Joint Disease and Management Options
Many horses suffer from joint pain at some point during their lives. Whether you have an athlete competing at the highest levels, or a trusty weekend trail partner, your horse can develop a lameness that is localized to a joint. Once there is trauma to a joint structure, this causes an
increase in the body’s inflammatory mediators within the joint. This inflammatory response not only causes your horse pain, but it causes a physical breakdown of cartilage. In early stages, this may just be a synovitis, or inflammation of the joint capsule lining. However if the process of cartilage degradation progresses, this can eventually lead to osteoarthritis. Osteoarthritis is progressive, meaning that we have no cure. However, there are several different options available for management, and many horses are kept comfortable for years despite their joint disease. Our goal for the management of joint pain is to decrease inflammation within the joint as much as possible, so as to slow down the process of cartilage degradation and alleviate pain.
So what are your options?
Corticosteroids- Triamcinolone, Methylprednisolone, Betamethasone:
Steroids are very potent anti-inflammatory drugs that have been used to treat the pain associated with osteoarthritis in horses for many years. There have been some negative affects associated with overuse of steroids, as it has been demonstrated that they can inhibit production of important components of joint cartilage at high doses. However, these drugs can be very beneficial and provide long-lasting pain relief when used judiciously and at appropriate doses.
Autologous Protein Solution- “Pro-Stride”:
Pro-Stride is a new regenerative therapy that uses a concentrated solution of your horse’s own anti-inflammatory proteins to alleviate joint
pain and prevent cartilage damage. This is a natural way to combat joint pain without the potentially negative effects of prolonged steroid use and is a great option for young horses, or other cases where we would like do use something other than steroids (horses with Cushing’s
disease, history of laminitis, etc). All it requires is a blood draw, and after about 20 minutes of processing we can then inject it into the affected joint. Studies have shown pain relief for up to 1 year with a single treatment.
Polyacrylamide Hydrogel - “Noltrex” :
Often in diseased joints we find that the synovial fluid, the fluid within the joint that acts as a lubricant, is a different consistency than in a healthy joint. Synovial fluid should be nice and viscous, but in a diseased joint it is thinner and has a more watery consistency. Noltrex is a synthetic gel that can be injected into joints, and becomes incorporated into the joint lining acting as a lubricant. Initial clinical trials have been very promising, with some horses staying sound for up to 2 years. This product has recently been made available in Canada, and the company reports that we will be able to get it in the US this fall!
Hyaluronic Acid- "HA," "Hy-Visc," "Hylartin," etc
Hyaluronic acid is often referred to as "synthetic joint fluid." Hyaluronic acid is a viscous liquid that is usually injected into a joint in combination with a steroid. The product may have anti-inflammatory effects and provide lubrication to cartilage. The scientific evidence for using Hyaluronic acid is mixed, but some people feel strongly that it helps their horse. We most commonly recommend the product for injection into bursa or sheath structures, like the navicular and "windpuff" areas.
We would love to talk with you about which of these options would be best for your equine partner!