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Equine Arthritis

Osteoarthritis, also know as degenerative joint disease, is a painful, progressive condition with no known cure

other potential causes for the ob-

served lameness (e.g., neurological

The term arthritis refers to an

diseases), a complete lameness ex-

inflammation of the joint. There

amination, the use of nerve and/or

are different kinds of arthritis, such

joint blocks to assist in localizing the

as septic arthritis and rheumatoid

source of the lameness, and a syn-

arthritis. However, the most im-

ovial fluid analysis are all important

portant arthritis affecting horses is

first steps in diagnosing OA. Radiog-

osteoarthritis (OA), which is char-

raphy (X rays) remains the primary

acterized by the erosion of articular

means of imaging joints to diagnose

cartilage—the layer of specialized

osteoarthritis (or other bony abnor-

tissue that lines the ends of the

malities); however, advances in diag-

bones inside the joint. Osteoarthri-

nostic imaging have and continue to

tis is a major cause of lameness in

occur. Ultrasonography, computed

athletic horses. Recent estimates

Recent estimates indicate that 60% of equine lameness prob-

tomography, magnetic resonance

indicate that 60% of equine lame-

lems are osteoarthritis-related

imaging, nuclear scintigraphy (a

ness problems are OA-related.

Osteoarthritis, historically referred to as molecules such as cytokines, nitric oxide, bone scan), and diagnostic arthroscopy can

degenerative joint disease (DJD), is a pain- free radicals, and prostaglandins and en- also be employed to assist in diagnosis.

Classic signs indicative of OA observed

ful, progressive condition with no known zymes called matrix metalloproteinases.

The end result is a physical degenera- on radiographs include effusion, the forma-

cure. Clinical signs of OA include heat,

swelling (i.e., joint effusion or a “filled” tion of the cartilage that usually occurs in tion of osteophytes or enthesophytes (which

joint), pain, and a reduce range of motion conjunction with changes in the underly- are bony changes evident at the margins of

ing bone (i.e., formation of enthesophytes the joint that result from remodeling of the

in the affected joint(s).

and osteophytes) and associated soft tissue joint during the development of OA), ebur-

structures, primarily the synovial mem- nation or sclerosis (increased density), or

Development of Osteoarthritis

lysis of the subchondral bone. Joint space

Articular cartilage is a highly specialized brane and joint capsule.

narrowing might also be evident.

body tissue composed of cells (chondro-

One of the major problems in diagnos-

cytes) embedded within an “extracellular

Causes of Osteoarthritis

matrix” that contains collagen, proteogly-

Osteoarthritis can develop in normal ing osteoarthritis is there often is a dispar-

cans, and water. Articular cartilage lines joints without any apparent cause. This ity between the observed clinical signs and

the ends of the bones within the joint and form of osteoarthritis is referred to as the degree of changes in the bone and/or

permits smooth, frictionless movement. primary OA. Alternatively, OA can de- soft tissues of the affected joint(s) that are

In addition, articular cartilage is shock- velop secondary to trauma (e.g., an intra- noted on radiographs. (The joint might be

absorbing and allows for the transfer of articular chip fracture) or in horses with in better shape than the radiograph indi-

body weight loads during movement.

poor conformation, with inappropriate cates, or vice versa.)

In normal joints the articular cartilage‘s shoeing, or horses with other musculosk-

extracellular matrix is continuously “turned eletal abnormality such as an untreated

Treatment

over” or remodeled to maintain a healthy, osteochondritis dissecans (OCD) lesions.

Despite aggressive research efforts, there

optimally functioning tissue. This means

Ringbone (involving the first or second is no cure for osteoarthritis. Instead, the

existing extracellular matrix components phalanx) and bone spavin (in the hock goal for managing OA is to slow the pro-

are degraded and replaced by new mol- joints, such as the distal intertarsal or gression of the disease once clinical signs

ecules synthesized by the chondrocytes.

tarsometatarsal joints) are both unique of disease have become evident. At pres-

In arthritic joints the balance between examples of OA in the horse that occur in ent, a multi-modal approach to managing

the degradation and synthesis of the ex- high-load-low-motion joints.

OA is recommended. Using a combination

tracellular matrix is disrupted favoring the

of therapies instead of relying on only one

destruction of the tissue. This destruction

Diagnosis

or two techniques is thought to maximize

is mediated by various pro-inflammatory

A full physical examination to rule out relief of pain and quality of life.

This Fact Sheet may be reprinted and distributed in this exact form for educational purposes only in print or electronically. It may not be used for

commercial purposes in print or electronically or republished on a Web site, forum, or blog. For more horse health information on this and other topics visit-

TheHorse.com. Published by

The Horse: Your Guide To Equine Health Care,

Jennay HITeSman

Overview

Additional Treatment Options

A number of alternate therapies can

also be considered in horses diagnosed

with osteoarthritis. For example, interleu-

kin-1 receptor antagonist protein (IRAP)

to block the cytokine interleukin-1 from

further damaging an arthritic joint is used

for OA-affected horses.

Extracorporeal shock wave therapy

(ESWT), which involves applying beams

of energy to the affected joints, also might

benefit OA-affected horses.

Finally, surgical fusion of a joint by

removing the articular cartilage and es-

sentially creating one long bone can also

be considered. This might be possible in

some of the lower motion joints (e.g., in-

terphalangeal joints), but not for higher

motion joints such as the knee.

All treatment options should be fully

discussed with your veterinarian.

horse’s age, and response to therapy. In

many cases, OA is career-limiting in athletic

horses (even young and otherwise healthy

horses). In horses that are severely affected

and continue to be uncomfortable despite

instituting a multi-modal treatment pro-

gram, OA is a life-threatening condition.

Fast Facts

■

Osteoarthritis (Oa)

is the most com-

mon and important form of arthritis in

horses;

■

OA is a painful, debilitating, and career-

and life-threatening condition caused by

the destruction of articular cartilage;

■

classic signs

of OA include pain, heat,

swelling, and a decreased range of mo-

tion (lameness);

■

Diagnosing

OA can be challenging and

involves a complete physical and lame-

ness examination in combination with

one or more imaging modalities such as

radiography (X rays), bone scans, and

diagnostic arthroscopy;

■

since there is no cure

for OA, the goal

is to slow the progression of the disease.

This is achieved using a multi-modal

treatment approach involving pain man-

agement, supplements, non-weight bear-

ing exercise, and weight management;

■

alternate therapies

are also available,

and more are being developed (e.g., gene

therapy) to help combat this disease.

Prevention

Osteoarthritis can develop as a prima-

ry cause or secondary to other underly-

ing conditions as described above. Since

there is no cure for OA, the main goal is

to prevent or slow the progression of OA.

Limiting repetitive trauma to the joints,

addressing underlying joint abnormalities

(e.g.., removing OCD lesions or articular

chip fractures, improving conformation,

and having the feet trimmed appropriate-

ly) are all important steps in minimizing

the development of osteoarthritis. Some

owners and trainers routinely administer

oral joint health supplements, or use poly-

sulfated glycosaminoglycans or hyaluronic

acid in young, healthy horses, to decrease

the chances of developing OA; however,

there is no or only a limited amount of evi-

dence that this practice is effective.

Prognosis

The prognosis for horses diagnosed

with OA is highly variable and depends on

a number of factors such as the number

and location of affected joints, the underly-

ing cause, the rate of disease progression,

From the patient. For the patient.

Biology beats chemistry

Treat equine lameness biologically with proteins from the patient’s own blood.

Tested

Trusted

Proven

Talk to your veterinarian about irap today.

Dechra Veterinary Products, 7015 College Blvd., Suite 525, Overland Park, Kansas 66211, 866-933-2472 www.dechra-us.com

irap0509-01-47818

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