By Amanda Hedges, DVM, cVA, CVSMT
What is Osteoarthritis?
A healthy joint relies on the production of synovial (joint) fluid to lubricate structures, bring in nutrients and clear away cellular waste products, and to transmit forces through the leg. Healthy synovial fluid is produced by cells in the cartilage in response to movement. Some components of healthy joint fluid include hyaluronic acid (HA) and polyglycosaminoglycans (PGAGs). Inflammation due to an acute traumatic event, chronic low-grade trauma/wear and tear, or a joint infection impedes the production of healthy joint fluid. Specifically, pro-inflammatory molecules damage cartilage. In general, inflammation leads to pain, as the joint loses its ability to lubricate, bring in nutrients and remove waste, and transmit force. In response to this pain and instability, the body attempts to stabilize the joint, remodeling it to limit mobility. The joint capsule becomes thickened and bone proliferates around the joint in an attempt to immobilize the damaged area.
What are the Signs of Osteoarthritis and How Do We Diagnose It?
In its advanced stages, signs of arthritis are hard to miss. These include clear lameness and/or visible joint distortion by extensive bone proliferation. However, signs can start subtly and the horse may be able to compensate, depending on the level of performance.
These milder signs may include uneven wear on the hoof/shoe, difficulty holding up a limb for the farrier, decreased performance abilities, difficulty standing square, difficulty laying down or getting up, or behavioral changes.
When dealing with an infected joint, joint fluid is sampled and analyzed for markers of inflammation. If arthritis is secondary to “wear and tear,” diagnostic imaging (radiographs, ultrasound, CT) is the best way to confirm the diagnosis. Diagnostic nerve blocks may be used during workup to both hone in on a particular joint and to shed light on the clinical significance of the changes seen on imaging.
There are three objectives of treatment: 1) decrease inflammation, 2) prevent further damage, 3) relieve pain. It is immensely important to remember that there is no one-size-fits-all program for treating arthritis. If there was, everyone would do it and we wouldn’t have so many options! It is always critical to work with your veterinarian to determine the best plan based on your goals for your horse; making sure to discuss reasonable expectations for treatment and possible costs.