Post-Blistering Recommendations

We would like to make several recommendations pursuant to the treatment your horse just received for intermittent upward patellar fixation. A combination of 2% iodine in a vehicle of almond oil was infused into both medial and middle distal patellar ligaments (see diagram above). An analgesic (pain killer) was administered along with the sedative to reduce discomfort during the procedure. No more medication for discomfort is recommended.

Avoid the use of antiinflammatory medications (such as Phenylbutazone, Banamine, Ketofen, Aspirin, and Dexamethasone) for at least 30 days post-treatment unless absolutely necessary (such as during an episode of colic). These medications will counteract the effect of the treatment.

Please do not bathe your horse for 24 hours following the procedure. Although the inject portals seal very quickly, we request that they not come in contact with water for at least 24 hours, as this may increase the chance for contamination.

Keep your horse MOVING! The injections are designed to create inflammation. Therefore, moderate to severe discomfort following the treatment is expected. Pain may make your horse unwilling to move. However, the more your horse stands still the worse the pain and stiffness will get. We highly encourage you to keep your horse moving as much as possible during the first 36-48 hours post-treatment. This will dramatically reduce pain, stiffness, and unwillingness to move.

Start exercising your horse immediately. When your horse wakes up from the sedative (which takes about 20 minutes), we recommend lunging at a walk/ trot for 10-15 minutes in each direction*. After lunging, turn your horse out (versus putting them in a stall) so they can continue to move around. Lunge them again every 2 hours until you go to bed, at which time we prefer that they be turned out overnight.

The following morning, lunge your horse again every 2 hours until they appear ridable. Some horses are ridable after the first lunging of the day. Begin riding as soon as they appear ready. Remember, some heat and swelling (edema) in the stifle area(s) is expected following this procedure, but should dissipate within 3-5 days.

Fitness- and/ or cross-train your horse for at least 30-45 days. We recommend a minimum of 45-60 minutes of work at least 5-6 days/week during the 30-45 day post-treatment period. Walk/ trot/ canter up hills as much as possible. The steeper and longer the hills, the better. Ride on a loose rein so your horse can adjust to his “new” stifles at his/her own pace. We suggest that you avoid ring work for at least 2 weeks, as the initial inflammatory reaction makes this difficult for your horse. Wait 4-6 weeks before assessing improvement, as it often takes this long for your horse to adapt.

We will call you an average of once weekly to check on progress.