Your horse’s joints are made of three basic components, each of which needs to stay healthy to maintain the integrity of the joint. These include the bones, the connective tissues that form both an inner lining of the joint (joint membrane) and its outer envelope (joint capsule) and the elastic connective tissue covering the ends of each bone surface (articular cartilage). All joints deteriorate over time as part of the natural aging process. While classically a breakdown in the cartilage layer has been deserving of the label “osteoarthritis,” inflammation of any of these three fundamental structures can contribute to degenerative joint disease.
Regular observation of your horse’s legs can reveal telltale signs that a joint problem is developing. An early sign of joint inflammation is increased fluid within the joint, called effusion. This appears as a bulging area near the joint and feels like a balloon filled with water. You may also notice heat or pain when you touch the surface of a joint. With more longstanding joint disease, the overall size of the joint can appear larger as the body builds new bone along the edges of the joint in response to the inflammation. The classic example here is ringbone, which earned its moniker for the circumferential thickening around the pastern joint. And finally, there is the most obvious sign of an unhealthy joint: lameness.
If you have a concern, schedule an examination with a sports medicine-focused veterinarian. Aside from a thorough physical and clinical examination, your veterinarian may conclude that further diagnostics are needed. The most objective way to assess a horse’s joint is to take an X-ray, also referred to as a radiograph. This is often the first step to diagnosing joint disease. Many owners radiograph their horse as part of the pre-purchase examination to evaluate for pre-existing joint disease. It can be beneficial to repeat selective radiographs as a horse ages and compare a joint’s appearance to see if there has been a progression of arthritis.
While radiographs show the accumulation of wear and tear on the bones over time, an ultrasound examination of a joint can be even more informative of what is going on in the moment and provides information about the soft tissues that comprise the joint. A veterinarian can assess if the joint capsule is thickened (capsulitis) or if the inner lining of the joint has become excessively thickened in response to inflammation (synovitis). And ultrasounds are more sensitive than radiographs for subtle changes at the bone surface and can show small bone spurs called osteophytes that indicate early arthritis.
If you identify that your horse has joint disease, work with your veterinarian to develop a management plan. More than a decade of research has focused on how to enhance joint longevity through nutritional support, and adding a joint supplement to your horse’s daily ration is a simple way to proactively slow the aging process. Scientific literature shows the most convincing results for ingredients such as avocado soybean unsaponifiables, Omega-3 fatty acids and glucosamine. Look for these ingredients, and if possible, choose a brand that invests in research to develop their product formulations. Aside from oral joint supplements, there are intravenous or intramuscularly administered products that can support joint health by providing hyaluronic acid or similar molecules that comprise the building blocks for healthy cartilage and joint fluid.
Another category of products that can be given systemically to maintain joint health is bisphosphonates. These are medications administered by a veterinarian that can slow or prevent bone loss. Scientific studies demonstrate improvement in lameness in horses with arthritis in their lower hock joints and back following administration of a bisphosphonate. Judicious use of this category of medications can help maintain joint health over time. Non-steroidal medications such as phenylbutazone can also be given orally to horses to address pain and inflammation due to joint disease.
If these measures are insufficient or if the joint disease has caused persistent lameness, your veterinarian may recommend an injection of an anti-inflammatory medication directly inside the joint.
A new focus in sports medicine is the use of regenerative products to heal and restore the joints. These regenerative products are created from the horse’s own blood which is processed to yield a solution rich in anti-inflammatory proteins and/or healing growth factors, which can then be injected back into the joint. In some cases, veterinarians can do this procedure at the home farm on a same-day visit. This approach to managing joint inflammation is becoming more popular and is likely to become a better option as research continues to prove that the results exceed those of more traditional corticosteroid joint-injection therapy.
Corrective shoeing is a noninvasive approach that can support your horse’s joint health. Your veterinarian and farrier can discuss changes to the shape or material of the shoe to improve the mechanics of how the foot moves through the footing to ease pressure and facilitate forward movement of the limb.
Undoubtedly science will continue to evolve and provide us better tools to recognize joint disease in its infancy when interrupting the disease cycle is more possible. Early recognition is essential because the more advanced joint disease is, the less likely intervention will be successful. To keep your horse feeling younger than his actual years, maintain a regimen of good shoeing, nutritional support and proactive care that addresses inflammation when these subtle clues arise.
This column has not been approved or endorsed by U.S. Equestrian.
About Cricket Russillo, DVM
Christina “Cricket” Russillo, DVM, graduated from the Tufts University School of Veterinary Medicine in 2001. After completing a large animal medicine and surgery internship at Texas A&M, she realized her desire was to work on elite sporthorses. Following 13 years of practice at Fairfield Equine Associates in Newtown, Connecticut, focused on high-level show-jumping and dressage horses, she joined Virginia Equine Imaging in 2015. Russillo has competed through Third Level in dressage and in February 2017 she was appointed the U.S. Dressage Team veterinarian. She is also a certified member of the International Society of Equine Locomotor Pathology.
This article originally appeared in the Summer 2020 issue.