Dres­sage Health

What op­tions ex­ist for treat­ing an older dres­sage horse?

Dressage Today - - Content - By Peter O’Hal­lo­ran, DVM, with Reina Abelshauser

Deal­ing with a Bone Chip

When it comes to treat­ing an older horse who has been show­ing signs of lame­ness from a di­ag­nosed bone chip, there are a few op­tions. If the chip is in an area such as the fet­lock joint, for ex­am­ple, sur­gi­cal treat­ment might not be the best op­tion be­cause re­cov­ery and re­ha­bil­i­ta­tion from surgery will take many months for an older horse. In­stead, treat­ing the lame­ness with hyaluronic acid and anti-in­flam­ma­tory drugs might be a bet­ter op­tion. That said, in­tra-ar­tic­u­lar med­i­ca­tion has its own risks, and with ei­ther treat­ment plan, com­plete res­o­lu­tion of the lame­ness, with the horse re­turn­ing to his pre­vi­ous form can­not be guar­an­teed. Ex­tended rest with re­ha­bil­i­ta­tion is also another im­por­tant op­tion to con­sider and, there­fore a vet will con­sider many cri­te­ria be­fore mak­ing a rec­om­men­da­tion.

The first ques­tion a vet may ask is how long the horse has been lame. If this is a re­cent event, the prog­no­sis for the sur­gi­cal op­tion is im­proved. For a more chronic lame­ness in an aged horse, in­tra-ar­tic­u­lar med­i­ca­tion is prob­a­bly best.

If the lame­ness has been lo­cal­ized to the fet­lock with in­tra-ar­tic­u­lar anes­the­sia, the bone chip may not be caus­ing any lame­ness. A chip can be imbed­ded in the lin­ing of the joint cap­sule and not be a prob­lem. In fact, many horses can have os­teo­chon­dri­tis dis­se­cans (OCD) bone frag­ments and re­main in dres­sage train­ing for many years.

Other ques­tions may in­clude: How long has the bone chip been present? Is there joint ef­fu­sion? Is the horse pos­i­tive to pas­sive and ac­tive flex­ion? How lame is he? Vet­eri­nar­i­ans also have to con­sider other pend­ing is­sues. For in­stance, some­times it may not be worth the time and ex­pense of surgery if there are other pre­dis­pos­ing fac­tors for new in­jury. For that rea­son, a vet may eval­u­ate the fol­low­ing: the horse’s hooves, his con­for­ma­tion, his gaits, whether or not he has any an­gu­lar limb de­for­mity, if he toes out or in, if his pasterns are slop­ing or more up­right and if he ex­pe­ri­ences any back sore­ness.

If the horse’s con­for­ma­tion ren­ders him sus­cep­ti­ble to ex­ces­sive stresses, surgery may not be a rea­son­able treat­ment plan, and treat­ment with in­tra-ar­tic­u­lar med­i­ca­tions may be a bet­ter op­tion for ex­tend­ing the horse’s ca­reer.

Hyaluronic acid and cor­ti­sone can have a pow­er­ful and some­times ex­tended af­fect. How­ever, oc­ca­sional re­peat treat­ments may be nec­es­sary. Another op­tion would be in­tra-ar­tic­u­lar treat­ment with au­tol­o­gous ther­a­pies such as IRAP, which is an anti-in­flam­ma­tory pro­tein that is pro­cessed from the horse’s own blood sam­ple. A vet­eri­nar­ian will also con­sider the level at which the horse has been per­form­ing. An ex­pec­ta­tion for the horse to con­tinue per­form­ing at his pre­vi­ous level may not be re­al­is­tic. All those in­volved can hope for the best, but ul­ti­mately a sat­is­fac­tory out­come can­not be guar­an­teed.

Con­se­quently, I would con­sider the re­sults of a thor­ough lame­ness exam, eval­u­ate the over­all prospect for suc­cess and try to com­mu­ni­cate a re­al­is­tic ex­pec­ta­tion when of­fer­ing a rec­om­men­da­tion to the owner.

Peter O’Hal­lo­ran, DVM, is a mem­ber of the Amer­i­can Vet­eri­nary Med­i­cal As­so­ci­a­tion and the Amer­i­can As­so­ci­a­tion of Equine Prac­ti­tion­ers. Based in Dick­er­son, Maryland, he is a vet­eri­nar­ian with Mono­cacy Equine Vet­eri­nary As­so­ci­a­tion.

For an older horse, treat­ing lame­ness with hyaluronic acid and an­ti­in­flam­ma­tory drugs might be a bet­ter op­tion than surgery.

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