Therapeutics for joint disease Flashcards
What are the systemic treatment options for osteoarthritis?
NSAIDs (all species) (+paracetamol)
Bisphosphonates (equine)
Glycosaminoglycan derivatives
What are the intra-articular treatment options for osteoarthritis?
Corticosteroids
Glycosaminoglycan derivatives (hyaluronic acid)
Synthetic hydrogels
Biological products (stem cells, IRAP, PRP)
What are the systemic treatment options for joint sepsis?
Antibiotics
NSAIDs
What are the intra-articular treatment options for joint sepsis?
Antibiotics
Opioids
What are the regional (Intra-venous regional limb perfusion) options for joint sepsis?
antibiotics
What are the systemic treatment options for immune mediated joint disease?
corticosteroids
immunomodulators
What can’t biphosphates be used in this case?
Not permitted in horses under 3.5 years in UK racing
Using them in younger horses removes them from racing permanently
Has a 30-day withdrawal period, which is too long
Why are biologic treatments (e.g., glycosaminoglycans) not suitable for this horse?
Limited evidence for rapid efficacy
Unlikely to provide enough anti-inflammatory effect before race
What is the preferred treatment for this racehorse’s joint disease?
Intra-articular corticosteroids
Triamcinolone is best choice due to shorter withdrawal time
Why is joint sepsis unlikely in this dog?
No massive neutrophilia in synovial fluid
Moderate protein increase, not as high as expected in sepsis
Chronic shifting lameness, rather than acute severe pain
What is the most likely diagnosis?
Immune-Mediated Polyarthritis (IMP)
Multiple joints affected at different times
Symptoms vary in severity
Autoimmune nature rather than infection
Why is local joint treatment (e.g., intra-articular steroids) not effective for IMP?
Different joints are affected at different times
Local injections only treat one joint, not systemic disease
Condition requires systemic immunosuppression
