Arthritis

Floss is an older horse, at 25 years she has had a busy life riding around the UK covering long distances.  Joining my boys for her retirement she is bound to be a bit stiff so I thought I would find out a bit more about Arthritis and if this could be her trouble!

What is it?

Arthritis, Osteoarthritis or Degenerative Joint Disease are all different names for the same thing.  It usually affects the articular cartilage found on the ends of bones where they come together to form a joint.  Articular cartilage provides a smooth and slippery surface which allows free movement and contributes to the shock absorbing properties of the joint.   Arthritis compromises the cartilage which affects the smooth surface of the joint.  As a consequence the joint becomes stiff and uncomfortable. The cartilage itself does not have any nerves and so the pain felt will be minimal initially.  As the disease progresses there are changes to the underlying bones, which were protected by the cartilage.  This is likely to cause lameness. 

The joints most often affected are the knee, fetlock, coffin, hock and pastern.   However, any joint can be affected including those in the jaw, neck and back.  As with people it usually affects horses as they age but constant stress, acute injury and poor conformation make it more likely.  

Signs.

• Stiffness, uneven gait and shortened stride, failing to track up. 
• Reluctance to pick up feet or to raising them for a long period eg: for the farrier. 
• Requiring a longer warm up. 
• Appearing lethargic. 
• Deterioration of athletic performance. 
• Lameness due to the pain in the joint. 
• Swelling of the joint. 
• Reduction in the range of joint movement. 
• Bony lumps. Bone Spavins are arthritis of the lower hock joint.  Ringbone is arthritis of the pastern or coffin joints.

Causes.

Arthritis is usually caused by trauma from repetitive hard work, poor action (as a result of poor conformation), or just long term repetitive work.  One off traumatic injuries to the joint eg: fractures can cause arthritis to develop.  Septic arthritis is caused by bacterial infection. 

Diagnosis.
Asking your vet to assess your horse they will observe the horse, conduct flexion tests  and palpate the joint.  Nerve blocks can be used to locate the source of the pain more accurately. 

X-rays of the identified joint will then show the degree of damage.  However, the articular cartilage does not show up on these and so early signs may be missed.  Ultrasound, MRI, CT scans are all other options for assessing the degree of damage the arthritis has caused.


Treatment.
Unfortunately articular cartilage does not regenerate or repair itself.  This means that there is currently no cure, but the pain can be managed and the progression of the disease minimised.  Vets can give anti-inflammatory drugs.  New treatments are under investigation such as injecting stem cells into the affected joints!

Oral joint supplements can help by providing support for healthy joint fluid and tissues.  These typically contain glucosamine, chondroitin sulphate or hyaluronic acid.  Although there are other ingredients:

• Glucosamine: supports the production of new cartilage and helps combat cartilage breakdown 
• Chondroitin sulphate: stimulates the production of hyaluronic acid and proteoglycans which inhibit the enzymes that break down the cartilage. 
• Hyaluronic acid: this is an integral component of joint fluid and articular cartilage. 
• MSM: is a highly bio-available form of suphur for building and repairing cartilage. 
• Vitamin C: is a potent anti-oxidant which protects tissues throughout the body and is vital in the production of connective tissues, including cartilage, tendons and ligaments. 
• Devil's claw & yucca: are herbs used to reduce discomfort.

If the horse is lame it should not be ridden but keeping them moving is important to maintain the joint mobility and suppleness.  So turnout is a good idea.    
Depending on the joint affected, some horses will benefit from massage, heat or acupuncture to relieve any related sore muscles.

Managing the horse's weight to ensure there is not excessive stress on the joints.

Remedial farriery may be helpful in some cases.

Arthritis does not necessarily mean the end of a horse's work life.  Light exercise (not lunging) can be beneficial to improve the range of joint movement and muscle tone.  Floss is mostly retired but turnout ensures she remains mobile.  She most certainly could do with losing some weight to reduce the stress this places on her though!  There is not a specific joint that causes her obvious pain, she just seems a little short striding.  However, a bit of weight loss will probably help this.

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Until next time!

Jo