IRAP for coffin joint arthritis

[nelliefinellie]

My 5 year old has been diagnosed with mild arthritis - 1/10th lame on a circle on the hard, and no obvious damage to the cartilage. She is supposed to be going back to vet next week to have the joint medicated with HA / steroids, but I've been reading about IRAP which sounds like a better long term solution.

Has anyone had this done? Where, how much did it cost, and waht was the outcome?

 

[merlinsquest]

Hi,

Merlin has had Irap therapy for an arthritic fetlock joint.

I would say that out of the six iraps the vet has done so far he says that the coffin joints have been more sucessful than the fetlocks (only 2 fetlocks done).

Merlin is having a second dose on monday along with tildren and steroids into his hocks as he is not really improved, infact he is worse now than when we started, but i think thats coz the hocks have now taken over!!!

From my memory the irap will set you back around £600, but obviously this will depend on the vet, and its not a one off treatment... it will need to be repeated as often as the effects wear off!!!

Good luck... which joint is the arthritis in??? It can make a difference as to whether irap is suitable.

 

[merlinsquest]

Sorry, Coffin Joint ......Doh.... brain shrinking in the rain!!!

 

[nelliefinellie]

Thanks for your reply - was it £600 for the whole treatment (I think it's 2 or 3 injections initially from the same batch of blood?) or per injection? Also what was the post treatment protocol? My horse is a nightmare when stabled, kicks the door continuously with her bad foot - grr - so box rest would be a bit counter productive, and as we have no walker I would have to move yards if there was a lot of walking involved.

Sorry to hear bout your horse's multiple problems. Hope you get him sorted out.

 

[merlinsquest]

I will sort out the invoice from the vets and let you know the breakdown, I know I was worried it would cost a fortune.

You need to pay for the Irap kit and for the first lot of blood to be taken, then a callout and injection cost for each time the irap is injected into the joint. I think that was the total amount but will check for you.

So far as aftercare is concerned, Merlin was allowed out with a bandaged fetlock as soon as he came round from the sedation, and as he wasnt lame as such I was able to ride him as normal. As it was winter I just made sure that it stayed clean till the injection site was healed over.....

 

[Benjamin]

Could someone explain what IRAP is please?

Thanks

 

[malibu211211]

Ooooohhhh!
Thanks for posting this

My boy has arthritis in his coffin joint and after 3 HA injections into the joint, being on Newmarket joint supplement for the last 3 years and several episodes of box rest to let the inflammation settle he still goes lame

He is only 12 and to retire him now would be a nightmare as he is difficult to handle at times and needs to keep his mind occupied.
Anyone know if Irap would be suitable for him?
Off to read up on it
Thanks

 

[judymoon]

Just out of interest did the HA injections work for you??

 

[merlinsquest]

If you google Irap for horses it will give you a far better description than I can, but basically you take blood from the horse, it gets sent off and played around with and a blood product is injected back into the joint to help to heal the arthritic surfaces and take the pain away.... it is not however a cure and does not mend arthritic joints.

My vet has said that he has had better success with coffin joints than fetlocks (but i cant remember if he said why)!!

In answer to the OP, my first invoice was for nearly £600 which covered the Irap kit.... you then have to pay for each subsequent visit to reinject, £130 for me as he has to be sedated as well so times this by three.... so nearer to 1K...... but merlin was one of the first horses to be done so was at the most expensive time, it should come down in price considerably eventually.

As for did it work..... I would say not really, as he is worse now than before, although this is possibly due to hock pain (he has had them done today with steroids,, and a dose of Tildren for general arthritic bits)

Hope this helps, there are not many horses out there who have had either Irap or Tildren done, so best to google for information as its in short supply on the forum.

 

[malibu211211]

Hi,
The HA injections do work, he definately comes back sound after having it done. But with D the most soundness I get is about 6 months and then we start to have problems again. Althought he hasn't had a HA injection for nearly a year but I'm sure that's what the vet will suggest today. Inbetween the HA injections box rest and bringing back into work gradually normally works.
My friends mare injured the fetlock joint and she has had 3 HA injections and she is fine now. Competes on all different types of ground where-as D we have to be careful with hard ground and he can only jump on a surface.

 

[Doublethyme]

My friends horse has severe coffin joint arthritis and navicular disease, he had remedial shoeing, HA/steroid injections all didn't work, even on bute.

She decided to give him a year off with the view to retiring him (he's 13). Vets and remedial farrier said keep shoes on as he wouldn't be sound. She didn't see the point in keeping him shod when he was just a pasture pet, but went along with it - he looked more and more uncomfortable in the shoes. Events overtook and he severely injured a ligament and ended up on extensive box rest over the autumn, farrier still didn't want shoes off, but my friend insisted in the end.

Its one year to the day that he was turned away and probably about 9-10 months since he has had his shoes off and the horse is the soundest he has been in a very very long time (in fact looks sounder now than I have ever known him since he was 4 years old!). He is walking sound over uneven concrete, has been in long reining work in the school for about 6-8 weeks, is sound on 10m circles when long reined in trot and this week my friend got back on him in the school.

He is also on no pain relief at all at present and still sound. Its early days and I don't for a minute think that taking his shoes off has been a cure all, but it does appear to give him relief and he is much sounder without them and my friend has the option of boots and pads for hacking if she wants to - luckily we have several barefoot horses including mine on the yard, so booting isn't such a weird thing for us.

Barefoot doesn't work for everyone, but it certainly seems to have helped this horse so far when everything else didn't and all the professionals were shaking their heads and saying there is no way he would cope without shoes!

 

[Ludi-doodi]

I have! Well, not me, but my horse. Ludo had an arthoscopy operation last June to repair the coffin joint - collatoral ligament had been damaged and the joint was moving in a way it shouldn't! One operation, 2 casts and 5 months off work later the vet suggested IRAP therapy. Ludo was sound on the straight but not on circles. They took the bloods and returned enough 'magic juice' to do 7 injections. We had the first just before Christmas and two weeks ago had the 4th. With each injection Ludo's soundness improved significantly. It's a cummulative effect so there wasn't a big difference after the 1st but from 2nd to 3rd and 3rd to 4th there's been a massive change. We are doing everything schooling wise we were doing before he had the op (last June) except for jumping and the vet said we can start that again next month!

As for cost it was about £700 including the overnight stay at the vets to collect the bloods. I understand there's a limited window of time to take the blood and get to the lab to do what's needed to it. I think our bloods went to Newmarket (from Yorkshire!!)

Ludo is 14 now so not exactly a youngster (nor an oldie) so with a 5 yo I think it might be well worth the try.

Edited to say as someone else mentioned, each injection incurs a cost - mine about £150 - but that includes sedation as the injection is straight into the joint
G

 

[nelliefinellie]

Thanks for all the feedback! I have just spoken to my vet, who has spoken to another vet at Newmarket and the consensus is to hold fire on IRAP for the time being for my horse. There are no bony changes ansd they think the priority is to address the imbalance in the foot. My farrier is going to look at the x rays with the vet to try and resolve the poor hoof-pastern axis. I rhink the plan is to shoe her with eggbars to give sme heel support and pull the shoe back to change the break over. They are going to medicate the joint with HA / steroids and also put her on a course of adequan and nutraceuticals. She will be reviewed in 3-6 months time. If she is still lame when the foot balance is improved, then they will consider the IRAP route.

 

[Doublethyme]

Arrghhhh why do all vets seem intent on putting horses in Egg Bar shoes when at best they offer temporary relief, but will eventually cause far more damage and problems than there was in the first place!

If your horse is still at the stage of just having soft tissue damage, the very best thing you could do for him is to take the shoes off, give him time of if necessary and put him on a progressive conditioning programme to develop his digital cushions back to how they should be. Egg Bars will "support" for a while, but whilst they are doing that job, the internal structures of the foot are not being stimulated and will get weaker and weaker. Once these structures can no longer do their job and absorb concussive forces, these concussive forces will transfer into joints and higher up the leg, which is when the bony changes start happening.

The vets are offering you a very short sighted, short term solution.

 

[judymoon]

If the HA works have a look at www.kinesishealth.com which has a 100mg per serving pure HA gel to be given orally. If the injections work then this will, its daily and saves a packet compared to injaections. Hope it helps