Page 364 - The Veterinary Care of the Horse

achieved in selected cases by chiropractic or osteopathic treatment from a skilled practitioner

with veterinary permission.
VetBooks.ir Corrective farriery

Where foot imbalance is considered to be a contributory factor in the development of joint

disease, this should be addressed. With painful lower-limb joints, shortening or squaring-off
the toe brings the breakover point of the stride further back and can reduce the discomfort.

Topical applications

Dimethyl sulphoxide (DMSO) may be used on its own or with corticosteroids as a topical
application to reduce inflammation and oedema following joint injury. It is also reported to

reduce pain and fibrosis.

Topical NSAIDs in the form of gels are used in man. These preparations, rubbed into the
skin over painful joints are now available for equine use.

Surgical management of joint disease

With increased use of arthroscopy, joint problems are being diagnosed earlier in the course of

the disease. Damage to the articular cartilage can be seen and treated before it shows up on
radiographs. Surgical treatments include the following.
• Joint lavage. This technique involves flushing the joint out to remove debris from

cartilage breakdown and the harmful inflammatory mediators that lead to ongoing

cartilage destruction.
• Removal of cartilage fragments attached to the joint surface that have developed as a

result of injury or developmental problems (Figure 8.8)
• Fracture repair or removal of bone fragments.

• Arthrodesis. This is a procedure that can be used in some cases when the pain from

degenerative joint changes cannot be relieved by management or medication. It is
sometimes recommended for certain joints that have relatively little movement including

the proximal interphalangeal (pastern) or distal tarsal (hock) joints. The cartilage surface
of the joints is surgically removed and the opposing bones are held together with plates
and screws in the same way as a fracture. If the operation is successful, the bones fuse

and the horse may become pain free. Fusion of the bones is known as ankylosis. Whether
or not the horse can return to work depends on which joint is involved and the level of