Osteoarthritis, commonly shortened to just arthritis, is a condition common to all species, including humans and horses. 'Osteo-' refers to bone, 'arthro-' refers to joints and '-itis' means inflammation. Therefore, the term osteoarthritis means inflammation of bone and joints, which is exactly what the disease is. It is also known as degenerative joint disease, or DJD for short.
Osteoarthritis is a very complex disease that affects a large proportion of the horse population. Young horses can be affected as well as older horses. A history of low-grade lameness, which the horse warms out of with exercise and is worse on cold mornings, is strongly suggestive of arthritis. A lameness examination, including nerve and joint blocks, followed by radiographs, confirms the diagnosis. Based upon the severity of the clinical signs, the severity of the changes on x-rays, and the use of the horse, the most appropriate treatment regime can be developed. Treatment will not reverse the changes present, but is aimed at reducing the rate of progression of the disease, rendering the joint pain-free, and prolonging the athletic career of the horse. The response to treatment can be a very individual horse-thing, so it can take some time to find what treatments and management work best for each individual horse. Arthritis can be a career-ending problem, but it is not often that a horse has to be euthanized for arthritis, they can usually be kept comfortable enough to live out their days in a paddock.
Frequently asked questions
Degenerative joint disease is one of the biggest causes of poor performance and a decreased competitive lifespan in the horse. This is true for all types of equine athletes, from racehorses through to dressage and show horses. Both young and old horses can be affected by degenerative joint disease resulting in a loss of athletic ability and possible early retirement.
Joint disease/ osteoarthritis is characterized by inflammation within a joint that sparks an inflammatory cascade resulting in the production of a large amount of inflammatory enzymes. Often the process of joint disease is characterized by an inflammation of the synovium (lining of the joint capsule) followed by the progressive destruction of articular cartilage. The development of joint disease can often progress un-noticed because the onset of lameness can be insidious. Often, it is not until an obvious lameness develops that the presence of degenerative joint disease is noticed.
The degree of the lameness when it is first reported can vary from mild to severe. The grading scale we use to quantify lameness runs from as scale of 0 to 10 with zero being a sound horse and 10 being a horse non-weight bearing on the limb in question.
Extracorporeal shockwave therapy (ESWT) is a widely used treatment for painful orthopaedic conditions in horses, dogs and humans. In humans it has been used for the treatment of gallstones, uroliths and burns. There are also recent, promising reports of its use as a novel treatment for burns in horses.
Extracorporeal shockwaves are pressure waves that are generated outside the body which can travel through fluid and soft tissue. In equine practice, the main indications for use of shockwave therapy are for the treatment of insertional desmopathies and the stimulation of osteogenesis. A desmopathy is a disease of the ligaments, such as the suspensory ligament. When we refer to an insertional desmopathy, we are referring to an orthopaedic condition of the bone-ligament or bone-tendon interface.
Platelet rich plasma is a therapy for the treatment of equine joint, tendon, ligament and bursae injuries. It is a welcome addition to the range of therapies available to treat these injuries because it offers an affordable, practical and scientifically based point of care treatment alternative to horse owners and trainers alike. Platelets are small cell fragments that circulate in the blood. A sample of blood is taken from the horse and processed to increase the number of platelets and growth factors it contains. This is done by passing the blood through a filter. The PRP sample can be ready to inject into the horse within 30 minutes after taking the blood sample.
Platelets release a large number of growth factors when they arrive at a site of tissue injury, including platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-beta), insulin-like growth factors (IGF), vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) that are known to orchestrate the movements of other cells and stimulate the production of repair tissue (extracellular matrix). This aids in speeding the recovery process and improves the end result.