Tuesday, May 28, 2013

Platelet Rich Plasma

As you know, Seven has some issues with her left carpal joint.  At the far too early age of 4, she already has arthritis and scar tissue that have greatly minimized the flexibility of the joint.
Seven's left wrist flexes only about 90 degrees (above).  Compare that to her right wrist that flexes to an acuter angle (below).
Interestingly, the right carpal joint used to be nearly as stubborn, but due to suggestions given to me by our rehab vet and Maddie's breeder and fiance (he breeds, raises, and trains racing greyhounds), it has regained much of its flexibility back.

We have not been as successful with the left wrist, but doing rotations, flexing, and compressing and pulling the joint help prepare the joint for torquing when Seven exercises.

The problem is that when Seven is goofing off, playing rough, or does a hard left turn in agility, she sometimes comes up acutely lame for a few minutes.  Then she walks out of it as if it never happened.  She often does very well running agility despite the tight left turns.  As long as I give timely cues, she seems to be able to manage her left turns very well.  She might also like agility so much that she does not complain that often on course.  But playing with Maddie, galloping on uneven ground, or chasing a toy can cause several minutes of limping.

Seven currently takes joint supplements and fish oil daily.  I also give her an Adequan injection once a month that helps to rebuild cartilage.  But she is still having a five minutes of lameness about 1-3 times a week.  The rehab vet researched injecting the joint directly and spoke to an orthopedic specialist.  Platelet rich plasma (PRP) was recommended.

I spoke to my orthopedic specialist vet and he agreed that injecting with PRP was worth a try.  The idea behind it is that when you have an injury, blood goes to the injury and platelets concentrate at the area to increase healing.  So by injecting platelets directly into the joint, you are increasing what the body already does.

I liked the idea because we were not injecting Seven's joint with something foreign or a steroid.  The platelets are taken from the patient's own blood.  If it works, repeat treatments are usually needed about every 6 months.

I had the procedure done a week ago and Seven did great! I would have freaked out about having a joint injected.  I had asked ahead of time if I could assist with handling Seven.  I explained that she is very good for the vet because I have carefully managed her experiences, but that she is very much a drama queen.  My concern is that if we do indeed repeat this procedure (a bad experience) every 6 months for the next several years that she will eventually have to be sedated.  The Doc said no problem.

The injection was performed on the floor of an exam room.  Seven laid flat with a tech holding her leg and making sure she did not jump up.  I dug my fingers into a tub of cream cheese and allowed her to lick off the creamy goodness as the unpleasant injection was conducted.  I LOVE food motivated dogs.  I don't think Seven even noticed. It worked like a charm!

Seven was given 5 days off from sharp turns.  She did straight line jump grids yesterday and was fine.  We will try more in the coming weeks.  I have kept a journal for the last couple of months so I know how often her issue pops up and why so it will be interesting to compare the next couple of months.

I hope it works!