Doctor's Corner: The Geriatric Horse

Pain Management Possibilities

Because of advances in nutrition, parasite control, dentistry and other preventative health care measures, horses are living longer. Just like us, aging horses develop arthritis and other aches and pains that must be managed effectively but safely. Fortunately, pain management in humans is a growing field of interest in the medical and scientific fields, and the research results spill over to benefit animals too. Here are some pain management methods available for the geriatric horse.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
These drugs have been the backbone of pain relief in most species for years. Examples of NSAIDs are phenylbutazone (“bute”), flunixin meglumine (Banamine), and aspirin. These drugs are extremely effective in horses in relieving pain and inflammation associated with a variety of conditions including colic, injuries and of course, arthritis. Most horses can tolerate low doses of phenylbutazone for long periods of time and we often tell owners to use phenylbutazone pre- and post- trail riding or during cold weather for their older horses.

NSAIDs can have severe side effects if used improperly or if a horse is particularly sensitive to the product. Some of the side effects include gastrointestinal irritation or ulceration and kidney disease. Blood tests can be very helpful to assess whether a horse can be on long-term NSAID therapy.

There are newer NSAIDs that are available to horses now that have a higher safety range. COX-2 inhibitors are a class of NSAIDs that are quite effective but are not as likely to cause stomach and colon irritation. Examples of COX-2 inhibitors include diclofenac (Surpass) and firocoxib (Equioxx). Surpass is a cream that can be applied directly to an area of inflammation or a specific joint that has arthritis. It can be useful on horses that have difficulty accepting oral medications.

Sodium Hyaluronate
Sodium Hyaluronate (Legend, Hyvisc, Hylartin) products are labeled for use in the joint for treatment of non-infectious osteoarthritis and/or synovitis (inflammation of the joint capsule). Legend can also be used intravenously. It is thought that sodium hyaluronate decreases the inflammatory enzymes that break down the joint and cause pain, as well as having joint lubricating properties.

Polysulfated Glycosaminoglycan (PSGAGs)
Polysulfated Glycosaminoglycans (sold as “Adequan”) can be used intramuscularly to help with the management of arthritis as well. PSGAGs may help by stimulating cartilage repair, restoring lubrication of the joints, decreasing inflammation and inhibiting harmful enzymes. PSGAGs are used frequently for maintenance of the joints of equine athletes that have a high risk of developing arthritis from chronic wear and tear.

Oral Joint Supplements
Certainly this is an area that has the most controversy. There is limited research on the effectiveness of many of the ingredients in most of the supplements and none besides Cosequin have any FDA approval. Glucosamine is one ingredient that has been proven to have some benefit in horses, but it has to be at therapeutic levels in the supplement. Oral supplements are not regulated because they fall under a class of products called neutraceuticals. This means that almost anyone can jar up a bunch of powders and herbs and sell it as a joint supplement.
With all of this said, many horses do seem to have some benefit with some of these products.  Talk with your veterinarian about products they trust and have seen good results with.

Exercise
In my opinion regular exercise is probably the cheapest and most overlooked form of geriatric pain control. I took this statement from the Arthritis Foundation’s website:
“Regular, moderate exercise offers a whole host of benefits to people with arthritis. Mainly, exercise reduces joint pain and stiffness, builds strong muscle around the joints, and increases flexibility and endurance. It reduces inflammation from arthritis and related conditions and reduces the risk of other chronic conditions.”

This same information can be applied to horses. Most horses in Western Washington don’t have a large amount of pasture turnout and spend the bulk of their time standing in a small paddock or stall. Even with pasture turnout, they probably have their mouths to the ground most of the time. Regular, active controlled exercise is much different than pasture turnout. Get on that horse or at least take it for a walk a couple of times a week.

Talk with your veterinarian about pain control in your older horses. Better yet, have a vet look at your middle-aged horses and discuss how you can prevent pain from arthritis and other chronic diseases.

NWHS

• Next >