Managing Joint Disease
Times have changed since American Regent Animal Health veterinarian Howland Mansfield started treating equine patients 15 years ago.
“I remember the hours we used to spend in a tiny, dark room developing x-rays, and now we are taking and looking at x-rays in the barn aisle.
“We can now get the horse treated faster than we ever used to be able to, and we have wonderful rehabilitation centers and alternative therapies like laser, chiropractic and acupuncture that weren’t there, or weren’t so readily available.”
However, one thing hasn’t changed and it’s a big one…
Osteoarthritis. Also known as “degenerative joint disease.”
“It’s estimated that 60% of lamenesses are due to osteoarthritis1,” Dr. Mansfield reports. And misconceptions still surround this ultra-common condition. Thanks to this lifelong equestrian and one-time eventer for assistance understanding how we can all help our horses cope with it.
Galway Gazette: What are some of the biggest misconceptions horse owners have about degenerative joint disease?
Dr. Mansfield: That it only happens to your older horse or the horse with bad conformation. Or, that if a horse is on a joint supplement, they don’t need anything else. Or, they only need a joint injection or a NSAID (non-steroidal anti-inflammatory drug).
The truth is there are so many more things out there that we can do.
GG: What were your main options for treating osteoarthritis when you started?
Dr. Mansfield: You could adjust the horse’s shoeing, use a NSAID and maybe an occasional joint injection.
GG: …and now?
Dr. Mansfield: We have so many advances in farrier care in terms of corrective shoeing – which is especially important for eventers because horses work on different terrains. We have wonderful rehab centers and complementary therapies, orthobiologics and many advances in our diagnostic abilities. Even training techniques can be part of managing a horse’s arthritis.
And we have so many systemic options. With Adequan® i.m., (polysulfated glycosaminoglycan) for example, we can inject Adequan® i.m. into the horse’s muscle and it can be detectable in joints in as little as two hours.2 We can double the amount of hyaluronic acid in 2 days, reducing inflammation and preventing the progression of the disease. 2,3 Please see the indications and important safety information on Adequan i.m. below.
GG: How does Adequan i.m. work?
Dr. Mansfield: Veterinarians have been using Adequann® i.m for over 30 years and it’s unlike any other joint product because it treats the arthritis, not just the symptoms of arthritis. It works in these multiple ways to maintain joint function 2,3 –
- Reduces inflammation.
- Restores synovial joint lubrication.
- Repairs joint cartilage.
- Reverses the disease process.
GG: What general information can you give owners regarding their horse’s joint health?
Dr. Mansfield: Don’t ignore the little things. Maybe your horse is backing off a fence a little more. There may be signs in his behavior that could be rooted in pain. Even a little bit of inflammation and/or pain can cause changes in behavior, like a reluctance to do things they once did willingly.
Our horses usually give their all for us, so if something is just a little off, that is something to pay attention to. I always told my clients that they know their horses best.
Some horses will tell you right away when they’re in pain, and others are your stoic guys. They’ll go around and never take an off step, even when they’re in pain.
GG: What role do weight and fitness play?
Dr. Mansfield: Good nutrition and weight management are keys to joint health. An overweight horse is not a healthy horse – even though there are misconceptions about that. Keeping your horse fit and in good shape prevents the harmful impact of excess weight on the joints.
GG: How else can we catch health issues early?
Dr. Mansfield: Most owners have the vet see their horse twice a year for routine vaccinations. I support having the vet do a performance exam, too. By that I mean palpating for soreness, watching the horse jog, and performing flexion tests, then comparing the results with those from the exam six months prior.
I see some of our higher-end athletes doing regular performance exams for preventative purposes, and more people that are willing to do them. That’s opposed to waiting until you have a problem. The earlier we can diagnose and treat a problem, typically the easier it is to treat and, usually, the better the outcome. It’s sometimes less expensive, too.
GG: What advice do you have for identifying legitimate claims regarding products or treatments that purport to help our horses?
Dr. Mansfield: That can be complicated. There’s a lot out there on social media, or a friend says one thing, and you read something else in the media. Supplements and drug products are regulated differently by the FDA, so supplements are not held to the same rigorous standards for proving safety and effectiveness or ingredient makeup, as is required for drugs.
As a side note, the FDA says supplements are not allowed to claim they treat a disease, and manufacturers aren’t required to submit their marketing materials to the FDA. Whereas Adequan i.m. is an FDA-approved drug for the treatment of equine arthritis, which comes with required regulations and assurance that our claims have been proven.
That’s why it’s really important to work with your trainer, your veterinarian, your farrier, etc. We rely on articles and research that is peer-reviewed and published in veterinary journals, so we’re in the know.
GG: Do you think the current focus on healthy aging for people is helping horses?
Dr. Mansfield: Absolutely. For me personally and, in general, as we age and realize more aches and pains ourselves, we start to think ,“Maybe my horse feels this way, too.”
GG: Is there a typical treatment plan for including Adequan® i.m in the arthritis management approach?
Dr. Mansfield: There’s no cookbook for preventing or managing joint disease. It starts with assessing the individual horse, finding the right fit for each horse, and adjusting it regularly as they age.
Once diagnosed, the approved label dose is (500 mg) every four days, for 28 days, intramuscularly. From there, you need to see how your horse feels afterwards. Some horses won’t need it for a year, and some need it more often. These assessments should be part of the soundness and performance exams performed by your veterinarian.
GG: Thank you for sharing your knowledge!
Dr. Mansfield: You’re very welcome!
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INDICATIONS
Adequan® i.m. is recommended for the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses.
IMPORTANT SAFETY INFORMATION
There are no known contraindications to the use of intramuscular Polysulfated Glycosaminoglycan (PSGAG). Studies have not been conducted to establish safety in breeding horses. WARNING: Do not use in horses intended for human consumption. Not for use in humans. Keep this and all medications out of the reach of children. CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. For full prescribing information, visit adequan.com
- McIlwraith CW, Frisbie DD, Kawcak CE, van Weeren PR. Joint Disease in the Horse. St. Louis, MO: Elsevier, 2016;33-48.
- Burba DJ, Collier MA, DeBault LE, Hanson-Painton O, Thompson HC, Holder CL: In vivo kinetic study on uptake and distribution of intramuscular tritium-labeled polysulfated glycosaminoglycan in equine body fluid compartments and articular cartilage in an osteochondral defect model. J Equine Vet Sci 1993; 13: 696-703.
- Adequan® i.m. (polysulfated glycosaminoglycan) Package Insert. American Regent, Inc.
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