Many oral supplements claim a wide array of effects, including maintaining joint health, offering anti-inflammatory benefits, improving welfare, reducing joint stiffness and pain, and slowing osteoarthritis progression, reports The Horse.

Since most supplements are sold as food products, they are not required to conform to regulations or quality — or to have demonstrated efficacy.

Tucker considered ingredients effective if they achieved a desired response in the joint. They must also be bioavailable when administered orally, and have an appropriate formulation and concentration that matches published studies.

Chondroitin sulfate is a building block of joints; it is bioavailable and reaches synovial fluid and cartilage. It has an anti-inflammatory effect on human joint tissues and has been shown to reduce pain and swelling, as well as to prevent joint space narrowing. Equine-specific studies, however, have shown that chondroitin sulfate has no measurable effect on the horse.

Glucosamine is present in cartilage and synovial fluid; the amino monosaccharide prevents joint breakdown and acts as an anti-inflammatory. Research has shown conflicting evidence: some studies show that glucosamine has slow or no utilization in tissue, while others find that it does have an effect on pain or function.

Boswellia serrata, also called Indian frankincense, claims to be an anti-inflammatory. There have been no veterinary studies on Boswellia serrata's use, so additional investigation is needed, Tucker said. It has shown some benefit in humans who have taken it.

Turmeric use in humans has demonstrated anti-inflammatory and antioxidant properties, but it has poor bioavailability. Only one veterinary study has been done to date, and the vets involved thought it showed significant improvement in dogs that consumed it.

While Tucker concluded that there is no concrete evidence that supplements work, they are safe to feed horses.

Read more at The Horse.

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Dr. Janny de Grauw, from Utrecht University in the Netherlands, and Diane Howard, PhD, MSc., Equine Science Master graduate from the University of Edinburgh, in the United Kingdom, are the recipients of the Donor-Inspired Study grant, funded by Dr. Wendy Koch, a veterinarian who has supported the Foundation for nearly 30 years. Dr. Koch has closely followed equine behavior and welfare research over the years and wanted to increase the amount of funding available for studies in these fields.

To effectively treat pain, caregivers and clinicians need a way of monitoring and quantifying the amount of discomfort felt. However, a survey of horse owners in the United Kingdom found that owners have limited ability to identify pain and disease in their horses, underlining the need for a simple way of helping people to recognize chronic pain in their equine companions.

“As veterinarians, we want to treat horses with painful and debilitating conditions like OA as effectively as possible,” said de Grauw. “How well we can manage their condition critically relies on recognition of subtle signs of (worsening) pain by owners and caregivers, who can then seek help.”

Under Dr. de Grauw's supervision, Howard developed the 15-item questionnaire based on changes in horse behavior through interviews with owners of horses diagnosed with osteoarthritis. The questions cover posture, facial expressions, movement and behavior.

She will validate the questionnaire by having 60 owners of horses with chronic OA pain and 20 owners of horses without OA complete it. The owners with OA horses will complete the questionnaire twice in two days while their horse's pain does not fluctuate, to evaluate how robust and reproducible the scoring instrument is.

The research team hopes the easy-to-use questionnaire will help horse owners recognize when their animals are in pain and contact a veterinarian for appropriate treatment. The instrument also may help owners monitor treatment effectiveness and pain progression over time, and guide owners and veterinarians in making quality-of-life decisions.

“Many horses may deal with pain that is not recognized, particularly in its early stages,” said Dr. Janet Patterson-Kane, Morris Animal Foundation Chief Scientific Officer. “Giving their caregivers effective tools for detection, monitoring and decision-making has the potential for significant animal welfare impact.”

Osteoarthritis is a major cause of chronic pain in horses but is an underrecognized and undertreated condition. Though often associated with advanced age, it can also occur in young horses. In addition to being painful, OA can severely curtail a horse's athletic career, and impact the bond between horse and owner if the condition limits a horse's ability to be ridden.

The Foundation's Donor-Inspired Study program allows individual donors and foundations to directly support research topics for which they have a passion and there is a pressing need. Applications for this grant were reviewed and rated, based on impact and scientific rigor, by a scientific advisory board, made up of equine behavior and welfare experts.

Morris Animal Foundation is one of the largest nonprofit organizations worldwide that funds health studies benefiting cats, dogs, horses, llamas, alpacas and wildlife. The Foundation currently is funding 150 studies encompassing a broad spectrum of species and diseases.

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Musculoskeletal disorders are prevalent in aging horses and can cause pain, weakness, stiffness and decreased range of motion in the animals' joints. Osteoarthritis and chronic laminitis are among the most common musculoskeletal disorders in horses and can greatly impact a horse's performance and quality of life.

KetoMed contains the same active ingredient (ketoprofen) in the same concentration and dosage form as the approved brand name drug product, Ketofen, which was first approved on September 26, 1990. In addition, the FDA determined that KetoMed contains no inactive ingredients that may significantly affect the bioavailability of the active ingredient.

The data submitted in support of the Abbreviated New Animal Drug Application demonstrate that KetoMed, when used according to its label, is safe and effective.

KetoMed is a prescription product because a veterinarian's expertise is required to diagnose musculoskeletal disorders and to determine whether ketoprofen is an appropriate treatment.

KetoMed is supplied in 50 mL and 100 mL multidose bottles. The recommended dosage is 1 mg/lb (1 mL/100 lbs) of body weight once daily. Treatment is administered by intravenous injection and may be repeated for up to five days.

KetoMed is sponsored by Bimeda Animal Health Ltd. based in Dublin, Ireland.

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“Osteoarthritis is common in any athlete,” explains Koenig “especially as they get older.” The development of bone spurs can cause the facets to become enlarged. Inflammation around the cervical facet joints can affect the soft tissues and nerve roots. It is hypothesized that slight neck instability or overuse can result in remodeling of the joint. There were a larger number of dressage horses relative to the hospital population in the study and dressage horses may be at a higher risk for overuse of the facet joints of the cervical vertebrae.

Clinical signs of Osteoarthritis in the neck include: atrophy/muscle wasting (pronounced hollow in lower neck and vertebrae appear prominent), stiff neck (e.g. limited range in carrot stretch, difficulty when ridden in a “frame”) and sometimes front limb lameness that does not resolve by nerve blocking up the leg.

One of the reasons for the OVC study was the fact that previous studies have shown radiographs indicating changes in the neck of younger horses (6 to 8 years old) with no other clinical signs of osteoarthritis. Koenig has seen for herself, horses dismissed after pre-purchase exams when radiographs indicate mild osteoarthritis. When previous studies indicate 50 percent of clinically normal mature horses present with mild osteoarthritis on radiographs, a study to explore the significance was in order.

Differing opinions in classifying the severity of the stage of osteoarthritis from radiographs was revealed to be a good case for not using radiographs alone in diagnosis. “The repeatability of grading of osteoarthritis from radiographs was not reliable,” says Koenig. Two-thirds of the horses in the OVC study that were treated with intra-articular cortisone injection returned to their full level of work. The study concluded that radiographs alone were insufficient to diagnose cervical facet disease and other clinical signs (atrophy, stiffness, or lameness unresolved by nerve block) need to be present.

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Dr. Judith Koenig notes that osteoarthritis is common in many athletes, especially as they age. Bone spurs may develop and cause the facets to grow larger, and inflammation around the facet joints can affect nerve roots and soft tissue. Overuse or neck instability can also cause the joint to remodel.

Clinical signs of osteoarthritis in the neck include stiff neck with a limited range of motion and atrophy in the lower neck. Some horses with osteoarthritis of the neck may show front-end lameness that does not respond to leg nerve blocks.

Prior studies had shown that X-rays indicated osteoarthritic changes of the neck in nearly 50 percent of horses that were between 6 and 8 years old who had no other clinical signs of osteoarthritis. This finding caused many horses to fail pre-purchase exams. Koenig created a study to explore the significance of these changes that seem to affect so many horses.

Koenig's study showed that there are differing opinions among veterinarians on how to classify the stage of osteoarthritis the X-rays show. Koenig noted that this was a reason why veterinarians should not rely solely on information the X-rays provide, but should take the X-rays in context with other clinical signs.

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