Rehab of the arthritic fatty....

SEL

SEL

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So yesterday we did the x-rays and yes, definite arthritic changes in both hocks. She's only 6, just done her first summer of light hacking so its probably genetics.

We're going to try cartrophen and then look to steroids next year if I can get her weight down a lot. A joint supplement is also going into the mix.

She is mainly draft horse by breeding but sadly without the bone in her leg structure to support the tummy of a draft. You wouldn't think she was that fat to look at her but she was 50kg lighter coming out of winter back in March and I need to get her back there. Winter is my friend.

To date she has been rugged when out because I was expecting to ride her (mud monster) and it is better for her muscular disorder. She has never grown a great coat, but would you step down from the 200g I've had on her or just go cold turkey and rugless? I would feel a bit mean especially as she's going to be on poor grazing but I'm probably being an over protective mum!

Also, has anyone had their horse on bute / danilon long term? I know it isn't good, but I want feedback from people who have been there.

After a sleepless night I'm setting myself some timescales to see how she responds to drugs and what that means for riding her. I'm not massively confident at the moment but she's happy in the paddock and mentally I'm not in the right place for considering other options right now - particularly because my other horse has very severe ringbone so if I made the decision for the youngster then I wouldn't be so cruel as to put the older one through the grief of losing his companion.

Probably a good thing I'm in the office on my own today because the mascara is taking a real battering!:blue::blue:
 
Mine was in danilon for about 3 years on 1 per day. He reinjured his tendon and was on box rest on 4 a day. A week later he got impaction colic. He was 21, had never had colic and had had numerous box rest spells. Vet thought the danilon use had affected his gut, given him ulcers and caused the colic.
 
I would switch from 200g to a no fill! My fat extremely good doer native is fully clipped and only in a no fill, apart from a couple of days last week when it was particularly cold and I put a 180g on her. She's a very warm horse and I'd rather she burned some extra calories keeping herself warm.

Are you allowed to keep hacking her? I'm sure that would help massively with her weight, and in turn when she looses weight that will help her arthritis. I also think gentle exercise is usually prescribed for arthritis? But speak to your vet about it :-)
 
Procrastination said:
I would switch from 200g to a no fill! My fat extremely good doer native is fully clipped and only in a no fill, apart from a couple of days last week when it was particularly cold and I put a 180g on her. She's a very warm horse and I'd rather she burned some extra calories keeping herself warm.

Are you allowed to keep hacking her? I'm sure that would help massively with her weight, and in turn when she looses weight that will help her arthritis. I also think gentle exercise is usually prescribed for arthritis? But speak to your vet about it :-)
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Unfortunately it isn't as simple when you have a PSSM horse. They need to be kept warm to help the muscle metabolize properly otherwise they can tie up really easily. :/
 
I think I would blanket clip and rug as lightly as possible so her back is warm but she is still having to use some energy to keep warm, taking her rug off or using a no fill will probably cause her PSSM symptoms to get worse, can she stay out 24/7 as that would help with all of her issues, if allowed some steady hacking as often as possible would be beneficial to help the PSSM, get the weight off and keep the arthritic joints moving.
I would not be too concerned about using low levels of bute to keep her moving, she may have a shorter life anyway if she can be more comfortable then use everything available while you can, there will always be someone with a negative experience from using bute but there will be more with positive ones, most vets think that it is worth taking the slight risk and that you can manage the ulcer risk as long as you are aware.
 
SEL said:
So yesterday we did the x-rays and yes, definite arthritic changes in both hocks. She's only 6, just done her first summer of light hacking so its probably genetics.

We're going to try cartrophen and then look to steroids next year if I can get her weight down a lot. A joint supplement is also going into the mix.

She is mainly draft horse by breeding but sadly without the bone in her leg structure to support the tummy of a draft. You wouldn't think she was that fat to look at her but she was 50kg lighter coming out of winter back in March and I need to get her back there. Winter is my friend.

To date she has been rugged when out because I was expecting to ride her (mud monster) and it is better for her muscular disorder. She has never grown a great coat, but would you step down from the 200g I've had on her or just go cold turkey and rugless? I would feel a bit mean especially as she's going to be on poor grazing but I'm probably being an over protective mum!

Also, has anyone had their horse on bute / danilon long term? I know it isn't good, but I want feedback from people who have been there.

After a sleepless night I'm setting myself some timescales to see how she responds to drugs and what that means for riding her. I'm not massively confident at the moment but she's happy in the paddock and mentally I'm not in the right place for considering other options right now - particularly because my other horse has very severe ringbone so if I made the decision <script id="gpt-impl-0.2588949994019647" src="https://partner.googleadservices.com/gpt/pubads_impl_105.js"></script>for the youngster then I wouldn't be so cruel as to put the older one through the grief of losing his companion.

Probably a good thing I'm in the office on my own today because the mascara is taking a real battering!:blue::blue:
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Had I known then (when my horse was diagnosed with spavin) what I know now I wouldn't have skipped a beat. I'd ask your vet about Tildren and go straight to that and if that doesn't work think about having ethanol fusion.

My boy was on half a sachet of bute for many years to ease any stiffness but because of 'outrage' on this forum over the fact that my vet had told me to work my horse and have fun and compete (local unaff level) I stopped giving it him. He's been on buteless for a couple of years now. I was accused of 'putting the welfare of my horse below winning a rosette' and all manner of other stuff, which is pretty upsetting and spiteful especially as the vet was giving me free rein to go out and have fun and was aware of the horses limitations as was I, after all he's been in our lives now for almost 13 years - the vet knows him inside out (literally!) He's always been the type to tell you if anything was amiss, some horses are like that. He loved his jumping, although we have stopped now on vets advice due to another separate problem.

Arthritis is more about a management issue than what you can shove down their throats or inject into their bodies. There is the weight management side of things, the remedial farriery, the correct feeding, riding on good surfaces, keeping warm, joint supplement, etc, etc, etc

Vet always said a horse will die of old age before it dies from problems related to bute. There are many horses worked and competed on very low level bute/danillon and I can't see a problem with this.

Basically my horses 'work' (although I'd call it exercise myself) is the 'glue' that keeps him together. Without being ridden he would fall apart - literally as it is so often with arthritis.
 
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Thanks all. My vet's view at the moment is probably closer to 'stuff the PSSM, just get the weight off!'. I might compromise with lower weight rug although it's forecasted to be minus 7 tonight so we won't move to that straight away (I'd have another sleepless night). Luckily I can do 24 hour turnout unless we have floods & I'm going to ask if my 2 can join the babies in the big paddock until it shuts in Jan. More space to wobble blubber off.

I can bring her back into work but she's still v green (late starter - long story) & hacking has been a bit unpredictable. I'm thinking of putting her on danilon, getting her up & out while I know the pain is managed and hoping that the unpredictable behaviour was pain related. She does loosen up when worked which is why I kept thinking it was PSSM symptoms.

Glad to hear others have used danolin on a maintenance basis. Unless cartrophen produces an amazing response I can't see another option. The vet did mention tildren but as a last resort. I'm going to do some more research because with these kind of changes at her age I'm feeling pretty 'last resort' today already!

As ever, massive appreciation for all the support and advice on here - I can't believe what a tough horsey year it's been. :-(
 
My share horse is considerably older and got diagnosed (finally, after 6 months on and off lameness) with an arthritic elbow. He had the steroid injection and hyaluronic acid injected directly into the joint too. We're only 3 weeks in and taking things slowly but the difference in him has been staggering. Even when he was sound before he was lethargic. Now he's bouncing everywhere! Cartrophen is hyaluronic acid too but the vet school (he spent 8 days in there getting diagnosed) said injecting it directly into the joint was far more effective. It might be worth asking your vet about that?
 
SEL said:
Thanks all. My vet's view at the moment is probably closer to 'stuff the PSSM, just get the weight off!'. I might compromise with lower weight rug although it's forecasted to be minus 7 tonight so we won't move to that straight away (I'd have another sleepless night). Luckily I can do 24 hour turnout unless we have floods & I'm going to ask if my 2 can join the babies in the big paddock until it shuts in Jan. More space to wobble blubber off.

I can bring her back into work but she's still v green (late starter - long story) & hacking has been a bit unpredictable. I'm thinking of putting her on danilon, getting her up & out while I know the pain is managed and hoping that the unpredictable behaviour was pain related. She does loosen up when worked which is why I kept thinking it was PSSM symptoms.

Glad to hear others have used danolin on a maintenance basis. Unless cartrophen produces an amazing response I can't see another option. The vet did mention tildren but as a last resort. I'm going to do some more research because with these kind of changes at her age I'm feeling pretty 'last resort' today already!

As ever, massive appreciation for all the support and advice on here - I can't believe what a tough horsey year it's been. :-(
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Just wanted to say there are lots of things you can try, obviously money dependent. Tildren is definitely not a last resort, though I would choose to use Osphos over Tildren.
 
SEL said:
. The vet did mention tildren but as a last resort. I'm going to do some more research because with these kind of changes at her age I'm feeling pretty 'last resort' today already!
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I would say that the last resort is actually ethanol fusion which usually follows Tildren, which usually follows intra articular injections, and in my experience (of my own horse and hearing countless other ethanol experiences) I would rather bypass the whole bl**dy lot and go straight to ethanol. :) The others I found were a total waste of time in the long term although they did produce short term relief (two or three years).

Read the end paragraph 'horses that are not helped by' http://horsesdaily.com/article/hock-injections-101

and a research paper: http://www.thehorse.com/articles/26...hers-alcohol-joint-fusion-effective-aaep-2010
 
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I have to say that being very strict with weighed and soaked hay reduced Tartines weight very quickly, even though she was still receiving 1.5% bw in forage a day.

I'd have no compunction in using Danilon to make her comfortable enough to exercise, you have to look at the balance - yes you are medicating to ride, but you need to exercise to reduce the weight for her health.

The other thing to consider, is the arthritis in the upper (mobile) or lower(static) joints of the hock? If in the lower joints I'd be doubly mean and ride without anti inflammatory support, as this will make the joints fuse quicker (yes it is very hard to do this, it broke my heart to ride P when he was having an off day, but his joints fused much quicker than if he'd been medicated).
 
I will add that although Danilon was part of mintos downfall (he was pts due to the tendon injury, we couldn't give danilon as he would colic but we couldn't not give him danilon due to the pain) I would still have given it to him again. It gave him 3 years of semi retired hacking. Initially he had bone spavin, treated with steroid injection and never any more bother, then had arthritis in fetlock which didn't respond to steroids hence the danilon.
 
Lower joint. Actually the leg I thought she looked better on is worse under x ray - but I guess she's holding herself to compensate. Vet didn't talk about hurrying up the fusion. I think I need a quiet day of Google and then a Q&A.

Would you want / could you get fusion in a young horse? I got the impression stage 1 was trying to manage the existing deterioration & stop it progressing. Hmm. Lots to learn.

Soaked hay is a challenge right now - long walk through mud to the field. Dry hay is tough enough but if I can get her in the big paddock then it's no hay unless she's in and she'll have to work for her grass. I expect grumpiness!

(Apparently apple flavoured topchop zero with balancer in is not a suitable breakfast - major strop this morning!)
 
Fusion is the ultimate goal (for static joints).

Although the lower hock joints are static, they still have a layer of cartilage where the bones face each other. With arthritis/DJD/spavin the cartilage is damaged and being worn away; this causes the raw ends of the bone to grind together (this is the painful bit). There is a big inflammatory process going on at this point which encourages extra bone growth (osteogenesis), eventually the bones actually grow together (fuse) and at this point they are not rubbing against each other and the pain recedes. As the lower joints of the hock are static, this doesn't lead to any mechanical lameness.

If you use anti-inflammatories during the fusion phase, it will decrease the level of inflammation and therefore the level of osteogenesis and the rate of fusion is slowed down, leading to a longer period of day to day pain.

In mobile joints (fetlock, pastern, upper hock etc), you will want to treat with cartilage preserving treatments, as fusion of mobile joints leads to mechanical lameness, though again, once fusion has occurred there is no more pain (in the joint, the horse may develop compensatory movement/pain as they can no longer move in the way nature intended them).

It is difficult as you may think a fusion has settled, then they come up lame again, and you find that there is a new area of osteogenesis. I went through this with my old horse. He had a fairly stable spavin, then my sharer over jumped him, and it created a new area of osteogenesis on an area that hadn't previously been active. He was off and on lame, especially on a circle for a few months until it settled again. I used to make sure he had a really long warm up, limited the amount of canter we did, and if he was feeling really bad I'd stick to straight lines. It was awful riding him when he was having a bad day, but the fusion occurred much faster than if he had been medicated, and he was completely sound again within 9 months.
 
This horse is six ,there's a limit to how many times you can inject into a joint so I would be avoiding that at this stage if it's possible .
 
Goldenstar said:
This horse is six ,there's a limit to how many times you can inject into a joint so I would be avoiding that at this stage if it's possible .
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I'm thinking this might be the vet's view as well (she's away for a couple of weeks). I think she was assessing options as she was speaking to me and showing the x-rays. Steroids out of the question because of the laminitis risk right now. The riding work is pretty much the PSSM protocol anyway so once all this ice has cleared then we'll start gentle riding work again & see how she gets on. If the bucking starts again (even with danilon) then I'm going to ask to X-ray for kissing spine.

Vet said low risk of genetic arthritis being in other areas of the skeleton & there was no sign of kissing spine on manual examination but given I can't see the horse being insurable for much after this year then we might as see what we can get done!
 
SEL said:
I'm thinking this might be the vet's view as well (she's away for a couple of weeks). I think she was assessing options as she was speaking to me and showing the x-rays. Steroids out of the question because of the laminitis risk right now. The riding work is pretty much the PSSM protocol anyway so once all this ice has cleared then we'll start gentle riding work again & see how she gets on. If the bucking starts again (even with danilon) then I'm going to ask to X-ray for kissing spine.

Vet said low risk of genetic arthritis being in other areas of the skeleton & there was no sign of kissing spine on manual examination but given I can't see the horse being insurable for much after this year then we might as see what we can get done!
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I am going through something similar at the moment, remember hind leg lameness and problems in the back often go hand in hand. Depending on the Vet you speak to, which causes which is not known.

There is no way that you can tell if there is a problem in the back by manual manipulation. If you are insured, or have the funds, I would have a back x-ray and scan.

Also are you absolutely sure her foot balance is spot on?
 
applecart14 said:
I would say that the last resort is actually ethanol fusion which usually follows Tildren, which usually follows intra articular injections, and in my experience (of my own horse and hearing countless other ethanol experiences) I would rather bypass the whole bl**dy lot and go straight to ethanol. :) The others I found were a total waste of time in the long term although they did produce short term relief (two or three years).

Read the end paragraph 'horses that are not helped by' http://horsesdaily.com/article/hock-injections-101

and a research paper: http://www.thehorse.com/articles/26...hers-alcohol-joint-fusion-effective-aaep-2010
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Thanks for these links. Really interesting reading - I need to understand why the vet hasn't headed straight to this.
 
LJR said:
I am going through something similar at the moment, remember hind leg lameness and problems in the back often go hand in hand. Depending on the Vet you speak to, which causes which is not known.

There is no way that you can tell if there is a problem in the back by manual manipulation. If you are insured, or have the funds, I would have a back x-ray and scan.

Also are you absolutely sure her foot balance is spot on?
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Foot balance - historically no. Until 6 months ago she could only have her feet handled by a farrier under sedation. She has very good strong feet but for obvious reasons she had gone long gaps between any hoof work before she came to me.

With a lot of work she's had 2 trims (well, rasps - she won't tolerate nippers) without sedation. I have a very good trimmer working with her now but she's limited in that she can only work on her back feet in what I call 'foot picking out' position. Now I know about the arthritis alongside the PSSM the behaviour makes a lot of sense. Obviously all the latest info will be shared with trimmer too.

Lots to think about!
 
Some way back in the thread there was a question re fusion at a relatively young age - my boy had a spavin at just under 12, vet (David Langrish in Hants) recommended fusion in the lower joint, very successful, has gone on to do all sorts of stuff and is now 28.......
 
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