Equine regenerative medicine has great potential to improve the quality of life for many injured horses, as well as return those who would have been slated for euthanasia back to a healthy and fulfilling life.
For a field that is filled with such hope, there are a lot of expectations placed on regenerative therapies, from both veterinarians and horse owners. Unfortunately, due to a lack of standardized treatment protocol, emerging scientific research, and a large financial barrier, traditional applications of equine regenerative medicine, such as stem cells, PRP, and IRAP, do not always hold up to the task.
However, there is a great need for this type of treatment modality in several different areas of veterinary practice, from musculoskeletal disorders to equine dermatology to wound management. Regenerative medicine has applications in the management of non-healing wounds, non-suturable wounds, and even difficult-to-manage skin irritations such as equine pastern dermatitis or insect bite hypersensitivity.
Skin diseases like equine pastern dermatitis and insect bite hypersensitivity reduce the quality of life for a large number of horses. One study found that up to 96% of the Rhenisch German Coldblood Horses in the study suffered from pastern dermatitis. Insect bite hypersensitivity is well known to be the most common allergic skin disease in horses.
Acute and chronic wounds are considered to be “highly prevalent” in horses, particularly wounds of the lower limb and in highly active areas of the body. These types of wounds represent a significant challenge to veterinarians worldwide, one that equine regenerative medicine may be able to alleviate.
In theory, if we can use equine regenerative medicine to encourage the horse’s body to heal itself, we’ll be better able to tackle injuries and conditions that would have previously been career, or even life, ending. The reality of this rapidly evolving field is a little more nuanced.
The Theory: A Life Saving New Treatment
Equine regenerative medicine has the potential to save the lives of horses who would have previously been euthanized or retired.
Some regenerative therapies have been shown to decrease the re-injury rates for soft tissue injuries “from 80% to 13–36% and to achieve a more tendon-like repair tissue with better histologic architecture and biomechanical properties of the healed tendon tissue compared to traditional treatments.”
Beyond management of soft tissue injuries, equine regenerative medicine provides promising new tools for equine wound management. According to Linda Dahlgren, DVM, PhD., “Regenerative therapies can function as scaffolds, cells, and bioactive factors or a combination of these building blocks of tissue regeneration.”
In the case of human non-healing wounds, one study notes, “Regenerative medicine strategies have the potential to restore tissue, perhaps equaling or exceeding pre-damage levels, resulting in improved outcomes and quality of life.”
This optimistic and exciting result in human medicine is also applicable to equine regenerative medicine in the case of non-healing wounds. Researchers are enthusiastically studying new applications for equine regenerative medicine, as well as exploring ways to get more consistent results.
As more research emerges, it is apparent that equine regenerative medicine could be a game changer in terms of how veterinarians manage conditions that were previously thought of as life-ending.
The Reality: An Evolving Field
While equine regenerative medicine has exciting applications, the reality is that it is a rapidly evolving and relatively new field. The equine subset of regenerative medicine is an even younger field. Some researchers have even called the understanding of equine stem cell biology, biofactors, and scaffolds, and their potential therapeutic use as “rudimentary.”
With a field as new and rapidly evolving as this one, results from the use of traditional regenerative therapies, such as IRAP and PRP, are varied in terms of success. Promising results that are achieved in preclinical studies, case reports, and small randomized studies, have not had the opportunity to be more thoroughly studied, as large placebo-controlled studies are scarce.
Ribitsch et al even goes so far as to say that “the field of RM faces several challenges like the lack of well-defined cells to be used as therapeutics and insufficient understanding of their mode of action… Currently, the mechanisms of the tightly regulated process, involving the interplay of growth factors, cytokines, proteinases, and cellular mediators combined with differences in cellular density, proliferation rate, inflammatory response, extracellular matrix (ECM) composition and synthetic function, are still poorly understood.”
Researchers in the field of equine regenerative medicine are undertaking pioneering work with the study of varied treatment protocols involving different administration and/or cell dosages. Still, the reality is that the effectiveness of traditionally thought of equine regenerative medicine, such as stem cell-based therapies,has not been studied in enough clinical trials with equine patients. Without a set and proven protocol in the use of many traditional methods of equine regenerative medicine, results will vary widely. These variable results are not only disheartening to the owner and a failure on behalf of the horse, but they represent a significant barrier to the use of equine regenerative medicine at all.
In theory, equine regenerative medicine could save the lives of many horses who would have otherwise been put down. In reality, the traditional applications of regenerative medicine, such as PRP and IRAP, have a long way to go.
The Financial Strain
One of the biggest barriers to traditional applications of equine regenerative medicine is the high price tag. The cost to perform traditional regenerative therapies varies based on the type of therapy involved.
Stem Cell injection is by far the most costly, as the process requires a lot of labor. The stem cells must be harvested, expanded in a lab, and implanted. If the owner or veterinarian would like the harvested cells stored in a stem cell bank, the cost will only increase from there. Without banking the cells, the cost for stem cell therapy ranges from a minimum of $2500 and can easily get into the mid-four figures.
IRAP is significantly less expensive, however the cost is still in the range of four-figures.PRP (Platelet Rich Plasma) injections are by far the least expensive, with a price tag ranging from $500 to $1000.
The average income of a horse owner in the United States is only$60,000 per year. In this day and age, this once sufficient salary is currently only moderate. Traditional equine regenerative medicine therapies are most likely out of reach for the average horse owner in the United States, based on price alone.
High Risk, High Reward
With a significant financial barrier in place, traditional applications of equine regenerative medicine, such as PRP, stem cells, and IRAP, are best thought of as a “high risk, high reward” treatment modality. Because it is a rapidly evolving field with new research emerging on a daily basis and no standard protocol based on scientific evidence, the results of traditional treatment methods of equine regenerative medicine have no guarantees.
Horse owners are taking a large risk by putting forward so much money to treat their horses with a therapy that has such diverse results. Some horse owners may be faced with the reality that they spent thousands of dollars on a new treatment that did not work as well as they’d hoped. However, if the desired results are achieved, horses who would have previously been put down or retired are able to return to work and have a long, fulfilling life.
This high risk, high reward aspect of equine regenerative medicine is a ball and chain on the progress of this field. Until the diversity of the results can be reduced, the average horse owner is unlikely to pursue this method of treatment, if only due to the financial barrier alone.
Zarasyl Equine: Low Risk, High Reward
The science behind Zarasyl Equine has regenerative properties but without the significant financial barrier, creating a low risk, high reward way for the average horse owner to access equine regenerative medicine.
Available to veterinarians through distribution, Zarasyl Equine uses advanced silicate technology based on over a decade of scientific research. Orthosilicic acid reportedly accelerates wound cicatrisation by stimulating basal epidermal and dermal fibroblast cells. Silica nanoparticles of the right size and shape, like those found in Zarasyl Equine, are reported to stimulate T cell receptors. These receptors are key regulators of the horse’s response to skin injuries.