TACK­LING THE PROB­LEM

EQUUS - - Eq In Brief -

Man­ag­ing mild arthri­tis often be­gins in the feed room, with a nu­tri­tional sup­ple­ment de­signed to sup­port and pro­tect joint health. The choices are nu­mer­ous and can feel over­whelm­ing, but most will con­tain one or more com­mon in­gre­di­ents. Un­der­stand­ing what those are is a good place to be­gin the process of se­lect­ing the best prod­uct for your horse. Hyaluro­nan (hyaluronic acid, HA) is a car­bo­hy­drate that binds to wa­ter in the body to cre­ate a vis­cous, lu­bri­cat­ing fluid. It is found in con­nec­tive tis­sue, car­ti­lage and syn­ovial fluid.

Glu­cosamine is an amino sugar that the body uses to cre­ate ma­te­ri­als for the pro­duc­tion and re­pair of car­ti­lage. You’ll often find this com­bined with chon­droitin sul­fate, a large pro­tein mol­e­cule used to build con­nec­tive tis­sues and car­ti­lage. It also helps car­ti­lage retain wa­ter.

MSM (methyl­sul­fonyl­methane) is an or­ganic com­pound con­tain­ing sul­fur, which is nec­es­sary for the pro­duc­tion of col­la­gen and con­nec­tive tis­sue.

Ex­tracts from soy­beans and av­o­ca­dos that block in­flam­ma­tory chem­i­cals, av­o­cado soy­bean un­saponifi­ables (ASU) pre­vent de­te­ri­o­ra­tion of car­ti­lage and stim­u­late the re­pair of con­nec­tive tis­sue.

Some­times a sup­ple­ment isn’t enough to man­age arthri­tis. In those cases, your vet­eri­nar­ian may recommend a med­i­cal ap­proach as well. There are a few dif­fer­ent ap­proaches that can be taken or com­bined.

Non­s­teroidal an­ti­in­flam­ma­tory drugs (NSAIDs), par­tic­u­larly phenylbu­ta­zone, in­ter­rupt the in­flam­ma­tory process of arthri­tis, pro­vid­ing pain re­lief while slow­ing the cy­cle of car­ti­lage de­struc­tion. While “bute” is ef­fec­tive for mi­nor arthri­tis, it in­hibits pro­tec­tive as well as de­struc­tive en­zymes, rais­ing the potential of adverse side ef­fects, such as gas­tric ul­cers, with long-term use. The drug firo­coxib (Equioxx) be­longs to a dif­fer­ent class of NSAIDs that in­hibit only de­struc­tive en­zymes, promis­ing fewer side ef­fects.

In ad­di­tion to an­ti­in­flam­ma­tory drugs, arthri­tis treat­ment may in­clude med­i­ca­tions in­jected di­rectly

into af­fected joints, which of­fers a more po­tent ef­fect. There are a few dif­fer­ent prod­ucts that might be used in this way.

Hyaluronic acid in­jec­tions are thought to have anti-in­flam­ma­tory ef­fects while stim­u­lat­ing the body to pro­duce nat­u­ral hyaluro­nan. HA in­jec­tions are typ­i­cally given di­rectly into the joint, although one prod­uct (Leg­end) is also li­censed for in­tra­venous use as well.

Com­plex sug­ars nat­u­rally found in ar­tic­u­lar car­ti­lage, poly­sul­fated gly­cosamino­gly­cans (PSGAGs) are in­jected to stim­u­late pro­duc­tion of hyaluronic acid as well as to in­hibit the de­gen­er­a­tion of car­ti­lage. The most com­mon PSGAG (Ad­e­quan) is li­censed for in­tra­mus­cu­lar in­jec­tions as well as in­jec­tions di­rectly into the joint.

Cor­ti­cos­teroid in­jec­tions have pow­er­ful anti-in­flam­ma­tory ac­tion and will im­me­di­ately halt the de­struc­tive pro­cesses while re­liev­ing the horse’s pain. Con­cerns of side ef­fects, how­ever, in­clud­ing adverse im­pact on car­ti­lage, lead vet­eri­nar­i­ans to be cau­tious in their use. Horses who are at risk for lamini­tis, for ex­am­ple, may not be good can­di­dates for re­ceiv­ing cer­tain cor­ti­cos­teroids.

More high-tech ap­proaches to treat­ing arthri­tis are be­com­ing in­creas­ingly affordable, ac­ces­si­ble and, as a re­sult, com­mon. In­ter­leukin-1 re­cep­tor an­tag­o­nist pro­tein (IRAP), works by har­ness­ing the body’s own re­sources for treat­ing arthri­tis. The vet­eri­nar­ian draws blood from the horse and pro­cesses it to stim­u­late the pro­duc­tion of IRAP, which blocks a pro­tein that ac­cel­er­ates joint dam­age, along with other ben­e­fi­cial in­flam­ma­tory me­di­a­tors. The re­sult­ing serum is in­jected back into the same horse’s in­flamed joint, typ­i­cally in three treat­ments once a week.

Stem-cell ther­apy har­vests un­dif­fer­en­ti­ated cells, typ­i­cally from a horse’s own body, and in­jects them back into a dam­aged joint to turn into car­ti­lage cells for re­pairs. One of the lat­est de­vel­op­ments in this field is ex­tract­ing stem cells from tooth buds of new­born foals to in­ject into other horses.

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