Treatment for Equine Arthritis

Arthritis is one of the most common problems encountered by both our equine athletes and our expanding population of elderly horses. As such, it is a condition that has spawned a large variety of treatments, with new discoveries being made every day. These treatments range from oral supplements to powerful new injectable medications, which can greatly decrease the pain and progression of this disease.

The simplest definition of arthritis is inflammation of a joint. Therefore one goal of arthritis treatment is to try and stop the inflammation. However, this definition only scratches the surface of a very complex disease.   Another part of the problem is the destruction of joint cartilage, the material that allows two bones to glide over each other as a joint flexes. Today’s article will look at how nutritional supplements can decrease this inflammation and cartilage destruction. Next month we will look at the prescription medications that offer even more potent treatment of arthritis.

Nutritional supplements are not drugs, but are over the counter products that are fed to horses in an attempt to promote joint health. Unfortunately because supplements are not drugs, manufacturers are not required to prove the effectiveness or safety of their products. As a result, there is very little quality research on these products. Fortunately, experience has shown us that these products are relatively safe, and offer some definite benefits. Of the products that are available, glucosamine hydrochloride and chondroitin sulfate are the supplements that currently have the most research showing effectiveness. These substances are part of the building blocks of healthy joint cartilage. The theory behind their use is to supplement the building materials needed to help the body replace damaged cartilage with normal cartilage. When combined, these two compounds seem to decrease the symptoms of mild to moderate arthritis. However, they are not potent enough alleviate more severe arthritis symptoms. These compounds also help prevent the destruction of normal cartilage. The down side to these products is they are slow to take effect, often taking up to a month before clinical signs improve.

Another important fact to be aware of is that because supplements are not drugs, there is no regulation or oversight of how they are manufactured. This means that the supplement you buy may or may not contain the ingredients stated or the amounts stated on the label. A recent study of human nutritional supplements found anywhere from 0% to 125% of label ingredients. The supplement that is a bargain may or may not be giving you money’s worth. Because you have no way of knowing what you are getting, it is best to go with a well-known joint supplement. Ask your veterinarian for a recommendation of a particular product that he or she has found to be effective.

Arthritis can be a real set back to an equine athlete, and heart breaking to see in our geriatric patients. But with the development of new treatments such as glucosamine hydrochloride and chondroitin sulfate supplements our arthritic equines have a much brighter future.

Treating arthritis is one of the most common problems faced by today’s equine veterinarians. As our equine athletes compete at higher levels and the population of older horses increases, the need for effective arthritis treatments has grown. Fortunately science has given us some very effective treatments. Last month’s article looked at nutritional supplements used to reduce the symptoms of arthritis. This month we will look at the use of prescription medications that not only treat the symptoms, but reverse some of the effects of arthritis.

Under the category of prescription arthritis drugs are several classes of medications.   The current classes are non-steroidal anti-inflammatory (drugs like aspirin or bute), corticosteroids (cortisone like drugs), hyaluronans (such as Legend), and polysulfated glycosaminoglycans (such as Adequan).

Non-steroidal anti-inflammatory are the most familiar of all arthritis treatments. These drugs include phenylbutazone or bute, Banamine, and aspirin. These drugs are good pain and inflammation relievers, but when used long term have side effects such as stomach ulcers and colic. These drugs currently are the main treatment for human arthritis sufferers. Fortunately, our equine patients have access to greater effective medications that have more benefits and fewer side effects.

Two such medications are the drugs in the classifications hyaluronans and polysulfated glycosaminoglycans. These drugs are best known under the brand names Legend and Adequan. When injected intravenously or intramuscularly, they have the amazing effect of traveling through the blood stream to decrease inflammation specifically in the joints. Because arthritis is inflammation of a joint, decreasing inflammation is critical to slowing the diseases progress. Interestingly, hyaluronan and glycosaminoglycan are a normal component of a healthy joint. These compounds are made by the body in order to maintain the cartilage, joint fluid, and the membrane that lines the joint. In an unhealthy joint, hyaluronan and glycosaminoglycans decrease as a result of inflammation. This causes more damage to the joint, which increases the inflammation. By giving an injection of these drugs we are actually breaking the cycle of inflammation, and are attempting to return the joint to a more normal state. Hyaluronan is also known as sodium hyaluronate and hyaluronic acid. Hyaluronan has been shown to increase cartilage strength and may increase the body’s own production of hyaluronan. This drug also has a strong anti-inflammatory effect in the joint, which seems to work best when the soft tissue of the joint is inflamed.   Polysulfated glycosaminoglycans have the ability to decrease and even reverse cartilage damage. They also have an anti-inflammatory effect. In addition, both of these drugs seem to offer some ability to prevent arthritis as well as treat it. Both medications also require a loading dose of 3-4 injections a week apart, and then a maintenance dose once a month.

The final thing to realize is that no drug or supplement cures arthritis; instead they make the joint less inflamed and healthier. By decreasing the inflammation we decrease the damage that arthritis is doing to the joint. By returning the joint to a more normal state we improve the damage that has been done. This in turn increases flexibility, decreases pain, and improves the quality of life. In this way, our equine athletes and geriatric horses can continue to enjoy their careers and lives.