Dr Elaine called bright and early this morning regarding the different treatment options she had discussed with me. She said she spoke to one of the other vets and they think the best option is the platelet rich plasma option. She said both the stem cell therapy and the plasma seem to work well with a lot of success, but the PRP is more cost effective. She said they usually only use the shock wave therapy if they can't find a lesion in the tendon, and since they know where it is, they recommend the plasma.
Cost is $800.
The process is described as follows from tevs.com:
"The collection and preparation of platelet rich plasma is simple, non-invasive and takes only about 30 minutes. Firstly, 60mls of venous blood is collected from the horses' jugular vein. The blood is transferred to a holding device, which is then placed into a portable centrifuge and spun for 3 minutes. This process separates the serum from the red blood cells. The serum is removed from this sample, placed into the centrifuge and spun for a further 15 minutes. This process leaves the platelets concentrated at the bottom of the sample. Excess serum is then removed and the platelets are re-suspended and ready for injection into the injured tendon. The injured horse is mildly sedated and a nerve block is administered to anaesthetise the injured area. The platelet rich plasma is then injected back into the injured tendon under ultrasound guidance."
From what I have read, horses treated with PRP have had great success with recovery. It doesn't seem to shorten the time of recovery, but horses have a greater chance of recovering fully with assisance from the PRP.
I have no problem spending $800 on Lilly. I want her to make a full recovery and will do whatever it takes to get her there. However, I don't want to throw away $800 either.
My farrier comes out tomorrow. He was already scheduled for routine trims/shoes, but he'll be putting wedge pads on Lilly's fronts, and I'm going to have him pull her rear shoes. She shouldn't need those anymore since she's not in work.
Tuesday Dr Elaine is coming back out to assess Lilly's progress. She said if she's making progress we might opt out of the PRP treatment. If she hasn't made any progress, then she thinks we should proceed with the PRP.
I trust my vet, and I trust my farrier, but could it hurt to get a second opinion? I feel like I am "cheating on them" if I go out and get the opinion of another vet. The opinion of another vet will cost me X number of dollars since I assume they'll want to do their own tests.
I think I might call the other veterinary office in my area depending on what happens Tuesday, and see about having one of their vets come out to take a look at Lilly's tendon.