Treatment of Proximal Patellar Hesitation (PPH): STEP TWO
Once your horse gets fit, there are several scenarios that could develop:
The problem eventually resolves once your horse gets very fit. No more therapy is required, although we would need to continue cross-training/ fitness training your horse approximately twice weekly to maintain good distal patellar (stifle) function.
Your horse improves with fitness training, but behavioral resistance persists as a result of his/her frustration. In some cases, we elect to treat horses exhibiting clinical signs of intermittent upward patellar fixation (IUPF) with estrogen. As you know, estrogen is a naturally-occurring hormone that is present in all horses (both male and female). Learn more about estrogen therapy HERE.
Your horse gets very fit but the problem persists. In these cases, we generally elect surgical intervention (Step THREE). At The Atlanta Equine Clinic, we combine two surgical techniques in an attempt to alleviate IUPF. Both techniques are performed in the standing (sedated) horse at the barn.
Click HERE to see Step THREE.