The following article, ‘Understanding New Options in Equine Regenerative Medicine’, was originally written in October of 2018 by Dr. Kristian Rhein, DVM and then published by the AAEP (American Association of Equine Practitioners) for their annual forum in Lexingon, Kentucky.

Dr. Rhein is the CEO of Empire Veterinary Group and a Co-Founder of Empire Thoroughbreds, based at Belmont Park in New York.  His prior practical experience includes a surgical rotation at Rood & Riddle Equine Hospital in Lexington, 11 years at Hunt and Associates and advanced training in Eastern Medicine at Chi Institute in the practice of acupuncture.  Dr. Rhein is a renowned expert in the diagnosis and treatment of lameness and performance issues, attracting clients from all over the world.

He has practiced veterinary medicine in Kentucky serving farms, training centers, Turfway Park, and Keeneland Racecourse.  Upon moving to New York, Dr Rhein began treating racehorses at Aqueduct Racetrack, Belmont Park and Saratoga Racecourse.  Dr. Rhein travels all over the United States, Europe, Saudi Arabia and Dubai to examine and treat horses.

Dr. Rhein utilizes the entire line of  regenerative therapies from MediVet Equine in his regular care of client’s horses to promote healing, recovery and inflammation management.  He has served on the Scientific Advisory Board for MediVet Equine since 2013 and is an invaluable asset to our team. 

Understanding New Options in Equine Regenerative Medicine

Over the course of the last decade, we’ve seen an exponential increase in the use of regenerative therapy options in horses – whether that’s Interleukin-1 Receptor Antagonist Protein (IRAP), Platelet-Rich Plasma (PRP), or, most recently, MediVet Autologous Conditioned Serum (ACS).

This increase can be attributed to significant scientific advancements made in regenerative therapies, that can treat a wide array of conditions, previously only treatable with traditional medicine and drugs.

With the increasing prevalence of these options across equestrian disciplines, it’s important to understand how they work to determine what option could be best for your horse.

Platelet Rich Plasma

While IRAP and MediVet ACS share some commonalities, PRP is somewhat unique from the other two. The platelets within a horse’s blood are responsible for the clotting mechanism and are considered the first responders to an injury. Platelets are also the part of the blood where certain growth factors responsible for healing are contained.

With PRP, blood is drawn from the horse and, utilizing a prep kit and high-speed centrifuge onsite, the platelets in the blood are concentrated to five to eight times what is found in normal blood. The PRP is then injected into the horse, delivering a high concentration of growth factors, via the platelets, to the specific area of injury.

PRP is most commonly used to jump-start healing and to accelerate tissue regeneration directly at the site of concern. Therefore, PRP is a prevalent choice for use in tendons and ligaments.

Interleukin-1 Receptor Antagonist Protein (IRAP®)

With IRAP and MediVet ACS, both are designed with the same primary objective in mind: blocking and terminating inflammation. When the inflammatory response is activated, cells in the body release inflammatory mediators into the blood that are sent to the affected area. These cells contain, or produce, more than 100 chemical mediators of the inflammatory cascade, including Interleukin-1.

The release of these mediators increases the blood flow to the area of injury, or infection, which, in turn, can cause redness or warmth, which, due to an increased number of cells and inflammatory substances in the area, results in irritation, swelling, and ultimately, pain.

With IRAP, the horse’s own anti-inflammatory protein, found within the blood – the Interleukin-1 receptor antagonist (IL-1ra) – is used to counteract the destructive effects of IL-1 by binding to the IL-1 receptors and blocking the continuation of inflammation.

After collecting blood from the horse, it is incubated in the presence of specially designed glass beads, which amplify IRAP production, and it is then administered by localized, sterile injection into the horse’s joint, where it can combat osteoarthritis and degenerative joint disease.

MediVet Autologous Conditioned Serum (ACS)

MediVet ACS is much like IRAP in that it also induces the IL-1ra to block inflammation. However, during the processing of MediVet ACS, three additional anti-inflammatory cytokines are induced, and six pro-inflammatory cytokines are inhibited. In layman’s terms, MediVet ACS is inducing additional inflammation blockers and further eliminating inflammation in the horse. MediVet ACS also up-regulates and concentrates growth factors present in the whole blood.

The other major difference between MediVet ACS and IRAP is MediVet ACS’s ability to be administered intravenously and through a nebulizer, as well as intra-articularly.

This allows the product to cater to a larger number of concerns, or conditions. Administered intravenously, it travels through the horse’s circulatory system to pinpoint where the horse may need it most. Because of this, MediVet ACS has been linked to helping treat various conditions ranging from arthritis and synovitis to inflammatory airway disease. I believe that horses on MediVet ACS are producing and secreting more of the targeted cytokines and growth factors because of the high concentrations being delivered back to them in the finished serum.

When horses are training and competing, they also experience wear and tear and micro injuries. When MediVet ACS is injected intravenously, those micro-injuries and minor inflammations are addressed before they become a larger problem. I look at MediVet ACS as the gold standard in regenerative therapies because of the powerful anti-inflammatory effects combined with the presence of regenerating growth factors.

Talk to your veterinarian to learn more about these regenerative treatment options for your horse.

Link to original article on the AAEP website (requires membership).