Equine Osteoarthritis Flashcards
(22 cards)
What are the major components of cartilage?
Proteoglycans and water
What are we treating in animals with OA (4)?
Mechanical stress
Inflammation of synovium
Decreased subchondral fluid viscosity
Cartilage breakdown
What are the stages of joint disease? Which is the point of no return?
What (5) tools do we have for the diagnosis of OA?
Radiographs (1st line)
Nuclear scintigraphy
Ultrasound
MRI
Arthroscopy (diagnostic or therapeutic)
What are the (6) therapeutic goals of OA treatment?
Decrease soft tissue and cartilage inflammation
Alleviate pain
Lubricate joint
Restore normal environment
Slow down disease progression
Remove inciting cause
What are the two categories of therapy for OA?
Anti-inflammatory
Chondroprotective
What is the basis of chondroprotective therapy?
Uses compounds that (1) normalizes synthesis of matrix components and (2) decreases matrix degradation to support joint structure and function
What are example of systemic therapies for OA?
NSAIDs (banamine, phenylbutazone)
PSGAGs (adequan)
Oral, slow acting agents (Cosequin, glycoflex)
What is the benefit of using Equioxx over other NSAIDs?
Safer, but more expensive
Reduced change of gastric ulceration
How do polysulfated glycosaminoglycans (adequan) work?
Stimulation of production of HA (synoviocytes)
Increases synthesis of proteoglycams and collagen by chondrocytes
Inhibit metalloproteases, cathepsins, and other degenerative enzymes
What are examples of intra-articular OA therapies?
Corticosteroids: anti-inflammatory, chondroprotective
Hyaluronan: chrondroprotective
Biological therapies
What is the MOA of corticosteroids?
Inhibitors of IL-1 and TNF-A
What are the beneficial effects of corticosteroids?
Reduce matrix MMP activity in vivo
Inhibit synthesis of MMP activators (plasminogen activator or plasmin)
Decrease WBC migration, fibrin deposition
Stabilize enzymes
What are the detrimental effects of corticosteroids?
GAG depletion
Suppressed collagen and HA synthesis
Laminitis
Steroids arthropathy
What is the half-life and quantity used of Triamcinolone Acetonide (Vetalog)?
1-5d
6-9mg/joint, 18mg total
What is the half-life and quantity used of Methylprednisolone Acetate (Depomedrol)?
1 month
40-60mg/joint
120mg total
When should you avoid using methylprednisolone?
In high movement joints
Never into healthy joints
What is the half-life and quantity used of Betamethasone?
Medium duration
2-40mg/joint
100mg total
What is the best first-line corticosteroid?
Triamcinalone
What are 2 possible complications of arthroscopy/joint injections?
Joint “flare” = acute inflammation
Joint infection
Hyaluronan
Non-sulfated GAG
Important component of the articular cartilage matrix
Synovial fluid viscosity
Sodium Hyaluronan
Greatest effects in treatment of acute synovitis
May have enhanced effects when combined with low dose steroids
