Reducing inflammation, slowing the progression of OA and providing comfort are the goals when treating our patients with joint pain. The equine practitioner is faced with multiple options, since one must sort through traditional treatments, regenerative medicine device considerations, complementary modalities and trends in the industry.
Legs of racing horses showing joint action.
By concentrating high levels of growth factors and anti-inflammatory cytokines, we can provide anti-inflammatory and healing properties to the joints and soft tissues.
© 2016 by Mark Higgins New window.
Often, owners request specific treatments, and the practitioner must spend time educating them on what’s best for their individual horse. As medicine and technology continue to evolve, the end game remains the same: prevent, diagnose and treat.
The equine veterinarian must sort through a spectrum of therapies, from noninvasive modalities like NSAIDs and physical therapy to more invasive therapies such as intra-articular injections or surgery. The realm of treatments and the evolution of therapies is ever-changing. For example, regenerative medicine is a rapidly evolving area of medicine that aims to replace or “regenerate” cells, tissues or organs to restore or establish normal function.
By concentrating high levels of growth factors and anti-inflammatory cytokines, we can provide anti-inflammatory and healing properties to the joints and soft tissues. Many therapies are combined to have an additive or synergistic response to inflammation. Equine veterinarians must keep up with this evolution when deciding which treatment options are best suited for a horse.
The most commonly used options for managing and treating equine OA include:
• NSAIDs
• General wellness and joint supplements
• Hydrotherapy
• Physical/rehabilitation therapy
• Corrective shoeing
• Shockwave therapy
• Acupuncture/chiropractic medicine
• Intra-articular therapies
◦ Corticosteroids with or without hyaluronic acid
◦ Autologous protein solutions (including Pro-Stride® APS)
◦ Platelet rich plasma (PRP)
◦ Autologous conditioned serum (IRAP)
◦ Mesenchymal stem cells (MSCs)
◦ Polyacrylamide gels
◦ Amnion-derived therapies
Factors to consider when choosing a treatment:
• Age and breed
• Medical history
• Body condition, measuring both fat and level of muscling
• Metabolic status/history of laminitis
• Degree of lameness
• High-motion vs. low-motion joints
• Level of exercise
• Withdrawal times of medications for competitions
Joint pain—let’s get physical
Once treated, proper conditioning and rehabilitation for the horse must be fulfilled. Conditioning options that have a low impact on the joints can be beneficial to the horse, both physically and mentally. Take advantage of these exercises, especially during the winter when the ground is frozen or when your client is taking a break from competing—this is an optimal time to incorporate these routines into the horse’s day-to-day.
Examples of low-impact conditioning include:
• Proper warming up to prepare for exercise and cooling down to recover
• Walking up and down hills for strength training
• Using trot poles to help build muscle and a strong topline
• Underwater treadmill or swimming
• Increasing frequency of days ridden while decreasing riding time
• Avoiding riding in deep, heavy snow and hard, frozen ground (conversely be cautious with excessive exercise in extreme heat in warmer months)
• When temperatures reach below 15 F, consider limiting exercise to ride walking and light trotting
Press release by Zoetis