TIPS FOR DIAGNOSING AND TREATING OCSOUND ADVICE FROM FELLOW
PRACTITIONERS
Diagnosing/Managing Osteochondrosis • Osteochondrosis (OC) is an
orthopedic disease commonly seen in young, growing horses (late
yearlings-2 years), as
well as performance and racing horses, that may have long-term
performance limiting effects and significant financial impact to
the horse owner if not properly diagnosed and treated
• Horses should have radiographs for OC at a young age (4-6
months) in order to accurately diagnose and enhance the likelihood
of treatment success and to resolve OC for sales radiographs
• With OC, bone is formed from a cartilage matrix which becomes
ossified or hardened. Failure of ossification may lead to
osteochondritis dissecans (OCD), also known as lesions
• Proper bone formation is stalled , and the lesions are formed
within the cartilage layer of the joint• Cartilage fractures or
detaches from the joint, leading to pain, inflammation, and
subsequently lameness• While the exact cause of OC lesions is
unknown, suggested factors include: genetics; rapid growth and
weight gain;
nutritional intake; mineral imbalances; and stressed joints•
Most common joints affected are the stifle, hock, and fetlock
Shock wave therapy for treating Osteochondrosis • May be used
exclusively or as part of multi-modal treatment plan• High-energy,
focused sound waves penetrate to heal (up to 110 mm)• Shown to
release proteins (cytokines) that reduce inflammation and
proliferate growth factors (VEGF, eNOS, IGF1,
PCNA, BMP – result in neovascularization and increased bone
growth)• Shock wave therapy most commonly used for treating OC:
− Subchondral bone cyst of the distal medial femoral condyle −
Lateral trochlear ridge OCD of femur and lateral distal trochlear
OCD of talus − Sagittal ridge of distal third metacarpal
Treatment recommendations for shock wave healing• Preparation:
Clean the area of debris and trim, wipe the skin with alcohol, and
apply ultrasound gel to the area or trode• Radiographs are critical
to identify and localize lesions• Extremely important to place
trode perpendicular to the lesion• Recommended protocols:
− Stifle and Hock: medial femoral bone cyst treated with horse
standing in flexion. 1,000 pulses weekly at energy level E6,
alternating the 5 mm and 20 mm trodes
− Fetlock: sagittal ridge OC treated standing in flexion. 1,000
pulses weekly at energy level E5 with 5 mm trode − Treat all
lesions once a week for 5 weeks. Repeat radiographs. If improvement
is noted, continue weekly treatments for an additional 4-6 weeks or
until resolved. No improvement, do not continue treatments.
• Retrospective evaluation and radiographs of horses treated
with shock wave had 85% resolved or significantly diminished OC at
6-8 weeks.*
©2011 PulseVet Technologies* Unpublished data.
“In my experience, shock wave can significantly reduce or
completely resolve radiographic OC lesions,” — Reese Hand, DVM,
DACVS, Equine Sports Medicine & Surgery, Weatherford, Texas