Joint pain is one of the most common causes of lameness in horses. Acute injuries can occur during work or in the pasture or paddock, while wear and tear injuries occur over time and often lead to arthritis.
With any joint injury there will be pain and inflammation and sometimes swelling of the joint. So how do we manage joint pain? In the acute injury cases we will want to rest the horse and use ice or cold water to help reduce the inflammation and pain. Some joints, for example, the fetlock can be bandaged with a padded bandage after icing to help support the joint. The horse will need to be confined to a small flat area to avoid further trauma to the joint. Box stall rest may be indicated in severe cases , but usually limited movement will help provide better and more rapid healing. Hand walking may be recommended.
Just like with humans, we do have medications for joint pain. Mostly we use a class of drugs called NONSTEROIDAL ANTIINFLAMMATORIES. These would include phenylbutazone, Banamine, , Previcox, etc. We are now also having good success using medications called ORTHOBIOLOGICALS to treat both acute and chronic joint disease. More about that later. For joints with chronic injury the goal is to slow the advancement of the disease and to MANAGE the disease process so the horse can be comfortable and usable. Medications containing things like glucosamine, MSM, chondroitin, cartrophen, hyaluron, etc may be beneficial for some horses. Low doses of non-steroidal drugs often help too. Older horses with multiple old tired joints often benefit from the above medications.
Individual joints are often treated with injectable products. CORTICOSTEROIDS (cortisone), either alone or combined with HYALURONIC ACID has been used for years to reduce pain and inflammation in joints. Cortisone works quickly and lasts for a varying amount of time from 30-180 days. It does not promote healing but works only by reducing the inflammation and pain.
The word ORTHOBIOLOGIC may be new to you. They are used in humans and horses. They are NOT drugs, but rather preparations of healing substances harvested from blood of the horse itself, then processed and concentrated with special equipment to end up with a small volume of product to inject into a joint. It can also be injected into soft tissue lesions such as injured tendons and ligaments.
Like corticosteroids, they reduce the inflammation but also promote healing of the injured or diseased tissues. Their effect is not as quick but lasts much longer ( up to a year). The final product that is injected contains PRP (platelet rich plasma), IRAP, and APS (autogous protein solution) which contains multiple growth factors and healing proteins. There are multiple systems available but we have been using a system called PROSTRIDE and have been very happy with the results. Another plus is that since the product came from the horse itself, there is no concern about drug testing for show horses.