The Ladder of Treatment Options for Equine Arthritis: Dr. Emily Graham
Your horse has been diagnosed with arthritis (also known as osteoarthritis or degenerative joint disease)… so now what? There are a variety of different treatment options available depending on where that arthritis is, the severity of the arthritis and of course, budget for treating the specific problem.
One of the first lines of treatment for arthritis can be oral supplementation of products like glucosamine, MSM, green lipped mussel and a variety of natural products. The benefit of these products is that they are usually readily available over the counter and easy for owners to administer with other feed products daily. There are some great products on the market like Immubiome Joint and Recovery or Equitop Gonex that have research and clinical trials behind their claims. However, some of the products out there are not clinically tested and do not have any scientific proof that they work. Another downside is that the bioavailability of these products can be poor and, therefore, require a large amount of the ingredients to be able to be absorbed and actually utilized by the body. Because of this, these feed products can end up being expensive when looking at effectiveness long term. If the arthritis is already moderate to severe, these products will often not make a significant difference.
The next “level” of treatment would be injectable products - there are a variety of different options including hyaluronic acid (Legend), Adequan, injectable glucosamine, Ichon, Polyglycan, etc. These are often given in a loading regime and then usually maintained once monthly. Most of these medications do require a prescription. The benefit of injectable medications is that these are injected directly into the horse, so we do not need to worry about bioavailability like we do when they are consumes orally. Due to this, these products may work out to be more cost effective than feed supplements in the long run. A lot of these products are used to promote and maintain cartilage and joint health and are used not only as a preventative, but also as a treatment for mild degenerative joint disease. Once again, if the arthritis is moderate to severe then more intensive treatment may be required.
A third option available is joint injections. This is a common method to treat degenerative joint disease in horses, in which the joint is sterilely prepped and medication is administered directly in the affected joint for a potent anti-inflammatory effect. There are multiple products that can be administered into the joint depending on the case. Most commonly, steroids and an antibiotic (to reduce risk of joint infection) are used. There are situations in which steroids are chosen to be avoided such as in an overweight pony, a horse with cushings disease, or cases where the patient has become refractory to steroid treatment, so in these cases medications such as noltrex, pro stride, hyaluronic acid or IRAP may be considered. Joint injections may need to be repeated every 6-12 months depending on the situation and its severity.
Hopefully this gives you a general overview aswell as an an understanding of the many options available following your horses diagnosis of degenerative joint disease. I would recommend consulting with your veterinarian to determine what is best for your own individual horse to be sure you are tackling treatment in the most effective way!
Dr. Emily Graham,
VSMT, cVMA
Westhills Equine Veterinary Services