synovitis

[parsley]

Has anyone heard of this before? Vet said that my boy has chronic synovitis (not villonodular). He had Xrays and ultrasound today.

At present he is on 2 weeks box rest and antiinflamatories. If it doesn't improve the vet may want to have a look at the joint with a camera and surgery.

 

[judymoon]

Synovitis is inflamation of the joint capsule, or inflamation of the synovial fluid (joint fluid) are you familiar with HA? if not it is what makes joint fluid, HA eventually runs out through general wear and tear and once gone does not regenerate. After its gone the joint becomes suseptable to attack from red blood cells and other chemical reactions which HA would normally deal with. When its not there you get inflamation/efsuion etc. Racehorse and young stock working harder than normal are commonly seen to get synovitis but obviously they are working extremely hard at a very early age. Once the HA has gone you begin on the road of joint degeneration, put it simply horses or anyone for that matter who has arthritis started out by running out of HA in joint. up until just the last few years HA could only be given by injection so it was and is very expensive but now you can get it in an oral gel or powder at the same level as injections. Its efficacy etc is well documented and it works amazingly well, a load of trainers use it etc try www.kinesishealth.com for this stuff, its called Conquer and is fab, they are the only ones at present where you can get it as its only been in the country a shortish while, if nothing else ask for info and research, but seriously consider using it as it has to be cheaper and a hell of a lot safer than invasive joint surgery. sorry to bang on but its my fav topic and i love this stuff!

 

[nikki_07766]

yep, my chap has got it quite bad i have batteled with his soundness over the past year i two had the option of an op but i said no as there is no garentee that they will even find anything and its a lot to put them through for no real outcome, he has bute if he tweeks it, and he is on cortaflex, hes not allowed turn out on a hill and he's not allowed in really muddy slippy conditions as this makes it worse as its pulling the joint around, let me know how you get on and u can pm me if u wanna know anything else

 

[Patches]

Oh Poor Bomber Parsley!!!

Bailey had a distended joint capsule which was indicitive of the arthritis he had in his joint resulting from his fractured fetlock.

He did have surgery to attempt to remove the sharp edges of bone that were grinding and wearing away his fetlock. Sadly, the surgery wasn't a success as it was too late, the damage done in Bailey's injury had already become very advanced. His sesamoids were crumbling.

However, he had Mobifor from the vet. This is a veterinary strength version of Naf Superflex. It was paid for by his insurance too, NFU. While he was on Mobifor he was definately much sounder and infact to the untrained eye appeared totally sound. His prognosis wasn't good though and I was told not to ride him as his fetlock was in danger of breaking down completely which could have been fatal to both him and me should it happen when cantering across a field etc. When his insurance ran out I just bought a cheaper Joint flex with Devils Claw in it and this still improved him.

Box rest did wonders for Bailey too. You'll be amazed how resting his joint will help. The swelling will probably go down in the short term at least.

Good luck. It's not the end of the world and you can get them sound again. If you had seen Bailey's x-ray and then how sound he was, you'd be amazed. The vets were. He had a HUGE shard of fetlock invading his joint space.

How were Bomber's X-rays? Any signs yet of arthritic changes? Sounds like you have caught his problem early on.

Fingers crossed.

 

[parsley]

As yet he isn't unsound with it although the vet did say he was low grade unsound after a flexion test. The ultrasound showed that there were enlarged synovial pouches and the vet was worried that it had started to inflame the bone but the X ray showed that it hadn't progressed that far yet. I can't believe he has got this - the poor chap is only 8! I am burying my head in the sand a bit at present as I don't want to believe that he could have something that is going to make him more and more unsound if we can't control it. I will just do all I can in these 2 weeks and keep my fingers crossed.

 

[ruscara]

I can't add any more information, but just wanted to say that it's such bad luck for you, and I am sorry to hear this. Let's hope the box rest helps, and he will be fine in a little while.

 

[Patches]

All I can say Parsley is to try not to panic. (Easier said than done I know)

Bailey did go sound when he was kept in all the time and just ridden from his box and his joint was totally shot! As I said in previous post, the vets couldn't understand how he could be so sound given what was wrong with that fetlock.

It was only when I started to let him have unlimited turnout and he went a bit ballistic (understatement) in the field that I noticed him become unsound.

This was when I decided to try the surgery. However, his joint was so badly damaged from the initial fracture that surgery couldn't help him regain a longer riding career.

Plenty of horses with mild arthritis continue to be ridden fully for many years. Getting to his problem early before any real damage has been done to the affected joint will prove valuable to you and Bomber's long term soundness.

Chin up, I know it's devastating and the worse case scenerios will of course be running through your mind. However, all is not lost and I'm sure you and Bomber will back out there riding again like nothing ever happened.

The hard ground could well have exasberated the situation as this summer has been unusually dry. With all the rain we've had (well I have had here anyway) the ground is much softer now and Bomber could well find he feels much comfier.

 

[judymoon]

did you look into HA?

 

[Patches]

He did have something injected into his joint a twice to try and regain some viscosity to his joint fluid. Maybe it was HA?

Sadly for Bailey his sesamoids had all but crumbled and his joint was in danger of totally breaking down. He was retired from work, age of 9, after battling for 12 months to help him.

I sold him into a companion home when he became jealous of my new riding horse.

 

[judymoon]

yeah that would be HA, i wonder if Parsley has looked into the oral version?

 

[Patches]

No idea. I think HA is in MObifor which is what Bailey moved onto.

 

[judymoon]

No, i had a look at mobifor and it doesnt have HA in, this conquer has 100mg per serving of HA which is higher than some of the injectables, i cant sout loud enough about using it, at least have a go Parsley!

 

[aran]

Hello
Synovitis is one of my things! It is inflamation of the joint capsule not inflamation of the synovial fluid (SF). Inflammation causes an increase in the amount of fluid.
SF contains hyaluronan (HA). It doesnt run out it is constantly made by the synovium (tissue which surrounds the joint capsule). There are no red blood cells in the joint and HA never deals with chemical reactions it simply acts as a lubricant reducing friction.
Synovitis is caused by the synovium releasing catabolic mediators into the SF which attack the cartilage or by an infection in the joint. The inflammed synovium can also get trapped in the joint and can therefore cause pain. The increase in the amount of fluid can also cause joint distension which can cause pain.

'anyone who has arthritis started out by running out of HA in joint' that statement is just not true. HA injections can help but the evidence is extremely limited and do not work for everyone. Indeed SF is constantly turned over 'cleared' and so adding extra usually only works for a limited time before it is removed from the joint.

'Its efficacy etc is well documented and it works amazingly well, a load of trainers use it etc try www.kinesishealth.com for this stuff, its called Conquer and is fab'
Please can you provide the research as being an orthopod I simply do not agree with you on this.

For synovitis it is important to get the reaction under control - surgery can be the only option as horse joints are notorious for not reacting to anti-inflammatories and anti-biotics. Once the synovium (which are the pouches) is calmed down things will get much better. The most important thing is the cartilage as long as this hasnt been damaged you are fine. Synovitis caught and treated is not a problem as long as the cartilage is unharmed. Once the cartilage is degraded then you have osteoarthritis which is un-reversible and can only be managed (but some do very well for years!).
How's he doing?

 

[judymoon]

aran, i guess i'm not a vet or phd student! sorry if i've rattled you. I picked up an info file at Bramham that had numerous studies, one in particular on sinovitis in horses treated with oral HA but my interpritation my be out?! the website offers the research so maybe you could get it from them. My mistake with the red cells, i did meen white cells now that i re read the article.
'HA is a natural and important component of joint fluid and cartlidge. Most people associate HA primarily as a lubricant to the joint surfaces, however, one of its greatest benefits is in blocking further influx of either inflammatory chemicals or white cells into the joint. It is also thought that it may disrupt how inflammatory chemicals interact with each other thus breaking the chain of events in inflammation'
Horse Health Magazine August
It is my understanding that HA does not replenish in any significant quantity otherwise we would not need to inject.
It is also my understanding that healthy joint fluid is high in HA which, as you said, lubricates the joint, but when it decreases the lubricating ability is lost thus there is no or little protection to the cartlidge which then erodes leading to a bone on bone scenario (osteoarthritis). It is now also acknowledged that high molecular weight HA has pain relieving properties too
'clinical trials show-and most veterinarians would agree based on their own experience-that high molecular weight HA produces a better pain relieving effect'
Horse Journal 2002 (U.S. publication)
like i said maybe you could request the info from the site
Also, study published in EVJ 'Oral Hyaluronan gel reduces post operative tarsocrural effusion in the yearling thoroughbred' maybe of interest, (july 06' issue) it also won the BEVA clinical evidence literary prize.

 

[aran]

don't worry - you didnt rattle me its just that there is a real issue with companies selling products and placing claims and mis-truths. People will jump at anything which may help and they feed of insecurities.

There are lots of suggestions to what HA does - very few have any evidence supporting. At the moment, as far as robust scientific studies stand HA is a wetting agent, space filler and flow barrier. It may also aid the protection of the cartilage surface by preventing angiogenesis (blood vessel formation) and scar formation. But mainly it is its role in acting as a barrier slowing and hopefully preventing catabolic mediators from disrupting the cartilage surface. therefore if missing degradation would occur. HA is synthesised and released from the synovium, probably in response to mechanical stimuli acting as a feed back loop. It is constantly replenished - thats why injections are usually not that effective.

Injections were commonly used for OA sufferers - however research has shown that it can be cleared from the joint within 24 hours and there was no more benefit than placebos. This is probably due to the fact you wouldnt expect much benefit from a joint that is already full of HA.

It is true that HA is an analgesic - although we dont know how

OA means progressive and permanent deterioration of cartilage. It is a heterogeneous group of conditions all of which lead to cartilage degradation. The causes are numerous. HA is increased in OA joints therefore adding it is not much use. The only beneficial time is following surgery when you have removed all the SF, adding protection until the tissue reforms the SF, or when, for some reason you have no SF.
All of my reading is from good quality pier reviewed journals. I'd be vary of press releases or manufacturers details as they are biased.

 

[parsley]

Thanks for your comments. I don't think it has gone into the cartlidge as the vet seemed much happier once she had looked at the Xrays. I have been packing the joint with ice (covered and held on by a travel boot) twice a day for about 40 to 50 mins. I have managed to get it sorted now so that the joint does get very cold. I think it is looking smaller (its hard to tell when you REALLY want it to be smaller

). His lameness was so low grade that I couldn't see it so I don't know if there is any progress there. He is happy enough in himself - constantly eating! He is like beserk lawnmower when I take him out to eat grass, then he comes in and has a chaff and kwik beet feed with his antiinflamatories, then a swede and his haylage.

I will keep weigh taping him I think