advanced therapy in equine lameness

ADVANCED THERAPY IN EQUINE LAMENESS

Hunter S. Lewis, DVM, DABVPGreene, Lewis and Associates

www.greenelewis.com

Osteocondritis Dessicans (OCD)

1. Degenerative Joint Disease (DJD)2. Characterized by cartilage

damage, new bone formation and joint effusion.

3. Caused by “use trauma”

Osteoarthritis

Subcondral Bone Cysts

Osteoarthritis Fetlock

Osteoarthritis Fetlock

Osteoarthritis Hock

Osteocondritis Dessicans (OCD)

1. Developmental Orthopedic Disease (DOD)

2. Characterized by failure of normal bone formation

Osteoarthritis

Subcondral Bone Cysts

3. Causes:

a. Genetic predispositionb. Rapid growthc. Nutritiond. Mineral Imbalancese. Endocrine Factors

4. Can result in DJD

OsteoarthritisOsteocondritis Dessicans (OCD)

Subcondral Bone Cysts

Osteocondritis Dessicans (OCD) Stifle

Osteocondritis Dessicans (OCD) Hock

1. Development Orthopedic Disease2. Characterized by failure of normal bone

formation and loss of normal bone3. Same causes as OCD but trauma is also

involved.4. Can result in DJD

OsteoarthritisOsteocondritis Dessicans (OCD)Subcondral Bone Cysts

Subcondral Bone Cysts

Stifle

Subcondral Bone Cysts Stifle

Subcondral Bone Cysts Fetlock

Assessment of Joint Treatment

Symptom-Modifying Osteoarthritis Drug (SMOAD)

Disease-Modifying Osteoarthritis Drug (DMOAD)

Types of Joint TreatmentOral

Injectable

Intra-articular

Types of Joint TreatmentOral

1. Glucosamin2. Chondrotin Sulfate3. Anti-inflammatories4. ASU – Avocado, Soybean

Unsaponifiable Extracts

Types of Joint TreatmentOral

4. ASU – Avocado, Soybean Unsaponifiable Extractsa. Did not improve lamenessb. Reduced damage to jointc. Increased production of

glycosaminoglycand. Stimulated cell and tissue repair

Types of Joint TreatmentInjectable

1. Adequon2. Legend3. Generics

a. Polyglycanb. Map 5

4. Tildren

Types of Joint TreatmentInjectable

4. Tildren Inhibits bone resorption and may

promote bone reformation Shown effective in hock

osteoarthritis and navicular syndrome

Most effective if used early in disease Cost ??

Types of Joint TreatmentIntra-articular

1. Corticosteroids2. Hyaluronic Acid3. IRAP – Interleukin-1 Receptor

Antogonist Protein

Types of Joint TreatmentIntra-articular

3. IRAP – Interleukin-1 Receptor Antogonist Protein

or ACS – Autologous Condition Serum Blocks IL-1 release Reduces negative effects of

inflammation Reduces pain Improves synovial membrane health

Types of Joint TreatmentOther

1. Extrocorporeal Shockwave Therapy

2. Surgery3. Alternative Therapies