ADVANCED THERAPY IN EQUINE LAMENESS
Hunter S. Lewis, DVM, DABVPGreene, Lewis and Associates
www.greenelewis.com
Osteocondritis Dessicans (OCD)
1. Degenerative Joint Disease (DJD)2. Characterized by cartilage
damage, new bone formation and joint effusion.
3. Caused by “use trauma”
Osteoarthritis
Subcondral Bone Cysts
Osteoarthritis Fetlock
Osteoarthritis Fetlock
Osteoarthritis Hock
Osteocondritis Dessicans (OCD)
1. Developmental Orthopedic Disease (DOD)
2. Characterized by failure of normal bone formation
Osteoarthritis
Subcondral Bone Cysts
3. Causes:
a. Genetic predispositionb. Rapid growthc. Nutritiond. Mineral Imbalancese. Endocrine Factors
4. Can result in DJD
OsteoarthritisOsteocondritis Dessicans (OCD)
Subcondral Bone Cysts
Osteocondritis Dessicans (OCD) Stifle
Osteocondritis Dessicans (OCD) Hock
1. Development Orthopedic Disease2. Characterized by failure of normal bone
formation and loss of normal bone3. Same causes as OCD but trauma is also
involved.4. Can result in DJD
OsteoarthritisOsteocondritis Dessicans (OCD)Subcondral Bone Cysts
Subcondral Bone Cysts
Stifle
Subcondral Bone Cysts Stifle
Subcondral Bone Cysts Fetlock
Assessment of Joint Treatment
Symptom-Modifying Osteoarthritis Drug (SMOAD)
Disease-Modifying Osteoarthritis Drug (DMOAD)
Types of Joint TreatmentOral
Injectable
Intra-articular
Types of Joint TreatmentOral
1. Glucosamin2. Chondrotin Sulfate3. Anti-inflammatories4. ASU – Avocado, Soybean
Unsaponifiable Extracts
Types of Joint TreatmentOral
4. ASU – Avocado, Soybean Unsaponifiable Extractsa. Did not improve lamenessb. Reduced damage to jointc. Increased production of
glycosaminoglycand. Stimulated cell and tissue repair
Types of Joint TreatmentInjectable
1. Adequon2. Legend3. Generics
a. Polyglycanb. Map 5
4. Tildren
Types of Joint TreatmentInjectable
4. Tildren Inhibits bone resorption and may
promote bone reformation Shown effective in hock
osteoarthritis and navicular syndrome
Most effective if used early in disease Cost ??
Types of Joint TreatmentIntra-articular
1. Corticosteroids2. Hyaluronic Acid3. IRAP – Interleukin-1 Receptor
Antogonist Protein
Types of Joint TreatmentIntra-articular
3. IRAP – Interleukin-1 Receptor Antogonist Protein
or ACS – Autologous Condition Serum Blocks IL-1 release Reduces negative effects of
inflammation Reduces pain Improves synovial membrane health
Types of Joint TreatmentOther
1. Extrocorporeal Shockwave Therapy
2. Surgery3. Alternative Therapies