Osteoarthritis (OA) is a term frequently heard within the equine world with an estimated 60% of lameness disorders being associated with this degenerative disorder.
What is osteoarthritis?
OA is a slow progressive condition affecting both high and low motion joints.
Joints are the meeting points of long bones, the ends of which are covered with cartilage. Cartilage provides a smooth, gliding surface to prevent friction during motion. Inflammation within a joint space releases chemicals that damage and breakdown cartilage leaving the underlying subcondral bone vulnerable. When subcondral bone becomes inflamed it produces and lays down additional bone. This process of new bone formation results in restricted movement within the joint, pain and lameness.
How do I know if my horse has osteoarthritis?
Horses with joint issues will show varying degrees of lameness, positive flexion test of the affected joint or sometimes only generalised stiffness. Early signs of joint disease may go unnoticed so owners should be vigilant in flagging up subtle signs such as joint swelling, localised heat, or subtle lameness. By the time these symptoms are noticed irreversible changes to the joint may already be underway. Common joints affected include the hock, pastern, coffin, fetlock, carpus and stifle joints. The source of pain or lameness needs to be identified via a thorough lameness examination. This usually involves a combination of diagnostic anaesthesia in the form of nerve blocks or joint blocks and x-rays.
What is the prognosis for a horse with osteoarthritis?
There are varying degrees of severity of OA amongst the horse population and also differences in expectations from owners for their horse’s careers. The bottom line being that there is no cure for OA but with numerous options available, we aim to have a horse as comfortable and pain free as possible. With successful treatment many horses are capable of continuing their competitive careers.
Mangement & Treatment
How can I manage my horse’s osteoarthritis and what are my options?
Essentially managing OA can be broken down into two sections, physical management and pharmacological management. Unfortunately, osteoarthritis is progressive in nature and we can only endeavour to do our best to slow down its progression.
Physical management involves making small changes that can make a huge difference to your horses comfort. Provided the degree of lameness doesn’t deteriorate, it is paramount to keep the horse active. Extra time spent warming-up, avoid working on hard, concussive surfaces at any pace faster than a walk. Keeping your horse’s weight under control reduces pressure on the joints. Having your farrier and vet assess your horse’s hoof balance will neutralise pressure through the limb.
Pharmacological management involves the usage of drugs to compliment physical management. Endless studies have gone into safety and efficacys of the usage of various treatment in relation to OA but there is no one size fits all. Here is a list of pharmacological techniques that your vet may recommend:
- NSAIDs (Non-steroidal anti inflammatory drugs) – these are oral painkillers/anti-inflammatories often useful in the management of chronic cases.
- Corticosteroids – used as intraarticular injections, there are several types of steroid all of which are aimed at decreasing ongoing inflammation within the joint.
- Hyaluronic acid – often used in combination with corticosteroid treatment, it is a naturally occurring substance in synovial fluid that acts as a lubricant within the joint, aids in providing nourishment and removing waste products from the avascular cartilage, and is an important constituent of the synovial membrane barrier.
- Pentosan polysulphate – shown to help with hyaluronic acid production within joints, which is essential for good joint function as described above.
- PAAG Hydrogels – Another intraarticular preparation, often reserved for those unresponsive to conventional corticosteroid treatment. These are aimed at reducing pain, preserving cartilage and promoting joint mobility. In essence providing shock absorption capability thus acting as a ‘cushion’ within the joint
- Biphosphonates – these are designed to have an effect on excessive turnover of bone which is part of the arthritic process.
- Autologous products – these are products taken from the patient processed and injected back into the patient. These may include extracting blood, bone marrow or fat in a highly specialised process.
- Joint supplementation – often with chondroitin sulphate and glucosamine as the main components, these contain the building blocks for healthy cartilage.
As reiterated earlier, the management and treatment of osteoarthritis is a complex combination of physical and pharmacological therapies where each horse is an individual. Have your horse examined by a vet where a treatment plan can be tailored accordingly.
‘Mud fever’ a sight we are all too familiar with seeing at this time of year.
What is it?
‘Mud fever’ is also know as greasy heels, cracked heels and pastern dermatitis.
It is a bacterial infection of the skin most frequently affecting the lower limbs in Winter and early Spring.
The combination of bacteria Dermatophillus congolensis, Staphylococcus and Pseudomonas are responsible for this condition. These are opportunistic bacteria meaning that under normal circumstances they live on the skin’s surface not causing any harm and feeding off of dead skin debris. When conditions become favourable and skin becomes compromised these bacteria can enter the skin and this is when problems arise.
What can be done?
Day 1 after Clip and Clean
How can I treat it?
The essence behind treating mud fever lies in treating any underlying disease, keeping limbs clean, dry and scab free!
Stabling removes your horse from the mud in turn protecting the skin from damp conditions and further skin damage.
Clipping allows you to visualise the lesions so they can be cleaned with dilute antibacterial solutions.
As the bacteria involved in mud fever struggle in the presence of oxygen, removing scabs and exposing the bacteria to the open air is key. It is often tempting to pick dry scabs but please refrain from doing so as firstly your horse won’t appreciate it and secondly picking leaves a bleeding wound underneath leading you back to the starting point of a skin abrasion and the cycle continues.
Instead, it is advisable to soak limbs initially with warm water and peel off any scabs that are ready to come off. Clean the limbs with dilute antibacterial wash in warm water. Towel dry with a clean towel and apply topical cream to the affected areas. This can be repeated on a daily basis.
Stable bandages can prove beneficial if legs are prepared correctly as above and not applied too tightly. Stable bandages must be clean and dry. Care must be taken as incorrect bandaging can be counterproductive.
Each case of mud fever is different and should be treated on an individual basis based on the above and your vet’s guidance. Should the lesions persist, limbs become more swollen or painful then please seek veterinary advice as your horse may need further veterinary attention.
What do I need? How can I prevent it?
24 Hours After
How can I prevent my horse from getting ‘Mud Fever’?
As with many conditions prevention is better than cure so here is a list of tips to avoid mud fever on your yard:
- Avoid overstocking paddocks and rotate fields
- Fence off muddy gateways with electric fencing
- Keep bedding clean and dry
- Regularly disinfect equipment such as boots, bandages
- If legs are washed make sure they are towel dried
- If using waterproof turnout boots, stable bandages or brushing boots ensure limbs are cleaned and dry beforehand
- Be vigilant for signs of underlying undiagnosed disease such as Cushing’s disease or photosensitisation as a result of liver disease
What will I need?
- Stabling or mud free area
- Examination gloves
- Cotton wool
- Antibacterial wash – Hibiscrub 0.1% or Iodine scrub (diluted)
- Warm water
- Clean towels
- Antibacterial cream – Silver sulphadiazine (Flamazine), Propylene Glycol (Dermisol)
Please contact the practice for more information on topical creams available and bandaging techniques.