Page 880 - Adams and Stashak's Lameness in Horses, 7th Edition
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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.
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