Is osteoarthritis in horses curable?

Since many mammals are constructed by nature in a similar (complex) way to humans, especially with regard to their joints, it is only logical that elephants, dogs, horses, etc. suffer from joint diseases like those that occur in humans. One of the most common is osteoarthritis, which, apart from injuries and accidents, is usually a sign of age-related wear and tear. At this point, a distinction should be made between rheumatic joint diseases, which are misguided autoimmune processes in which the cells of the joint cartilage are categorized as foreign and are constantly attacked by the immune cells, leading to extremely painful inflammation.

Osteoarthritis is a wear and tear phenomenon of the musculoskeletal system that mainly occurs in older working or sport horses that are constantly under a lot of strain. As horses get older, their bodies are less and less able to synthesize the substances required for joint metabolism from their food. In horses, due to their high weight at the onset of osteoarthritis, it is primarily the lower joints that show degenerative symptoms. But the horse's spine is also often affected by arthritic changes (kissing spines). 

In addition, premature wear and tear is a problem in a wide variety of breeds. We would like to take a closer look at the factors that contribute to this today:

Causes of Osteoarthritis in Horses

• Age-related wear and tear
• Overload and incorrect loading, especially during the growth phase
• limb misalignments
• Poorly executed or completely missing horseshoes
• overweight
• Injuries and traumas, for example from blows, muscle or tendon strains
• Permanent, one-sided strain, which may be caused by injury
• Genetic predisposition, including autoimmune diseases such as osteolytic spavin
• nutrient or vital substance deficiency
• Excess of protein or carbohydrates (starch)

Osteoarthritis develops when the physiological interaction between the joint capsule, synovial fluid (synovia) and articular cartilage is disrupted in the medium and long term. The "head" of a horse's joint, where two or more movable bone parts meet, is covered with articular cartilage. This is constantly supplied with synovial fluid. This not only enables "smooth" mobility, but the enormous elasticity of this material means that instantaneous pressures and impacts that correspond to many times the weight of the horse can be absorbed. 

The joint capsule, which surrounds the joint and contains the synovial fluid, is a connective tissue covering that ultimately flows into the periosteum. The viscous, lubricating body fluid is produced by the inner coating of the joint capsule and supplies the articular cartilage, which incidentally does not contain any blood vessels or nerves. The synovia builds up the articular cartilage and nourishes it. It consists of nutrients and active substances such as:

• hyaluronic acid
• lipids
• proteins
• mucins
• immune cells
• glycosaminoglycans

The latter have a high water-binding capacity, stimulate cartilage formation, hold back bacteria and detoxify by breaking down metabolic products. 

It is important that the synovia constantly and at all points surrounds the cartilage, which normally happens automatically as the cartilage is alternately loaded and unloaded. If the horse is not exercised regularly, for example because of an injury, the cartilage can quickly become undersupplied, resulting in irreparable cartilage damage. In this sense, long periods of standing in winter due to keeping conditions are a real problem. In many cases, the joint metabolism reacts with increased synovia production, which is often noticeable as slight swelling. Unfortunately, however, overproduction is associated with a reduction in the viscosity of the synovial fluid. In conjunction with possible bleeding, this fluid even takes on an aggressive character. The so-called joint galls are a typical sign of such a development, in which the cartilage is increasingly attacked and arthrosis develops as a result.

Measures to Prevent Osteoarthritis in Horses

It is always bitter to lose your horse too early as a "worthless" companion horse because of the devastating diagnosis of (incurable) arthritis. Therefore, you can never take the following aspects of consistent feeding, housing and training management into account early enough:

• Always use high-quality mineral feed with an optimal calcium-phosphorus ratio in the total ration.
• The feeding plan should provide joint-active nutrients and vital substances from time to time as part of a treatment. These include:
  - Linseed oil and linseed, which contain many omega-3 fatty acids
  - Hay with a high calcium content
  - Rose hips contain a lot of vitamin C
  - Galactolipids, vitamin K, manganese, MSM or methionine are important suppliers of organic sulfur
  - the trace elements zinc and selenium
  - Sunflower oil contains a lot of vitamin E
  - Carrots mean beta-carotene
• The market offers special mixed and concentrated feeds that can cause young horses to grow a little too quickly and become too heavy. But this is exactly what should be avoided at all costs.
• There are basic and concentrated feeds that have too high a phosphorus content, which ultimately leads to demineralization of the bones. Therefore, use maize, silage and wheat bran sparingly.
• Growing horses need a lot of playful exercise for the healthy development of their muscles, tendons and joints, ideally in the middle of an age-appropriate herd.
• Obesity must be avoided at all costs; no feed mixtures containing sugar.
• Regular training is important for the muscles and joints. The value of the approximately 20-minute warm-up phase cannot be overestimated.
• Make sure the surface is suitable for the horse. Even when the foal is still small, its hooves need to be professionally trimmed.
• Misalignments or blockages must be treated regularly with osteopathy as early as possible.
• The lying area must be padded softly enough for the horse. Older or lower-ranking horses must also be given the opportunity to rest lying down.

How can you recognize the onset of osteoarthritis in horses?

A slight lameness can usually be quickly overcome with moderate training. The first noticeable signs of serious joint problems are so-called galls or spongy joints. Difficulty lying down or getting up and a high sensitivity to pressure on the withers can indicate kissing spines. If joints are swollen and very warm at the same time, this is often arthritis, i.e. inflammatory arthrosis. It develops, for example, when the cartilage in certain places has receded to such an extent that the periosteum is already rubbing against each other. 

If the diagnosis of osteoarthritis in the horse is confirmed

Even if that sounds harsh, there is no hope of a cure. All we can do with treatment is try to limit the animal's pain. This is important because pain causes the animal to not move at all, and that is counterproductive. Aside from our sympathy, it is therefore essential to improve the sick horse's quality of life. 

• homeopathy
  This method has proven to be effective in mobilizing the horse's self-healing powers, although homeopathy is nothing more and nothing less than a supportive measure. The method requires a qualified homeopathic doctor and should under no circumstances be attempted alone.
• leech
  The saliva of the leeches ensures local blood thinning and contains anti-inflammatory and pain-relieving substances.
• Chondroprotective substances 
  These include, for example, hyaluronic acid, chondroitin, glucosamine and mussel extract. They can largely prevent or halt the further breakdown of collagenous connective tissue and the unfavorable changes in the synovia. This offers the chance that the affected joint can be stabilized and cartilage cells can even be regenerated. Nutritional support is provided by "Getriebe Akut".
• Herbs
  Comfrey, rose hip, ginger, white willow, spirea, devil's claw and yucca contain secondary plant substances that have a beneficial effect, especially during the arthritic phase.
• The joints can also be relieved by professional, regular treatment of the hooves or horseshoes .

Veterinary treatment options

• In case of acute inflammation, the veterinarian will first rubbing with circulation-stimulating, anti-inflammatory lotions. In the case of spavin, accelerated ossification is even desired, which means that in this case the doctor will resort to a relatively strong agent.
• NSAID stands for non-steroidal anti-inflammatory drugs. These are fever-reducing medications that also have analgesic and anti-inflammatory effects.
• glucocorticoids are steroidal anti-inflammatory drugs that are usually injected into the joint together with hyaluronic acid.
• hyaluronic acid is injected into the joint, but can also be administered orally. Due to the metabolic processes in the gastrointestinal tract, however, it is controversial whether orally administered hyaluronic acid can really have an effect.
• At the IRAP therapy This is a method known as "interleukin 1 receptor antagonist". Blood is first taken from the horse and then mixed with inert glass beads. This creates an anti-inflammatory and simultaneously regenerating serum, which is then injected back into the joint.
• At the arthroscopy Deposits and bone fragments are removed using an endoscope in a minimally invasive manner. The joint is then rinsed.

Which method is used for your horse depends on the diagnosis made by the veterinarian. In some cases, surgery will be the only option, but every operation carries significant risks. For this reason, it is strongly recommended that you always try to restore the horse's joint to its nutritional state using low-risk nutritional supplements or phytotherapy before deciding on an operation. 

In practice, regular feedings, for example with MobiCare from Natural Horse Care or ArthriAid by NutriScience has proven to be very effective. On the other hand, a long-term addition of anti-inflammatory and pain-relieving herbs such as ginger, white willow or devil's claw is less suitable because of the strain on the stomach lining. However, since osteoarthritis is often preceded by arthritis, such herbs or MSM can be very helpful as a temporary (maximum two months) accompanying measure. The aim must always be to find and combat the causes so that all well-intentioned attempts to rebuild the cartilage do not come to nothing.