Ep.21 Osteoarthritis and drugs used to counteract the Tornado inflammation. Keeping the Water bed of cartilage plump Horse Talk with Doc

In this episode. Dr. Rice and Yardley Talk about equine joint Arthritis. 

1. Components of joint fluid

a. Synoviocytes produce hyaluronan and lubricin

i. Act to regulate the composition of synovial fluid

ii. Act as barrier lubricant for the surfaces in the joint

iii. Hyaluronan also a component of the articular cartilage

2. Articular cartilage composition – brief

a. Collagen – major component

b. Proteoglycans

i. Protein + glycosaminoglycans

ii. Glycosaminoglycans attract water and create pressure in the cartilage

3. Aim of therapies

a. Decrease pain

b. Prevent progression of disease

c. Do this by mimicking those components of joint fluid and cartilage

d. Help diminish inflammatory response in the joint

e. Claims

i. Prevention

ii. Retardation

iii. Reversal of OA

iv. Don’t always have the science to back it up

4. Common Products

a. Corticosteroids

i. Most potent anti-inflammatory

ii. Can be beneficial when used judiciously

1. At high concentrations and sustained usage à detrimental effects on joint

iii. Most common

1. TA – often more common in high motion joints

2. Methylprednisolone

3. Betamethasone

4. All can have beneficial and detrimental effects

b. Hyaluronic Acid

i. Glycosaminoglycan à component of synovial fluid and cartilage

ii. Can help to replenish what is lost during joint disease and OA

iii. Often used in conjunction with other IA products

1. Synergistic effects of corticosteroids + HA in people

iv. IV formula – Legend

1. Non-invasive

2. Able to treat more than one joint

3. Studies have shown it mainly acts as an anti-inflammatory

c. Adequan - Polysulfated glycosaminoglycans

i. IA formula

1. Often combined with antibiotics

2. Studies have shown that it can modify OA

a. Reduces bone remodeling

b. Decreases inflammatory cytokines

c. Increases synthesis of HA

d. Decrease lameness

ii. IM Formula

1. Easier to administer

2. Used more frequently due to previous issues with joint infections and IA Adequan

3. Less data than IA use

4. More as a preventative for OA