The Disease Du Jour 179: Diagnosing and Managing Equine Soft Tissue Injuries with Dr. Kara Brown

In this episode of Disease Du Jour, host Carly Sisson interviews Dr. Kara Brown, an assistant professor of equine sports medicine and rehabilitation at Penn Vets New Bolton Center, about the diagnosis, management, and long-term care of equine soft tissue injuries. Dr. Brown explains the pathophysiology of tendon and ligament injuries, emphasizing that most result from chronic repetitive strain rather than acute trauma, leading to degeneration, inflammation, and eventual structural damage. She outlines common injury sites—particularly the flexor tendons, suspensory ligament, and deep digital flexor tendon—and discusses key risk factors such as speed, age, conformation (e.g., long toe-low heel), metabolic diseases like Cushing’s, and discipline-specific demands. The episode covers a comprehensive diagnostic approach, highlighting ultrasound as the primary field tool, with MRI and PET scans used for more complex or subtle cases. Dr. Brown details early management strategies including cryotherapy, anti-inflammatory medications, and controlled exercise, stressing the importance of balancing rest with functional loading to promote proper healing. She highlights the transformative impact of regenerative therapies like PRP and autologous mesenchymal stem cells, which improve tissue quality and reduce re-injury rates. Additional modalities such as shockwave therapy and class 4 laser are discussed for their evidence-backed benefits in healing and pain relief. The role of farrier collaboration through biomechanical shoeing (e.g., wedge shoes) is emphasized as critical for reducing strain on injured structures. The conversation concludes with long-term management strategies, including modified training, performance risk assessment, and owner education to detect early signs of re-injury, as recurrent injuries often follow a downward spiral in prognosis.