JOINT THERAPIES: Myths

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JOINT THERAPIES Myths Facts Associated with
Supplements, Injections Other Treatments

• Mark T. Reilly, DVM, Dipl. ABVP (Equine)
• Equine Affaire 13 Nov 2008
• South Shore Equine Clinic
• Diagnostic Center
• southshoreequineclinic_at_yahoo.com
• 781-585-2611

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JOINT THERAPIES

• South Shore Equine Clinic Diagnostic Center
• 151 Palmer Road Plympton, MA 02367
• [phone]
• www.ssequineclinic.com

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Joint Therapies Care of the Equine Athlete
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Care of the Equine Athlete

• Basic husbandry
• Vaccines
• Shoeing
• Deworming
• Dentistry

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Care of the Equine Athlete

• Shoeing
• 4-6 weeks
• Therapeutic
• Prophylactic (Pads)
• Discipline

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Care of the Equine Athlete

• Deworming
• Internal parasites (worms) can cause extensive
  internal and external damage to your horse
• Annual intestinal parasite exam

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Care of the Equine Athlete

• Basic husbandry
• Vaccines
• Shoeing
• Deworming
• Dentistry

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Care of the Equine Athlete

• Performance Dentistry
• Floating the teeth to maximize the performance of
  that horse both in mastication and when ridden
• (differentiate from the practice of simple
  removal of sharp points)

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Care of the Equine Athlete

• Nutrition
• Good quality forage
• Grass Hay
• Timothy/Alfalfa

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Care of the Equine Athlete

• Nutrition
• Grain
• Complete pelleted feeds
• Sweet Feed
• Specialized Diets
• Fat/Carbs/Protein

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JOINT THERAPIES

• Nutrition
• Supplements
• Joints
• Muscles
• Hoof
• Vitamin Supplements
• Blood builders

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JOINT THERAPIES

• Nutrition
• Joint Supplements
• Chondroitin Sulfate
• Glucosamine
• MSM
• PSGAGs
• Ascorbic Acid
• Hyaluronic Acid

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JOINT THERAPIES

• Chondroitin Sulfate Glucosamine
• Oral
• Bio-avalability ?
• Human, K-9, Equine
• Do they work?

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JOINT THERAPIES

• MYTH 1
• All joint products are the same provided they
  have the same amounts of Glucosamine and/or
  Chondroitin.
• FALSE

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JOINT THERAPIES

• MSM
• DMSO in dry form
• Ant-inflammatory
• Free radical Scavenger
• 33 industrial
• 90 medical

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JOINT THERAPIES

• PSGAGs
• Polysulfated Glycosaminoglycans
• Intra-muscular injections
• Adequan IM

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JOINT THERAPIES

• MYTH 2
• Generic Adequan works the same as the real
  Adequan.
• FALSE

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JOINT THERAPIES

• Ascorbic Acid
• Ester-C
• Vitamin C
• Cellular Health
• Cellular Turnover

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JOINT THERAPIES

• Hyaluronic Acid
• Oral Form
• Chondrogen
• Intravenous Form
• Legend (Caution)
• Intra-articular Form
• Hylartin-V, Legend

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JOINT THERAPIES

• MYTH 3
• Legend and Adequan are the same thing
• FALSE

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JOINT THERAPIES

• Nutrition
• Supplements Multiple
• Chondroitin
• Glucosamine
• Creatine
• MSM
• Vitamin C and EFAs

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JOINT THERAPIES

• FACT 1
• Starting a horse on joint supplements is
  beneficial to the health of his joints
• TRUE

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JOINT THERAPIES

• Nutrition
• Muscle Supplements
• Gamma Grow
• Rice Bran Oil
• Creatine

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JOINT THERAPIES

• Nutrition
• Hoof Supplements
• Methionine
• Biotin
• Zinc

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Care of the Equine Athlete

• Athletic Training
• Veterinary Care /
• Maintenance

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Care of the Equine Athlete

• Athletic Training

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Care of the Equine Athlete

• Athletic Training

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Care of the Equine Athlete

• Athletic Training

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Care of the Equine Athlete

• Athletic Training
• TOPICAL TREATMENTS

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Care of the Equine Athlete

• Athletic Training
• TOPICAL TREATMENTS
• To increase or decrease circulation

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Care of the Equine Athlete

• Athletic Training
• TOPICAL TREATMENTS
• To increase or decrease circulation

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Care of the Equine Athlete

• Athletic Training
• TOPICAL TREATMENTS

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Care of the Equine Athlete

• Two Simple Rules of Topical Treatments
• If its cold heat it up!
• If its hot - cool it out!

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Care of the Equine Athlete
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Care of the Equine Athlete

• Veterinary Care / Maintenance

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Care of the Equine Athlete

• Veterinary Care / Maintenance
• Diagnostics
• Therapeutics
• Prognostics

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Care of the Equine Athlete

• Veterinary Care / Maintenance
• Diagnostics
• Physical exam
• Lameness exam

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Care of the Equine Athlete

• Veterinary Care / Maintenance
• Diagnostics
• Radiographs

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Care of the Equine Athlete

• Radiographs
• Show primarily bone pathology
• Arthritis
• OCD
• Fractures

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Care of the Equine Athlete

• Radiographs
• Bone evaluation
• Local therapy
• Medical
• Surgical
• Prognosticate

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Care of the Equine Athlete

• Veterinary Care / Maintenance
• Diagnostics
• Ultrasound

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Care of the Equine Athlete

• Ultrasound
• Shows primarily soft tissue structure
• Tendons, ligaments
• Joint surface evaluation/cartilage
• Limitations
• Soft tissues within the hoof

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Care of the Equine Athlete

• Advanced Diagnostics
• Nuclear Scintigraphy
• Shows areas of active bone or soft tissue
  remodeling
• Sensitive, not specific

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Care of the Equine Athlete

• Advanced Diagnostics
• Magnetic Resonance Imaging (MRI)
• - Shows bone, tendon,
• ligament, some cartilage
• - Very sensitive and specific

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Care of the Equine Athlete

• MRI
• Excellent for identifying pathology within the
  hoof
• Targeted therapy

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Care of the Equine Athlete

• MRI
• Identify lesions not visible on radiographs
• Cysts
• Bone edema or hemorrhage
• Fractures

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Care of the Equine Athlete

• MRI
• Identify lesions unable to be visualized with
  ultrasound in foot
• DDFT
• Impar Ligament
• Collat. Sesamoidean Ligament of Nav. Bone
• Collateral Ligaments

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Care of the Equine Athlete

• Advanced Diagnostics
• Thermography
• Sensitive, not specific
• Temperature Dependent

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Care of the Equine Athlete

• Veterinary Care / Maintenance
• Diagnostics
• Therapeutics
• Prognostics

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Care of the Equine Athlete

• Veterinary Care / Maintenance
• Therapeutics
• Systemic
• Local

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Care of the Equine Athlete

• Therapeutics
• Systemic - NSAIDs
• Bute
• Banamine
• Ketofen
• Equioxx
• Robaxin -not an NSAID

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JOINT THERAPIES

• MYTH 4
• Bute and Banamine are pain killers
• FALSE

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Care of the Equine Athlete

• Therapeutics
• Systemic - Joint Treatments
• PSGAGs
• Hyaluronic Acid
• Injectable glucosamine
• ? Adequan

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Care of the Equine Athlete

• Therapeutics
• Local
• Topical
• Joint Injection
• Soft tissue Injection

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Care of the Equine Athlete

• Therapeutics
• Local
• Topical
• Joint Injection
• Soft tissue Injection

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Care of the Equine Athlete

• Therapeutics
• Local
• Joint Injections

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Care of the Equine Athlete

• Local Therapeutics
• Joint Injections
• Combination HA/cortisone
• Hyaluronic Acid
• Depo-Medrol, Vetalog

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Care of the Equine Athlete

• Local Therapeutics
• Joint Injections
• IRAP Interleukin -1 Receptor Antagonist
  Protein
• Bodys own product (Autologous Serum)
• Anti-inflammatory
• 24 hour incubation
• 3 doses one week apart
• Human Rheumatology use

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JOINT THERAPIES

• MYTH 5
• Once I starting injecting my horses joints, I
  will have to continue to do so
• FALSE

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Care of the Equine Athlete

• Therapeutics
• Local
• Joint Injections
• Which joints?
• With what?

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Care of the Equine Athlete

• Therapeutics Hock Joint Injections
• Combination HA/steroids/Amikacin
• 3 joints with Hyaluronic Acid
• Depo-Medrol in sliding joint
• Vetalog in flexion joint

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Care of the Equine Athlete

• Therapeutics Hock Joint Injections
• Cost?
• 2 joints with steroids 250 - 300
• 2 joints w HA/Depo 375 - 600
• 3 joints w HA/Cortisone 725 - 900

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JOINT THERAPIES

• MYTH 6
• Cortisone is the worst thing for my horses
  joints
• FALSE

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Care of the Equine Athlete

• Therapeutics
• Local
• Focused ExtracorporealShockwave Therapy
• Improves blood flow and speeds up healing

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Care of the Equine Athlete

• Focused Extracorporeal Shockwave Therapy
• Soft tissue injuries, hock arthritis, ringbone,
  backs

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Care of the Equine Athlete

• Therapeutics
• Local/Targeted
• Soft Tissue Injections
• Platelet Rich Plasma
• Stem Cells
• Fat
• Bone Marrow

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Care of the Equine Athlete

• Therapeutics
• PRP Injection
• Stem Cell Injection
• Local infiltration of growth and healing factors
• Stagnant lesions

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JOINT THERAPIES

• FACT 2
• Using my horses own cells will help him to heal
  without risking bad reactions
• TRUE

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Care of the Equine Athlete

• Therapeutics
• Systemic
• Local
• Alternative
• Acupuncture
• Chiropractic
• Mesotherapy

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Care of the Equine Athlete

• Therapeutics
• Alternative
• Systemic
• Local

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Care of the Equine Athlete

• Veterinary Care / Maintenance
• Prognostics
• Historical
• Follow Up

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Care of the Equine Athlete

• Prognostics
• Adherence to Rehabilitation Plan is imperative
  for treatment success!!

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Joint Therapy Care of the Equine Athlete

• Thank you for your attention

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Joint Therapy Care of the Equine Athlete

• Questions? Comments?
• Mark T. Reilly, DVM, Dipl ABVP(Equine)
• South Shore Equine Clinic
• www.ssequineclinic.com

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• South Shore Equine Clinic
• Diagnostic Center
• www.ssequineclinic.com