Systemic Joint Therapy

A number of medications are used systemically to decrease joint inflammation and pain.  In our practice, we advocate the rational use of Nonsteroidal Anti-Inflammatory Drugs, and Chondroprotective medications.

Nonsteroidal Anti-Inflammatory Drugs or NSAIDs are among the most commonly used medications in human and veterinary medicine.  They work by interfering with prostaglandin synthesis and thereby blocking the inflammatory cascade.  A number of inflammatory mediators and enzymes are produced by the inflammatory cascade that lead to joint pain as well as cartilage and soft tissue damage.

NSAIDs work by decreasing these inflammatory mediators, and in the case of some NSAIDs, by decreasing pain perception in the central nervous system.  Commonly used NSAIDs in horses include

• Aspirin
• Phenylbutazone
• Flunixin Meglumine or Banamine
• Ketoprofen or Ketofen
• Firocoxibb or Equioxx
• Diclfenomate or Surpass Topical Cream

The rational use of NSAIDs is important due to the potential for toxicity to the gastrointestinal system or kidneys.  Furthermore, the use of these medications is strictly regulated by the United States Equestrian Foundation (USEF) as well as other governing bodies.

Chondroprotective agents are medications that work to inhibit degenerative joint disease or arthritis by blocking the action of joint inflammation.  We use Adequan and Legend in our practice as the injectable chondroprotective agents of choice.  Both are FDA approved and have been used with great success in equine practice.

Adequan is a polysulfated glycosoaminoglycan administered by intra-muscular injection.  Although the exact mechanism of action is not known, Adequan binds cartilage components in the joints and decreases inflammation and increases the synthesis of hylauronic acid and glycosoaminoglycan in the joint. This leads to less inflammation and degradation of the joint.

Legend is Hyaluronic Acid (HA) that is administered intra-venously, hyaluronic acid binds to receptors in the soft tissue of the joint as well as the cartilage and results in decreased joint inflammation and the production of improved synovial fluid and cartilage.

We have found that the routine use of chondroprotective agents in our practice to be beneficial for the soundness and longevity of our equine athletes.