Osteoarthritis, or degenerative joint disease, can be a source of lameness and pain a horse of any age. Arthritis is most commonly seen as a horse ages, or as the amount of work they perform accumulates over their life span. Most horses with an athletic career suffer from some form of this disease at some point in their lives. There are many medical, as well as certain surgical, approaches to ameliorating the pain and inflammation associated with osteoarthritis. The most common methods of treatment for the disease includes joint injections, intravenous drugs, intramuscular drugs, and oral drugs.
Joint injections are considered the ultimate in treatment modalities for cases that require the optimal in the form of pain and inflammation reduction. This is a sterile surgical procedure in which an anti-inflammatory, or a combination of anti-inflammatory and joint lubricating/protecting drugs, are deposited directly into the joint space. Steroids are used as powerful anti-inflammatory drugs for this procedure. Recent studies have shown that certain steroids used in this fashion can not only control inflammation, but also act as a chondroprotective agent for the cartilage that makes up the joint surface. Steroids are not the only drugs used for this purpose; hyaluronic acid (HA) products, such as Legend, Hylartin, and Hylovet are also used either on their own or in combination with steroids to have powerful anti-inflammatory, lubricating, and protective properties.
Intravenous use of one of the HA products, Legend, has been proven to produce powerful results in inflamed joints. Legend, is the only product which has been studied for the intravenous route of administration, and it is the only HA product approved for use through intravenous administration. As compared to joint injections with HA alone (no steroids), this route of administration compares favorably when the proper number of doses and frequency is utilized. The recommended initial therapy consists of three treatments spaced one week apart, although many different protocols and treatment regimens have been developed successfully. One of the advantages of this treatment is the effect that the drug can have on multiple joints, via the Intravenous route of administration.
Intramuscular use of the approved Poly Sulfated Glucosamino Glycans (PSGAG), commonly know as Adequan, has been shown as quite effective in treating certain cases of degenerative joint disease or arthritis. This product displays similar therapeutic properties as the HA products, and has gained some popularity due to its route of administration. The recommended initial therapy for this product is 7 doses spaced four days apart and as with the HA products this is not the only regimen that is in use.
The judicious use of non-steroidal anti-inflammatory drugs (NSAID), such as Phenylbutazone, Ketoprofen, and Carprofen, are often used for the treatment arthritis. Of these potent anti-inflammatory drugs, phenylbutazone (Bute) is certainly the most common due to its cost benefit ratio. This low cost anti-inflammatory drug is often used to treat everything from mild to severe arthritis. Bute is available in both oral as well as injection forms and is thus easy for owners to administer themselves. The largest problem with this drug is the usually severe side effects of long-term use. The most common of these side effects include gastric ulceration, kidney damage or failure, and right dorsal colitis (inflammation of the right dorsal colon), all of which can lead to colic.
Another very common and very confusing area of joint therapy is the orally administered joint and anti-inflammatory compounds known as nutraceuticals. These products are intended to be used as daily feed supplements. They include any or all of an assortment of feed supplements with no claim of disease cure or treatment. They include compounds such as glucosamines, chondrotin sulfate, perna canaliculus mussel, devils claw, methylsulfonomethane, bromelain, and yucca, to name just a few of the most common ingredients. The confusion comes for a number of reasons. Other than one product Cosequin, which is a combination of glucosamines and chondrotin sulfate, these products have not undergone research studies to prove efficiancy. None of these products are subject to FDA regulations and thus label claims for ingredients and doses are based solely upon the manufacturer's claims. At this time there are over seventy products on the market with dozens of different formulas and multiple combinations of ingredients. Still many of these products, when administered to horses suffering from mild to moderate degenerative joint disease, seem to produce a reduction in pain and lameness, and from inference, a reduction in inflammation. I find these products to be somewhat useful in treating the aged horse that is retired, or semi retired, and I also have found these products to be useful as an additional therapy in active sport horses. Although they are limited in number, we do have a few "favorites", meaning products that we have used on multiple horses and found to be effective. These "favorites" come in both a liquid and a granular product that is formulated for the Equine Medical Service clinic.
The listed products are the most popular of therapies for degenerative joint disease, and as one can see, there are many options for decreasing pain and inflammation, and extending the useable life of the equine athlete with degenerative joint disease. It is impossible to say that there is one "best" treatment for degenerative joint disease, but through the careful selection of a degenerative joint disease therapy product, one can produce the best treatment for their horse. When selecting a product, consult with your veterinarian who will help you base your decision upon effectiveness and efficiency of the product, the difference in lameness degree of the horse, the location of the effected joints, the age of the horse, the horse's activity level, your goals, and your budget.