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Common Hock Problems Focus on the ‘Big Three’: Bone Spavin, Bog Spavin, and OCD

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Common Hock Problems Focus on the ‘Big Three’: Bone Spavin, Bog Spavin, and OCD SPECIAL ADVERTISING SECTION SHOWCASING PRODUCTS AND SERVICES FOR THE THOROUGHBRED INDUSTRY Common Hock Problems Focus on the ‘Big Three’: Bone spavin, bog spavin, and OCD BY D.J. CAREY LYONS ock: The name is simple, but treating osteoporosis, but researchers Hthe structure is not. This major have found that the breakdown of bone joint includes 10 bones, the joints associated with osteoarthritis in any spe- connecting them, and extensor tendons, cies is comparable to osteoporosis.” flexor tendons, and collateral ligaments. Tibia In a 2010 study, veterinarians adminis- Because of the great strain the hock en- tered Tildren or a placebo in horses with dures during any type of work, hock ail- bone spavin and found significantly im- ments can develop in any horse. The “big proved lameness scores in those receiv- three” conditions include bone spavin, ing the bisphosphonate. Talocrural Calcaneus bog spavin, and osteochondritis disse- Joint “The drug’s ability to inhibit bone loss cans (OCD). This article explores these may be one reason; its anti-inflammatory issues and how owners and veterinar- effect is probably another,” Dechant said. ians can manage them, with the goal of While she hasn’t yet used bisphospho- returning patients to work at some level. nates for bone spavin, “I probably would It also provides tips horse owners can use Troculea of Talus if other treatments were not working and to minimize horses’ risk of developing I felt confident that the problem was in these conditions. the hock.” Tarsal Dechant noted bisphosphonates might Bone Spavin Bones be particularly helpful in cases where Technically known as distal tarsal os- hock pain occurs in the bone itself rather teoarthritis (inflammation in the joint), than the joint. bone spavin is one of the most common As for feeding nutritional supplements hock conditions, said Dr. Julie Dechant, Cannon and/or injecting chondroprotective Bone associate professor of clinical equine agents into joints (e.g., with polysulfated ARND BRONKHORST surgery at the University of California, The hock is a complex structure with 10 bones glycosaminoglycan, or Adequan) to re- Davis. and connecting joints, tendons, and ligaments. duce arthritic discomfort, Dechant sees “It manifests as lameness and as per- no harm in doing so; however, “they’re formance deficits—the horse doesn’t per- then advance to more elaborate ones only costly and are best used as adjunct form as well as he should,” she explained. if milder treatments no longer ease pain. therapies.” In other words, she doesn’t “Conformation can be a cause; so can oc- recommend them as the sole treatment. cupation. But bone spavin also occurs in Pharmaceutical Options Something she does recommend for any horses with seemingly no risk factors.” For a horse in light work, veterinar- horse with bone spavin is having his feet In this condition the small joints in the ians might initially recommend admin- trimmed for correct balance and shod to lower (distal) part of the hock become istering non-steroidal anti-inflammatory promote breakover. inflamed. These joints provide very little drugs (NSAIDs), such as phenylbutazone of the hock’s motion; by far most move- (Bute), flunixin meglumine (Banamine), Joint Fusion ment takes place in the big talocrural or firocoxib (Equioxx), in response to Because the joints bone spavin affects joint connecting the hock to the tibia discomfort. contribute so little to hock motion, one op- bone above it. But for a horse in heavy or regular tion if medication no longer provides re- When Dechant suspects bone spavin, work, said Dechant, as-needed NSAIDS lief is facilitated ankylosis, or deliberately she performs a detailed lameness exam might be impractical. Instead, she might fusing the joints. “Once they’re fused,” and joint blocks, followed by radiographs administer an intra-articular (within the Dechant explained, “there’s essentially (X-rays) to confirm the pain originates in joint space) corticosteroid or hyaluronic no more arthritis. Fusing stabilizes them, the hock region. If the case presents with acid injection, which can relieve pain so the little bit of motion that was causing ambiguous or atypical clinical signs, she (lameness) for several months by acting pain can’t happen.” might follow up with nuclear scintigra- as an anti-inflammatory agent. An appropriate joint fusion candidate is phy (bone scan) or possibly MRI or com- A newer treatment option attracting at- a horse that has been performing fairly suc- puted tomography. tention, although not yet FDA-approved in cessfully despite bone spavin, but whose “Then, because bone spavin is an ar- the United States, is intravenous bisphos- steroid injections “are not working as long thritis, we can’t make it go away,” she phonate. “Bisphosphonates (e.g., Tildren) as they used to,” Dechant said. “Instead said. “We can only manage it.” are a group of drugs used for treating os- of once a year, maybe he needs treatment Typically, veterinarians begin manag- teoporosis (weakening and thinning of every couple of months. And that’s pretty ing bone spavin with basic approaches, bone),” Dechant explained. “We’re not often—because injecting a joint always in- 2590 BloodHorse.com O SEPTEMBER 15, 2012 TZ.indd 2590 9/10/12 3:53:32 PM BLACK YELLOW MAGENTA CYAN BH38-2590.pgs 09.10.2012 15:57 TheBloodHorse Get the competitive edge ... Strength Speed TM Agility Endurance The first to combine an aquatic treadmill for conditioning with a cold salt water spa for rehabilitation. +1 (941) 723-7517 www.EquineAquaTRAK.com BLACK YELLOW MAGENTA CYAN BH38-2591.pgs 09.06.2012 16:54 TheBloodHorse fbegley SPECIAL ADVERTISING SECTION SHOWCASING PRODUCTS AND SERVICES FOR THE THOROUGHBRED INDUSTRY volves some risk (e.g., infection),” as well as expense. the presence of specially designed glass beads. The resulting Currently, three fusion techniques are available: drilling, enriched serum blocks the effects of interleukin-1, a cartilage- laser treatment, and ethyl alcohol or ethanol injection. Ethyl damaging inflammatory protein the animal’s immune system alcohol injection is the newest and least expensive method for secretes. treating bone spavin. But “one study finds its success rate to be Another possible treatment is extracorporeal shock wave about 50%; another, more like 80%,” Dechant said. “So it seems therapy, which human doctors first introduced as a way to break there’s some variability.” up kidney stones. A transducer sends pressure waves into areas And alcohol injection carries a risk the other two fusion tech- of discomfort resulting from bony changes such as those caused niques don’t: “With drilling and laser, nothing you’re doing can by bone spavin. Studies indicate this method can reduce inflam- go beyond those two joints,” she said. “But with alcohol, you mation in bone spavin cases for as long as three months. must make sure first that the joints to be injected don’t ‘commu- Published research on both these treatments, however, is nicate’ with other hock joints—as they do in some horses.” very limited. The veterinarian does this by injecting the targeted joints with a contrast substance detectable via radiographs, then watching Bog Spavin to make sure it doesn’t go beyond those joints. If the contrast Bog spavin, or tarsocrural effusion, is a fluid swelling in the study indicated the joint communicated with other structures, large talocrural joint mentioned earlier. (Why “bog,” you ask? the injection would be aborted, as the alcohol could destroy or The word is Gaelic for “soft” or “moist.”) damage cartilage in the higher motion joints, leading to severe Bog spavin can develop from injury: Strained ligaments, bleed- osteoarthritis and debilitating lameness. ing into the joint, fracture, or other damage can cause swelling Following any fusion procedure, horses need layup time— and possibly lameness. Bog spavin can also appear spontane- typically six months to a year—to let the bones fuse. Then, al- ously, with or without apparent lameness. The most common though an owner might need to modify expectations somewhat, cause of bog spavin is osteochondritis dissecans. Dechant said most horses can return to an athletic career at Whether or not lameness is present, Dechant pointed out it’s some level. important to identify the underlying cause and treat it accord- “When fusion procedures don’t work well,” she added, “it may be that the problem involved not just joint pain but also bone pain—which fusion can’t relieve.” Other Treatments AquaTrak on Track to Bring Interleukin-1 receptor antagonist protein therapy involves Each Horse Back to Best drawing some of the horse’s own blood and incubating it in Possible Form quaTrak™ is the first of its kind to combine an aquatic treadmill Afor conditioning with a cold saltwater spa for rehabilitation. It offers many health and fitness benefits including: • Significantly accelerating the conditioning and rehabilitation process. • Improving performance, increasing cardiovascular fitness, improv- ing strength and flexibility, and promoting correct posture and gait in a safe, controlled environment. • Enabling the horse to extend through a full range of motion more easily and with significantly lower impact than with traditional exercises. • Providing the ability to target specific areas on the horse for conditioning. • Decreasing rehabilitation time and facilitating rapid recovery from Celebrating 30 Years Of injury and pain. Prince Farm co-owner, Anne Prince, said: “AquaTrak™ is nothing short of amazing! By making it easy to target Outstanding Service specific muscle groups, it allows us to sculpt and shape our horses and gives us an incredible edge in our conditioning program. With the first Superior Leather Goods stallion to ever become the 2011 All American Quarter Horse Congress Grand Champion and AQHA World Champion as a yearling, the results speak for themselves.” And Great Prices Bradford Lane Farm owner/trainer, Laure Connelly, said: PLUS Full Service Repair & Engraving “The underwater treadmill is a valuable tool in our Thoroughbred rehab program.
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