b'OA: EARLY INTERVENTIONthe other, because the treatments work inFunctional electrical stimulation (FES, different ways and can complement oneusing electrotherapy devices to stimulate another. The hope with these products issensory nerves and muscles) Oakley says that we reduce the need for or frequencythis therapy can help restore normal of joint injections.movement to the spine and decrease Intra-articular (in the joint) injections,muscle spasms that may arise because of such as corticosteroids, hyaluronic acid,OA-caused abnormal movement patterns.and regenerative products Short-termAsk your veterinarian which therapies use of corticosteroids is highly effective ashe or she typically performs and which an anti-inflammatory treatment, but re- ones might be suitable for your horse.peated use in high-motion joints can have some side effects, says Oakley. We haveIt Takes a Teamalso had success with regenerative treat- Oakley and Morettas approach to BIANCA MCCARTYments such as IRAP (interleukin-1 recep- managing early OA cases is to explore tor antagonist protein), PRP (platelet-richevery avenue. Our bottom lineis to plasma), and APS (autologous proteinconsider the whole horse, says Oakley. solution). In our clinical experience,Therapies such as laser can be effective toolsOften, when there is primary joint pain, regenerative treatments are promising,for controlling joint pain and inflammation. the horse changes his movement pattern, although they dont work quite as quicklyand you may end up with tendon or liga-as corticosteroids. We feel that regenera- reduce pain and inflammation; relievement injuries somewhere else due to a tive treatments may last longer for certainmuscle spasms; and improve nerve func- compensatory gait pattern. First you treat joint problems and may help to decreasetion and range of motion, says Moretta. the primary cause, then address ancillary the frequency of joint injections that aSpinal manipulation Moretta says sheissues.horse may need during his career.likes to use acupuncture and spinal ma- For instance, in the case of a horse Moretta and Oakley stress that innipulation in combination to try to lessenwhose movement has changed, Moretta their practice, they dont inject by thepain and restore normal biomechanics.says she and Oakley figure out why it calendar (such as every six months) but,If I can reduce inflammation and muscleoccurred, treat the pain, and utilize re-rather, based on a complete performancespasm with acupuncture, I can then usehabilitation protocols with both Western exam and appropriate diagnosis. spinal manipulation to increase rangeand integrative approaches.Laser, therapeutic ultrasound, andof motion and reduce restriction in theRehabilitation (recovering from in-shock wave therapy These are all effectivejoints, she says. We need to restore mo- juries) and prehabilitation (preventing tools for local control of pain and inflam- tion to early osteoarthritic joints. By re- injuries) are essential parts of keeping mation in the equine athlete, says Oakley. ducing inflammation quickly, you restorehorses sound and happy. Regular work Acupuncture Used as a complemen- more normal nerve function and circula- with adequate warmup and cool-downtary treatment, acupuncture might helption to the joint so it can heal faster. our sources suggest 15 to 20 minutes of walking pre- and post-workis also key. In general, lots of walking is both good prehab and rehab to stay sound, says Oakley. It is important that the horse is not a weekend warrior. Also, older athletes dont need drilling or repeti-tive work every day. They need to stay loose. They already know their jobs, so they may benefit from strength work (this varies by horse but can include ground poles, light lateral work, and walking over varied terrain) every other day.Our sources agree that keeping horses soundat any performance level involves a best practices team effort, in-cluding correct shoeing, regular turnout, appropriate weight management, and periodic soundness exams to screen for brewing subclinical issues. Its the team approach that is so important: the client/rider, the farrier, the vet, traditional and complementary medicine, says Moretta.h20January 2020The Horse|TheHorse.comOsteoarthritis USE.indd 20 12/4/19 10:28 AM'