North American Trainer - August to October 2016 - issue 41

Page 81

JOINT INJECTIONS

there were any specific reasons why joint medication with corticosteroids might be harmful to that individual, such as if there was joint infection, fractures or fissures, or laminitis. Some horses were initially included but had to be excluded after treatment began, for example if they developed additional lameness relating to another joint before the trial was finished. Horses were also excluded if they were given additional medications such as phenybutazone (bute), polysulphated glycosaminoglycans, or nutraceuticals within three weeks of the trial joint medication. The medications were injected into the injured joint in a routine manner and afterwards horses were restricted to stall rest for the day of treatment, then underwent a controlled walking exercise program for three weeks. They were then re-examined by the same vet to assess lameness and effusion scores. Three months later, the owners

completed a standardized questionnaire by phone.

How was success measured?

Clinical success rate was defined as the proportion of patients that showed > 2 grades reduction of lameness three weeks after treatment compared to pre-treatment lameness score. Dr. De Grauw also looked at reduction in lameness and effusion scores at three weeks compared to baseline, and the proportion of horses that had returned to their previous level of performance at three months.

And the results were‌

After randomization, 41 patients were assigned to the TA group and 39 to the TA plus HA group but because a few horses dropped out along the way, by the end of the three-month trial, there were 37 in the TA group and 34 in the TA plus HA

group. Lameness and effusion scores were lower at three weeks compared to baseline in both, indicating that both treatments were effective for short-term reduction of lameness and effusion. However, significantly more horses that received IA injection of TA alone were classified as treatment success after three weeks than horses receiving TA plus HA. Indeed, 35.9% in the TA plus HA group had no or only a partial response compared to 12.2% in the TA group. Despite this, by three months there was no difference found between the medication groups: around half the horses had returned to their previous level of performance, and this was 51.4% in the TA alone horses and 48.5% in the TA plus HA horses.

Adverse events

Four horses had adverse effects thought related to the drugs, three were related ISSUE 41 TRAINERMAGAZINE.COM

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