Treatment of Degenerative Joint Disease of the Horse: A Review and Commentary

Some of the predisposing factors for the development of degenerative joint disease, such as fatigue, early training, conformation defects, and others, are outlined. Swimming, a controlled weight-bearing exercise, is discussed and strongly recommended for treatment of degenerative joint disease in the horse. A brief review of counterirritants and vesicants, as well as current therapeutic suggestions, are presented. Cryotherapy, which is a relatively new form of counterirritation, is discussed. The benefits and limitations of radiation therapy are briefly discussed, and gamma rays are felt to be superior to x-rays. The most frequently used antiinflammatory drugs are discussed, and the two main categories, corticosteroids and nonsteroidal antiinflammatory drugs, are presented in detail. Among the nonsteroidal antiinflammatory drugs, hyaluronic acid, DMSO, and superoxide dismutase are presented and their mode of action, as well as benefits and disadvantages, are evaluated. Joint lavage is an effective tool in the management of joint disease, because it removes degenerative debris and inflammatory cells from the joint. The management of degenerative joint disease generally involves more than one of the therapeutic regimens mentioned. On the other hand, there is not a single treatment combination that is superior in all situations. The clinician treating degenerative joint disease must select the treatment regimen that works best for him and for the case to be treated. Such a choice must be based on a thorough understanding of applicable therapeutic agents and modes of physical therapy.