By PAYTON MEDFORD
Ask the Horse Podcast hosted a live Q&A with veterinary experts Dr. Jennifer Feiner Groon and Dr. Sarah le Jeune on preventative equine joint care. The Plaid Horse has wrapped up an hour of thoughtful discussion to bring the impactful points to you.
To listen to the full podcast, click here.
What are Preventative and Proactive Steps to Avoid Osteoarthritis?
The foundation of preventing the early onset of OA is a balanced diet—and not just through making sure your horses have enough forage compared to feed. Vitamins and minerals in deficits or excess can lead to impacts in bone and cartilage development, especially in horses that are growing or are older. There is also the need to balance omega 3 and omega 6 fatty acids as they are involved in inflammatory responses.
Supplements are a good way to help balance a diet that may be lacking in important nutrients, but regarding joint health specifically, there are not many supplements that have the scientific data to prove their effectiveness. The only supplement with scientific evidence of improving joint health is glucosamine–commonly known in the animal world as Cosequin.
Right behind diet for prevention is proper turnout, exercise and rest. It is ideal for horses to have at least 12 hours of turn out time a day. The natural movement of horses while grazing provides joints with a constant stream of fluids that carry in good nutrients and carry out harmful waste products.
Exercise should be kept to a level adequate for the horse’s health, age, ability, and include a proper warmup and cooldown. Five to ten minutes of an engaged warmup and cooldown greatly reduces the risk of soft tissue and ligament injury. The type of footing you ride on can also impact joint health, so be sure that the footing is appropriate for your discipline.
During exercise, there is always the question of whether or not to use leg protection. Any type of leg protection is going to cause a buildup of heat in the legs, which can cause damage to all supporting tissue and ligaments. It is important to ask yourself if it is actually needed. If your horse tends to overstep or has tracking issues that may cause them to nick themselves, it may be worth it.
Just keep in mind that there will be a buildup of heat in the leg. Research shows that the worst thing you can do for a horse is exercise them in polo wraps due to their ability to hold heat. It is always encouraged to cold hose, use ice boots or apply poultices such as liniment to reduce any heat and inflammation after a workout.
A proper shoeing regimen is also important for healthy joints. Typically, we want to keep the impact of the hoof on the ground as low as possible, but for horses with high impact jobs like jumping, shoes provide a way to reduce that concussive force. It is always a good idea to have balance radiographs taken once a year. Research shows that 90% of lameness begins in the hoof.
If you are still looking for ways to be proactive, there are injectable treatments for joint health. Zycosan, Adequan, Legenend, and Arthramid can all be used as a preventative measure. Consult your veterinarian on preventative strategy and if injections would be a fit for your horse.
What Options Are There to Treat Osteoarthritis?
First, we want to determine what product to use. This varies for every horse and is dependent on age, current and planned athletic level, any current health issues, and your budget.
Steroids have always been a standard for intra-articular injections. They are low cost and provide almost immediate pain relief and reduced inflammation. However, steroids cause an increased rate of degeneration in the joint, and for FEI level events there are varying lengths of withdrawal periods, post-injection, before the horse can compete.
Orthobiologics, on the other hand, are much more expensive and take longer to provide relief. What gives orthobiologics the leg up on steroids though, is they don’t cause that increased rate of degeneration. Polyacrylamide gels integrate into the joint capsule to provide up to a 20% increase in joint elasticity and can provide relief for longer periods of time compared to steroids.
Osphos is an intramuscular injection used to decrease bone resorption (the process of breaking down bone tissue and releasing the minerals into soft tissue). It is labeled for the treatment of navicular disease, but due to its potent anti-inflammatory properties and longer standing analgesic effect, it’s frequently used off label for other conditions–commonly for suspensory branch desmitis, back pain, neck pain and bone spavin. It can take up to a month for it to take effect, and usually lasts a total of six months. Osphos is not to be used with NSAIDs as it is also tough on the kidneys.
Equioxx is a non steroidal anti-inflammatory that is labeled to control pain associated with osteoarthritis. It’s in the same class of drug as Bute and Banamine, but not as quite as potent. It’s more popular for use in older horses due to it being more gentle on the kidneys and gastrointestinal tract. Just like any other NSAID though, you should have the kidney values of your horse checked if they are going to be on it for any extended period of time.
How Does Treating Limb Joints Differ from Treating Spinal Joints?
Horses have three types of joints: the synovial joints, which are most of the joints in the horse (hocks, fetlocks, stifles, etc); fibrous joints, which are joints between the bone in the skull that we don’t treat; and cartilaginous joints, which are bones that are connected by cartilage (spinous processes and vertebrae).
When treating things like kissing spine, it’s usually better to avoid using hyaluronic acid, polyacrylamide or similar products because all you want to do is reduce inflammation in that area. A steroid or Sarapin, which is a neuro-irritant, are good options for injections. Sarapin irritates the nerve in a way that it reduces its firing–what causes the chronic pain. Osphos can also be used to stop any bony changes in the back that would be causing pain.
Other great options are shockwave therapy and laser therapy. Shockwave therapy down regulates C-fibers (the nerve fibers that are responsible for the sensation of dull, aching, burning pain), increases circulation to the area which brings in all kinds of good things, it decreases pain and is totally noninvasive.
Laser therapy works similarly as it gets rid of pain, is completely noninvasive, brings STEM cells to the area, stimulates angiogenesis (the formation of new blood vessels in the area), and lets the body get rid of inflammation in its own way. Acupuncture is also a great treatment option and produces very similar results.
You also need to make sure your equipment fits appropriately. Improperly fitted saddles can cause pain in many different areas of the back and horses can display that pain in ways that may seem like a training problem. The weight of the rider can also make an impact, especially for a horse with kissing spine. In general, backs are degenerative and tend to get worse over time. It’s important to be aggressive and treat those signs of pain early.
To listen to the full podcast, click here.
About the Experts:
Jennifer Feiner Groon, VMD
Jennifer Feiner Groon, VMD, is an equine veterinarian with a focus on sports medicine. Graduating from the University of Pennsylvania’s School of Veterinary Medicine in 2006, she has since built a successful practice, The Feiner Equine, based out of Central New Jersey and Wellington, Florida. Groon’s career has been marked by a diverse range of experiences. Prior to establishing her own practice, she served as a member of the Hagyard Equine Medical group in Lexington, KY, and an ambulatory veterinarian at MidAtlantic Equine Medical Institute in Ringoes, NJ. She served as the Head of Quarantine and a USEF/FEI Veterinary Apprentice at the 2007 Beijing Welcome Games Test Event and the 2008 Beijing Olympic Games. She was actively involved with the Area II and Area VIII Eventing Teams during the 2009 FEI Adequan North American Junior and Young Rider Championships. In 2010, she was in charge of the quarantine efforts at the Alltech FEI World Equestrian Games. In her free time, she competes in hunter and jumper disciplines. She loves sharing her passion for everything about animals with her family.
Sarah le Jeune, DVM, DACVS, DACVSMR, CVA, Cert. Vet. Chiro
Sarah le Jeune, DVM, CVA, Cert. Vet Chiro, Dipl. ACVS, ACVSMR, focuses on the diagnosis and treatment of lameness and various performance-related musculoskeletal injuries with an integrative, whole-horse approach. She is the chief of the Equine Integrative Sports Medicine Service at the University of California, Davis, and is also a board-certified equine surgeon and member of the UC Davis Equine Surgery faculty since 2003. She is certified in veterinary acupuncture, veterinary chiropractic, and in thermographic imaging. She is the founder and chair of the International Task Force on Laterality in Sport horses.
