b'2019 AAEP CONVENTION WRAP-UPwhy theyre important, Werpy said.Multiple imagingArthamid Vet to be the most biocompat-These sets of radiographs areproducedible with these tissues.for this reason. This ultrasound ismodalities are alwaysIn previous studies researchers have important for this reason. We put thembest when evaluatingfound Arthramid Vet integrates into soft in priority order and subtract, workingtissue through blood vessel ingrowth, backward from the budget. But Im goingthe stifle.collagen deposition, and water exchange to explain what we might miss when weDR. NATASHA WERPY with the surrounding tissue, he said, add-remove things from the list, she said. ing that integration stabilizes the joint, For example, ultrasound will revealtion as inflammation sets in and cartilageimproving load transfer. more about overall stifle health thanbreaks down. Any of you that work inThe Study De Cliffords study spanned radiographs alone. Does the joint havethis field or have arthritis yourself know11 months and included flat-racing evidence of chronic inflammation? Doesrestriction of movement in the jointThoroughbreds from a single stable in it contain debris? Is the joint capsulecapsule is a key component to the diseaseMelbourne, Australia, which had more thickened? Being able to evaluate soft tis- process, said Leigh de Clifford, BVSc,than 500 horses. The goal was to test the sue is especially relevant in this area.Cert. AVP, PGDipVPS, MVSc, of Matama- product in a controlled clinical setting, he The stifle is extremely important inta Veterinary Services, in New Zealand. said. It all took place at a single training our Western performance horses (and itIn horses this commonly leads tosite: same track, same riders, same feed, has) complicated anatomy, said Werpy.chronic and performance-limiting lame- same farrier, same management systems.Multiple imaging modalities are alwaysness. Veterinarians have a litany of OAAn independent blinded veterinarian best when evaluating the stifle.treatment options at their disposal, allidentified 29 Thoroughbreds, all in full Similarly, when imaging front feet, twooffering varying results. Those treatmentstraining, that exhibited lameness grades skyline angles (taken from the back sidetraditionally include corticosteroid andof 1-3 on the AAEPs five-point lameness of the leg from a steep angle, with thehyaluronic acid (HA) joint injections.scale (0 being sound and 5 non-weight-X ray plate in a tunnel under the foot)Another option2.5% polyacrylamide hy- bearing). De Cliffords team randomly di-are almost always better than one: Thedrogel (2.5% PAAG)is showing promise,vided the horses into three groups, and a standard view for assessing the navicularaccording to a growing body of research.second blinded vet treated the joint with:bone and a second to better visualizeHowever, no researchers had previ-Group 1: 2 mL of 2.5% PAAG;the most common site for flexor tendonously investigated 2.5% PAAGs effect inGroup 2: 12 mg of triamcinolone ace-surface erosions. However, standing MRInaturally occurring OA in a large group oftonide (TA, a corticosteroid); andexamination might be a better option ifracehorses. So de Clifford and a team ofGroup 3: 20 mg of sodium hyaluronan the purchase price of the horse justifiesresearchers set out do just that, while also(a form of HA), followed by two IV treat-the cost, said Werpy, particularly whencomparing 2.5% PAAG results to those ofments of 40 mg HA at weekly intervals.the two feet dont match on radiographs.corticosteroid and HA treatments. The study included 33 joints that exam-There are plenty of other things thatWhat is PAAG? Parents and teachersining vets identified for treatment using this applies to, she added. might recognize PAAG as a messy, water- flexion tests and radiographs. All horses When I look at things that are clini- absorbing toy in their kids science kitsrested for 48 hours after the injections cally relevant, the two categories that are(aka water jelly crystals). Its also widelybefore returning to their regular training super-easy are the ones that probablyused as a cosmetic filler (think breast orroutines. At this point all horses were at wont cause lameness and the ones thatfacial augmentation), for making contacta full-gallop stage, said de Clifford. probably will, Werpy said. The gray zonelenses, as a food packaging productThe initial veterinarian then re- is where you see multiple horses with this(flexible cold packs), and as those water-examined all the horses at Weeks 2, 4, finding, and sometimes its limiting andabsorbing beads that keep your house- and 6. He re-examined the 2.5% PAAG-sometimes it is not a problem. Its hard toplants roots moist.treated horses at Week 12. The research-make decisions about those horses.PAAGs biocompatibility in a wideers defined success as full resolution of Its important to consider performance- range of tissues lent itself to being as- the lameness grade identified at Day 0. limiting issues versus resale-limitingsessed for its ability to manage arthritis,At Week 6 the examining veterinarian issues, she said. The findings are seldomsaid de Clifford. deemed 83% of the 2.5% PAAG-treated black and white. So, as with other aspectsFor the study, his team used Arthra- horses lameness-free, compared to 27% of the prepurchase exam, the ultimatemid Vet, which is 2.5% PAAG and 97.5%of the TA-treated horses and 30% of the goal of imaging is to provide a clearersterile water. Researchers on prior studiesHA-treated horses. All successfully treated view of key areas so a buyer can decidereport that this PAAG product (which dehorses in the 2.5% PAAG group remained whether this is the right horse for theClifford noted uses a patented technol- lame-free at 12 weeks.job.Betsy Lynch ogy) is not harmful to living tissues inThe take-home is that the 2.5% humans and other animals. polyacrylamide hydrogel was found to 2.5% Polyacrylamide Hydrogel: AnNot all hydrogels are the same,be superior and longer-lasting than the Alternative OA Treatment Option he said, citing previous research thattwo conventional treatments we put it up Osteoarthritis (OA) exerts its painfulevaluated the 11 currently availableagainst in our clinical setting, de Clifford effects by decreasing joint range of mo- PAAG products. The investigators foundsaid.Michelle Andersonh52March 2020The Horse|TheHorse.comAAEPWrapUp.indd 52 2/5/20 2:54 PM'