"Oh, you again," the big gray gelding's eyes seemed to say with a huge sigh of resignation. I was retrieving Bacchus, a mellow, retired Belgian/Quarter Horse-cross gelding, from his paddock for a session of his twice-daily therapy--the old guy had a reinjured tendon, and we followed a morning and evening ritual of retrieving, tying to hitching post, cold-hosing the bow, drying off leg, applying medication to areas of dew poisoning from the wet-dry-wet-dry posed by hosing over the prior weeks, and turning back out. I'll admit, it was a bit tiresome for both of us, but this horse was practically sainted, and his owners wanted this former foxhunter and general all-around packer pasture sound and comfortable. As I had happily piloted him many times in his sound years, I was also on board with this plan, so our twice-a-day routine was well worth the trouble.

What's amazing to me is how far tendon (and ligament) diagnostic and treatment techniques have come in just the few short years since Bacchus' treatment regimen.

For quite a while now veterinarians of high-performance horses have employed diagnostic ultrasound for these types of injuries, and these clinicians continue to progress in their use of this and other diagnostic imaging methods (MRI, etc.). (I'm always amazed by what can be seen in terms of tendon fiber alignment, etc., on that little ultrasound screen!) Over time, top vets have adopted their preferred surgical and mechanical approaches to treatment (also described in our June issue cover story--beginning on page 20). And extracorporeal shock wave therapy has seemingly gone mainstream over the past 10 years.

Regenerative medicine came onto the scene in more recent years. Vets, owners, and the popular press are discussing this subject, so it's important we provide some insight on what researchers are saying. As with many other equine veterinary issues, there are distinct sides: One side is utilizing the technology daily and promoting its usefulness. Another side is tapping the brakes, reminding vets to be critical of treatment that isn't backed by many years of peer-reviewed, published research. Yet a third side (which may also contain members of the prior two groups) is examining efficacy/applications through research.

These forthcoming studies will add to the body of published material forming on the subject. In the meantime, work with a vet whom you trust and who is examining the evidence to choose the best treatment route: one that's optimal for your horse and in synch with your recovery goals and bank account. As one doc pointed out: Sometimes traditional rest, rehab ("good ol' R&R!"), and controlled exercise (i.e, small paddock turnout) are the ticket! For others, these newer modalities might fit.

Kudos to those studying the many treatment methods out there and determining efficacy and optimal applications: The better informed our veterinarians are with research results, the better decisions we can make in caring for our horses.

Today veterinarians are kicking off the North American Veterinary Regenerative Medicine Association Confrence (NAVRMC) in Lexington, Ky. Held in collaboration with the UC Davis Center for Equine Health, Alamo Pintado Equine Medical Center, and Rood & Riddle Equine Hospital, researchers will be presenting on all aspects of stem cell therapy and regenerative medicine in horses and small animals. Watch for write-ups of some of the presented material on TheHorse.com.

Your Turn: Has your horse had a tendon or ligament injury that your veterinarian was able to help using advanced diagnostic and treatment techniques? What were those techniques?

(Viewpoint adapted from the June 2011 issue)