Page 880 - Adams and Stashak's Lameness in Horses, 7th Edition
P. 880
846 Chapter 7
and blood and urine fluorine levels can usually eliminate 3. Auer JA. Surgical equipment and implants for fracture repair. In
fluorosis as the cause. Lateral radiographs of the chest Equine Fracture Repair, 1st ed. Nixon AJ, ed. W.B. Saunders Co.,
Philadelphia, 1996;52–62.
VetBooks.ir Effects of Medications on Bone 4. Auer JA, Watkins JP. Instrumentation and techniques in equine
or abdomen may help locate the causative lesion.
fracture fixation. Vet Clin North Am Equine Pract 1996;12:
283–302.
chondral bone pathological changes in the distal metacarpi/meta
Recent research and development have demonstrated 5. Bani Hassan E, Mirams M, Mackie E, et al. Prevalence of sub
tarsi of racing Thoroughbred horses. Aust Vet J 2017;95:362–369.
the effects of various medications on bone metabolism and doi:10.1111/avj.12628.
bone healing. The two most investigated medication groups 6. Baxter GM. Subchondral cystic lesions in horses. In Joint Disease
recently have been nonsteroidal anti‐inflammatories in the Horse. McIlwraith CW, Trotter GW, eds. W.B. Saunders Co.,
and bisphosphonates. Philadelphia, 1996;384–397.
Nonsteroidal anti‐inflammatory medications 7. Baxter GM. Treatment of orthopedic infections in horses. Vet Clin
North Am Equine Pract 1996;12:303–336.
(NSAIDs) are commonly used in horses to manage inflam 8. Blackwell JC, Griffith AD, Crosby WJ. Surgical correction of an
mation and the pain from a variety of sources. They are alveolar mandibular bone cyst. Equine Pract 1985;7:70–73.
also used commonly to manage pain post‐fracture and 9. Blood DC, Henderson JA, Radostits OM. Veterinary Medicine.
Lea and Febiger, Philadelphia, 1979.
fracture repair. However, there has been work to show 10. Booth LC, Feeney DA. Superficial osteitis and sequestrum forma
that NSAIDs can have a negative effect on bone healing, tion as a result of skin avulsion in the horse. Vet Surg 1982;11:2.
especially the “osteo‐immunologic” cascade that is respon 11. Bramlage LR. Current concepts of emergency first aid treatment
sible for appropriate bone remodeling. By reducing the and transportation of equine fracture patients. Comp Cont Educ
64
Pract Vet 1983;5:S564–S574.
inflammatory component of bone healing, a key signal 12. Bramlage LR. Osteochondrosis related bone cysts. Am Assoc
ing component is compromised, thus delaying bone heal Equine Pract Ann Convent 1993;39:83–84.
ing. This has been demonstrated in several experimental 13. Bramlage LR. First aid and transportation of fracture patients In
models, including one study in the horse. Specifically, Equine Fracture Repair. Nixon AJ, ed. W.B. Saunders Co.,
Philadelphia, 1996;36–42.
mineral apposition rate was reduced in horses adminis 14. Bueno AC, Galuppo LD, Taylor KT, et al. A biomechanical com
tered phenylbutazone. However, severe inflammation parison of headless tapered variable pitch and AO cortical bone
95
can impede bone and soft tissue healing, requiring signifi screws for fixation of a simulated slab fracture in equine third
cant anti‐inflammatory therapy to overcome. The thresh carpal bones. Vet Surg 2003;32:167–177.
old at which NSAIDs should be used has not been 15. Campanacci M, Capanna R, Picci P. Unicameral and aneurysmal
bone cysts. Clin Orthop Relat Res 1986;204:25–36.
determined. 16. Colgan SA, Hecker AT, Kirker‐Head CA, et al. A comparison of the
Bisphosphonate therapy emerged on the equine mar Synthes 4.5‐mm cannulated screw and the Synthes 4.5‐mm standard
ket several years ago as a means of treating lytic lesions cortex screw systems in equine bone. Vet Surg 1998;27:540–546.
50
in the bones of horses. Bisphosphonates act to inhibit 17. Coudry V, Thibaud D, Riccio B, et al. Efficacy of tiludronate in the
osteoclast production and function. Tiludronate was ini treatment of horses with signs of pain associated with osteoar
thritic lesions of the thoracolumbar vertebral column. Am J Vet
tially marketed for equine use and shown in small clini Res 2007;68:329–337. doi:10.2460/ajvr.68.3.329.
cal studies to be effective in managing pain in horses with 18. David JB, Cohen ND, Nachreiner R. Equine secondary hyperpar
caudal heel pain, bone spavin, and back pain. 17,20,33,74 The athyroidism. Comp Cont Educ Pract Vet 1997;19:1380–1386.
Freedom of Information report for approval of til 19. Davidson EJ, Ross MW. Clinical recognition of stress‐related bone
injury in racehorses. Clin Tech Equine Pract 2003;2:296–311.
udronate in the United States shows that it had a positive 20. Denoix JM, Thibaud D, Riccio B. Tiludronate as a new therapeu
effect on improving lameness by one grade in horses tic agent in the treatment of navicular disease: a double‐blind pla
diagnosed with caudal heel pain. 120,121 Clodronate later cebo‐controlled clinical trial. Equine Vet J 2003;35:407–413.
emerged on the market, and it too showed ability 21. Denoix J‐M, Jeffcott LB, McIlwraith CW, et al. A review of termi
nology for equine juvenile osteochondral conditions (JOCC)
to improve lameness in horses with caudal heel pain. based on anatomical and functional considerations. Vet J
However, the exact mechanism by which bisphospho 2013;197:29–35. doi:10.1016/j.tvjl.2013.03.038.
nates work in horses is unknown. It is likely that they 22. Dodd DC, Raker CW. Tumoral calcinosis (calcinosis circum
possess significant anti‐inflammatory properties by scripta) in the horse. J Am Vet Med Assoc 1970;157:968–972.
which the action occurs, and the anti‐osteoclastic effect 23. Dutton DM, Watkins JP, Walker MA, et al. Incomplete ossifica
tion of the tarsal bones in foals: 22 cases (1988‐1996). J Am Vet
has minimal clinical impact. Regardless of the therapeu Med Assoc 1998;213:1590–1594.
tic effects, there is concern about potential negative 24. Dykgraaf S, Firth EC, Rogers CW, et al. Effects of exercise on
effects on young horses and the normal bone remodeling chondrocyte viability and subchondral bone sclerosis in the distal
cascade that is necessary for physical adaptation to train third metacarpal and metatarsal bones of young horses. Vet J
2008;178:53–61.
ing. The AAEP has produced a white paper concerning 25. Eagle MT, Koch DB, Whalen JP. Mineral metabolism and immo
the suggested use of bisphosphonates in horses, and the bilization osteopenia in ponies treated with 25‐hydroxycholecal
FDA has regulated that they should only be used in ciferol. Cornell Vet 1982;72:372.
horses older than 4 years of age. 26. Ellis DR. Fractures of the proximal sesamoid bones in thorough
bred foals. Equine Vet J 1979;11:48–52.
27. Farnum CE, Wilsman NJ. Ultrastructural histochemical evalua
tion of growth platecartilage matrix from healthy and osteochon
dritic swine. Am J Vet Res 1986;47:1105–1115.
References 28. Field JR, Hearn TC, Arighi M. Investigation of bioabsorbable
screw usage for long bone fracture repair in the horse: interfrag
1. Anderson JD, Galuppo LD, Barr BC, et al. Clinical and scinti mentary compression and axial load response in equine cadaver
graphic findings in horses with a bone fragility disorder: 16 cases long bone fractures. Vet Clin Orthop Trauma 1995;8:191–205.
(1980‐2006). J Am Vet Med Assoc 2008;232:1694–1699. 29. Firth EC. Specific orthopedic infections In Equine Surgery. Auer
2. Andrea CR, Stover SM, Galuppo LD, et al. Comparison of inser JA, ed. W.B. Saunders Co, Philadelphia, 1992;932.
tion time and pullout strength between self‐tapping and non‐self‐ 30. Frank N, Hawkins JF, Couetil LL, et al. Primary hyperparathy
tapping AO 4.5‐mm cortical bone screws in adult equine third roidism with osteodystrophia fibrosa of the facial bones in a pony.
metacarpal bone. Vet Surg 2002;31:189–194. J Am Vet Med Assoc 1998;212:84–86.