Page 3 - Randlab TechTalk Newsletter Issue 2

RANDLAB TechTalk 43
Recommended Medication for Joint Disease (based on using HA 10mg/mL)
• IV: 2 or 4mL once weekly or 1-2 days prior to event (ensure compliance with event rules)
And/or
• IA: 2mL alone or in combination with steroids (as noted in key points)
FIGUre 3: Sterile technique should always be used for intra-articular administration of HA, especially when used in combination with corticosteroids.
Given recent changes to the Australian rules of racing
in regard to the use of intra-articular medication with corticosteroids close to race time, more attention is being given to medicating joints using HA alone, which is not impacted by these changes.
Careful case selection is one of the keys to ensuring the best results are obtained when using hyaluronic acid, either with or without corticosteroids. Those cases with severe clinical and radiographic signs will of course respond the least, particularly in the short term, while those cases that have primary synovitis or low grade inflammatory joint disease are the best candidates for HA therapy.
Intravenous HA therapy works best in horses with low-grade joint disease particularly where multiple
joints are affected or if close to competition. Frequently 20 to 40 mg is given IV 24 to 48 hours before any strenuous athletic activity and can have a significant anti- inflammatory effect on joint disease.
Horses following joint surgery for traumatic arthritis can also benefit greatly from regular HA treatment, either intra-articularly and/or intravenously starting 1 to 3 weeks following surgery. My regular protocol following carpal or fetlock arthroscopic surgery in athletic horses is to administer 20 mg of HA into each affected joint any time from 1 to 3 weeks post operatively and then every 3 to 4 weeks for a total of four treatments.
The beneficial effects of combining corticosteroids with the intra-articular administration of HA has been well documented. Most commonly triamcinolone is added in the same syringe. For most joints 10mg triamcinolone and 10-20 mg HA is adequate. For larger joints, such as a stifle or shoulder, then 20 mg HA and up to 40 mg triamcinolone can be used if injecting a single joint.
HA without corticosteroids
can provide significant anti- inflammatory and analgesic effect to joints.
FIGUre 4: Horses following joint surgery for traumatic arthritis will also benefit greatly from regular HA treatment, either intra-articularly and/
or intravenously. Generally 20 mg of HA is given into each affected joint starting 1-3 weeks following surgery and then every 3 to 4 weeks.
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