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  Discussion on Knee problem in older horse
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New Member:
hhhpaint

Posted on Wednesday, Jan 13, 2010 - 10:04 pm:

I was typing along and my post suddenly vanished... I will start over. My gelding is 21 years old. His knees have started looking swollen in last few years, and he has been tripping more. I had x-rays done a year ago, and they showed bone chips in knees. We recently did x-rays again of knees, and they show very little space between the bones compared to a year ago. This horse is VERY important to me. I want to keep him alive as long as I can without causing him to suffer. I have used Bute and had good results. I have also used Previcox with good results. I guess I would like to get some advice from folks out there who have kept a horse on Bute or Previcox for extended periods of time. How long is reasonable to keep a horse on these drugs? What tips or advice would you give to someone in my situation? My gelding has a little turnout area, but most of it is on a hard hillside. I have been walking him about 20 minutes every other day on level ground just to keep his knees moving. Is this a good thing to do? His knees look somewhat like a cabbage (lumpy.) My vet does not seem to want to be the one to say that he needs to be let go... am I prolonging unneccessary suffering? I am so hopeful that this horse can stay with us a little longer. He still bosses the other horses around and has a lot of spark. I invite any suggestions or advice from others who have had this experience. Thank you.
Moderator:
DrO

Posted on Thursday, Jan 14, 2010 - 7:28 am:

Hello Holly,
How long is it reasonable? It would be reasonable as long as it provides your horse an acceptable quality of life and treatment meets your goals. If this is the only way to provide a acceptable quality then it would be reasonable for this to become a life long plan but that is not the same as saying it is safe.

We have a subtopic in the article on phenylbutazone entitled "What is a Safe Dose?" on this subject along with suggestions on monitoring horses on long term NSAID therapy. But I also want you to consider some of the ancillary therapies that may help you maintain your horse on lower doses of NSAIDs and non-NSAID ways to deal with acute exacerbations of pain. You will find a very good discussion on this in the treatment subtopic of Diseases of Horses » Lameness » Joint, Bone, Ligament Diseases » Arthritis and DJD: An Overview.
Member:
npo33901

Posted on Friday, Jan 15, 2010 - 3:37 pm:

Holly, I am suffering the same problem like your horse !!
I have painful knee for years . IXray are showing bone on bone - no cartelige left. I've been told I must have complete knee protheses. My husband found on Medical site that there are new developments in intra-articular injections using hyaluronicaacid which is a normal lubricating substance in joints.I know of a friend of mine Internist on the staff of Washington MedicalSchool, whose own knee was showing crepitus( the sound of bone crunching on bone)---extreme pain,and 2 injections one week apart and he is perfect now. Some orthopaedic specialists say this only works on YOUNGER patients but a surgeon friend of mine told me of a colleague of 63 who with arthritis has had huge relief after these injections. It helps if MRI can be done to see if bone debris is in the joint, and with arthroscopy, this is removed BEFORE injections. Dr. O, surely this can be applicable to hoses too?
If you want any more information, you may contact me on my Email.
AM.
Member:
mjq1

Posted on Friday, Jan 15, 2010 - 8:57 pm:

Holly, I also had a 24 year old horse who had very swollen fetlock joints, laying down all the time, etc. I know others don't believe it works, but I put my horse on oral Hyaluronic Acid/H.A. with the product Conquer Gel 100mgs a day. Within a week, he was up and moving normally. Within two weeks his fetlocks were of normal size and he was bopping around like a new horse. My vet was amazed. At age 30, I had to put him on Equioxx 1/3 of a dose to ease his joints. He has been on it for two years with perfect blood levels. He could not tolerate bute or other NSAIDS. I know people advise 'quality of life' and that is EXACTLY why I am doing it. He is out every day in the pasture giving the mares trouble and enjoying his life free of pain. When that day ends and he starts to slip, I will put him down. Just know their are options if you can afford them and I support your efforts.
Moderator:
DrO

Posted on Sunday, Jan 17, 2010 - 12:03 pm:

Anna, we have been using hyaluronate injections in horse joints for nearly 20 years now and you can read about it in the article on arthritis and in the medication section under anti-inflammatories.

We should also note that the horse's "knee" is actually the same anatomical structure as your wrist (the carpus). Your wrist has the same bones though proportions are different and in the horse's "knee" there are only 3 hand bones to articulate with, while your's has 5. Your knee is actually the horses stifle, patella and all.
DrO
Member:
npo33901

Posted on Monday, Jan 18, 2010 - 12:07 pm:

Thanks Dr.O,i think maybe i should visit YOU first for a consultation for my knee, instead of my proposed consult at Northwest Hospital in Chicago! My husband sent me for an xray of a broken finger some years back to our VETERINARY clinic, as he found that their x-rays were superior to the local hospital´s .What are they using now for horse`s knees? I know that Syn- Visc used to be a 3 injection course at weekly intervals but the new version is a single shot or two a week apart. Some Orthopaedic Surgeons believe that it actually softens the old cartilage and may even lay down a new microscopic covering layer. Is there any evidence of this in the horse, and what is the brand name for the most popular gel (used intra -articulary in the treatment of horses now?)
Moderator:
DrO

Posted on Tuesday, Jan 19, 2010 - 7:23 am:

Anna, besides hyaluronate there are now a plethora of pharmacological and biological products out there used in the treatment of osteoarthritis and we cover them in a logical step wise fashion in the article I reference above. There are then links to the specific products / procedures that each have their own article in the medication or lameness treatment section where we cover the proposed mechanisms by which they work and the current research on proof of efficacy.
DrO
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