NORTH NAPLES — Dynamite was slowing down and getting left behind in the barn.
Riding instructors at Naples Equestrian Challenge started thinking it might be time for him to retire. That would mean telling the children and adults with developmental disabilities that the 27-year-old black Mustang, affectionately called Dyno, would go to greener pastures in Texas.
The potential loss of one of the beloved horses in the therapeutic riding program in North Naples was averted earlier this spring with the help of Naples-based Arthrex Inc.
Known internationally for its development of 6,000 products for minimally invasive orthopedic surgery in humans, Arthrex started its lesser-known Vet Systems division in 2004. The privately held company has applied its expertise in orthopedics and biologics for humans to develop more than 100 products so far for horses and dogs.
Through its Vet Systems division, Athrex provided Dyno with a biologic treatment for equine osteoarthritis in his right hind knee, or stifle.
After three treatments, Dyno returned to riding lessons and retirement is out of the picture, said Sheryl Soukup, executive director of Naples Equestrian Challenge.
"Dyno is one of our best horses for lessons. He is very steady, very reliable and has a good temperament," she said.
The nonprofit therapeutic riding program is grateful Arthrex provided the costly therapy at no charge, and did the same for two other horses.
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The Vet Systems division brings in revenue of $3 million annually but is poised to gain more market share among veterinarians.Until recently, independent distributors had four people selling Arthrex Vet Systems products but now distributors are ramping up their numbers of sales representatives, said David Shepard, director of Vet Systems.
Internally, the veterinary division is expanding with new hires of a product manager and project coordinator. That compares to two dozen product managers on the human side of the business.
The canine market is vast, Shepard said.
For instance, an injured cranial cruciate ligament in a dog is four times more common than the similar knee injury in humans to the anterior cruciate ligament, Shepard said.
"One million ACL surgeries are done in dogs at an average cost of $2,500," he said. "Their knee is just like ours, but the repair is different."
All in all, $1.3 billion is spent annually for treating dogs with injured ACLs, he said.
"Dogs can't walk with a torn ACL and dogs get arthritis within weeks of tearing an ACL," he said.
The Arthrex Tightrope technique for repairing injured human ankles was repurposed for use in dogs to repair their torn knee ligament.
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Co-developed with a well-known veterinarian surgeon, Dr. James Cook, at the University of Missouri, the Tightrope for dogs is minimally invasive compared to traditional treatments. It involves making tunnel incisions in the femoral and tibia bones at precise locations, to pass through strands of the Tightrope prosthetic ligament in a way that will mimic the natural ligament and provide optimal range of motion.
At least 43 veterinarians took part in clinical trials. There was a 95 percent success rate involving 2,563 dogs, according to Arthex clinical data.
Dr. Frank Ogden, a veterinarian at Bonita Springs Veterinary Hospital, went to Arthrex's training center in Scottsdale, Ariz., eight years ago to learn how to use it.
"I probably do a Tightrope every day, maybe two," Ogden said of his practice today.
Training veterinarians is a key element of Vet Systems, just as it is for training orthopedic surgeons on company products on the human side, Shepard said.
"We do 20 to 30 (training) labs annually for vet surgery," he said.
The prosthetic material in the Arthrex product is better than what's in other products, Ogden said.
"Dogs do quite well with it," he said. "We try to get them back to good pet quality function. They won't limp. They won't favor the leg. Before (with other treatments) it was getting them back to reasonable function."
Another option is cutting and plating the bone with screws.
"Most people, I give them the option," Ogden said. "The Tightrope is less expensive. There are very few complications — that has to do with the Arthrex material and design."
Dr. Marc Havig, a board-certified veterinarian surgeon in Naples at Animal Specialty Hospital of Florida, likewise uses Arthrex's Tightrope in cases he deems appropriate, generally with medium-size dogs or smaller.
"It's just a modification of the original technique for stabilizing the (CCL) tear," he said.
He thinks Arthrex's development of its Tightrope product for dogs really helped the company's move into the veterinary market. There clearly is a plus with the company's expertise in orthopedics for humans.
"I do think it's interesting," he said. "I do have Arthrex arthroscopic instruments I use."Vet Systems also has developed a technique and implant, called the Unicompartmental Elbow, for treating cartilage and bone abnormalities of a dog's elbow. The technique spares how much bone resurfacing is necessary, which is less invasive, Shepard said.
"We are helping these dogs who can't be treated," he said.
For horses with osteoarthritis, like what Dyno suffered, Vet Systems fine-tuned a biologic treatment that involves a sample of the horse's blood. The technique, called IRAP, originally was developed by a company in Germany and Arthrex later refined it.
By the numbers
All in all, $1.3 billion is spent annually for treating dogs with injured ACLs.
The alternative before was a steroid injection, which damages tissue with repeated use.
Using IRAP, the blood sample is incubated for 24 hours to stimulate white blood cells to secrete proteins which are therapeutic and anti-inflammatory.
"You get a double whammy — you get growth factors and you get anti-inflammatory proteins," said Dr. Hank Gendron, an equine veterinarian in Naples.
As Arthrex's veterinarian, he set up 10 clinical sites in 2003 to test the company's IRAP approach.
"It is very, very effective for slight to moderate osteoarthritis. If it's bone to bone, it won't work," he said.
Improvement is usually within a few days, sometimes with multiple treatments, Gendron said.
It takes 24 hours for IRAP (Interleukin-1 Receptor Antagonist Protein) processing but it can be frozen and that's a plus for horses on show circuits.
"I have an RV and I go to shows and my freezer may be full of IRAP," Gendron said.
The IRAP treatment is used with race and sport horses; the cost of $1,500 to $2,200 generally is prohibitive for recreational horses, he said.
It has not been used in any of the 3-year-olds in the Triple Crown races, he said.
"Not that I know of," he said.