Need an alternative to steroids for treating arthritis in your horse?
Intra-Articular steroid introduction
Many horse owners need to consider alternatives to using steroids in their horse, and this can be for a variety of reasons. Corticosteroids are frequently reached for by equine veterinarians to treat lameness and the inflammatory pain associated with synovitis and/or osteoarthritis in horses. Corticosteroids are potent anti-inflammatory agents. Commonly used intra-articular corticosteroids include triamcinolone (Vetalog), methylprednisolone (Depo-Medrol), and betamethasone (Betavet). These steroids are usually combined with hyaluronic acid (HA). This hits the joint with a one:two punch of anti-inflammatory + lubricating effects. This combo quickly and effectively relieves joint pain and discomfort. The duration of action differs between steroid types and veterinarians will preferentially use one or the other in different joints.
Reasons for restricting steroid use
There are a number of reasons why steroids may not be a viable option to treat arthritis pain for all horses. The reasons may be specific to an individual horse based on medical history or pre-disposition to react adversely to steroid use. Another reason we see the withholding of steroid use comes from rules set forth by the governing bodies over races and other competitions with drug testing regulations.
Medical history concerns
Some horses may have medical conditions or predispositions that preclude them from being candidates for intra-articular steroid use. Common conditions that can predispose a horse to having an adverse reaction to intra-articular administration of corticosteroids are: history of laminitis or founder, EGUS (equine gastric ulcer syndrome) and PPID/Cushings. Horses with these conditions should not be treated with steroids. Vets will look to alternative therapies to manage arthritis in these cases.
Drug testing: FEI, Racing, etc.
The current ARCI (Association of Racing Commissioners International) recommended withdrawal times for intra-articular administration of corticosteroids is seven days for triamcinolone & betamethasone and 21 days for methylprednisolone. Other governing bodies have their own criteria for detection and withdrawal times relative to competition times. The FEI lists the three named corticosteroids above as “controlled” substances. When drug-testing is of utmost concern, timing of therapeutic treatments must be well planned. Alternative drug-free therapies may be a safer choice.
Non-steroid alternatives for treating arthritis in horses
There are many intra-articular alternatives to steroid use. These include the use of HA as a stand-alone IA treatment, which is generally less effective than the combination of HA + a steroid; biologics such as IRAP, PRP or Stem Cells which may be cost-prohibitive and often require a series of multiple injections; and a newer technology called polyacrylamide hydrogel or “PAAG”.
2.5% polyacrylamide hydrogel “PAAG” – Arthramid ®Vet: A new alternative to using steroids to treat arthritis in horses
Arthramid®Vet is labeled for the management of all stages of non-infectious osteoarthritis and degenerative joint disease in horses in the USA. In this study it was concluded that 2.5% “PAAG significantly alleviated lameness and joint effusion in osteoarthritic joints. PAAG is a promising, safe and lasting (at least 24 months) new treatment for OA in horses.”
Ask your vet about using Arthramid®Vet if you’re looking for a safe, effective, long-lasting and affordable alternative to intra-articular corticosteroid injections.