TACKLING THE PROBLEM
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.