Degenerative Joint Disease

In case of osteophyte, there is an abnormal development of bone from surface of joint. Osteophyte is the earliest sign of arthritic change at the margins of the small tarsal joints. The location of the osteophyte formation may vary with the type and/or use of the horse and the stage of the disease.

Degenerative joint disease may occur as a result of joint infection (septic arthritis). Most septic arthritis occur fllowing surgery or a puncture wound. Septic arthritis may occur in any joint. Horses with septic arthritis present with severe lameness, joint swelling, fever, loss of appetite, stiffness and pain. Bone changes are more severe and progress rapidly and are usually visible during radiographical examination. Septic arthritis treatment include antibiotics and surgery (in severe cases).

Degenerative joint disease may occur as a result of untreated Osteochondritis dissecans (OCD), a disease associated with defective development of bone from cartilage leading to inflammation in affected joints. Often loose fragments of cartilage and/or bone present in joint, usually stifle, hock, fetlock and shoulder. The disease may occur in any joint, but is most commonly seen in the tarsus (hock). Breeds with a high-incidence of tarsal osteochondrosis include Standardbreds, Quarter Horses, Warmbloods and Arabians.

Medical reports show that about 76 percent of treated horses raced successfully or performed their intended use following surgery. In many cases, however, additional techniques to improve the healing response in bone and cartilage are needed so as to preserve articular function.

The principles of treatment of Degenerative Joint Disease include prevention or treatment of septic arthritis and osteochondritis dissecans; treatment of active soft tissue disease contributing to articular cartilage degeneration, including rest, physical therapy, synovectomy and administration of anti-inflammatory drugs, sodium hyaluronate and polysulfated glycosaminoglycans; treatment of articular cartilage loss or degeneration, including articular cartilage curettage (removal), subchondral bone drilling, and osteophyte removal.

The equine practitioner is faced with many choices for controlling inflammation in osteoarthritis (OA.) The proper combination of systemic nonsteroidal anti-inflammatory drugs (NSAIDs), intraarticular steroids, viscosupplementation (injection a preparation of hyaluronic acid into the joint that acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads), and chondroprotectants (supplements which work to maintain cartilage health) can be used to treat the disease and stop further progression of degenerative changes to the cartilage surface.

Although the whole nutraceutical industry is essentially unregulated, with manufacturers making outrageous claims on products that have never been tested at all, are often of poor quality, and occasionally lacking in any active ingredient, ongoing research shows that oral administration of nutraceutical products, such as Glucosamine and chondroitin to the horse is common and easy and is perceived to be a benign treatment for OA in horses. The main goal for use of nutraceuticals is to use them in OA cases to attempt to lower the dose of other drugs that are more problematic while potentially preventing further progress of DJD.

Clinical findings have revealed that glucosamine sulfate and chondroitin sulfate are effective and safer alternatives to alleviate symptoms of OA (Glucosamine and chondroitin sulfates in the treatment of osteoarthritis: a survey by de los Reyes GC, Koda RT, Lien EJ). Glucosamine is an amine-sugar that has been marketed as a natural product for the treatment of osteoarthritis. It has been popularized in the complementary section of pharmacies as a safe over-the-counter treatment for osteoarthritic pain.

Recent research suggests that it may not only provide symptomatic pain relief, but may have a role in chondroprotection. This is due to the fact that articular cartilage is critically dependent upon the regular provision of nutrients (glucose and amino acids), vitamins (particularly vitamin C), and essential trace elements (zinc, magnesium, and copper). Therefore, dietary supplementation programs and nutraceuticals based on antioxidant vitamin C, polyphenols, essential fatty acids, used in conjunction with non-steroidal, anti-inflammatory drugs (NSAID) may offer significant benefits to patients with joint disorders, such as OA and OCD.

There is also evidence that the combination of oral nutraceutical joint supplements containing high quality glucosamine (GU) and chondroitin sulphate (CS) may be more effective in preventing or treating osteoarthritis in horses than either product alone.

 

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