Photos courtesy of Dr. Katherine Ellis
A pony with chronic laminitis.
weeks with no improvement. His appetite has also been decreased, and central sensitization is suspected. “You might consider continuing to use an NSAID given the horse’s pain level, but I would consider switching to firocoxib, given the decreased appetite and chronic use of phenylbutazone,” Dr. Ellis said. “Since we have evidence of central sensitization, we could also try gabapentin and some non-traditional treatments, such as transcutaneous electrical nerve stimulation [TENS], acupuncture, and manual therapy.” Gabapentin has shown mixed results in horses. One
study evaluated gabapentin at either 5 mg/kg or 10 mg/ kg orally 3 times daily for 14 days in horses with chronic osteoarthritis. No significant improvement in lameness was seen with either dose. “There have been some individual case reports in horses with chronic laminitis that showed improvement with gabapentin.” Dr. Ellis added. “It has a low bioavailability when administered orally, so higher doses are likely needed to be effective.” Unfortunately, there is no evidence in horses— laminitis or not—regarding TENS therapy. “All of our evidence comes from human medicine, which does show some conflicting results,” she explained. “However, many studies have shown improved pain control for both postoperative pain and chronic pain.” Acupuncture, however, has been studied more in horses. One study showed that 2 acupuncture treatments performed 1 week apart improved lameness scores in horses with chronic laminitis. Another study showed improvements in subjective pain levels in 6 of 7 horses with chronic laminitis. For secondary pain of the axial skeleton, manual therapy, such as massage, chiropractic and physiotherapies, can also be considered. “While evidence for pharmaceutical and non-pharmaceutical approaches in the laminate course are somewhat limited,” Dr. Ellis concluded, “We do have multiple treatment options available.” MeV
OA of Caudal Cervical Region Common in Warmbloods Osteoarthritis (OA) of the caudal cervical region is a relatively common finding in radiographs of actively performing Warmblood jumpers, which suggests this finding may be of less clinical significance than previously thought, according to a recent study. Researchers performed a descriptive study aimed to assess the prevalence of cervical OA in a group of Warmblood jumpers to ascertain its correlation with age, level of performance, neck pain and mobility. During a competition series in California, they enrolled 108 sound Warmblood show jumpers that had competed in at least 10 classes. The median age of the population was 10 years and the median height of the current level of performance was 1.3 m
Cervical pain and range of motion of the neck were subjectively assessed. Lateral radiographs of the cervical spine were taken from C3 to C7 and the presence of OA at the cervical articular process joints (APJs) was evaluated and graded as absent, mild or moderate to severe by 3 board-certified radiologists. The prevalence of OA increased caudally, with the C6–C7 APJ most commonly affected by OA (63% of horses). Horses competing in higher level classes had significantly higher OA grades at C6–C7. This correlation was not significant for the remaining APJ. There was no association between age, time jumping, neck pain and neck range of motion with the presence of OA on radiographs.
For more information: Esoinosa-Mur P, Phillips KL, Galuppo LD. Radiological prevalence of osteoarthritis of the cervical region in 104 performing Warmblood jumpers. Equine Vet J. 2020 Nov. 10 https://doi.org/10.1111/evj.13383 https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.13383 ModernEquineVet.com | Issue 3/2021
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