Page 912 - Adams and Stashak's Lameness in Horses, 7th Edition
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878   Chapter 8


            progression of OA; their effect was also measured at a   chronic back soreness secondary to pain associated with
            dose lower  than what’s required  to inhibit bacterial   the axial skeleton or as a component of multimodal
  VetBooks.ir  that orally administered doxycycline was able to pene-  and opiate treatment. Dosages range from 5 to 20 mg/kg
                                                               analgesia for musculoskeletal pain refractory to NSAID
            growth.  Follow‐up work from the same group reported
                   19
                                                               PO two to three times daily with dosages being titrated
            trate  and accumulate within  the  synovial fluid,  and
                                                      62
            when administered to horses orally at 5 mg/kg every 24   to effect. 37
            hours  for  four  doses,  synovial  fluid  obtained  from   Manufacturer’s Details
            treated horses had significantly reduced MMP‐13       a Osphos , Dechra  Veterinary  Products,  Overland
                                                                         ®
            expression.  At that time, the authors supported the use   Park, KS.
                      47
            of doxycycline as a disease‐modifying drug for OA. 47
                                                               References
            ESTROGEN
                                                                 1.  Aghighi SA, Tipold A, Piechotta M, et al. Assessment of the effects
              Estrogen therapy has been used to treat intermittent   of adjunctive gabapentin on postoperative pain after interverte-
            upward fixation of the patella in horses.  It has been   bral disc surgery in dogs. Vet Anaesth Analg 2012;39:636–646.
                                                17
                                                                  doi:10.1111/j.1467‐2995.2012.00769.x.
            hypothesized that estrogen affects muscle cell metabo-    2.  Amanat N, Brown R, Bilston LE, et al. A single systemic dose of
            lism and muscle tone leading to the anecdotal benefit   pamidronate improves bone mineral content and accelerates res-
            sometimes reported. However, no studies currently     toration of strength in a rat model of fracture repair. J Orthop Res
            exist examining whether this therapy is beneficial as   2005;23:1029–1034. doi:10.1016/j.orthres.2005.03.004.
            a  medical treatment.  Recommended  therapy is  1 mg     3.  Andrews JL, Sutherland J, Ghosh P. Distribution and binding of
            of  estradiol cypionate IM for every 45 kg of body    glycosaminoglycan polysulfate to intervertebral disc, knee joint
                                                                  articular cartilage and meniscus. Arzneimittelforschung 1985;35:
                                                           17
            weight (i.e. 11 mg/500 kg) once weekly for 3–5 weeks.    144–148.
            Concurrent anti‐inflammatories along with exercise to     4.  Arvin KL, Han BH, Du Y, et al. Minocycline markedly protects the
            strengthen the quadriceps muscles are usually recom-  neonatal brain against hypoxic‐ischemic injury.  Ann Neurol
                                                                  2002;52:54–61. doi:10.1002/ana.10242.
            mended as well.                                      5.  Bauss F, Schenk RK, Hort S, et al. New model for simulation of
                                                                  fracture repair in full‐grown beagle dogs: model characterization
                                                                  and results from a long‐term study with ibandronate. J Pharmacol
                                                                  Toxicol Methods 2004;50:25–34. doi:10.1016/j.vascn.2003.11.003.
            METHOCARBAMOL (ROBAXIN)                              6.  Bowman S, Awad ME, Hamrick MW, et al. Recent advances in
              Methocarbamol, marketed under the trade name        hyaluronic acid based therapy for osteoarthritis. Clin Transl Med
                                                                  2018;7:6. doi:10.1186/s40169‐017‐0180‐3.
            Robaxin in the United States and Canada, is a centrally     7.  Brandt KD, Mazzuca SA, Katz BP, et al. Effects of doxycycline on
            acting muscle relaxant commonly prescribed for various   progression  of  osteoarthritis:  results  of  a  randomized,  placebo‐
            inflammatory and traumatic muscle disorders and to    controlled, double‐blind trial.  Arthritis Rheum 2005 52:2015–
            treat  muscular  spasms  in  the  horse.   Methocarbamol   2025. doi:10.1002/art.21122.
                                            42
            produces variable results, but it seems to be most benefi-    8.  Burba DJ, Collier MA, Default LE, et al. In vivo kinetic study on
                                                                  uptake and distribution of intramuscular tritium‐labeled polysul-
            cial in horses that are prone to rhabdomyolysis or back   fated glycosaminoglycan in equine body fluid compartments and
            soreness secondary to musculoskeletal disease of the   articular cartilage in an osteochondral defect model. J Equine Vet
            axial skeleton or hind limbs. At our hospital, methocar-  Sci 1993;13:696–703.
            bamol is commonly prescribed in conjunction with     9.  Caldwell FJ, Mueller PO, Lynn RC, et al. Effect of topical applica-
                                                                  tion of diclofenac liposomal suspension on experimentally
            gabapentin in horses with suspected axial skeleton dis-  induced subcutaneous inflammation in horses.  Am J  Vet Res
            ease with associated secondary epaxial muscle sensitiv-  2004;65:271–276.
            ity. Horses are treated for 4–8 weeks, while IA therapy   10.  Caron JP. Intra‐articular injections for joint disease in horses. Vet
            (articular process joints, sacroiliac joint, etc.) is allowed   Clin North  Am Equine Pract 2005;21:559–573. doi:10.1016/j.
                                                                  cveq.2005.07.003.
            time to improve the horse’s comfort. Previous publica-  11.  Clegg PD, Jones MD, Carter SD. The effect of drugs commonly
            tions have reported a dose range of 4.4–55  mg/kg.    used in the treatment of equine articular disorders on the activity
                                                           42
            While an IV formulation can be obtained, oral tablets   of equine matrix metalloproteinase‐2 and 9. J Vet Pharmacol Ther
            are now available for use in veterinary medicine.     1998;21:406–413.
                                                               12.  Cohen SB. An update on bisphosphonates. Curr Rheumatol Rep
                                                                  2004;6:59–65.
                                                               13.  Coudry V, Thibaud D, Riccio B, et al. Efficacy of tiludronate in the
            GABAPENTIN                                            treatment of horses with signs of pain associated with osteoar-
                                                                  thritic lesions of the thoracolumbar vertebral column. Am J Vet
              Gabapentin, an analog of  γ‐aminobutyric acid       Res 2007;68:329–337. doi:10.2460/ajvr.68.3.329.
            (GABA), has been  shown to have analgesic  effects   14.  Delguste C, Amory H, Doucet M, et al. Pharmacological effects of
            through modulation of voltage‐gated calcium ion chan-  tiludronate in horses after long‐term immobilization. Bone
                                                                  2007;41:414–421. doi:10.1016/j.bone.2007.05.005.
            nels.  It is used as an antiepileptic medication and for   15.  Denoix JM, Thibaud D, Riccio B. Tiludronate as a new therapeu-
                28
            the treatment of neuropathic and chronic pain in      tic agent in the treatment of navicular disease: a double‐blind pla-
            humans.  Very little data exists to support its analgesic   cebo‐controlled clinical trial. Equine Vet J 2003;35:407–413.
                   67
            properties  in animals, 1,9,61  although  small numbers  of   16.  Dutton DW, Lashnits KJ, Wegner K. Managing severe hoof pain in
                                                                  a horse using multimodal analgesia and a modified composite
            case reports have found it beneficial as one component   pain score. Equine Vet Educ 2009;21:37–43. doi: 10.2746/095777
            of multimodal analgesia for head shaking in temporohy-  308X382669.
            oid  osteoarthropathy  (THO)  and  for  chronic  pain  in   17.  Dyson SJ, Ross MW. Diagnosis and Management of Lameness in the
                                                                  Horse, 2nd ed. Ross MW, Dyson SJ, eds. Elsevier, 2001;555–563.
            cases of laminitis. 16,59                          18.  Ferris DJ, Frisbie DD, McIlwraith CW, et al. Current joint therapy
              At our hospital, gabapentin is most commonly pre-   usage in equine practice: a survey of veterinarians 2009. Equine
            scribed in conjunction with methocarbamol to combat   Vet J 2011;43:530–535. doi:10.1111/j.2042‐3306.2010.00324.x.
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