Q. My 17-year-old dressage horse has been showing some signs of discomfort due to osteoarthritis. My veterinarian and I have been discussing potential medical management options but, because he lives on my property, I’m able to adjust his daily management in any way necessary. What are some management changes I should make to help keep him comfortable and working as long as possible?

A. This is an important question that equine veterinarians encounter and discuss with clients on a daily basis. Over one’s career, an equine athlete experiences “wear and tear” as a result of training and competition. Inevitably, almost all athletic horses develop some degree of osteoarthritis (OA). At 17 years old, your horse has likely seen a fair share of work, and your suspicion that OA might be contributing to stiffness, reduced performance, or lameness is well founded.

Fortunately, there are a number of ways to help manage and maintain horses with osteoarthritis. To best understand what your veterinarian might suggest for management at home, some background on osteoarthritis is helpful to review. 

Osteoarthritis, also referred to as degenerative joint disease, develops over time as a result of repetitive insult to joint structures. Joints are made up of many components that all work together to allow the articulation of two bones. Synovium (joint lining), cartilage, and soft tissue support structures are among the more important of these components. Under normal conditions, without pathology (disease or damage), a joint flexes and extends easily without discomfort. If any of the components are injured, homeostasis is disrupted, and an inflammatory cascade develops. Over time, if homeostasis is not restored, the joint begins to overreact to the inflammatory process and the degradation process begins. While there is no cure for OA once it begins, there are tools and strategies available to manage the clinical signs and slow the progression.

As you have probably noticed with your horse, lameness or poor performance often occurs with the onset osteoarthritis. An examination by an experienced veterinarian is essential for a proper diagnosis and treatment plan. Veterinary intervention with intra-articular medications is typically the first, most effective step. However, there is quite a bit that can be done without direct veterinary involvement. Regardless of what joint is affected, proper body condition, nutritional support, hoof care, and appropriate amounts of exercise are paramount.

The body condition of your horse should be appropriate relative to its age and use, and the severity of arthritis present. Your horse should have the appropriate muscle mass to support the distal limb structures while maintaining the lightest frame possible to reduce loading on the joints. As a rule of thumb, you should be able to easily feel your horse’s ribs but not see them. While it varies depending on energy demands, your horse should consume 1.5-2% of their body weight in dry feed per day and, although it is not always convenient, weighing your feed can be helpful in making sure your horse is not being under- or overfed.

You can also supplement your horse’s feed using nutraceuticals and joint support products. There are countless products on the market for supporting and maintaining joint health these days. Most contain some form or combination of MSM, chondroitin sulfate, hyaluronic acid, glucosamine, or omega-3 fatty acids. There are many products with claims that are “too good to be true,” so speak with your veterinarian about what supplements make the most sense for your horse.

There is an old saying in the horse world: “No foot, no horse.” Regular and proper hoof management is paramount in keeping arthritic horses feeling their best, especially when OA is affecting the lower limb joints. You can significantly reduce undue stress on joint structures by balancing the feet and, in many cases, therapeutic shoeing can further increase the horse’s comfort levels depending on the specific condition. Your veterinarian might recommend radiographs to assess the current balance of your horse’s foot and provide your farrier with in-depth information that will allow them to provide the optimal trim or shoeing option. When your horse’s feet are in top condition, it allows the limbs to function and move at their best.

Regular low-impact exercise can play a vital role in the management of OA by keeping the limb muscles strong, decreasing bone loss, and helping control joint swelling and pain. Joint movement replenishes lubrication to the cartilage and, in turn, reduces stiffness and pain. Of course, the degree of movement should be adapted to the needs of the individual. In the case of your horse, it seems that the OA present might be in its early stages, in which case he could be able to continue his level of work without experiencing overt lameness. Placing heating pads over the affected joints prior to work can relax the region and get it ready for increased motion, while ice therapy after a workout can help soothe swollen joints.

It is always important for horse owners to manage expectations and working environment. If it appears your horse simply cannot manage the task, it would be advisable to reduce his level of work to a degree more suitable. During ridden exercise try to take notice of the footing your horse is working on. Footing that is too firm might be uncomfortable for horses with arthritic issues because concussive reaction forces with the ground might more easily aggravate the joint structures than softer, more depressible footing. When not working, if possible, allow your horse to live in a large paddock or turnout where he can move freely.

In cases of progressed osteoarthritis that is less responsive to environmental and supplemental management, medication administration can be pursued. Non-steroidal anti-inflammatory drugs (NSAIDs) are excellent at reducing discomfort caused by osteoarthritis. The most common forms are phenylbutazone (Bute), flunixin meglumine (Banamine) and firocoxib (i.e. Equioxx). These medications, while not void of potential side effects, are very useful for managing orthopedic disease in horses. Firocoxib has a different mechanism of action than phenylbutazone and flunixin and is consequently prescribed by many veterinarians for longer-term use for pain management, but all can be effectively used to manage acute episodes of discomfort.

There are many ways you can support your horse’s joint health and manage osteoarthritis at home. Appropriate exercise, nutrition and supplementation, medication, and adjunct therapies should be used in conjunction with your veterinarian’s therapies to make your horse as comfortable as possible.