Horse Illustrated Magazine

What can I do for my horse’s joint pain? It’s a question we all ask our veterinarians at some point. Whether from an injury or age, most horses suffer from osteoarthritis or a musculoskeletal injury sometime during their lives. 60% of horses will become lame due to osteoarthritis during their lifetime, according to research in “Joint Disease in the Horse, Second Edition.” Zoetis Pro-Stride APS is a Regenerative Medicine Device that uses your horse’s own blood to produce a concentrated cell solution that when injected back, helps heal the joint space and provide anti-inflammatory relief. This helps relieve pain and improve lameness in horses suffering from joint injuries or arthritis.

“Dr. Chad Davis recommended that we use the Pro-Stride APS device to support CR’s joints, given the high level of work and impact that he sustains for training as well as competition,” shares Colleen Rutledge, whose horse Covert Rights – called CR – is a retired 5-star eventer. The 2006 gelding now competes in PSG dressage. CR has been on other treatments in the past but has now been on Pro-Stride APS for three years. “As most horse sports are a game of millimeters and seconds, anything that we can do to maximize comfort and minimize damage is always welcome. CR has always been very demonstrative when he doesn’t feel his best, and the Pro-Stride APS device helps him maintain his comfort.”

What is Pro-Stride APS and How Does it Help Horses with Joint Pain?

Pro-Stride APS – autologous protein solution – is a device that produces an all-natural concentrated injectable solution that uses your horse’s blood to help counteract the effects of osteoarthritis and musculoskeletal injuries. “The Pro-Stride device utilizes a combination of concentrated anti-inflammatory proteins, white blood cells and growth factors from platelets derived from the horse’s own blood,” explains Dr. Holly Helbig. “It works primarily by blocking interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF-alpha) from binding to the cartilage surface. These are two major pro-inflammatory proteins that lead to degeneration of the joints.”

Your veterinarian can administer Pro-Stride APS stall-side in about 20-30 minutes. They will draw your horse’s blood and run it through a centrifuge in a two-step process. This creates a concentrated cell solution that contains your horse’s own anti-inflammatory cytokines and growth factors. When injected back into your horse, it helps to reduce inflammation and pain. “Not only does this therapy address inflammation, but it also promotes healing of the joint space,” explains Helbig. “Biological therapies continue to gain the attention of veterinarians and horse owners for corticosteroid-free management of osteoarthritis.”

In a 2014 study published in the American Journal of Veterinary Research, client-owned horses who were evaluated for lameness and then treated with Pro-Stride APS showed significant improvement in lameness grade up to a year later, and in some cases longer, after just one injection.¹

How long effects last will vary from horse to horse, depending on many factors including type of injury or condition being treated. Helbig explains that after one treatment, your veterinarian will assess your horse’s response and create a plan from there. In her experience, Helbig says, “We evaluate the horse’s response to see if the Pro-Stride device improved lameness approximately 4-6 weeks post injection.”

An Alternative Treatment to Steroids for Horses with Joint Pain

While corticosteroids are the norm for treating osteoarthritis and musculoskeletal injuries, Pro-Stride APS may be a better alternative. Steroids are known for being fairly fast-acting, reducing pain quickly, but does not address the healing process like Pro-Stried does. Additionally, there are potential negative side effects to repeated and long-term use. “High doses of corticosteroids as well as repeated use has more recently been associated with degradation of articular cartilage, leading to potential further damage to a horse’s joints,” explains Helbig. This means that the treatment you are using may eventually make the problem you are trying to solve worse.

While all injections have a small risk of complication including localized pain, swelling or infection at the injection site, Pro-Stride APS will not degenerate the joint further like steroids. “The Pro-Stride APS device has safety and efficacy studies showing a strong safety profile and efficacy up to 12 months post-injection,” she adds.

Nonsteroidal anti-inflammatory drugs – NSAIDS – are also common systemic treatment for pain in horses with osteoarthritis and musculoskeletal injuries. However, NSAIDS have negative side effects from prolonged use as well, including papillary necrosis, equine gastric ulcer syndrome and right dorsal colitis, according to “Non-Steroidal Anti-Inflammatory Drugs and Associated Toxicities in Horses” published in 2022.

With Pro-Strides APS, you may be able to ditch the NSAIDS too. “It depends on the condition that we’re treating or managing,” explains Dr. Chad Davis, when asked about stopping NSAIDS with regenerative therapy like Pro-Stride APS. “In our practice, it’s uncommon to keep horses on chronic NSAID therapy or treatment. Rather, we would look to medical devices like Pro-Stride APS to allow for a more comprehensive response and better outcome than using NSAID therapy alone. Our thought process when using orthobiologic devices and therapies is to condition and train the injured location and associated cells to be less inflammatory in response to an injury or disease, and more reparative and regenerative in nature. Inflammation control is key, but how you address inflammation is the science behind the treatments and therapies.”

Can I Compete with Pro-Strides APS on Board My Horse?

A big question with any treatment we use on our horses is whether it’s legal for competition. So can you use Pro-Stride APS before a competition? “There are no drugs, medicines or additives in a Pro-Stride device since it’s a byproduct of the horse’s own blood,” answers Helbig. “Speak with your veterinarian to ensure that your horse is fit for competition, and if lame, has an appropriate diagnosis and plan to ensure timing of the injection. Most equine organizations have a minimum number of days between injection and competition times. Check with your veterinarian or governing body for appropriate rules and regulations.”

“As for using the Pro-Stride APS device before a big event, the short answer is yes,” adds Davis. “The extended answer is to ensure you have enough recovery time after the therapy to achieve the maximal responses. We see many orthobiologic therapies and devices, not only as point-of-care medicine but also as preventive medicine. Preventive medicine ensures optimal performance and predictable outcomes and is a focus at our practice with the Virginia Equine Rehabilitation and Performance Center.”

We all want to keep our horses happy, healthy and pain-free. Pro-Stride APS uses your horse’s amazing power of self-healing to ease discomfort and possibly regenerate the joints. Learn more about Pro-Stride APS at the Zoetis website and ask your vet if it may be right for your horse.

¹ Bertone AL, Ishihara A, Zekas LJ, et al. Evaluation of a single intra-articular injection of autologous protein solution for treatment of osteoarthritis in horses. Am J Vet Res. 2014;75(2):141-151. doi: 10.2460/ajvr.75.2.141.

This article is a web exclusive for Horse Illustrated magazine. Click here to subscribe!