The results of a veterinarian survey on joint therapies were summarized by Dora Ferris, DVM, a staff veterinarian in Colorado State University's Orthopaedic Research Center, at the 2009 American Association of Equine Practitioners (AAEP) convention, held Dec. 5-9 in Las Vegas, Nev. In a 2009 survey of veterinarians, of 831 respondents, 80% practice exclusively on horses. Over half the respondents focus on lameness and performance practice at least half the time; most respondents have been in practice more than 10 to 20 years.

Seventy percent of the respondents use corticosteroids in their intra-articular therapeutic strategy, usually combined with another medications, such as hyaluronic acid (HA) or the antibiotic amikacin. For 22%, personal experience is relevant as to which intra-articular corticosteroid they select. Scientific data on efficacy determines what medication 38% use. For high-motion joints (coffin, fetlock, carpus), the vets most commonly use triamcinolone (TCA). For low-motion joints (distal hocks), methylprednisolone acetate (MPA) is the corticosteroid of choice. Because MPA is known to increase cartilage pathology (damage) at a 100-mg dose, most respondents inject far less.

Most practitioners (70%) do not use compounded medications in the joints, preferring FDA-approved and tested products specifically formulated to target joint therapy. Only 4.1% rarely or never use corticosteroids for joint therapy.

For joints that are unresponsive to corticosteroid therapy, 38% of respondents turn to autologous conditioned serum treatment, which uses the horse's own blood to produce interleukin-1 receptor antagonist protein (IRAP) and other anti-inflammatory proteins to combat pro-inflammatory molecules. Reporting response to IRAP therapy, 37% feel the fetlock responds best, 22% feel the stifle responds best; and 20% are "encouraged by results" in coffin joints. English performance horse practitioners are most likely to use IRAP in their cases