Understanding and alleviating osteoarthritis in horses: What really helps

What is osteoarthritis? 

➡️ Video tip: Understanding and recognizing osteoarthritis in horses - This video clearly explains how osteoarthritis develops in horses, what symptoms indicate it and how synovial fluid and cartilage degradation affect mobility. A must for horse owners to recognize warning signs in good time and ensure their horse's well-being!

Osteoarthritis in horses is a chronic joint disease in which the cartilage between the joints gradually breaks down. The articular cartilage forms a thin, elastic layer between the ends of the bones and serves as a natural shock absorber during movement. The suppleness of the joints is supported by the synovial fluid - also known as synovia. This fluid lubricates the joint and supplies the cartilage with important nutrients such as hyaluronic acid.

During healthy movement, the synovial fluid is distributed throughout the joint, lubricating the cartilage and supplying it with nutrients. In osteoarthritis, however, this process no longer functions smoothly. If the horse moves too little or the warm-up phase is too short, the cartilage does not receive enough synovia. As a result, it loses its elasticity and becomes more susceptible to damage.

As a result of the lack of synovial fluid, the cartilage suffers from a nutrient deficiency, which gradually wears away the cartilage layer. The consequences are serious: the joint can become inflamed, leading to acute arthritis. As the cartilage degradation progresses, in the worst case the bones rub directly against each other, which is extremely painful for the horse and causes lameness. These recurring inflammations eventually lead to chronic joint inflammation - the actual osteoarthritis. In addition, bone formations (osteophytes) can develop, which make the joint stiffer as the joint space narrows.

Types of osteoarthritis

The different types of osteoarthritis can affect different joint areas and cause specific symptoms and limitations depending on their location. The following overview shows the most common forms of osteoarthritis in horses and their characteristic features

Osteoarthritis causes

Osteoarthritis is often seen as a symptom of old age, as older horses are often affected by long-term stress on the joints. However, osteoarthritis can also occur in young horses and is often caused by a combination of overloading, injury and lack of exercise.

Signs of age and wear

With increasing age, the joints become worn due to long-term stress, which accelerates cartilage degradation. This mainly affects older horses.

Injuries and overloading

• Acute arthritis: Acute joint inflammation often precedes chronic osteoarthritis. This can be triggered by injuries, tendon damage or bone fractures that lead to incorrect loading.
• Resting postures: Pain in one leg, for example due to injury, often leads to the other leg being overloaded, which damages the joints.

Malpositions and hoof problems

Incorrect hoof trimming or congenital hoof malpositions lead to incorrect loading and can promote osteoarthritis in the long term.

Obesity and feeding

Being overweight increases the strain on the joints enormously. Almost half of leisure horses are classified as overweight, which increases the risk of osteoarthritis and also promotes metabolic diseases such as laminitis.

Early stress in young horses

Horses are not fully grown until they are around six years old. Young horses that are intensively trained too early - for example by lunging on tight circles, jumping or dressage - risk damage to their immature joints.

Lack of exercise

In contrast to overloading, a lack of exercise also leads to problems: Without regular movement, the synovial fluid is not distributed sufficiently, the cartilage remains undernourished and dries out more quickly, which makes the joint stiffer and more susceptible.

Symptoms of osteoarthritis in horses

There are various symptoms that can indicate osteoarthritis in horses. These signs occur frequently:

• "Running in": If the horse shows a clammy or even lame gait at the beginning of a riding session, which improves after a short time, this is a typical sign of osteoarthritis.
• Lameness: Recurrent or persistent lameness, especially after exercise.
• Swollen joints: Swelling of the affected joints is a common symptom.
• Difficulty standing up and lying down: Horses with osteoarthritis often have difficulty lying down or standing up.
• Frequent stumbling: Stumbling occurs more frequently, especially off-road or when walking fast.
• Bile in the joints: These accumulations of fluid in the joints indicate inflammation.
• Reluctance to move: Affected horses often show little motivation to move and appear stiffer overall.
• Weather-dependent symptoms: Pain and lameness can increase in cold, damp weather. The cold slows down the metabolism and makes the synovial fluid (joint fluid) more viscous.

Diagnosis of osteoarthritis

➡️ Video tip: Diagnosing osteoarthritis in horses - This video shows step by step how osteoarthritis can be diagnosed in horses. It explains typical examination methods such as lameness analysis, imaging procedures (X-ray, ultrasound, MRI) and the importance of joint fluid analysis.

If osteoarthritis is suspected, a vet should be consulted immediately. The vet will first examine the horse at a walk and trot on different surfaces and check the mobility of the joints. Systematic anesthesia (conduction anesthesia) is also often performed, in which certain sections of the horse's leg are anesthetized one after the other. After each anaesthetic, a lameness analysis is carried out to precisely localize the source of the pain.

Various imaging procedures are available for a detailed diagnosis. X-rays, ultrasound, computer tomography (CT) and MRI offer different advantages depending on the case. In some cases, a diagnostic arthroscopy may also be useful. Here, the horse is placed under general anesthesia and the affected joint is filled with a saline solution to create sufficient space for a precise examination. An arthroscope with a camera allows the surgeon to look directly into the joint and analyze damage to the cartilage in detail. After the examination, the fluid is removed again.

Scintigraphy can also be helpful in detecting very early changes in bone metabolism. A small amount of radioactive substance is injected, which accumulates in the bones and becomes more concentrated in damaged areas. This allows problem areas to be detected before they are visible on an X-ray.

➡️ Video tip on scintigraphy: How does scintigraphy work in horses? - This video shows how scintigraphy works, when it is useful and how it helps to detect osteoarthritis and other bone problems at an early stage. A helpful insight for horse owners who want to learn more about this procedure and its benefits!

Costs and procedure of scintigraphy

Scintigraphy is a helpful but cost-intensive procedure. According to the current scale of fees for veterinarians (GOT), a scintigraphy alone costs at least 460 euros. This does not include additional costs for the hospital stay, sedation and any follow-up treatment.

The procedure is also time-consuming: The injected drug takes around two hours to process in the body before the actual examination - which takes another hour or more - can be carried out. As the horse has to stand absolutely still during the scans, it is sedated and the shoes on its front legs have to be removed. A scintigraphy should therefore be carefully considered.

The overall diagnostic method required depends on the severity, localization and visibility of the osteoarthritis.

Treatment options for osteoarthritis

As osteoarthritis in horses cannot be cured, treatment aims to keep the horse pain-free for as long as possible and improve its quality of life. The earlier the disease is detected, the better the chances of successful treatment. In acute phases, anti-inflammatory and pain-relieving medication alleviates the symptoms.

Hyaluronic acid injections

A frequently used method is the injection of hyaluronic acid, either directly into the joint or intravenously. Hyaluronic acid is a natural component of the synovial fluid (synovia) that lubricates the joint and neutralizes inflammatory mediators. In severe cases, cortisone can also be administered to inhibit inflammation. In cases of more severe damage, high molecular weight hyaluronic acid or a combination preparation of high and low molecular weight hyaluronic acid is often used to form a long-lasting, protective film around the joint. Hyaluronic acid can also be administered via the feed to increase the hyaluronic acid level in the blood and provide the joint with a better supply.

Autologous blood therapy (IRAP/ACS)

Treatment with autologous blood is a modern and expensive approach that originally comes from human medicine. Blood is taken from the horse, which is processed and concentrated using special procedures. The substances in the processed serum can reduce the breakdown of cartilage and promote regeneration. The so-called IRAP (interleukin receptor antagonist protein) or ACS (autologous conditioned serum) is particularly effective in osteoarthritis, as it blocks the cytokines that drive cartilage degradation. This treatment is usually repeated two to five times and costs up to 1000 euros.

Therapeutic arthroscopy

Arthroscopy is used both diagnostically and therapeutically for osteoarthritis. During this procedure, the cartilage surface is smoothed and loose fragments are removed. Arthroscopy is often used for joint chips. However, its benefit in osteoarthritis is controversial, as a study in human medicine showed no significant improvement compared to no treatment.

Special fitting

A specially made shoe can help to relieve pressure on the joints. If the horse is to run barehoof, regular and professional treatment is required to prevent misalignments and protect the joints.

Alternative methods

In addition to traditional therapies, many horse owners rely on alternative methods:

• Leech therapy: Leeches are used to suck blood. This is said to have an anti-inflammatory effect.
• Acupuncture: Long, thin needles are inserted into the affected regions to release blockages in the energy flow.
• Therapy gaiters with ceramic fibers: These gaiters can have a supportive effect and improve well-being.

Alternative methods should always be seen as supportive measures and do not replace veterinary treatment.

Riding with osteoarthritis

➡️ Video tip: Sprightly pensioners - What does an old horse need? - In this video, you will learn how older horses can stay healthy and active in old age. It shows the best care and exercise strategies for older horses, explains the importance of adapted feeding and gives tips on how you can specifically alleviate osteoarthritis and other ailments associated with old age. A valuable guide for anyone who wants to give their horse a long and fulfilling life in old age!

A diagnosis of osteoarthritis does not necessarily mean that a horse can no longer be ridden - on the contrary. Regular, gentle exercise helps to slow down the progression of the disease as it supports joint function and builds up muscles that relieve pressure on the joints. A well-trained muscular system protects the joints and helps to avoid excess weight, which can aggravate osteoarthritis.

However, as a horse with osteoarthritis is more sensitive, it is important to make adjustments during training. An extended warm-up phase of at least 20 minutes is essential so that the synovial fluid is well distributed and the joints remain supple. Tight turns should be avoided as they put strain on the joints. Instead, straight lines on soft ground are suitable, ideally also off-road. It is important to pay attention to the ground conditions here, as they influence the load.

Walking over small obstacles such as tree trunks or poles promotes joint mobility and strengthens the muscles. With mild osteoarthritis, pole work in all gaits can help to maintain mobility. Jumping should be avoided, however, as the shock absorption in the affected joints is limited. Similarly, classic lunging on a tight circle is not advisable as it places one-sided strain on the joints. Instead, work in hand, long rein work or double lungeing are suitable - exercises that take place on large tracks and do not require the rider's weight.

It is important that the horse is only ridden or moved when it is free of lameness. Lameness or ticking is a sign of pain and should always be taken into account. As osteoarthritis can increase symptoms depending on the weather, the rider should also take the horse's daily form into account.

For all horses - especially those with osteoarthritis - free exercise is essential to activate the synovial fluid. An active or open stable with a quiet herd and movement stimuli is ideal. The exact exercise capacity of a horse with osteoarthritis should always be discussed with the treating vet.

Which foods can help with osteoarthritis? 

Food supplements cannot replace the treatment of osteoarthritis, but certain home remedies can have a supportive effect as they have anti-inflammatory and pain-relieving properties. Proven supplements include

• Green-lipped Mussel Powder
• MSM (methylsulfonylmethane)
• Devil's Claw
• Ginger
• Nettle
• Hyaluronic acid

These supplements should be fed in courses, as long-term administration can put a strain on the horse's stomach. Every horse reacts differently to the supplements - it is therefore advisable to try out different supplements to find out what helps the horse best.

When does a horse have to be euthanized due to osteoarthritis? 

Even though osteoarthritis is easily treatable today, it remains incurable. If the disease and the associated pain are so severe that the horse can no longer lead a life worth living, it is the horse owner's responsibility to take the final step and put the animal out of its misery.

Osteoarthritis in horses: In summary

Osteoarthritis in horses is a progressive, incurable joint disease that can be well controlled with the right measures and appropriate care. Early diagnosis and individualized treatment, which includes anti-inflammatory therapies, controlled exercise and special feed supplements, can significantly improve the horse's quality of life. It is important to train carefully and in a way that is gentle on the joints, to avoid overloading and to respond to the horse's daily form. Alternative therapies such as leeches, acupuncture or special shoeing can also support veterinary measures.

It is crucial for horse owners to recognize the symptoms early and work closely with their vet. This allows the horse to lead an active and fulfilling life despite osteoarthritis. However, if the point is reached where the quality of life can no longer be guaranteed, a responsible decision is required in the interests of the animal.

Osteoarthritis in horses: the most important questions and answers

What aggravates osteoarthritis in horses?

Lack of exercise, overweight, incorrect hoof trimming, early and intensive loading and uneven terrain can exacerbate the symptoms of osteoarthritis.

What helps best with osteoarthritis in horses?

‍Gentle exercise, an adapted diet and anti-inflammatory supplements such as green-lipped mussel powder and devil's claw can alleviate the symptoms. Veterinary treatment with hyaluronic acid injections and autologous blood therapy can also have a supportive effect.

Can a horse with osteoarthritis be ridden?

‍Yes, exercise is important, but the intensity should be adjusted. Gentle training, straight lines and a thorough warm-up phase of at least 20 minutes help to mobilize the joints.

What can I give a horse with osteoarthritis as a painkiller?

‍Veterinaryprescribed anti-inflammatory medication and supplements such as MSM (methylsulfonylmethane) and devil's claw can alleviate the pain. However, they should always be administered in consultation with the vet.

What really helps with osteoarthritis in horses?

‍Regular, controlled exercise, a balanced diet and targeted supplements such as hyaluronic acid and MSM can improve quality of life. Veterinary advice is crucial for a suitable therapy.

Can you still ride a horse with osteoarthritis?

‍Yes, but the training should be adapted to the horse's needs. Exercises in hand, long rein work and avoiding tight turns relieve the joints and promote mobility.

When should a horse with osteoarthritis be put down?

‍Ifthe pain can no longer be controlled despite treatment and the horse no longer has a life worth living, euthanasia may be a responsible decision. This should be done in close consultation with the vet.

Which supplementary feed helps with osteoarthritis in horses?

Feed supplements such as green-lipped mussel powder, MSM, devil's claw, ginger and hyaluronic acid can have an anti-inflammatory and pain-relieving effect. It makes sense to try out different supplements to find out what helps the horse best.

What can be done against osteoarthritis in horses?

‍Regular, gentle exercise, adapted feed and targeted treatment by the vet help to alleviate the symptoms and maintain the horse's quality of life.

How does osteoarthritis manifest itself in horses?

‍Typicalsigns are stiffness, lameness, problems getting up, swollen joints, increased stumbling and reluctance to move, especially in cold weather.

What exercises can you do with a horse if it has osteoarthritis?

‍Gentle ground work, long rein work, straight-line movement on soft ground and light pole work at a walk help to keep the joints mobile and build up muscles.

How do I move a horse with osteoarthritis?

‍Thehorse should be moved regularly and gently, ideally with a long warm-up phase. Straight movements on soft ground or off-road and avoiding tight turns relieve the joints.