concluded.

“Lameness from arthritis is an extremely common problem in horses and IRAP is a very promising alternative to traditional treatments,” noted White. “IRAP therapy is a cutting-edge treatment we’re offering to our clients and it clearly produces excellent results in many horses,” he said.