Presented by Dr. Lisa Fortier, Cornell University College of Veterinary Medicine, and recorded on Tuesday, October 15th via Zoom.

Intra-articular injections in horses are commonly performed with a multitude of justifications including the perceived source of pain, stiffness, poor performance, routine maintenance, radiographic changes, effusion, or post-operative care. There are numerous products available for injection including corticosteroids, autologous biologics, and polyacrylamide hydrogels, with new products constantly emerging for consideration. To determine which product to use when, it is important to have a current understanding of osteoarthritis (OA).

It has been known for decades that osteoarthritis is an inflammatory disease and therefore mediated by the immune system. OA is not an auto-immune disease like rheumatic arthritis, but there is clear involvement of immune in the initiation and perpetuation of OA. Inflammation in the joint follows that classic cascade of injury/inflammation with primarily neutrophil involvement, followed by cell proliferation and matrix remodeling during tissue formation with an influx of macrophages and monocytes, and finally cell differentiation with tissue remodeling with a predominance of T cells. All of this happens at the level of the synovial membrane where the inflammatory cells originate and infiltrate the joint fluid. Cartilage is an innocent bystander.

Therefore, medications/products for intra-articular use should target immune cells in the joint capsule or synovial fluid. Finally, all phases of inflammation are important; the goal is not to eliminate inflammation, but to ensure that the joint passes through each phase and doesn’t linger in any one phase which would lead to prolonged inflammation, tissue disorganization and scarring with loss of function. Categories of joint medications will be discussed from the lens of OA in an inflammatory disease of the joint capsule.

Read more: Intra-articular Approaches to Osteoarthritis - Cornell Equine Seminar (Oct 2024)

Troubleshooting Tricky Rides

by Susanna Wright

Horses are living creatures, like people, and will have good days and bad days. When your horse is having an “off” day, how do you determine what to do?

Say you have a horse who is normally mellow and easy-going, but today he surprises you with a buck while you’re riding. This could be caused by several different things, such as fear, pain or discomfort, a miscommunication in training or riding, or a behavioral issue.

These varying causes each warrant different responses, so it is important to be able to distinguish them.

Fear

As discussed in prior lessons, horses are prey animals that rely on a group or herd for safety.

If one horse in a group spooks or has a fear response, others will pick up on that and may react as well. This level of intuition and responsiveness has helped horses survive for thousands of years.

It is ingrained in equine DNA.

Unfortunately, this sensitivity extends to you, the rider/handler as well. If you are nervous, anxious, or scared, your horse will likely pick up on that.

Some horses will be more affected by a rider’s fear than others.

For example, a lesson horse may be pretty numb to typical beginner fear responses, but a high-strung, green horse may be more affected, thus requiring a more confident rider.

Need help managing your anxiety around horses? Check out the Facing Your Fears online course from our friends at Inspired Riding.

If your horse is acting up in a fear response, evaluate the situation.

Is it something you can control?

For example, if your horse is spooking at a plastic bag blowing across the arena, dismount and secure the object.

It doesn’t hurt to let the horse look at it and determine for him/herself that it isn’t going to eat them.

Remember, horses have better vision using both eyes, so it can be helpful to turn them to face the scary object and view it with binocular vision.

Pain

Pain can be a trickier cause to pinpoint.

First and foremost, if you believe your horse is injured or ill, immediately call your vet. It is best to involve a professional early on for the best long-term prognosis!

Enlisting the help of your vet to rule out a physical problem can be helpful in diagnosing the underlying cause.

Poor tack fit could cause a pain response.

For example, if your saddle is too narrow, it could pinch the withers.

If your headstall isn’t adjusted correctly, it could pinch the horse’s ears or cause the bit to sit incorrectly in the horse’s mouth.

Did you check your saddle pad before putting it on the horse? A burr or pokey object could cause irritation under the saddle.

Fortunately, tack fit issues are relatively easy to identify and fix.

Physical pain such as lameness can be more difficult to diagnose. While grooming your horse, always look for swelling, cuts, scrapes, or other signs of trauma or discomfort.

Colic can come on suddenly and cause a drastic change in behavior. Be alert to signs such as unusual sweating, pawing, panting, or biting at the abdomen.

Again, consult your veterinarian with questions if you think something is wrong. It is always helpful to have a physical examination done to rule out illness or injury as the cause of a problem.

Miscommunication

Horses do not all have the same buttons. For example, squeezing your heels against the horse’s sides may be a command to go faster, or it could be a command to stop depending on that horse’s training.

Even horses within the same barn could have different “buttons.”

A lazy horse may need more leg, while a more spirited mount may simply need the slightest bump to speed up. Work with a trainer to ensure you and your horse are speaking the same language.

Learn more about how to speak your horse’s language in Open Communications With Your Horse, an online course from Equestrian Movement.

Behavioral Issue

If you have ruled out fear, pain, and communication errors, you may be dealing with a behavioral issue. This category can be one of the most difficult to diagnose.

A few examples of behavioral issues include:

Speeding up when heading back to the barn. Some horses get “barn sour” and will refuse to leave the barn, or may take advantage of a timid rider and bolt back towards the barn.

This can generally be corrected with some retraining and the help of a strong rider.

Laying down in the arena. One particularly lazy horse learned if she laid down, her beginner rider would dismount and give up.

This behavior was quickly fixed with the help of an assertive rider who made the horse work even harder after pulling this kind of stunt. The horse quickly learned she would be better off, and get to stop working faster, if she behaved.

Biting when the girth is tightened. First, work with your trainer and vet to ensure that the response is not caused by actual pain or injury, and your equipment fits and is appropriate for your horse.

Next, tie the horse so that you are not in danger of being bitten.

Then, watch your horse’s reaction as you tighten the girth. If the horse tries to reach around and nip, do NOT release the pressure! That simply teaches the horse that negative behavior works. Instead, keep applying slow, steady pressure.

Only release it when the horse displays the correct behavior—calmly and nicely accepting the girth.

Repetition is key—you generally won’t fix a problem in one session. Being consistent and fair will help eliminate this particular behavior over time.

Remember that every time you interact with your horse, you are training them.

Be fair and consistent with your interactions.

Parting Thoughts

Identifying the root cause of an issue can be a lengthy, complicated process. Keep a mental (or physical) checklist of what may be responsible for an issue, and work through each possible cause from most obvious to least obvious.

By using the process of elimination, you can help pinpoint the root cause.

Don’t hesitate to enlist the help of your vet or trainer.

Remember the safety of you and your horse is important—unfortunately, pain, fear, and behavioral responses put both you and your horse at a higher risk of injury. Keep safety front-of-mind and ask for help if you need it.

This article originally appeared on Horse Rookie and is published here with permission.

You can read more interesting articles in our section on Health & Education.