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Therapeutic Ultrasounds Case Studies

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Splint reduction:

1) Rood & Riddle - Dr. Chris Newton, DVM

Horse Information:  Nine year old, thoroughbred, gelding. Mid level event horse.

Condition:  Acute presentation of 3/5 lameness on the right forelimb.  A new splint had formed on the proximal aspect of the 4th metacarpal bone of the right fore. The horse blocked to regional local anesthesia of the splint and suspensory ligament. Radiographs revealed no fracture but active periosteal proliferation of the splint. Ultrasound of the suspensory ligament showed mild inflammation at the region associated with the splint.

Treatment Protocol:  The horse was treated with the anti-inflammatory Equioxx for 10 days. A regional injection at the splint/suspensory interface of betamethasone / serapinlpredef was done. The horse was stall rested for 7 days, stalled and tack walked for 7 days. Small paddock with tack walk for remainder of 30 days.

An UltrOZ therapeutic ultrasound unit was introduced 2 days after the initial injection.  Treatment was performed for 4 or more hours daily for 3 consecutive weeks. The unit was used under a standing bandage to hold in place. The unit stayed in place for overnight treatment every day for 3 weeks with no difficulties.

Treatment Outcome:  Lameness was 40% improved at 7 days, 100% sound at 2 weeks. The splint was reduced in size by 50% by week 3. 

Doctor/Therapist Comments:  The speed of return to soundness and the rapid reduction in the size of the splint were the atypical components of the outcome compared to the normal case. The horse has remained sound back into work 6 weeks later.

2) Churchill Downs, Kentucky – Therapist Dianne Volze  

Horse Information:  Subject was a 2 yr old thoroughbred filly.  The filly had been in race training on a farm and was moving up to the next level of training by coming to the Churchill Downs race track

Condition:  The filly arrived at the track with a large splint on the right front leg, medial aspect.  No lameness upon arrival but owner concerned about injury due to increased activity level in training.

Treatment Protocol:  The UltrOZ unit was applied to the caudal aspect of the splint, covering the suspensory ligament as well.  It was applied from 10 a.m. to 3 p.m. every day, 7 days a week from 10/22 to 11/20.  No other treatments were performed.

Treatment Outcome:  The filly never exhibited any soreness in the suspensory ligament, which is unusual with splints this size.  The splint was reduced in size by 30% over the 4 week period of use.  Doctor/Therapist Comments:  The trainer and Equine Therapist were very happy with the results of treatment.  The reduction of splint size during an increase in exercise activity was atypical and positively correlated with the use of the UltrOZ therapeutic unit.

3) Rood & Riddle –Dr. Chris Newton, DVM

Horse Information:  Subject was a 2 yr old thoroughbred filly.  The filly had been in race training on a farm and was moving up to the next level of training by coming to the Churchill Downs race track

Condition:  RF medial splint – small, acute, slight heat, mild reaction to palpation

Treatment Protocol:  LIUS therapy applied for 4 hours for one day directly over affected area.  Copious amount of gel applied, neoprene wrap utilized.

Treatment Outcome:  Significant soft tissue swelling and heat present above and below RF medial splint where LIUS unit was applied. Sensitive to palpation

Doctor/Therapist Comments:  Unit became too hot or unit shifted to area with no gel.

 

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Bone Repair:

1) Lexington, KY - Dr. Holly Schmitt

Horse Information:  The horse under trial was a grand prix jumper

Condition:  Fractured accessory carpal bone in July 2010 over a warm-up fence before a jump-off.  It was a simple fracture with no displacement and no damage to the structures through the carpal canal on ultrasonographic exam.

Treatment Protocol:  Beginning in October 2010, the subject received 3 additional shock wave treatments one week apart, a treatment of Tildren, and the addition of the UltrOZ portable therapeutic ultrasound treatment applied for 4-6 hours daily for 30 consecutive days.Treatment Outcome:  Lameness was 40% improved at 7 days, 100% sound at 2 weeks. The splint was reduced in size by 50% by week 3. 

Doctor/Therapist Comments:  It is my veterinary medical opinion that UltrOZ therapeutic ultrasound is responsible for the majority of increased healing noted in the past 30 days.  Tildren’s mechanism of action is to inhibit bony resorption, so while this is aiding in the healing process it does not account for the increased bony production recorded.  The therapeutic ultrasound applied daily in a focal manner helps to increase blood supply to the area and deliver pro-inflammatory cells that stimulate bone remodeling and healing.  This particular system is ideal because it is very user-friendly, which allows the barn manager or trainer to apply the therapy daily without a licensed therapist or veterinarian involved.

 

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Tendons & Ligaments:

1) Wellington, FL - Dr. Suzan Oakley

Horse Information:  16 year old Hanoverian mare

Condition:  RF distal check ligament injury

Treatment Protocol: On January 12, 2011 I examined and videoed the mare on the lunge line before treatment. She showed Grade I lameness RF.  She was then put in the stall and the UltrOZ wearable ultrasound applied to the affected area for 4 hours during the first day.  The ultrasound unit was subsequently applied daily for 4 hours before riding over the course of 3 weeks.

Doctor/Therapist Comments: I feel that this appears to be an effective treatment modality.

2) DeLeon Springs, Florida – Gwen Poulin

Horse Information:  16  year old Dutch gelding, 17.3 hands, does grand prix level dressage

Condition:  Right hind leg high suspensory injury with a 4 month layup ( January 19, 2011 started back to light trot work daily and walking on treadmill)

Treatment Protocol:  Added UltrOZ wearable ultrasound for 4 hours daily, DMSO with cortisone applied to skin, standing wraps in the evening.  Treatment duration was 6 weeks.  Horse in light work and walking on treadmill.

Treatment Outcome:  Horse has returned to soundness without heating or swelling during activity. Due for a ultrasound checkup March 21st  to see possible visible results

Doctor/Therapist Comments:  I am happy with the ultrasound, my horse is sound and back to work.

3) Elk River, MN – Dr. Tracy Turner

Horse Information:  12 year old Dressage 1st level Paint

Condition:  RH medial branch suspensory ligament tear

Treatment Protocol:  treated average 1 hr/ day for 6weeks

Treatment Outcome:  Excellent. This lesion had failed to respond to other therapies and finally we see excellent improvement in echogenicity and fiber alignment.

Doctor/Therapist Comments:  Excellent. Very happy.

4) Rood & Riddle –Dr. Chris Newton

Horse Information:   7 year old warmblood gelding

Condition:  Acute injury to RH lateral suspensory branch 1.25 cm proximal to sesamoid attachment. No ultrasonographic tear, only inflammation

Treatment Protocol: Applied LIUS 4 hours daily for consecutive 30 days. Treated with anti-inflammatories and shockwave

Doctor/Therapist Comments: The lameness had resolved at 2 weeks. The inflammation at suspensory was gone by 30 days.Returned to full work. Had better response than is typical with other therapies alone.

Sesamoiditis:

1) Lexington, KY - Dr. Katherine Farrell

Horse Information:  Thoroughbred yearling colt

Condition:  Focal lucency (moderate sesamoiditis) in medial sesamoid, RH fetlock.

Treatment Protocol: Tildren on 1/21/13, aspirin/isoxuprine 5/1/13-9/12/13, ULTROZ 4 hours daily 6/15/13 – 9/4/13.

Doctor/Therapist Comments: The focal lucency resolved and the sesamoid was normal. Radiographs on 3/29/13 showed no difference in the lucency after the dose of tildren. Additionally traditional drugs (aspirin/isoxuprine) used to treat sesamoiditis do not have proven efficacy. I do believe the ULTROZ offered an effective, non-invasive treatment to a problem that can be so difficult to treat.

 

2) Penelope Rochelle, DVM, CVA, CVSMT

Horse Information:  3 year-old Thoroughbred filly “Roan Annie”

Condition:  First diagnosed August 2012 soon after training was started. She presented 3/5 lame on right front limb; medial sesamoid was sore on palpation and later was visibly enlarged and warm to touch.

Treatment Protocol: Radiographs taken on 9/7/12 and 2/8/13, and also on 6/2013 after 3 months of UltrOZ treatment. Initially the injury was treated conservatively with rest, cold therapy and NSAIDS. Several months of chronic, intermittent lameness followed. The UltrOZ was first used in April 2013 and was part of her treatment for 2 months. She was turned out during the day and no NSAIDS or other therapy was used during this time.

Doctor/Therapist Comments: Lameness exams every month from June through November have not shown any clinical lameness. “Roan Annie” has remained sound and is currently in training. The UltrOZ played a pivotal role in helping the horse continue her training.

Joints:

1) The Horse Journal - Dr. Grant Miller

Horse Information:  21-year old Dutch Warmblood gelding

Condition:  Distal hock arthritis that typically requires injections once a year.

Treatment Protocol: The UltrOZ was applied to both hocks 5 days a week for approximately 4 hours a day.

Doctor/Therapist Comments: The UltrOZ made a noticeable difference. The longer it was used, the better he performed. On the off days, Alex was stiff and short-strided when warming up. He also didn’t perform as dynamically as he did when the UltrOZ was used.

2) The Horse Journal - Dr. Grant Miller

Horse Information:  8 year-old Quarter Horse gelding who does upper level reining.

Condition:  Arthritis of both carpal joints. Comes out of stall stiff every day, even with injections and various joint supplements.

Treatment Protocol: The UltrOZ was applied to both knees daily for 2 weeks overnight.

Doctor/Therapist Comments: The results were undeniable! When Rupert wore the UltrOZ, he walked out of his stall with much greater ease. He was able to bend his knees and didn’t show resistance when picking out his hoof. Without the UltrOZ, he was an 8 out of 10 on the lameness/pain scale. With the UltrOZ, he came out around a 4 overall. Applying the system cut his lameness in half by the end of the 2 weeks.