by Casie Bazay

Horse arthritis treatment options explained

Horse arthritis treatment options explained

While many people may think of arthritis as being an old horse problem, the fact is that this gradually debilitating condition affects a large percentage of pleasure and performance horses of all ages. It is also believed to account for up to 60% of all lameness cases. We previously discussed the ins and outs of equine osteoarthritis, often referred to as simply arthritis, noting how the condition occurs, the symptoms, and how a diagnosis is made. However, if your horse is dealing with arthritis, you’re probably wondering what your treatment options are.

It’s important to note that arthritis in horses can’t be cured, but it can be managed in order to alleviate pain, control existing inflammation, and prevent further damage from occurring. The following sections will cover some of the most commonly used equine arthritis treatment options.

Horse joint injections

Many horse owners automatically think of joint injections for horses with arthritis, aka intra-articular therapy, as the first option. For this type of treatment, a veterinarian injects a corticosteroid or alternative medication into the affected joint(s), which acts to shut down the enzymatic attack on the joint structures. The result is often dramatic relief of joint pain and a temporary stop to cartilage destruction. 

However, the relief joint injections bring is temporary, and they might bring a false sense of security, leading the owner to believe that the horse is improving while continuing to use him for rigorous activity. The truth is that as long as your horse is working, the cartilage degradation process will continue and eventually, the length of time that a horse can go between injections will begin to decrease. 

Dr. Rob Franklin, Fullbucket co-founder and equine veterinarian clarifies, “Joint injections are very helpful for synovitis and often cure this acute condition. Injections for chronic synovitis and arthritis have shorter effects and may result in that false sense of security.”

When joint injections no longer have a long lasting effect, the horse’s condition has likely worsened to the point where joint injections can no longer serve as the sole treatment strategy. 

Some veterinarians prefer to only use joint injections as a preventative strategy instead of using them to treat horses with existing lameness, and the treatment may, in fact, be more successful when used in this manner. 

Dr. Franklin also mentions the other intra-articular injections that are available now. “Polyacrylamides are very effective in returning horses with mild to moderate arthritis to therapy. Not only do we have IRAP, but also platelet rich plasma (PRP) and ProStride, which are collectively referred to as autologous conditioned plasma. These therapies can help mitigate synovitis, reduce inflammation and slow the progression of arthritis.”

Joint supplements for horses 

Joint supplements are also a top choice for treating equine arthritis. The main problem with horse arthritis supplements, however, is finding one that will be effective as there are a variety on the market. The most important thing to evaluate in a joint supplement is the main active ingredient, as well the amount of that ingredient provided in the supplement.

Some of the most effective joint supplement ingredients include the following:

1. Glucosamine and chondroitin sulfate

These two ingredients are often included together, but glucosamine is an amino monosaccharide (sugar attached to the amino acid, glutamine) and chondroitin sulfate is a glycosaminoglycan, which is an important component of joint cartilage. Both work to protect and provide nutrients to joints.

2. Hyaluronic acid (HA)

HA is another glycosaminoglycan naturally found in joint cartilage as well as the lubricating synovial fluid. It works by coating cartilage cells, giving them shock-absorption properties. 

3. Omega-3 fatty acids

While they may not be a cure-all, ingredients rich in Omega-3s such as fish oil, algae, flaxseed, or chia seeds can reduce inflammation and appear to lower inflammatory markers in synovial fluid of arthritic joints. 

4. Methylsulfonylmethane (MSM)

MSM is a naturally occurring compound in the same family as dimethyl sulfoxide (DMSO) which is believed to play a role in glutathione--an intracellular antioxidant which is critical for preventing cell damage.

5. Avocado soy unsaponifiables (ASU)

ASU is a newer approach to treating equine arthritis, but studies suggest that it may help to reduce inflammation and protect cartilage. 

6. Combination supplements

Sometimes, the best joint supplements for horses have a combination of proven ingredients, and while these supplements may be more expensive, they may also be more effective. 

Injectable horse joint support

Another popular horse arthritis medicine involves using injectable joint support products such as Adequan, Legend, or Pentosan. These medications are injected either in the muscle or intravenously and work similarly to oral joint supplements, only bypassing the digestion and absorption process. 

Adequan (polysulfated glycosaminoglycan) is a prescription that is injected into the horse’s muscle; It should be given by a veterinarian. This medication has been shown to bring relief and aid in the long term health of joint cartilage. There is a loading dose and then the injections can usually be tapered off to once a month.

Legend (hyaluronic acid) is also a prescription medication, but because it should be administered intravenously, it needs to be given by a veterinarian. Legend works by improving the quality of the joint fluid and reduces joint inflammation. Like Adequan, there is typically a loading dose which is tapered off to one injection a month for most horses. 

A newer medication targeted for equine arthritis is Pentosan, which is often used by veterinary surgeons post-surgically as a joint lavage. Pentosan can also be used as an intramuscular injection with a similar loading dose as Adequan and Legend. 

As with joint injections, these injectable medications may be more effective when used as a preventative rather than as a treatment, especially when arthritis has progressed beyond a certain point. 

Alternative therapies for equine osteoarthritis

Several therapies have gained popularity for treating equine arthritis in recent decades. They include: 

  • Extracorporeal shockwave therapy (ESWT), which involves directing a beam of energy waves at a targeted location and has shown promise as a horse arthritis treatment.
  • Surpass, a topical cream containing diclofenac sodium, can be applied directly to the skin over an affected joint and has been shown to have protective effects on joints. 
  • Interleukin-1 Receptor Antagonist Protein (IRAP) Therapy, which works by blocking a specific protein that has been implicated in accelerating joint damage. The most common type of IRAP therapy involves taking blood from the arthritic horse, stimulating the production of IRAP and producing a serum which is then injected back into the horse’s inflamed joint. 

Managing horses with arthritis

Aside from the treatment options listed above, how you manage your arthritic horse can also play a role in keeping the inflammation in check. Overweight horses automatically have more stress placed on their joints. In fact, for every additional pound of body weight, there is an added 4 pounds of force placed on affected joints, so managing your horse’s weight can be a key factor in keeping them more comfortable.

From a nutritional perspective, prioritizing fresh forage, minimizing grains when possible and balancing omega fatty acids profiles in your horse’s diet can go a long way in minimizing arthritis symptoms. 

Movement is beneficial for arthritic joints and keeping a horse stalled can actually have a negative impact on their condition. Plenty of turnout and daily exercise is often helpful for horses with arthritis,  and may help decrease stiffness and inflammation.

One thing to keep in mind: when it comes to arthritis treatments, every horse is different and may respond differently to various treatment options. There may also be some trial and error involved in finding what works best for your horse. Oftentimes, a combination of therapies is best, and as with most conditions, being proactive and using preventative strategies will help to keep your horse’s joints healthier in the long term. 

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