Lecture 32 4/10/25 Flashcards
What are the general characteristics of anti-inflammatory treatments?
-meant to be used on hot/warm/inflamed musculoskeletal lesions
-used to relieve or prevent excessive inflammatory responses
-alleviate pain
-mask pain, sepsis, and deterioration
-can lead to animal abusing areas that are otherwise protected by pain
What are the characteristics of cold hydrotherapy?
-excellent first aid for musculoskeletal lesions
-can be accomplished with turbulator boots, trash cans of water, or hoses
-typically done for 20 minutes 3 times a day
-useful for tendonitis, sprains, bucked shins
What are the characteristics of steroids?
-have anti-phospholipase A activity
-reduce pain, edema, and leukocyte infiltration
-have anabolic effects
-want to treat at lowest dose for shortest possible time
-common to inject steroids intra-articularly
What are the indications for steroids?
-arthritis
-allergic reactions
-chronic muscular problems
Why are steroids reserved for “low motion” joints?
-steroids can cause cartilage degradation in joints that results in fusion
-repeated use in high motion joints can lead to unwanted fusion and decreased mobility
-fusion in low motion joints is acceptable since those joints do not normally undergo much motion
What are the potential problems with using steroids?
-suppress anabolic processes of cartilage
-lead to cartilage degradation
-sensitize blood vessels to endogenous vasoactive compounds like epinephrine and serotonin
-can potentiate laminitis
Which systemic steroids can be used in horses for musculoskeletal lesions?
-azium/dexamethasone
-predef
-solu-delta-cortef
Which intra-articular steroids can be used in horses for musculoskeletal lesions?
-depo-medrol/methylprednisolone
-vetalog/triamcinolone
-betavet/betamethasone
What are the characteristics of depo-medro/methylprednisolone?
-tends to have the most adverse effects on the chondrocytes
-has the longest acting effects (3 months) compared to other IA steroids (30 days)
What are the characteristics of NSAIDs?
-affect the arachidonic acid cascade
-primarily inhibit cyclooxygenase
-inhibit production of thromboxane and prostaglandins (can lead to problems)
What are the main problems with giving NSAIDs to horses?
-nephrotoxicity
-GI ulceration
-blood dyscrasia
-allergic reactions
What are the characteristics of butazolidin/phenylbutazone?
-primarily for musculoskeletal pain
-extremely irritating if injected perivascular
-irreversibly binds to cyclooxygenase
What are the characteristics of banamine/flunixin meglumine?
-primarily for GI/visceral pain
-good for endotoxemia
-irreversibly binds to cyclooxygenase
-can lead to clostridial myositis when given IM
What are the characteristics of ketofen/ketoprofen?
-used for musculoskeletal and GI pain
-inhibits both cyclooxygenase and lipoxygenase
-not currently on the market
What are the characteristics of equioxx?
-labelled for osteoarthritis
-coxib class
-targets COX2
-spares COX1; maintains blood flow to kidneys and spares gastric mucosa
-oral and VI formulations
What are the characteristics of Surpass?
-topical NSAID
-diclofenac sodium
-apply a five-inch ribbon twice daily over the affected joint
What are the characteristics of aspirin?
-antipyretic
-for muscular pain
-irreversibly blocks cyclooxygenase
-antiplatelet properties; used to prevent platelet aggregation
What are the characteristics of acetaminophen?
-antipyretic
-anti-inflammatory
-for muscular pain
-COX1 and COX2 inhibitor
-similar adverse effects as other NSAIDs but not as frequent
What aer the characteristics of hyaluronic acid?
-many different products
-typically for intra-articular use
-acts as soft tissue boundary lubricant
-anti-inflammatory action
-re-establishes normal joint environment
What are the indications for hyaluronic acid usage?
-arthritis
-synovitis
What are the characteristics of adequan?
-similar to mucopolysaccharide in cartilage
-anti-inflammatory
-stimulates production of hyaluronic acid
-incorporated into cartilage to improve integrity
-does nothing for fibrocartilage
What are the indications for adequan?
-degenerative joint dz
-arthritis
What is the main complication of adequan?
can potentiate joint infections
What are the characteristics of pentosan polysulfate sodium?
-similar to adequan
-indicated in DJD and arthritis
-stimulates hyaluronic acid and glycosaminoglycan synthesis
-inhibits proteolytic enzymes
-scavenges free radicals
What are the characteristics of oral joint supplements?
-available but classified as food additive, not as a therapy
-efficacy unknown; look at research for individual products
-products vary
What are the characteristics of DMSO?
-anti-inflammatory
-free radical scavenger
-bactericidal
-diuretic
-analgesic
-available as medical grade and non-medical grade
-can be used topically, IV, oral, or intra-articular
What are the indications for DMSO?
-laminitis
-arthritis
-CNS trauma
-septic arthritis
What is the main problem with DMSO usage?
hemolysis when given IV in a greater than 20% solution
What are the characteristics of MSM/methylsulfonyl methane?
-DMSO derivative
-same properties as DMSO
-classified as a food additive
-indicated in DJD and arthritis
What are the types of biologic medicines?
-bone marrow concentrate
-autologous conditioned serum
-autologous protein solution
-platelet rich plasma
-alpha-2 macroglobulin
-stem cells
-amniotic tissue allograft
What are the methods for giving bone marrow?
-direct injection
-bone marrow concentrate
-ex vivo expansion
What are the characteristics of bone marrow concentrate?
-straight bone marrow can be used, but has fat and bone spicules that can lead to poor healing
-centrifuged to separate regenerative cells, growth factors, and platelets out for injection
-low cell counts compared to other techniques
What are the characteristics of ACS?
-may decrease lameness if injected 2 to 14 days after injury
-provides IL-1Ra as well as growth factors
-1 to 3 mLs injected intralesionally
What are the characteristics of APS/ProStride?
-concentrated solution of cells, platelets, growth factors, and anti-inflammatory proteins
-primarily used for osteoarthritis
What are the characteristics of platelet rich plasma?
-platelets play a prominent role in wound healing
-degranulation of alpha-granules releases numerous growth factors
-initial burst of growth factor release occurs
-contains a 3 to 5 fold increase in growth factor concentrations
-associated with enhancement of healing
What are the characteristics of platelet rich plasma formulation?
-can only be made from anticoagulated blood
-usually used unclotted for soft tissue injection
-bovine thrombin can be used to activating clotting mechanism and form a gel for use on wounds and bone defects
What are the characteristics of alpha-2 macroglobulin?
-orthobiologic
-reported to slow progression of OA
-prevents cartilage breakdown and loss
-utilizes patient’s own blood
-has receptors that bind proteases that are destructive to cartilage
-effects reported to last up to a year
What are the characteristics of stem cell therapy?
-stem cells are characterized by their ability to self-renew and differentiate into multiple cell/tissue types
-generally considered as being embryonic or non-embryonic in origin
-available treatments for horses are autologous or allogenic and use adult mesenchymal tissue-derived stem cells
What is the mode of action for stem cells?
-applied to an injured tissue
-engraft and differentiate into tissue-specific fibroblasts
-produce the appropriate wound matrix
What are the general characteristics of stem cell source?
-most are from autogenous sources, but allogenic is becoming more common
-current options center on donor connective tissue type and level of isolation and expansion
-bone marrow aspirate and fat are currently the most practical sources
What are the characteristics of fat-derived stem cells?
-adipose-derived MSCs exhibit similar degree of multipotentiality to BM-derived MSCs
-stem cells from fat are now being expanded ex-vivo
What are other sources for autogenous stem cells?
-peripheral blood
-umbilical blod
-skin
What are other sources for allogenic stem cells?
-embryonic
-bone marrow
-any other tissue by induction
What are the characteristics of RenoVo?
-liquid, acellular, equine amniotic tissue allograft
-comprised of amnion and amniotic fluid
-rich source of biologically active factors involved in tissue regeneration
-reported anti-inflammatory, anti-bacterial, re-epithelialization, and anti-fibrotic properties
