When we ask our horses to push their bodies to their maximum capabilities, in order to excel in competition or give us a thrilling ride, it is only fair that we give them all of the tools they need to keep them comfortable, healthy and happy as they do. In any conditioning programme, the bones and ligaments take the longest time to adapt to the enhanced performance we’re asking them to produce, which is why it’s so important to keep your horse’s joints healthy and pain-free.
Joint mobility can vary irrespective of a horse’s breed or age, and limited mobility is a very real concern for horse owners, particularly those who compete. Joint pain due to osteoarthritis (OA) is one of the primary causes of lameness and lost training days, accounting for 60%, so it’s really important to understand how it should be treated. To alleviate pain vets will often use non-steroidal anti-inflammatory drugs (NSAIDS) and corticosteroids, but there are also many supplements available which contain substances naturally occurring within the horse’s body to aid in cartilage production, and improve mobility and flexibility. So how do all of these treatments stack up?
Systemic Treatment of Joint Pain
The most commonly used pain relievers are known as NSAIDs, and they function by inhibiting the enzyme cyclooxygenase (COX) and limiting the production of pro-inflammatory molecules known as prostaglandins. Most traditional NSAIDs inhibit COX-1, which is associated with beneficial functions such as protecting mucosal barriers in the gut, as well as COX-2, which causes pain and inflammation in the body. Newer NSAIDs are working to combat this indiscriminate inhibition.
Bute – officially Phenylbutazone – is the most popular NSAID, being both highly effective and inexpensive. However, its effect on cartilage is questionable, and it acts more as a pain inhibitor than a treatment. It also has a worryingly narrow safety margin, and a link has been proven between being medicated with Bute and developing gastric ulcers.
Banamine is mainly used for treating abdominal pain, but has also proven effective for treating lameness.
Metacam is a COX-2 inhibitor, and is the only NSAID which has data proving its effects on cartilage in vivo (in the live horse). This means that it not only acts as a pain-killer and anti-inflammatory, but also has a mitigating effect on the inflammation-induced damage to the cartilage.
Local Treatment of Joint Pain
Local treatment generally consists of intra-articular (IA) corticosteroids, which reduce inflammation and promote cartilage turnover and repair. They have proven controversial due to the deleterious effects of frequent long-term use on cartilage integrity, but there is now a consensus that where they are used judiciously, the benefits far outweigh the disadvantages.
This long-lasting corticosteroid has clear anti-inflammatory properties, and still preserves the normal joint environment.
This medium-to-long acting corticosteroid has unfortunately been shown to have a detrimental effect on cartilage in vitro (in the lab).
Triamcinolone acetate has a medium duration of action, and is one of the most popular corticosteroids. In vitro studies have indicated that it suppresses inflammation without negative effects on the transcription of extracellular matrix genes, which are found in the articular cartridge.
Opioids like morphine are often used in humans to lessen post-operative pain. They have been shown to have a significant effect on lameness, joint effusion and behavioural signs of pain, but are still in the experimental stage. Many have pointed to them as a promising new treatment.
Pain relief alone can have very favourable short to medium-term clinical effects, but can have potentially adverse effects on the underlying disease process and long-term outcome. You should therefore work with your vet to use these drugs judiciously and determine what works best for your horse.
Your horse’s diet can also affect joint health, and correct feed can improve joint mobility exponentially.
Omega-3 Fatty Acids
Omega-3 Fatty Acids are anti-inflammatory by nature, and low in omega-6 fatty acids, which are pro-inflammatory. To improve joint health and mobility, you should increase your horse’s fibre intake (hay and grass) and add fats rich in omega-3 to their diet, whilst reducing grains and oils which are high in omega-6. The ratio of omega-3 fatty acids to omega-6 fatty acids should not exceed 5:1, and ideally should be around 3:1. Research has shown that horses with joint pain supplemented with omega-3 fatty acids exhibited reduced levels of inflammation, less pain and a longer stride length.
High-quality joint supplements should contain effective levels of glucosamine and chondroitin sulphate, key nutrients necessary for the maintenance of normal joint function. Glucosamine acts as a substrate for certain components of the cartilage matrix, whilst chondroitin sulphate controls the enzymes associated with inflammation and tissue destruction. You should look for formulas which contain hyaluronic acid, as this supports and nourishes the synovial fluid which coats and protects the surface of joints. Maganese is also an important cofactor in the formulation of the cartilage matrix and synthesis of connective tissue, and can be helpful in supporting a healthy joint. A manufacturer such as Equiform Nutrition should be able to recommend a suitable supplement for your horse, so it’s worth getting in touch with a brand you trust to receive some expert advice.
The Right Treatment for Your Horse
We all want to keep our horses in top shape, so you might be wondering what treatment is best for you and your horse. First and foremost, consider the extent of the problem you’re trying to address. As horses age, the wear and tear of a lifetime of activity takes its toll on their joints, but not always to the same extent, and this affects how you must handle the problem. If you’re looking for a preventative measure, then dietary adjustments are the best course, and most feed manufacturers will be able to recommend a suitable supplement.
If your horse is showing any of the following symptoms, however, then it’s time to call a vet:
- Subtle changes in movement, such as shortening of their stride, hollowing their back or raising their head
- Unwillingness to perform tasks that came easily in the past
- Stiffness which goes as your horse warms up
- Puffiness, warmth or pain around the area of a joint
They should perform a complete physical to rule out other possible problems, before pinpointing the affected joints, determining the severity and helping you to develop a suitable treatment plan.
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