The disease isn’t just for older horses. Younger performance horses can show early signs of the disease. Tools, treatments and management can help keep horses going strong.
Some of the same aches human athletes experience have direct parallels to equine athletes. And, those pains may signal the early onset of osteoarthritis, also known as degenerative joint disease (DJD).
“It can happen in all different horses, but a lot of people reserve the term ‘arthritic’ for those old campaigners,” says Britt Conklin, DVM, professional services veterinarian, Boehringer Ingelheim Vetmedica, Inc. “As equine practitioners, we can often see visible evidence on an X-ray that younger performance horses can have significant signs of osteoarthritis.”
Sometimes the disease can be brought about by a single, traumatic event. However, equine osteoarthritis can also have an insidious onset – a slow development from years of training and competing. For a practitioner, some of those early signs might include pain and swelling. However, most often the earliest signs of the disease are subtle changes in behavior that lead to reduced performance in the show ring: a reluctance to change leads, run barrels or take jumps.
“Our goal is to identify and treat these horses, and provide appropriate treatment before clinical signs develop,” says Hoyt Cheramie, DVM, MS, DACVS, manager, Merial Large Animal Veterinary Services. “We may see sinusitis, capsulitis or damage to articular cartilage that can give us mild or initial lameness, but over time, we can see osteophytes and other radiographic changes develop. But for horses that are in work and not overtly lame, we don’t have the tools to easily recognize those subtle changes.”
Once the disease process starts, it’s often irreversible. However, steps can be taken to slow the progress and/or relieve the symptoms. Early identification and addressing the subclinical problems can help manage the disease over the long-term career of these equine athletes, Cheramie says.
Early disease, early treatment
There’s no better time to start preparing for joint problems than before early indicators of the disease occur, Cheramie recommends.
“Horses performing certain activities or disciplines are predisposed to certain problems,” he says. “A veterinarian should discuss with the trainer and owner their overall plan for addressing issues when they first arise. It’s much better than waiting for a more significant problem to happen.”
Once a horse owner and veterinarian have identified early signs of osteoarthritis, the next step is to chart a course of action. In many cases, the veterinarian reaches for two types of drugs:
• Symptom-modifying osteoarthritis drugs (SMOADs) which alleviate pain and inflammation but may not affect the progression of the underlying disease process, or
• Disease-modifying osteoarthritis drugs (DMOADs), which slow or reverse the disease process but may not have any direct effect on the clinical signs of the disease.
Historically, treatments have been limited to symptom-modifying drugs that reduce pain but didn’t actually improve joint health. Now, veterinarians are reaching for those drugs that can improve functionality, mobility or improve the environment of the joint itself.
“If you’re dealing with disease-modifying drugs, they actually slow down the degradation of the cartilage matrix, “Conklin says. “Maybe they improve the cartilage itself or fluid within a joint or the capsule holding the joint together. Perhaps they improve a visible injury, fibrillation or something like that where we visibly see improvement in the other cartilage or the various other parameters that tell us it is disease-modifying.”
Disease-modifying drugs offer the greatest benefit when they are use dearly on, Conklin says.
“Like any degenerative process, the earlier you intervene, the greater the likelihood that you can return the animal to full performance and improve the joint environment,” Conklin says. “This is why vets play such an important role for equine athletes.”
Symptom-modifying drugs, like most non-steroidal anti-inflammatory drugs (NSAIDs), can help relieve pain and inflammation that often accompany equine osteoarthritis. However, these products are restricted for use in performance horses just before or during competition.
No products are approved to prevent equine osteoarthritis, Cheramie says. Many products aimed at targeting inflammation can be used at the first onset of mild lameness signs, which helps break the cycle that progresses the disease.
For example, joint therapy products can be given systemically or directly into a specific joint. Yet, joint injection products aren’t without mild risk, he says.
Disease-modifying drugs are only part of a multi-faceted approach. Overall management can help slow progression of disease and maintain performance. Owners and trainers might want to consider rest, rehab, shoeing changes and/or dietary supplements to support joint health.
Conklin cautions that not all supplements have been studied and have research to support the claims. Owners should invest their money where research supports disease-modifying capabilities.
In addition, products that are labeled for a specific route of administration should be used according to directions to get the best result, Cheramie says.
DSRs can help veterinarians navigate the numerous options for equine osteoarthritis management by digging into the studies supporting each product, Conklin says. This can include the range of treatments and supplements available, such as stem cell therapy, IRAP and PRP.
“Distributors can give a good foundation for what has legitimate controlled studies, what products might be disease-modifying and what products might be symptom-modifying, “he says. “As a veterinarian, when you need to treat a joint, you have to know what really works. A veterinarian relies on a DSR to be knowledgeable across the board on a lot of products.”
• Equine osteoarthritis is a progressive disease.
• The common characteristics are joint pain, inflammation, limited range of motion and progressive deterioration of the articular cartilage.
• The disease can result from a single traumatic event or repetitive injury.
• It can also result from persistent inflammation even when combined with a light workload.
1 Nelson BA and Goodrich LR. Treatment of Joint Disease. In: Robinson’s Current Therapy in Equine Medicine by Spayberry KA and Robinson NE. Elsevier Health Sciences: 798-802.