PrintVeterinarians debate the pros and cons of oral supplements and different types of injections for care of working equine joints.
It’s a simple fact of life that an equine athlete’s joints deteriorate. The hind legs that once effortlessly coiled at the base of a jump, propelling the horse and rider high in the air, lose their flexibility and power. The swinging, ground-covering trot eventually lacks its former brilliance.
A lame horse with a hot, swollen joint is the textbook example of joint disease, but the process is a degenerative one that begins and has effects well before the end result of heat, swelling and lameness. Degenerative joint disease, or osteoarthritis, is a relentless enemy that begins his march stealthily and quietly, laying the groundwork for debilitating effects in the future.
Walk down the aisle of any tack store or flip through the pages of any horse magazine, and you’ll be astounded at the number of products on the market that claim to stem the tide of joint disease.
You can choose from a veritable cornucopia of oral joint supplements for your horse. You can administer injected systemic medications such as Legend or Adequan or treat the joint directly with intra-articular injections, delivering medicines directly into the joint capsule.
But how do you know where to begin, and how do you approach the insidious enemy, joint disease? What’s the best way to reinforce your horse’s joints against his onslaught?
The best way to think about the three routes of delivery of medication—oral, parenteral (intravenous or intramuscular) injections, or intra-articular injections—is to realize that their potency somewhat increases the more targeted their delivery.
“If you rate them on a scale of 1 to 10, with 10 the best and 1 barely working at all, intra-articular medications as a class would be the 10,” said David Frisbie, DVM and Ph.D. of Colorado State University’s Equine Orthopaedic Research Center. “Parenterals would be at a 4 or a 5, with oral supplements coming in between 1 and 3.”
While delivering medication via intra-articular injections is the gold standard of treating joint disease, oral supplements and parenteral medications such as Adequan and Legend have a place in the battle as well.
“The answer to me is that if oral supplements don’t make a difference, I think you need to look farther and maybe consider an injectible medication. And then if that’s not working, you need to look farther and make sure there’s not a lameness that needs to be treated,” said Richard Markell, DVM, of Ranch and Coast Equine Practice in Encinitas, Calif.
“Unfortunately, nobody definitively has any of the answers. There really is no solid research that tells you the answers to these questions. I think that’s why, if you talk to 20 different veterinarians, they’re going to have 20 different opinions on this subject,” Markell continued.
Locate The Problem
The most important step in managing a horse’s joint disease isn’t choosing between different therapies. It’s pinpointing the exact problem.
“An accurate diagnosis is the cornerstone to an effective treatment,” said Markell. “You can spend a lot of money on supplements and joint therapy and waste a lot of time during which the joint disease is progressing, when you should have had an accurate diagnosis in the first place.”
The strain of repeated extreme effort takes a toll on the synovial fluid and cartilage that are essential to a healthy joint environment. The “wear and tear” on a joint is an active disease process: osteoarthritis.
In osteoarthritis, the normal rebuilding of cartilage in the joint becomes outpaced by cartilage degradation, resulting in the cartilage becoming thin and damaged, which causes inflammation. The synovial fluid in the joint also becomes less viscous and loses its lubricating ability as joint disease progresses.
Marked lameness, especially with heat and swelling evident in a joint, is the most obvious symptom of joint disease. But horses can indicate that their joints are inflamed and causing problems well before overt lameness develops. A reluctance to change leads or perform collected work might be a sign that joint disease is compromising your horse’s performance.
“Part of the problem is that horses can’t tell us which joint hurts, and for mild joint disease, the joint doesn’t swell excessively, so people often don’t realize that what seems to be a more generalized problem is actually one particular joint,” said Frisbie.
“If you have a training issue in a performance horse, absolutely the first thing you need to do is to rule out a medical basis for the training issue. Is he not changing leads because he has a sore sacroiliac joint? Or is he resistant to piaffe because his neck hurts?” Markell said.
“Not every orthopedic issue is a limping horse. Most horses want to do what you’re asking. If they don’t want to do it, you have to investigate the possibility of a medical issue. And an accurate diagnosis is key to pinpointing the problem,” Markell continued.
Oral Supplements: Part Of Management
Hundreds of oral joint supplements on the market claim to slow the progression of joint disease. They incorporate various ingredients to decrease inflammation and maintain a healthy joint environment. But they’re limited in their ability to make a lame horse sound.
“In 26 years of practice focused on sports medicine, I’ve never seen a lame horse that got better just from adding an oral joint supplement,” said Markell. “Oral supplements might help manage things, but they don’t fix things.
