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by Kentucky Equine Research Staff
Veterinary researchers recently conducted a comprehensive review of 22 studies using platelet-rich plasma (PRP) to treat tendon and ligament injuries in horses.* These soft-tissue injuries are major contributors to lameness and result in substantial economic losses for both owners and trainers. Despite growing interest, limited controlled clinical data support the efficacy of PRP.
PRP is a type of orthobiologic therapy derived from the horse’s own blood. The blood sample is processed, usually by centrifugation, to create a concentrated suspension of live platelets and white blood cells. This mixture is then injected directly into the horse’s injured soft tissue, guided by ultrasound.
“After the PRP is injected, it transforms into a platelet-rich ‘gel’ that releases growth factors and anti-inflammatory mediators,” explained Catherine Whitehouse, M.S., a nutrition advisor for Kentucky Equine Research.
Those molecules then attract nearby stem cells and promote regenerative mechanisms that ultimately help repair and heal damaged tissues.
During the researchers’ review of the studies, they asked six questions that may help owners better understand PRP.
Yes, across all 22 studies, no significant adverse effects were reported following PRP treatment.
Across the 22 studies, fresh whole blood volumes collected from horses ranged from 15 mL to 300 mL, with most researchers using between 50 and 81 mL. The standard method for producing PRP involved a double-centrifugation protocol; however, alternative approaches were used, including single-centrifugation semi-automated kits and gravitational filtration systems.
This remains unknown. The platelet concentration in PRP in the studies ranged from 100 x 103 to 1,370 x 103 platelets/ìL. When reported (only nine of the 22 studies reported concentration), this value alternated between 1.3 to 8.7 times the concentration of platelets in whole blood.
Veterinarians injected platelet-rich plasma directly into the lesions in all studies. The volumes varied dramatically, from 1 mL to 12 mL. Most studies used between 2 mL and 5 mL, and most adjusted based on the size of the lesion on ultrasound. Most studies used a single injection, but one study performed three injections into the same lesions at two-week intervals.
“Considering that the concentration of platelets varied markedly in each PRP preparation, the difference in injected volume further complicates the issue of decoding the optimal dose,” explained Whitehouse.
Platelet-rich plasma yielded positive results in 18 of the 22 studies (86%), with researchers citing improvements in lameness, ultrasound appearance, and recovery times. However, researchers only reported positive results in two of the four randomized clinical trials when PRP was used as the only treatment. In the two randomized clinical trials with positive results, lameness scores decreased by 30% to 60% compared to 10% to 25% in the control groups.
The reviewers added, however, “PRP appears to be effective at promoting short- and medium-term recovery, but its long-term efficacy may depend on factors such as injury severity and concurrent therapies.”
Yes. All case series and clinical trials included in the review combined PRP with controlled exercise programs to enhance healing.
In some studies, PRP was also paired with mesenchymal stem cells or bone marrow aspirate concentrate. However, current data are insufficient to determine whether these combinations offer added benefit. Further research on combining PRP with other regenerative therapies, such as extracellular vesicles or gene therapy, is needed.
“Standardized reporting and methodological rigor of PRP studies should be improved to ensure reproducibility and facilitate evidence-based veterinary practice,” concluded the researchers.
“To support the horse’s musculoskeletal system, including soft-tissue structures and joints, offer oral joint health supplements,” recommended Whitehouse.
*Carmona, J.U., and C. López. 2025. Efficacy of platelet-rich plasma in the treatment of equine tendon and ligament injuries: A systematic review of clinical and experimental studies. Veterinary Science 12(4):382.
Reprinted courtesy of Kentucky Equine Research. Kentucky Equine Research is an international equine nutrition, research, and consultation company serving horse owners and the feed industry. Our goals are to advance the industry's knowledge of equine nutrition and exercise physiology, apply that knowledge to produce healthier, more athletic horses, and support the nutritional care of all horses throughout their lives. Learn more at Kentucky Equine Research.
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When quarter horse gelding Wrangler acted up and bolted at a horse show, his owner, Anjanette Nicolazzo knew something was amiss. “I was baffled,” says Nicolazzo. “I had ridden him for eight months prior to this and he had never done anything of the sort. I knew his bolting was a cry for help because it was so out of character for him.” In fact, this smart, show-winning horse had been hiding a highly painful condition known as kissing spine, in which the vertebrae touch or grind against each other.
Each week we ask trainers a question and gather their answers for you. These trainers have a range of experience, backgrounds, and focus points of their programs, so the answers have as much variation as you would expect and also probably much more similarity.
This week’s question posed is: How would you help a rider who struggles with measuring and riding through in-and-outs or combinations?
Here are their answers:
“The key to measuring correctly into an in-and-out (or any related distance) is to measure to the out element. On the approach, the rider should set their sight to the top/back rail of the out and the focal point in one big plane of vision. Keeping eyes set through the in, count and measure from the same quality canter rhythm. If you measure to the out, you’ll always find a reasonable distance to the in!” -Claire Gordon-Neff
Read more from Claire here.
“I’d begin with just a simple one-stride, helping the rider understand how their horse relates to two fences at a time. Once that feels consistent, we’d build into longer combinations. As they ride through, I’d have them count strides out loud, it keeps them present, prevents getting lost in the line, and naturally encourages breathing. Most importantly, I’d remind them to ride the stride they feel, since every horse has its own rhythm and balance.” -Katie Jones
“I find that the most common habit from riders approaching combinations is pulling when they second-guess their eye. We’ve all been there! Not seeing the right distance into the combination or in-and-out, and then adding a stride in and having a launch distance or bad chip out, even a refusal.
A trick that I find helpful is to have riders count down from 3 to the first jump (3-2-1) so they don’t have the opportunity to change their minds at the last minute. Once they land in the combination, count up (1-2, or 1-2-3, etc., depending on the striding). Developing the habit of counting down in and then counting up on the way out helps riders trust their eye initially and rely on their pace, and they’re less likely to doubt themselves at the base.” -Ariel Univer
Read more from Ariel here.
“When a rider struggles with measuring and riding through in-and-outs or combinations, I like to bring the focus back to rhythm and track. Instead of overthinking the stride, I have them practice on poles and low fences where they can feel the natural step of their horse. Once the rider gains confidence in keeping a consistent pace and straight line, the distances begin to come up naturally, and measuring becomes less intimidating.” –Michael Meyers
This article originally appeared in the Trainer Tuesday Series from The Plaid Horse Magazine and is published here with permission.
There are more informative articles in our section on Health & Education.
Mastering this movement to further a horse’s balance, power, and elasticity to lighten the forehand and drive from the hind end. See this title and more in the Effective Horsemanship Series.
Watch full screen Travers; What, When, How & Why Trailer (2:40)
by Kentucky Equine Research Staff
Ohio has one of the largest horse populations in the United States, with close to a quarter million horses. A recent survey of Ohio horse owners and enthusiasts gathered data on current management practices, with the goal of identifying research and educational opportunities to enhance equine welfare. In this article, Kentucky Equine Research nutritionist Ashley Fowler, Ph.D., addresses some of the survey findings related to nutrition, offering practical insights to help horse owners improve the health and well-being of their animals.
General Information
A total of 1,422 Ohio residents responded to the 52-question survey, the majority of whom were horse owners. Respondents reported owning a wide variety of breeds, with Quarter Horses being the most common (29%), followed by Thoroughbreds (9%), Paints (8%), Warmbloods (7%), and Miniature Horses (7%). Most horses (21%) were between six and ten years of age.
In terms of housing, 32% were group-housed on pasture, 31% were stalled with unlimited turnout, and 13% were either stalled full-time or had limited turnout. Despite this, horses typically had access to grazeable pasture for only about six months of the year.
Additionally, 27% of horses were classified as “at maintenance,” receiving only voluntary exercise.
Feeding Hay and Concentrates
Most survey respondents (96%) reported offering concentrates that were fed either by weight or visual estimation. The primary reason owners fed concentrates was to “meet nutrition requirements not met by forage alone,” such as vitamin, mineral, and protein needs, as well as energy requirements.
“As the researchers discussed, a limitation of this question is that horse owners were not asked to specify what kind of concentrate they fed. Ration balancers, complete feeds, and other commercial concentrates are fed for different reasons,” explained Fowler.
The reasoning for feeding a concentrate is sound, according to her, as forage rarely provides all the required nutrients. Ration balancers provide important vitamins, minerals, and high-quality protein and are appropriate for horses that do not need additional calories, such as horses in light work or easy keepers. More energy-dense concentrates help provide additional calories beyond what forage can provide, in addition to filling gaps in minerals, vitamins, and amino acids.
Forage was primarily fed by flakes, bales, or “armfuls” rather than by weight.
Read more: Horse Management Survey Results: A Nutritionist’s Perspective
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