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Lameness in Horses ASCI 221 > Treatments of Lameness > Flashcards

Treatments of Lameness Flashcards

1
Q

What do NSAIDs do?

A

Inhibit the cyclooxygenase (COX) pathway and the production of prostaglandins

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2
Q

Which NSAIDs block both COX pathways?

A

Bute
Banamine
Aspirin
Naproxen

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3
Q

Which NSAIDs only block COX-2 pathways?

A

Firocoxib (Equioxx and Previcox)

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4
Q

Bute

A

Phenylbutazone

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5
Q

What are some concerns with the use of bute?

A

renal toxicity
gastric ulcers
Perivascular necrosis with IV

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6
Q

What are some concerns with Firocoxib?

A

Expense
Loading period
Off-label use
Potency
Blocks some good prostaglandins?

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7
Q

Why do you have to be careful with the use of corticosteroids?

A

It is hard to stop the use
Can speed up cartilage damage
Do not use if an infection is suspected

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8
Q

What are the benefits of corticosteroids?

A

Pain relief
Decreased production of MMPs which degrade the matrix
Decreased interleukin-1 (IL) and tumor necrosis factor (TNF-alpha) which decreases the synthesis of matrix molecules and induces the production of MMPs

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9
Q

MMP

A

Matrix metalloproteinases

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10
Q

Disadvantages of corticosteroids (Name three)?

A

Induces severe and irreversible chondrocyte necrosis
Decreases matrix production for 3-4 months
Affects other joints
Steroid-induced laminitis
Steroid arthropathy (accelerated joint destruction)
Provide pain relief which increases joint use and damage

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11
Q

Types of Steroids

A

Methylprednisolone (Depo-medrol, Predef)
Triamcinolone (Vetalog)
Betamethasone (Celestone)

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12
Q

In what joints should Methylprednisolone be used in?

A

Low-motion joints

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13
Q

In what joints should Triamcinolone be used in?

A

High-motion joints

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14
Q

What should be added with corticosteroids for intraarticular use?

A

HA and/or antibiotics (amikacin)

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15
Q

What is Hyaluronan (HA)?

A

a type of glycosaminoglycan (long unbranched polysaccharides)

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16
Q

Where is HA normally found?

A

Articular cartilage and synovial fluid

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17
Q

What are the uses of HA?

A

Injection of HA for horses with OA
Treats synovitis (slows progression of OA)
Lubricates the joint capsule
Local anti-inflammatory and analgesic

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18
Q

PSGAGs

A

Polysulfated Glycosaminoglycans

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19
Q

What is the brand name for PSGAGs?

A

Adequan

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20
Q

What do PSGAGs do?

A

stimulates chondrocyte metabolic activity
Inhibits the effects of enzymes involved in cartilage breakdown
Stimulates HA synthesis by the synovial membrane
Anti-inflammatory and analgesic

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21
Q

PPS

A

Pentosan Polysulfate

22
Q

What does PPS come from?

A

Xylan, beechwood trees

23
Q

What is the mechanism of action in PPS?

A

Stimulates the synthesis of proteoglycans and increases their inclusion in the extracellular matrix of cartilage
Stimulates synoviocytes to produce more HA
Inhibits inflammatory mediators
Increases blood flow by preventing clogged vessels

24
Q

PAAG

A

Polyacrylamide Hydrogel

25
Q

What are PAAGs used for?

A

Viscoelastic supplement with IA use for OA
Decreases joint capsule stiffness
Creates lubrication in the joint

26
Q

Topical anti-inflammatories

A

1% diclofenac (Surpass, Voltaren)
DMSO (dimethyl sulfoxide)

27
Q

Muscle relaxer

A

Methocarbamol (Robaxin)

28
Q

Vasodilators

A

Isoxsuprine
Acepromazine

29
Q

Anti-endotoxin

A

Banamine
Plasma
Polymixin-B
Pentoxifylline

30
Q

Bisphosphonates

A

Tildren (Tiludronate disodium)
OSPHOS (Clodronate disodium)

31
Q

What are biphosphonates used for?

A

Navicular
Bone spavin (OA)
Kissing Spine

32
Q

What is the mechanism of action of bisphophonates?

A

biphosphonates encourage osteoclasts to undergo cell death which causes decreases in bone breakdown/resorption

33
Q

What are some concerns with bisphophonates?

A

Colic (shortly after administration)
Renal Toxicity (with NSAIDs)
Not tested in growing or pregnant/lactating horses
Increased bone fragility over time

34
Q

What are the additional mechanisms of action in Tildren?

A

Increases bone density short term
Inhibits the secretion of enzymes that degrade articular cartilage

35
Q

What is a concern with OSPHOS?

A

off label use in race horses

36
Q

When is cold therapy effective?

A

During the acute phase (first 24-48 hours)

37
Q

When is hot therapy effective?

A

During the chronic phase (after 48 hours)

38
Q

IRAP

A

Interleukin-1 Receptor Antagonist Protein

39
Q

What is IL-1?

A

a major inflammatory mediator that causes inflammation, cartilage breakdown, and bone resorption

40
Q

What does IRAP do?

A

IRAP competes with IL-1 for space on the receptor which blocks the inflammatory effects of IL-1

41
Q

How is IRAP made?

A

Draw blood from horse
Incubate for 24 hours in a syringe with chromium coated beads, then centrifuge and inject into joint

42
Q

What are the benefits of adult mesenchymal stem cells?

A

There is no risk of tissue rejection

43
Q

Fibronectin

A

Aids in cell migration through the area of injection

44
Q

What are the advantages of adipose stem cells

A

minimally invasive
more concentrated cells
a more diverse population of cells
1-day turn-around

45
Q

PRP

A

Platelet Rich Plasma

46
Q

How does PRP work?

A

Platelets clot and activate which release granules that form the fibrin matrix –> the fibrin matrix traps more platelets and provides the framework for fibroblast migration and adhesive glycoprotein

47
Q

HBOT

A

Hyperbaric Oxygen Therapy

48
Q

What does HBOT do?

A

Dramatically increases the amount of dissolved oxygen in plasma
Increases O2 concentration in all tissues
Stimulates angiogenesis
increases natural antioxidants and free radical scavengers
Enhances WBC action and potentiates antibiotics

49
Q

What are the uses of HBOT?

A

Acute trauma
Laminitis
Surgical incisions
Chronic non-healing wounds
Bone infections
Ligament and Tendon Injuries

50
Q

Pro-Stride

A

PRP and IRAP

Lameness in Horses ASCI 221 (5 decks)

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