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Joint Therapy: Is It the Right Decision for Your Horse?
William Moyer, DVM, AAEP
The public demand for a precise diagnosis and treatment of lameness problems has increased many fold over the past decade. Horse owners, through exposure to state-of-the-art medicine and a multitude of publications, such as The Horse, are increasingly aware of what is possible.
Prior to the mid-1970s, placing a needle in a given horse's joint was, for the most part, limited to racetrack practice. The actual procedure was thought to carry considerable risk. Although that perception still lingers in some quarters, joint injections for both diagnostic and therapeutic reasons are considered by many veterinarians to be standard procedures.
Intra-articular therapy is common veterinary practice, and the availability of intra-articular medications has increased in both number and quality. The diagnostic benefit of intra-articular anesthesia--blocking an area of the horse in order to determine where the problem might be--is of enormous value as it enhances the ability of the practitioner to provide accurate diagnosis. It is only with an accurate diagnosis that one can give an accurate and, hopefully, useful treatment and prognosis (predicting the future).
The ease and safety of the procedure have been greatly enhanced with more malleable needles, short-acting tranquilizers, and sedatives allowing for improved horse handling, and improved awareness of technique and joint anatomy by the veterinarian.
A multitude of compelling reasons exists for utilizing joint injections or aspirations (i.e., the removal of fluid). Certainly one of the most rewarding is the capability of the veterinarian to make better and more accurate diagnoses of lameness problems. The broad categories for use are therapeutic and joint disease. Common medications include local anesthetics, sodium hyarulonate products (i.e., Adequan), anti-inflammatory drugs, and antibiotics. Often such compounds are injected in combination.
Before joint therapy is undertaken, however, your veterinarian should perform a thorough lameness examination to make sure the primary source of the lameness has been identified. Again, this has become a very common procedure in most veterinary practices and is one most veterinarians are quite capable of performing.
During the examination, your veterinarian will palpate and flex the affected area, and the horse will be jogged on a hard surface to determine any changes or deviations in movement. It is important to note that areas of soreness do not necessarily indicate the offending area, as some soreness can develop when the horse tries to compensate for the original pain.
Your veterinarian then will advise you on the course of action to take regarding your horse's therapy. While intra-articular injections are growing in popularity among horse owners, it is important to realize that this therapy is not a cure-all, but is one of many tools that should be used only under the advice of a veterinarian.
William Moyer, DVM, is Department Head, Large Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University
American Association of Equine Practitioners 4075 Iron Works Pike Lexington, KY 40511 (606) 233-0147 www.aaep.org