(C2) Equine Skeletal Disorders

cold therapy is good for

aiding in the decrease of inflammation

what are the methods of cold therapy (4)

1. Cold water

2. Cold stream

3. Ice packs or frozen vegetables

4. Leg wraps that ice packs go in

what does IRAP stand for

Interleukin-1 Receptor Antagonist Protein

how to use Interleukin-1 Receptor Antagonist Protein (4)

1. Collect blood

2. Incubate with glass beads to stimulate WBC’s to produce anti-inflammatory and regenerative cytokines

3. Inject supernatant into patient

4. Good alternative to joint injections with steroids

Interleukin-1 Receptor Antagonist Protein assists with (3)

1. Unresponsive chronic osteoarthritis affected joints

2. Tendons

3. Post surgical

stem cells are good for (9)

1. any injury

2. Aid in inflammation

3. promote lesion healing

4. Degenerative joint disease

5. Osteoarthritis

6. Tendon injuries

7. ligament injuries

8. Osteochondrosis

9. subchondral bone cysts

where are stem cells found (6)

1. Bone marrow

2. Adipose tissue

3. Muscle

4. Tendons

5. Cartilage

6. Synovial membranes

PRP stands for

Platelet Rich Plasma

Platelet Rich Plasma helps with (2)

1. tendon injuries

2. ligament injuries

high power laser therapy helps with

destroying cancer cells

low intensity laser theraypy helps with (6)

1. pain relief

2. stimulate repair

3. Increase blood flow

4. Increase lymphatic flow

5. stimulates endorphins

6. Accelerate wound healing

when should you do Stretching and Manipulation (3)

1. After strenuous exercise

2. Injured tissue to restore or enhance natural elasticity

3. Before exercise to prevent injury

what are static magnets for

Improve circulation

what are pulsing currents for

Create eddies thereby causing vasodilation and improve circulation

TENS stand for

Transcutaneous Electrical Nerve Stimulation

what is Transcutaneous Electrical Nerve Stimulation for

The use of electric current produced by a device to stimulate the nerves for therapeutic purposes.

what is chiropractic therapy for

The intent is to obtain pain relief, restoration of normal joint biomechanics and to free the surrounding soft tissues

what are the therapy options (14)

1. Cold Therapy

2. Interleukin-1 Receptor Antagonist Protein (IRAP)

3. Stem Cells

4. Platelet Rich Plasma (PRP)

5. Shock Wave Therapy

6. Therapeutic Ultrasound

7. LASER Therapy

8. Acupressure

9. Acupuncture

10. Massage

11. Stretching and Manipulation

12. Magnets

13. Transcutaneous Electrical Nerve Stimulation (TENS)

14. Chiropractic Therapy

define joint capsule (2)

1. Tough, fibrous sac that encloses the joint

2. Provides protection

define synovial membrane (3)

1. Permeable membrane inside the joint capsule

2. Filters what enters

3. Secretes synovial fluid

define cartilage (2)

1. Shock absorber

2. Covers the bones in the joint

what causes degenerative joint disease (7)

1. Caused by repeated wear and tear

2. Can be from abnormal forces on a normal joint or normal forces on an abnormal joint/conformation

3. Not a septic arthritis

4. Inflammatory enzymes accumulate

5. Thinning of synovial fluid

6. Loss of shock absorbing quality of cartilage

7. Bone spurs and osteophytes develop

clinical signs degenerative joint disease (3)

1. Lameness

2. Positive response to flexion

3. Potential distention of joint

how to diagnose degenerative joint disease (3)

1. Radiographs

2. Ultrasound

3. MRI

how to treat degenerative joint disease (10)

1. no cure

2. Na-hyaluronate (hyaluronan)

3. Polysulfated Glycosaminoglycan (PSGAG’s)

4. Glucosamine Sulfate or HCL (nutraceutical)

5. Chondroitin (nutraceutical)

6. MSM (nutraceutical)

7. NSAID’s

8. Steroids

9. Pentosan Polysulfate

10. Bisphosphonates (Tildren)

what is the goal of treatment for degenerative joint disease

to help alleviate clinical signs and potentially slow progression of arthritis

purpose of Na-hyaluronate(hyaluronan)

aids in joint Lubrication

purpose of Polysulfated Glycosaminoglycan (PSGAG’s) (2)

1. Increase viscosity of synovial fluid

2. May give antibiotic at the same time to reduce joint Sepsis

purpose of Glucosamine Sulfate or HCL (nutraceutical)

Building block for proteoglycans in the cartilage

purpose of Chondroitin (nutraceutical) (2)

1. May decrease destructive enzymes in the joints

2. Aids chondrocytes in production of proteoglycan

purpose of MSM (nutraceutical)

helps form strong collagen matrix

purpose of NSAIDS

Reduces inflammation

purpose of steroids (3)

1. synovial effusion

2. synovitis

3. pain relief

steroids are contraindicated in what kind of injury

fractures

purpose of Pentosan Polysulfate

Anti-inflammatory effects

purpose of Bisphosphonates (Tildren)

Inhibits osteoclasts

Bisphosphonates (Tildren) is cautioned in horses that … (3)

1. breeding

2. pregnant

3. lactating

OCD stands for

Osteochondritis Dissecans

define Osteochondrosis

the underlying disorder

define Osteochondritis

the inflammatory response to the disorder

Osteochondritis dissecans

the separation of an area of cartilage and/or bone, forming a flap

what causes OCD (6)

1. OCD occurs when the bone fails to develop normally in a growing animal and is unable to repair itself.

2. Seen in large rapidly growing foals up to two years of age

3. rapid growth

4. genetic

5. diet

6. Immature cartilage retained

OCD is most commonly seen in … (5)

1. stifle

2. hock

3. fetlock

4. elbow

5. shoulder

clinical signs of OCD (3)

1. Predilection to certain joints

2. Synovial effusion

3. Periodic lameness

how to do diagnosis (4)

1. Radiography

2. Ultrasound

3. CT

4. MRI

how to treat OCD (2)

1. conservative

2. surgical

how to do conservative treatment OCD (4)

1. Rest

2. NSAIDs

3. joint meds

4. Wait until age of 1 before surgery

how to do surgical treatment (4)

1. Debridement

2. removal of fragments

3. Medicate joint

4. Strict post operative protocol

how to prevent OCD (3)

1. Breeding management

2. Appropriate feed quality (contents)

3. Do not over feed

SBC stands for

Subchondral Bone Cysts

what causes SBC (3)

1. Found in the commonly in the stifle (medial condyle of femur)

2. +/- result of trauma or OCD

3. Incidence highest in horses under 3 years of age

clinical signs of SBC (2)

1. +/- distension of the joint

2. Varying severities of lameness

how to diagnosis of SBC (1)

radiographs

how to treat SBC (5)

1. Rest

2. NSAIDs

3. Intra-articular corticosteroids

4. intra-lesional corticosteroids

5. Surgery

what causes physitis (8)

1. Inflammation of growth plates

2. enlargement of growth plates

3. High energy diets

4. copper defieciency

5. excess zinc

6. Trauma

7. excessive exercise

8. Obesity

what commonly causes physitis (5)

1. distal radius

2. tibia

3. 4th metacarpal bone

4. 4th metatarsal bone

5. proximal first phalanx

physitis affects under what age

under 1 yrs old

physitis is most often in — —, — — — during the summer

well-muscled, fast-growing foals

clinical signs of physitis (8)

1. Enlargement of distal radius

2. enlargement cannon

3. enlargement tibia bones

4. “knobby” joints

5. Varying degrees of lameness

6. +/- painful upon palpation of joint

7. Knee has “dished in” appearance

8. Fetlock has “hourglass” appearance

how to diagnose physitis (1)

radiographs

how to treat physitis (8)

1. Balance Ca:P in ration

2. Adequate Zn

3. adequate Cu

4. Correct any present angular limb deformities

5. Restricted exercise

6. Monitor food intake

7. Avoid hard ground

8. Keep feet trimmed

define congenital angular limb deformity

born with deviation in limbs

define acquired angular limb deformity

develops until growth plate closes

define Carpal valgus

MC deviates away from midline

whats wrong?

carpal valgus

define fetlock varus

pastern deviates towards midline

whats wrong?

fetlock varus

what causes angular limb deformity (8)

1. congenital

2. acquired

3. in utero malposition

4. Hypothyroidism

5. Trauma

6. Poor conformation

7. Excessive joint laxity

8. Defective endochondral ossification

clinical signs of angular limb deformity

Medial or lateral deviations of the limbs as foal develops

how to diagnose angular limb deformity

1. Clinical signs

2. Radiographs

what would be considered mild angular limb deformity

less than 10° deviation from straight

what would be considered moderate angular limb deformity

10° to 20° deviation from straight

what would be considered severe angular limb deformity

greater than 20° deviation from straight

how to treat angular limb deformity (6)

1. Many correct with rest

2. Control exercise to aid with muscle development

3. Corrective trimming or hoof work

4. Periosteal stripping

5. Transphyseal bridge

6. Glue on shoes

how long can a glue on shoe be left on a foal for (range)

10 - 14 days

define flexural deformities

Contracted Tendons in Foals

what causes flexural deformities

1. congenital

2. Intrauterine positioning

3. teratogenic insult

4. genetic defect

5. Persistent contraction of musculature

6. clubfoot

7. OCD

8. DJD

clinical signs of flexural deformities

1. Flexion of carpus

2. flexion of fetlock

3. difficulty standing

4. difficulty walking

5. unable to stand

how to diagnose flexural deformaties (3)

1. If just the muscles connected to the SDFT are involved in the contraction, then usually just the fetlock and pastern are buckled forward, and the heel usually stays on the ground

2. If the muscles connected to the DDFT are contracted, then the heel is usually lifted off of the ground

3. Flexural deformities of the carpus

how to treat congenital flexural deformities (4)

1. Large dose oxytetracycline IV

2. Corrective splinting

3. Physiotherapy

4. exercise

how to treat acquired flexural deformities (3)

1. NSAIDs

2. Corrective farrier work

3. Surgery

tendon looseness aka

laxity

what causes tendon looseness (2)

1. congential

2. premature

clinical signs of tendon looseness (1)

standing directly on fetlocks

how to diagnose tendon looseness

visual determination

how to treat tendon looseness

1. Usually none – self corrects within a few days

2. Monitor for any secondary wounds from improper movement

3. +/- supportive splints