Arthritis

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LittleIndian23

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My 9 year old has been diagnosed with a trauma related arthritis in his right knee.
He's has bone spurs growing on the edges of his intermediate and third carpal bones.
He's had steroid injections and last month we had the green light to start light hacking and bringing him gradually back into work.
Can anyone tell me if there are any differences between trauma arthritis and the usual arthritis except for the cause?
And does anyone know if it can be treated differently as I've been told it can be surgically removed?

Thanks
 
A quick google search tells me that traumatic arthritis is often as a result of a fall or a penentrating wound into the joint so direct trauma in other words. These injuries can damage the cartilage and/or the bone, changing the mechanics of the joint and making it wear out more quickly than would be the case from 'normal' arthritis which is caused by old age, or repeat trauma to a joint due to concussion on a road surface for example, or repetitive strain to a joint due to incorrect farriery for example.
 
While I can still hack my horse for shorter times than before I am worried I'll never school him again.
So frustrating that I can't get a definite answer but all horses are different.
Has anyone had a horse with this before and what sort of work can they do?
 
Yeah and all he tells me is I can't give you an answer.
Seems I have to now just try and bring him back to where he will be comfortable to work.
Am starting 30 mins schooling tomorrow just walk exercises with a few trot strides added in. My trainer is helping me too.
I'm a bit disappointed in my vet aftercare. I would like to see them have a carbon book where they outline treatment plans and aftercare plans and both owner and vet sign it. I found it hard to take in all the information he gave me and had to keep calling him or going to the surgery and that's not ideal when he has a day full of appointments.
 
LittleIndian23 said:
YI found it hard to take in all the information he gave me and had to keep calling him or going to the surgery and that's not ideal when he has a day full of appointments.
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I find it very hard to concentrate at the time of a vets visit, I think it is because I feel overwhelmed and stressed out by it all (although don't appear this way in front of vet or horse). So my vet knows now that he must write things down for me, or let me write things down. Then when I have written his instructions down he will ask me to read them out to him to check they are correct.

I am like this at work too, I have to write down what people ask me to do - I think it is just me!

I'm afraid there comes a time in any horses rehab programme when you have to 'suck it and see'. You have to increase the workload very very gradually (say a half school length of trot twice in one session) the same again next day and then one length of trot twice, and so on. This is what I did with my horse.
 
I'm the same if it's written down then I can't get it confused!
I will start to write down anything from now on I think!

I've been so scared of making him worse or just giving him pain that I really did play it too safe. However I think having these sessions weekly will help!
I'm also in my own fields so have no other horsey people around and don't always trust my own judgment or instinct, so having my trainer there will give me more peace of mind I think
 
Given those circumstances I think that's a good approach. I also have the same problem with vets, it all makes sense at the time but when I try to relay it back after there are "holes" !

My horse had some time off earlier this spring with lameness that we never really got to the bottom of- he has arthritis too (mild changes to 1 front coffin joint and both hocks) but is also prone to laminitis.

He's on a slow return to work it's going ok. The vet didn't give any definite red lines about what he could and couldn't do except to avoid heavily concussive work and too much/prolonged schooling. He also said don't be afraid to give pain relief such as the odd danilon when the ground is hard, because he is prone to laminitis he is not a candidate for steroid injections.
 
I'm no expert but have been told many times that you must keep a horse moving when it has arthritis. My old gelding has arthritis in his right fore coffin joint and also mild arthritis in his hock joints. He has had numerous treatments but nothing worked and I regret to say the steroid injections don't last, they get progressively less effective. Personally, I think its a good idea if you can give him anti-inflammatories (Bute or Danillon) which will help with pain relief but also, and most importantly, get the inflammation down. I am also convinced that the use of anti-inflammatories in the long term does achieve a modicum of success without which it wouldn't happen. Maybe you could look into buying some magnetic brushing boots (Bioflow) which some people swear by. Not cheap but anything is worth a try! Chat to your vet. Good luck.
 
The problem with schooling an arthritic horse is usually that the soft surface and tight(er) turns put extra strain on their joints. My horse has arthritic hocks. We don't really bother with the school, and instead school while out hacking. Anything you can do in the school, you can do out hacking.
 
Sorry to jump on this but I have a 22 year old pony just diagnosed with arthritis of the knee (it was quite bad). He had a steroid injection in two of the joints six weeks ago and now he is lame again (heat at the knee) and I don't know what to do. I am waiting to hear back from my vet but keen to hear other people's thoughts. I haven't ridden him since June (when we diagnosed him) and have only been taking him out in-hand. Is it worth sticking with the jabs and exercising him? What are others experiences?
 
We had 30 mins in the school on Sat. Did squares not circles in walk mainly and had 3 trots from 'B' to 'M' then that night his swelling came back and has been there ever since. He's had a sachet of bute and will have another tonight.
I am waiting to hear from vets about possibly having the bone growths surgically removed in the UK but am non the wiser as yet.
Does anyone know if you can have these growths removed? I've not heard of anyone having it done, only on floating bone chips?
 
I never post on here- however reading this I thought I should share my experience with Knee arthritis- sadly it is not a good one.

My horse was diagnosed with knee arthritis about a year and half ago through X-rays, as he was intermittently lame. Having gone through the fact that knee arthritis is less predictable than others due to the lack of research- My vet suggested we try IRAP rather than going straight to steroids. So he had a 6 week course or IRAP alongside Catrophen- this made him sound for light hacking for around 8 months. He then went lame again, another x-ray showed it had progressed very quickly so I decided to try steroid injections alongside cartrophen again this time he managed to stay sound for 6 months, at which point with did another x-ray- which showed even further progression. Alongside all the treatment I used magnetic boots and blankets, kept him turned out 24/7 and every single joint supplement under the sun.

Myself and the vet then decided to keep him comfortable on bute and retire him to the field- sadly about 4 months later he wasn't even field sound on 3 bute per day so I had to make the hard decision to have him PTS.

I just thought I would share my experience.
 
Its very important to remember with arthritis that often every horse is different. One persons experiences will never match up to anothers. Ive treated elderly horses with arthritis very successfully for long periods of time with NSAIDs, eventers with steroids into the joint and others with bisphosphonates all with varying degrees of success.

One user earlier mentioned that steroids were not effective on her horse, and i have known this to be the case in some patients. Others respond brilliantly, and simply require a top up injection every 6 months. I tend to find that in horses which go lame again within three months steroids are not really an appropriate long term option.

Like I mentioned I have no opposition to using NSAIDs to treat arthritis. However i am always wary about putting younger horses on long term courses. In older horses I dont really have a problem with it, as they need to be comfortable to have a decent quality of life. However starting a horse in its early teens on long term NSAIDs is not really a long term solution in my opinion. With NSAIDs we really are just trying to decrease pain with the prospect of providing quality of life. As arthritic joints degenerate more NSAIDs are required to keep the animal comfortable, and eventually you reach a threshold where the drugs just dont control the pain anymore.

It might be worth having a chat with your vet about the use of bisphosphonates such as tildrin or osphos. I have had moderate success with these treatments and although the method of action is not completely understood, these are thought to change the arthritic process in the joint by altering the action of the cells that make and break down bone. The idea is that they inhibit the action of new bone formation and decrease bone turnover, therefore slowing down the arthritic process.

In terms of surgery, most joint surgeries can be done via arthroscopy. However this is not something to enter into lightly, as there are risks associated with general anaesthetic and surgery in general. In some occasions despite performing arthroscopy the debridment performed can be quite limited. Surgeons can only remove what is safe to do so. That being said some horses do see improvement after arthroscopy, but the cost can be prohibitive for many people.
 
ash_vet said:
Its It might be worth having a chat with your vet about the use of bisphosphonates such as tildrin or osphos. I have had moderate success with these treatments and although the method of action is not completely understood, these are thought to change the arthritic process in the joint by altering the action of the cells that make and break down bone. The idea is that they inhibit the action of new bone formation and decrease bone turnover, therefore slowing down the arthritic process.

In terms of surgery, most joint surgeries can be done via arthroscopy. However this is not something to enter into lightly, as there are risks associated with general anaesthetic and surgery in general. In some occasions despite performing arthroscopy the debridment performed can be quite limited. Surgeons can only remove what is safe to do so. That being said some horses do see improvement after arthroscopy, but the cost can be prohibitive for many people.
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I'm very interested in your reply and I see you mentioned Osphos and Tildren. I understand that this is the next step following steroid injections for a longer term benefit.

You then mention in this horses case that surgery may be an option via arthroscopy.

I know that this isn't relevant to the OP's case but as a generalization for the majority of horses that have arthritis in their hocks and don't wish to take the surgical fusion route, can I ask whether you consider chemical arthrodesis/ethanol fusion to be a good solution for spavin? Is there potential for this to be used on any other joint on the horses body or is it only considered for use in hocks due to the structure of the joints involved?

I found it excellent for my own horse although wasn't aware of the 6-5% of horses that have complications some three to four years following this treatment.

Sorry to hijack the post somewhat but I would be interested in your opinion given that you are a vet.
 
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applecart14 said:
I'm very interested in your reply and I see you mentioned Osphos and Tildren. I understand that this is the next step following steroid injections for a longer term benefit.

You then mention in this horses case that surgery may be an option via arthroscopy.

I know that this isn't relevant to the OP's case but as a generalization for the majority of horses that have arthritis in their hocks and don't wish to take the surgical fusion route, can I ask whether you consider chemical arthrodesis/ethanol fusion to be a good solution for spavin? Is there potential for this to be used on any other joint on the horses body or is it only considered for use in hocks due to the structure of the joints involved?

I found it excellent for my own horse although wasn't aware of the 6-5% of horses that have complications some three to four years following this treatment.

Sorry to hijack the post somewhat but I would be interested in your opinion given that you are a vet.
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Bisphosphonates dont necessarily have to be the next step, I have used them exclusively of steroids in horses who I feel would benefit more. Unfortunately for steroids, they are only analgesic, they dont really have a disease modulating effect. Therefore as the arthritis worsens, the effect of the steroids diminishes, hence why many people see a decreasing response over time. Bisphosphonates do not work in every horse, particularly if that horse already has a severely damaged joint. They cant repair a joint, but they slow down the process.

Without knowing the horse in this case, it is difficult to say whether arthroscopy would be a suitable option, but often after a traumatic injury arthroscopy can be beneficial to remove loose bits and pieces of cartilage. However as time goes on after surgery the benefit of the surgery decreases.

Chemical arthrodesis of joints is a difficult one. I have never performed one, but I do know of colleagues who have. Injecting ethanol straight into a joint works very quickly. Initially it kills off the nerves very rapidly, and then results in the fusion. That is often why horses improve so quickly, because we have just blasted the nerve endings with ethanol. There have been quite a lot of studies about this now, and the majority seem to suggest an improvement in between 60-70% of horses. This is not a bad success rate, however the procedure is certainly not without its risks. The tarsus is naturally a complicated area, and there are a multitude of joints some of which interconnect, and you certainly dont want to inject ethanol into the wrong part of the joint as you might end up with a permanent lameness. I have not actually heard of anyone using this technique in other joints, although there are a few papers out there suggesting it could be used in the pastern.

For me arthrodesis whichever way you do it is a salvage procedure, and the horse will never be able to move that joint freely again after that stage. Often we are arthrodesing them to provide them with the quality of life required to be a field ornament, so at the end of the day you are making the most of a bad situation. To be honest I dont really know that much about the long term implications. That being said it certainly wouldnt be my course of action ahead of either corticosteroid treatment or bisphosphonates in the majority of cases. I also think that if you catch certain conditions early enough then regular arthroscopy provides a very good prognosis going forwards.

No problem, I enjoy reading this forum and will try to pitch in with my opinion occasionally.
 
applecart14 said:
Is there potential for this to be used on any other joint on the horses body or is it only considered for use in hocks due to the structure of the joints involved?
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Fusion of the joint is only really an option for low motion joints, such as the DIT and TMT joints (the lower two joints of the hock). The knee - as would be the fetlock, elbow etc - wouldn't be ideal to fuse due to the range of motion required for normal movement.

Hope that helps somewhat :)

Arthritis is one of those things that can be very individual as to how horse's respond to the different treatment options. Personally, if you are worried I would discuss it with your vet again (maybe arrange a time you can call them for a chat) as they are the ones with the X-rays! I know it can seem a bit like info overload when your horse is diagnosed with something, and a concrete plan of 'do A for x weeks, then B' would be lovely, but horses never read the textbooks so prescriptive programs miles in advance are not always an option unfortunately!
 
sarahandwilby said:
Fusion of the joint is only really an option for low motion joints, such as the DIT and TMT joints (the lower two joints of the hock). The knee - as would be the fetlock, elbow etc - wouldn't be ideal to fuse due to the range of motion required for normal movement.

Hope that helps somewhat :)

Arthritis is one of those things that can be very individual as to how horse's respond to the different treatment options. Personally, if you are worried I would discuss it with your vet again (maybe arrange a time you can call them for a chat) as they are the ones with the X-rays! I know it can seem a bit like info overload when your horse is diagnosed with something, and a concrete plan of 'do A for x weeks, then B' would be lovely, but horses never read the textbooks so prescriptive programs miles in advance are not always an option unfortunately!
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thank you ashvet and sarah willouby for your replies. i have recommended fusion with ethanol as its worked do well on a number of horses mine included who have all gone back into full work without issues. some vets seem to use it a lot obviously dependent on whether its at the right stage in the treatment plan for that horse. It seems to be becoming more of a popular treatment. It is always as a last resort because once done there is no space in that joint for anything else like steroid to be added but the sucess rate shows it to be a good gamble for horses that havent responded to steroids or tildren. . thankyou for your answers. interesting from a vets perspective.
 
My horses x-rays are being referred to an equine hospital in the UK as we don't have specialist equine vets over here.
We did 30 mins in the school all walking work then small trots from 'B' to 'M' and that night he'd swollen around the knee again and he was visibly uncomfortable in anything other than a walk in the field.
I have no idea what they might say or recommend but I hope to have at least a better care plan and a better understanding of the issues with his knee as I feel very blind sided at the moment.

I have copies of his x-rays if that would help, or if anyone would be interested to see?
 
LittleIndian23 said:
My horses x-rays are being referred to an equine hospital in the UK as we don't have specialist equine vets over here.
We did 30 mins in the school all walking work then small trots from 'B' to 'M' and that night he'd swollen around the knee again and he was visibly uncomfortable in anything other than a walk in the field.
I have no idea what they might say or recommend but I hope to have at least a better care plan and a better understanding of the issues with his knee as I feel very blind sided at the moment.

I have copies of his x-rays if that would help, or if anyone would be interested to see?
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I'd love to see them out of interest, but I'm not a vet so couldn't offer any advice. Maybe compare them to xrays on the internet?
http://www.bing.com/images/search?q=xray+equine+bone+spur,+knee&FORM=HDRSC2

http://www.mayoclinic.org/diseases-conditions/osteoarthritis/multimedia/knee-arthritis/img-20006349
http://hubpages.com/health/Knee-X-ray-Understanding-the-signs-of-Arthritis
 
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You upload to photobox then click on the photo that's uploaded and take the URL code and upload to here, or save on your computer drive and then transfer onto H&H forum into your photo album. Its not easy.
 
LittleIndian23 said:
Blimey you're not wrong! Sounds very technical! Might wait till I get home and my techy other half can earn some brownie points by helping me haha
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That's quite easy compared with making your signature at the bottom of your post!! You need a degree in I.T for that! :)
 
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