Lecture 32 4/10/25 Flashcards by Danika Boltz

What are the general characteristics of anti-inflammatory treatments?

-meant to be used on hot/warm/inflamed musculoskeletal lesions
-used to relieve or prevent excessive inflammatory responses
-alleviate pain
-mask pain, sepsis, and deterioration
-can lead to animal abusing areas that are otherwise protected by pain

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What are the characteristics of cold hydrotherapy?

-excellent first aid for musculoskeletal lesions
-can be accomplished with turbulator boots, trash cans of water, or hoses
-typically done for 20 minutes 3 times a day
-useful for tendonitis, sprains, bucked shins

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What are the characteristics of steroids?

-have anti-phospholipase A activity
-reduce pain, edema, and leukocyte infiltration
-have anabolic effects
-want to treat at lowest dose for shortest possible time
-common to inject steroids intra-articularly

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What are the indications for steroids?

-arthritis
-allergic reactions
-chronic muscular problems

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Why are steroids reserved for “low motion” joints?

-steroids can cause cartilage degradation in joints that results in fusion
-repeated use in high motion joints can lead to unwanted fusion and decreased mobility
-fusion in low motion joints is acceptable since those joints do not normally undergo much motion

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What are the potential problems with using steroids?

-suppress anabolic processes of cartilage
-lead to cartilage degradation
-sensitize blood vessels to endogenous vasoactive compounds like epinephrine and serotonin
-can potentiate laminitis

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Which systemic steroids can be used in horses for musculoskeletal lesions?

-azium/dexamethasone
-predef
-solu-delta-cortef

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Which intra-articular steroids can be used in horses for musculoskeletal lesions?

-depo-medrol/methylprednisolone
-vetalog/triamcinolone
-betavet/betamethasone

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What are the characteristics of depo-medro/methylprednisolone?

-tends to have the most adverse effects on the chondrocytes
-has the longest acting effects (3 months) compared to other IA steroids (30 days)

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What are the characteristics of NSAIDs?

-affect the arachidonic acid cascade
-primarily inhibit cyclooxygenase
-inhibit production of thromboxane and prostaglandins (can lead to problems)

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What are the main problems with giving NSAIDs to horses?

-nephrotoxicity
-GI ulceration
-blood dyscrasia
-allergic reactions

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What are the characteristics of butazolidin/phenylbutazone?

-primarily for musculoskeletal pain
-extremely irritating if injected perivascular
-irreversibly binds to cyclooxygenase

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What are the characteristics of banamine/flunixin meglumine?

-primarily for GI/visceral pain
-good for endotoxemia
-irreversibly binds to cyclooxygenase
-can lead to clostridial myositis when given IM

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What are the characteristics of ketofen/ketoprofen?

-used for musculoskeletal and GI pain
-inhibits both cyclooxygenase and lipoxygenase
-not currently on the market

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What are the characteristics of equioxx?

-labelled for osteoarthritis
-coxib class
-targets COX2
-spares COX1; maintains blood flow to kidneys and spares gastric mucosa
-oral and VI formulations

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What are the characteristics of Surpass?

-topical NSAID
-diclofenac sodium
-apply a five-inch ribbon twice daily over the affected joint

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What are the characteristics of aspirin?

-antipyretic
-for muscular pain
-irreversibly blocks cyclooxygenase
-antiplatelet properties; used to prevent platelet aggregation

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What are the characteristics of acetaminophen?

-antipyretic
-anti-inflammatory
-for muscular pain
-COX1 and COX2 inhibitor
-similar adverse effects as other NSAIDs but not as frequent

What aer the characteristics of hyaluronic acid?

-many different products
-typically for intra-articular use
-acts as soft tissue boundary lubricant
-anti-inflammatory action
-re-establishes normal joint environment

What are the indications for hyaluronic acid usage?

-arthritis
-synovitis

What are the characteristics of adequan?

-similar to mucopolysaccharide in cartilage
-anti-inflammatory
-stimulates production of hyaluronic acid
-incorporated into cartilage to improve integrity
-does nothing for fibrocartilage

What are the indications for adequan?

-degenerative joint dz
-arthritis

What is the main complication of adequan?

can potentiate joint infections

What are the characteristics of pentosan polysulfate sodium?

-similar to adequan
-indicated in DJD and arthritis
-stimulates hyaluronic acid and glycosaminoglycan synthesis
-inhibits proteolytic enzymes
-scavenges free radicals

What are the characteristics of oral joint supplements?

-available but classified as food additive, not as a therapy -efficacy unknown; look at research for individual products -products vary

What are the characteristics of DMSO?

-anti-inflammatory -free radical scavenger -bactericidal -diuretic -analgesic -available as medical grade and non-medical grade -can be used topically, IV, oral, or intra-articular

What are the indications for DMSO?

-laminitis -arthritis -CNS trauma -septic arthritis

What is the main problem with DMSO usage?

hemolysis when given IV in a greater than 20% solution

What are the characteristics of MSM/methylsulfonyl methane?

-DMSO derivative -same properties as DMSO -classified as a food additive -indicated in DJD and arthritis

What are the types of biologic medicines?

-bone marrow concentrate -autologous conditioned serum -autologous protein solution -platelet rich plasma -alpha-2 macroglobulin -stem cells -amniotic tissue allograft

What are the methods for giving bone marrow?

-direct injection -bone marrow concentrate -ex vivo expansion

What are the characteristics of bone marrow concentrate?

-straight bone marrow can be used, but has fat and bone spicules that can lead to poor healing -centrifuged to separate regenerative cells, growth factors, and platelets out for injection -low cell counts compared to other techniques

What are the characteristics of ACS?

-may decrease lameness if injected 2 to 14 days after injury -provides IL-1Ra as well as growth factors -1 to 3 mLs injected intralesionally

What are the characteristics of APS/ProStride?

-concentrated solution of cells, platelets, growth factors, and anti-inflammatory proteins -primarily used for osteoarthritis

What are the characteristics of platelet rich plasma?

-platelets play a prominent role in wound healing -degranulation of alpha-granules releases numerous growth factors -initial burst of growth factor release occurs -contains a 3 to 5 fold increase in growth factor concentrations -associated with enhancement of healing

What are the characteristics of platelet rich plasma formulation?

-can only be made from anticoagulated blood -usually used unclotted for soft tissue injection -bovine thrombin can be used to activating clotting mechanism and form a gel for use on wounds and bone defects

What are the characteristics of alpha-2 macroglobulin?

-orthobiologic -reported to slow progression of OA -prevents cartilage breakdown and loss -utilizes patient's own blood -has receptors that bind proteases that are destructive to cartilage -effects reported to last up to a year

What are the characteristics of stem cell therapy?

-stem cells are characterized by their ability to self-renew and differentiate into multiple cell/tissue types -generally considered as being embryonic or non-embryonic in origin -available treatments for horses are autologous or allogenic and use adult mesenchymal tissue-derived stem cells

What is the mode of action for stem cells?

-applied to an injured tissue -engraft and differentiate into tissue-specific fibroblasts -produce the appropriate wound matrix

What are the general characteristics of stem cell source?

-most are from autogenous sources, but allogenic is becoming more common -current options center on donor connective tissue type and level of isolation and expansion -bone marrow aspirate and fat are currently the most practical sources

What are the characteristics of fat-derived stem cells?

-adipose-derived MSCs exhibit similar degree of multipotentiality to BM-derived MSCs -stem cells from fat are now being expanded ex-vivo

What are other sources for autogenous stem cells?

-peripheral blood -umbilical blod -skin

What are other sources for allogenic stem cells?

-embryonic -bone marrow -any other tissue by induction

What are the characteristics of RenoVo?

-liquid, acellular, equine amniotic tissue allograft -comprised of amnion and amniotic fluid -rich source of biologically active factors involved in tissue regeneration -reported anti-inflammatory, anti-bacterial, re-epithelialization, and anti-fibrotic properties