Wendy Furness MA VetMB CertEP MRCVS explains the different treatment options for horses with arthritis.
As any animals (and humans!) get older we tend to notice them getting stiffer, exhibiting signs of lameness and moving differently.
Causes of Arthritis
The causes of these are multifactorial and osteoarthritis is very common. Joints are actually very complex structures composed of a number of connective tissues including bone, cartilage, supportive soft tissue structures, a lining called the synodical membrane and synovial fluid (joint fluid). This tissue is responsible for the load bearing function of the limb and in a healthy joint, cartilage surfaces glide over each other.
In osteoarthritis there are changes to these structures which are progressive over time. Alongside the changes come varying degrees of pain and altered function of the joint such as reduced range of motion. Over time altered function can lead to reduced mobility and range of motion and reduced muscle mass. In the upper limb and back, muscle loss contributes to further changes as stability of the joints from the surrounding structures is lost.
Osteoarthritis can be suddenly onset in cases such as trauma or following a septic joint however in most cases the onset is much more insidious. Symptoms of osteoarthritis can include:
- Joint swelling
- Over lameness
- General stiffness
- Reduced range of motion of joints
- Work avoidance
- Altered behaviours and performance
- Abnormal shoe wear
- Difficulties in showing and trimming
- Reluctance to lie down
More extreme cases can present as weight loss from bullying by other horses or even apparent narcolepsy (sudden falling asleep) as the horse has extremes of tiredness if it can’t cope with its normal sleeping behaviours.
Symptoms of Arthritis
Symptoms are highly variable between horses. Some horses will have relatively severe findings but cope well and others will not tolerate relatively minor changes. My own horse Cassie who retired some years ago has arthritis; the initial symptoms for her were altered behaviour while working. She very much enjoyed jumping to the point where I had to be careful collecting rosettes that there wasn’t an incident involving jumping the course for a third time! However initial symptoms were the occasional stop which escalated to avoidance of jumping. Further investigation revealed pastern arthritis which has progressed steadily over time.
Treatment of Arthritis
This all sounds very doom and gloom, however there are many ways we can help horses with osteoarthritis and what this help looks like is tailored to the individual horse and owner combination.
Diagnosis of arthritis can be made from a thorough clinical examination however in some cases a lameness workup is required involving nerve or joint blocks and scans or x-rays.
If the horse is still in work wherever possible we try to keep them in some level of work to maintain their muscle mass and flexibility. In mild cases this will often involve reviewing exercise patterns and working alongside a physiotherapist. We would also often work alongside a farrier to find a shoeing/trimming combination that suits the condition.
In some cases, joint medication is appropriate. Direct joint medication can include using steroids (a potent anti-inflammatory drug) to reduce the inflammatory cycle in the joint and sometimes using HA which at a simple explanation helps normalise joint fluid. Other medications are also available at the practice and induce some biological therapies such as IRAP or more systemic medication in groups of drugs known as bisphosphates and PSGAG’s.
There are advantages and disadvantages of all of these drugs and various degrees of evidence for their use. Prior to starting any treatment, we would go through which options are available and which we would recommend as being potentially useful in your horse’s case.
In some cases, horses go onto long-term anti- inflammatory medication such as ‘bute’. Some horses will need this in specific situations such as prior to the farrier, others may be on a low dose to maintain some level of work and others may require it to be comfortable in the field.
Many people fear putting their horse on long-term medication for concerns around side effects. We are always happy to talk about this and help to balance concerns around risk with comfort for the horse in question. Managing horses with arthritis is tailored to you and your horse’s requirements. There are many horses that have very many happy and productive years living with arthritis.