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Thursday, March 01 2018 / Published in General

Vet Talk with Dr. Richard Wheeler

Richard Wheeler, DVM, was born in the U.K. and graduated from the Royal Veterinary College, London, in 2002. Dr. Wheeler then completed a two-year internship at Greenwood, Ellis and Partners (now Newmarket Equine Hospital) in Newmarket. In 2005, he moved to Wellington, Florida, to join Palm Beach Equine Clinic and he became a partner in 2009. Dr. Wheeler’s primary concentration is equine sports medicine. He is an FEI Veterinary Delegate for Show Jumping and Dressage and has authored several published articles on the topic of equine sports medicine. Dr. Wheeler has served on the board of the USHJA Horse and Rider Advocates Committee. In 2016, Dr. Wheeler became a founding director of the Sport Horse Research Foundation. Dr. Wheeler and his wife, Jessica, have two children. Do you have a question you want Dr. Wheeler to answer? Send questions to editor@sidelinesnews.com.

There has been a lot of chatter recently about a common anticoagulant drug that is said to help prevent a life-threatening neurological complication of equine herpesvirus type 1 (EVH-1) infection. What are your thoughts?

There have been a few recent papers evaluating the role of coagulation in the neurologic form of EHV-1, and subsequently the potential use of the anticoagulant, heparin, as a treatment. This is very exciting, as there are currently limited treatment options for this rare but very dangerous strain of the disease. In one study from 2016, a Swiss research group administered heparin to approximately half of 61 horses infected with EHV-1 during an outbreak. The group that received the medication showed a lower incidence of neurologic signs (one out of 31) than the untreated horses (seven out of 30).

I discussed this topic with PBEC’s Dr. Peter Heidmann, who is board certified in large animal internal medicine.

Dr. Heidmann said that as with many scientific studies, there are limitations, and this is further complicated given the rare and unpredictable nature of the neurologic strain of EHV-1. The study does, however, suggest a possible benefit for the use of heparin and if low-molecular-weight heparin is used, the risk is minimal. While we need more studies to investigate the full potential of the drug for this indication, given the severity of the disease, it is certainly a treatment option to consider.

My horse suffered an injury to the foot, and after an MRI examination, a surgery called navicular bursoscopy has been recommended. Have you seen good results with this procedure?

I think this is a very useful procedure and one that is routinely performed at PBEC, so we’ve seen a good number of outcomes.

The procedure involves the insertion of an arthroscopy camera (think key-hole surgery) through the bottom of the digital flexor tendon sheath in the pastern region. A hole is then made between the tendon sheath and navicular bursa, giving the surgeon a good view of the navicular bursa, flexor surface of the navicular bone and adjacent deep digital flexor tendon. Given that only a small incision is required, the technique is relatively noninvasive and usually does not take a long time under general anesthesia. The navicular bursa is a small structure, and one limitation of the procedure is whether the specific injury is easily visualized. Often we can predict this from the MRI results.

My advice would be to make sure you select a surgeon who has plenty of experience with such procedures and make sure they have a chance to evaluate the MRI images prior to surgery. PBEC’s head surgeon, Dr. Brusie, has been performing this procedure for more than six years and has seen good results. In his experience, complications are rare.

As with most surgical procedures, there is rarely a quick fix; several months of rehabilitation and careful veterinary supervision, as well as good farrier care, will be important for success.

While each case is different, I am happy to say that since this procedure became available, I have seen many successful results with the horses returning to a similar level of training. In one study out of the U.K. in 2012, 61 percent of horses undergoing navicular bursoscopy returned to work sound, with 42 percent returning to their previous level of performance.

My horse hurt one of his tendons recently and my veterinarian mentioned the use of regenerative therapies. What are these therapies and how can they help over just rest?

Regenerative therapies are an exciting area of equine medicine that has developed rapidly over the last few years. This encompasses therapies that use natural cells and chemicals to encourage the horse’s tissues to heal. These treatments can be used to treat some of the more challenging musculoskeletal injuries in the sport horse such as tendon and ligament injury and osteoarthritis. Many of these therapies are “autologous” meaning they use tissue from the patient and therefore are unlikely to produce an immune reaction.

One of these therapies is Platelet-Rich Plasma, or PRP. Platelets circulate in the bloodstream along with red and white blood cells. They play a vital role in blood clotting and, during normal healing, they promote tissue repair and regulate inflammation. PRP can be harvested by taking a sample of the horse’s blood and spinning it down so there’s a concentrated portion of plasma containing mainly platelets. This can then be injected into a tendon or ligament, as well as a joint that has acute inflammation. We’ve found this treatment can increase the quality of healing.

Interleukin-1 Receptor Antagonist Protein (IRAP) is a therapy that blocks a pro-inflammatory protein (called a cytokine), interleukin-1. It is produced by taking a sample of the horse’s blood into a syringe containing glass beads and incubating it over a 24-hour period at body temperature. White blood cells within the blood recognize the glass beads as foreign material and produce anti-inflammatory protein or IRAP. The blood cells are then separated from the serum concentrated with IRAP. This therapy has the benefit of producing multiple doses with one blood draw, which decreases the cost of recurrent treatments. IRAP is used to manage osteoarthritis and inflammation in joints, especially with horses that require repeated treatments.

Stem cells are undifferentiated cells capable of self-renewal and are able to produce specialized types of cells. This means if put in a tendon, stem cells should differentiate into tendon cells. Stem cells are harvested from fat or bone marrow and also provide the “building blocks” to repair damaged tissue. The process involves harvesting cells, then concentrating and propagating them in order to deliver them to the area of injury. The goal of this treatment is to provide higher numbers of cells than the body would normally provide, which results in better-quality healing. Recently, allogeneic stem cells have been reproduced, which allow cells from a donor horse to be used in other horses.

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Tagged under: Dr. Richard Wheeler, palm beach equine clinic, vet q&a

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The✨April issue✨ of Sidelines Magazine is here The✨April issue✨ of Sidelines Magazine is here and we are so excited to feature three-day eventer Liz Halliday on the cover! Big thanks to photographer Melissa Fuller for the beautiful photo of Liz and Cooley Nutcracker- Liz Halliday-Sharp - HS Eventing. Liz and her horses have taken the eventing world by storm - and find out how Liz is at the top of the sport as a female eventer! As the horse world gears up for the Land Rover Kentucky Three-Day Event 2023, it's the perfect time to enjoy our eventing issue!! We also feature eventer and woman entrepreneur Frankie Thieriot Stutes, who is not only an eventer, but also runs Athletux and FRANKIE CAMERON handbags and accessories. And don't miss our eventing story on Robert "Bobby" Costello, who will be leading the US Eventing team to the 2024 Paris Olympics- and US Equestrian has named Bobby the eventing technical advisor/chef d'equipe!! Liz, Frankie and Bobby all have GREAT stories - don't miss any of them and don't forget to get your tickets for the Land Rover Kentucky Three-Day event! We are also excited to introduce you to hunter-jumper rider Casey Lorusso Smith, who is not only a talented rider but also a psychotherapist and incorporates horses into her career. If you are up for adventure, then read the story on dressage rider Priscilla Baldwin who certainly doesn't let any grass grow under her feet! We also head to the west coast to catch up with hunter-jumper trainer Jim Hagman of Elvenstar Farm, we feature beautiful art by equestrian artist Tammy Tappan, and we get to know Miranda Jones and her family. Miranda is not only an attorney who spends a lot of time in the courthouse, but she's a rider and spends lots of time riding, and is joined by her daughters also! We are excited to feature Stephanie Lightner in our Unbridled column, and don't miss our columnists George Williams, Robert R.L. Jacobs and Margie Sugarman! It's a great issue - and you can read it online, but don't forget to go to the website and order a subscription and get every issue delivered to your mailbox!! Enjoy this issue and enjoy the ride: Link in bio!!
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Marie Meyers has been around the world because of Marie Meyers has been around the world because of dressage, but it’s her farm in Moorpark, California, that has captured her heart. The farm and the business that thrives there represent Marie’s lifelong journey—a journey made up of good friends, spectacular horses and relationships made to last.

Marie was raised in Southern California, and spent her childhood playing just about every sport under the sun, but she didn’t discover riding until she was 14 years old. “I loved animals so much, so I started taking lessons. I did jumping at first, but I was very bad at that, for sure!” Marie laughed.

After some time, Marie moved on to take lessons at Foxfield Riding Academy and began riding dressage. “I fell into dressage by accident,” Marie said, “At the beginning, I thought it was extremely boring, but then I got hooked. By the time I graduated from high school, I had plans to travel to England to work for Franz Rochowansky, a former head of the Spanish Riding School.”

In 1988, Marie’s hard work paid off, and the pair was selected as alternates for the 1988 Summer Olympic Games. “They didn’t take the alternates that year, so we didn’t go to Seoul, but the experience, the training and the European Tour afterwards set me up for the 1990 World Equestrian Games in Stockholm, Sweden,” Marie said.

In addition to having success representing her country, Marie was busy with her life—marriage, a business, teaching lessons and clinics. 

Learn more about Marie in this month's edition of Sidelines Magazine. Click the link in our bio for more 🦄

📸Photos by Lindsey Long Equine Photography, www.lindseylong.com

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We are starting a ‼️new series‼️ here on o We are starting a ‼️new series‼️ here on our socials where we share some of the lovely stallions, and their breeders featured in each month's magazine. Our first feature on this #STUDSunday is...

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You can find ALL of the stallions featured towards the back of the magazine in the equestrian gallery. Keep a look out EVERY Sunday for a new handsome STUD muffin🧁 and don't forget to subscribe to get your very own edition of Sidelines Magazine, the magazine for horse people, about horse people 🦄

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