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Ask the Vet w/ Dr. Kaneps – Joint injections, swollen joints, osteoarthritis & more! – January 2019


DAN: Hi, SmartPak fans. Welcome to SmartPak’s
video series, Ask the Vet. I’m SmartPaker Dan. Now, generally you
guys are used to seeing Dr. Lydia Gray with me. But today, we have a special
guest, Dr. Andy Kaneps. Now, some of you
might recognize him from our previous
Ask the Vet video and some of our other
SmartPak videos here. So we are super excited
to have you back. DR ANDY KANEPS: It’s
good to be here. DAN: Now, we figured, with
January being Joint Health Awareness Month,
that having someone of Dr. Kaneps’ expertise– it’d be very appropriate
for him to come and answer your joint health
questions for this month. So you think you’re
ready to get started? DR ANDY KANEPS:
I’m all set, Dan. DAN: All right, let’s
dive right on in. So question number one was
submitted by Jena on Facebook, and she wants to
know– she said, “My horse is getting older– 15– and stiffer in
his hocks and stifles. He is currently getting
a SmartPak for joints as well as Devil’s Claw
Plus for anti-inflammatory. A lot of people– not experts– have
told me that he will benefit from joint injections. While I agree that it
may help him move better, I’m hesitant about the
cost-to-benefit ratio. My horse is mainly turned out
in a dry lot pasture, ridden lightly in the arena, or out on
easy trails one to three days per week. Is the cost of joint
injections going to be practical
for his workload? Is there anything else I
can add to his routine that may help be less costly? Just looking for
your two cents.” DR ANDY KANEPS: Sure. DAN: It’s like she’s describing
me, my horse, and my riding style. So I’m very excited
for this answer. DR ANDY KANEPS: No– definitely worth the $0.02. For this type of horse,
there are multiple things that can be done to make
them more comfortable, especially for the type of light
work that she’s referring to. Certainly, joint injections
are at the top of the list. If a joint is
inflamed and painful, an injection in the
joint works better than any other
type of treatment. However, that’s not the only way
to treat that kind of an issue. One of the treatments is
already what the horse is on– oral joint supplements. One potential step up
in treatment efficacy is a product given in the
muscle or in the vein. And that type of
medication can help horses with mild to moderate
joint stiffness, along with the support
of an oral supplement. And that’s medication. There are other things
other than medication that can be used to help keep
a horse more comfortable. Some examples would be– always
take time to warm up the horse. Don’t just hop on the saddle
and shoot off for the horizon. Just imagine– at
least, myself– I won’t talk about yourself– just getting out
of the bus at 6:00 in the morning at the starting
line of the Boston Marathon and just taking off
at the starting gun. You can’t do that. And one way to empathize with
your horse is, try that once. On a cold morning, go out. And just suddenly go
pounding down the pavement. Horses need appropriate
warm-up time. DAN: Yeah, I wouldn’t
be sound if I did that. DR ANDY KANEPS: So those
are some of the aspects. So there’s more than just joint
injections that can be done. DAN: Well, and especially
as to your point as far as the warm-up– her horse is now 15. So things are a
little bit different. And it might need a little
bit of an extra warm-up time to get ready to go for exercise. DR ANDY KANEPS: Absolutely, and
warm-up time for most horses is 10 to 15 minutes of light
work, not asking collection, not asking lateral work– just nice, free,
easy, flowing walk. DAN: OK, so we’re thinking– she’s doing the joint
supplement already– potentially doing something–
an injection in the muscle or one of those
types of medications. And then of course,
having a joint injection as being another option, if
we feel we need to go there. DR ANDY KANEPS: Yes, absolutely. DAN: Perfect. All right, so on to
question number two. This was submitted by
verityandcomet on YouTube. And she wants to know– “I was wondering
if all horses can get swollen joints
after exercise or if it’s just thoroughbreds. If so, is there
any way to treat it other than cold packs and
ice for horses that hate it, like hers. I’ve got a cob on
light work that does a little galloping
every second day or so but gets swollen fetlocks. Is this normal? If not, what should I do?” DR ANDY KANEPS: Good question– some horses will carry a small
amount of joint swelling. And for most horses,
it doesn’t change. It doesn’t come and go. When you have significant
amounts of joints swelling, especially those
that come and go, one of the first steps
we undertake is– ask the question, “Is
the horse lame or not?” If the horse isn’t
showing lameness, then it’s likely
benign and likely not really an issue other
than for us to worry about it. The things that we need
to do to investigate whether this type of joint
swelling is a problem is– first, again, as I
said, a lameness evaluation. Second– that can be
undertaken during the exam– is to manipulate the
joint, to flex the joint, to put an extra
stress on the joint. And if the horse is
sound initially but then lame following the– DAN: Flexion. DR ANDY KANEPS: –flexion of
one of the swollen joints, that can mean a potential
low-grade problem in that joint. Then the third aspect– if the horse is lame and has
pain in that joint on flexion– is to image the joint,
usually with X-rays. And the thing that we’re
looking for in particular with swollen joints
is osteoarthritis that show up as lips or
hooks or irregularities in the joint surfaces. And with more clarification
of the joint issue that’s associated with that
increase in joint filling, we can come up with a
much more reasonable plan on how to deal with it. DAN: Perfect. Well, I was going
to stay, with her, it doesn’t sound like her horse
currently has any lameness, if she’s still– DR ANDY KANEPS: I
would agree– yeah. DAN: –galloping– DR ANDY KANEPS: I would agree. DAN: –second day–
things like that. So maybe something just
to monitor down the road and just keep an eye on. DR ANDY KANEPS:
Yeah, and one thing that she can do with
her horse, too– if it’s hard for her to tell
whether the horse is showing lameness is have someone
on the ground watch while she’s riding. Because a lot of times, you’re
involved with your horse. Again– speak about myself– I’m just hanging on and unable
to really appreciate all the subtleties of the horse. But someone that’s on
the ground and watching the rider and the horse
move out, oftentimes, gives you a clearer perspective. DAN: Well, also, sometimes,
I find for myself, I’m a little bit– I don’t know– of
a hypochondriac. So if I think there’s a
problem, I look for the problem. DR ANDY KANEPS: Sure– sure. DAN: So sometimes,
I need someone to tell me I’m overthinking it. DR ANDY KANEPS:
Yeah, and as always, having your veterinarian
out to take a look– DAN: Yes. DR ANDY KANEPS: That’s
the gold standard. But you can get help from your
friends at the barn, as well. DAN: Perfect. Well, keep monitoring your
horse and talk with your vet. And hopefully, things keep
going better for you guys. So on to question number three– this was submitted by
Rosemary on YouTube. And Rosemary said, “I
ride an older horse– about 20-years-old– and
he loves to jump still. He will jump the wood logs
on the property sometimes. Are there any ways to
keep his joints and bones in good condition?– like
a supplement or a liniment? Since he’s older, I worry
he might pull something. We don’t jump
higher than 3 feet. Thanks.” First off, congrats that your
20-year-old is jumping 3 feet. DR ANDY KANEPS: Yeah–
no, that’s great. That’s great. No, that’s excellent. And yes– not so much
me, but wear and tear happens as we age. I’m just joking about that. I have plenty of
wear and tear myself. But any horse that’s 20
years of age will have some– what we call wear and tear. And it’s usually
not an impediment. By being careful with your
horse, by good nutrition, good exercise
program, warming up, like we talked about before– all very important parts of
keeping the horse comfortable. Oral supplements for horses
that are sound and still in regular work without
significant joint or soft tissue injuries is
an excellent way to keep the joint system
working as well as it can. DAN: To help support what
you already have going on. DR ANDY KANEPS: Yeah, exactly. And any horse, whether they’re
20-years-old or 2-years-old can be susceptible to injury. And just taking the good careful
steps of support, for example, with joint supplements,
support by keeping the horse in a level of work
rather than just resting and resting and resting
and then getting on for a weekend
of hard riding– regular consistent work,
good consistent warm-up and cool down following
exercise– all of those play a role in keeping the
horse comfortable and happy. DAN: Well, I think, with her,
it sounds like she’s keeping him in fairly regular
work, which is probably helping at keeping him going– DR ANDY KANEPS: Yeah. DAN: –so nicely. DR ANDY KANEPS: Yeah. DAN: I think a lot of
people get to the point where their horse
gets to, like, 20 and– like, oh, I need
to back off and then only try to ride on the weekend
and do too much too soon. DR ANDY KANEPS:
Yeah, and the key is, pay attention to your horse. The horse will tell you
when they’re having issues. You’ll notice a
change in behavior. You’ll notice a change
in level of comfort as you start off on your ride. All of those things–
pay attention to that, because the horse has
their ways of telling you if there’s an issue that
needs more careful attention. But Rosemary’s horse sounds
like it’s in great shape. DAN: She’s doing great. DR ANDY KANEPS: Yeah. DAN: And I love how she mentions
three feet as though it’s casual. I was like, anything above a
ground pole, I struggle with. So Rosemary, keep
up the great work. DR ANDY KANEPS: Yeah. DAN: So on to
question number four– this was submitted
by Ellie on YouTube. So Ellie says, “My
17-year-old Oldenburg gelding used to be a high-level hunter
horse in his younger days, before she knew him. From mid-2016 to mid-2017, he
was leased out by his owners and received horrific
farrier work, where he had three-degree front wedges
on with no apparent purpose or need for them. When he came to my barn,
he was about 10% sound. He is a million times
better now and is perfectly suitable for my riding–
very minimal, low jumping on good days. He still has a little bit
of pain in his front right on and off and comes
out stiff some days. He has stifle issues
as well, apparently due to some compensation
from the pain in his fronts. He is on Previcox and
methocarbamol, which work extremely well
for him, as well as some joint and overall
health supplements. My question is this– do we have any
suggestions on how to improve quality-of-life
of semi-retired sport horses with chronic osteoarthritis? I’ve read a lot about
high-dosage omega 3, for example with
the EPA and DHA. Thanks so much–” with
four exclamation points. She’s very excited. DR ANDY KANEPS: Four– very– yeah. Good question, Ellie. There are a number
of things that can be done to keep
your older sport horse happy and comfortable. And you’ve taken a fair
number of them already– the work, the not over-facing
the horse with jumps. All those things
are very beneficial. Keeping a horse in
regular consistent work, as we’ve already
emphasized, is a huge part of maintaining
comfort and soundness. Other things that can be done,
more specifically regarding conditioning, can also
help a horse like this. You can talk all the medications
and all the supplements in the world, but building or
maintaining a good solid core strength and also
enhancing joint mobility are two main facets
of conditioning that we sometimes
forget about, especially in a well-seasoned older horse. An example– we go
out in the ring and we plod along or do whatever
we’re doing with our horse’s discipline– or out on trails. But one thing that can
really help the horse with joint mobility is
introducing some ground poles or introducing low
cavaletti poles. Those types of
processes encourage the horse to pick the legs up. That’s all there is to it. They have an obstruction
in front of them– they pick their legs up. And in doing that, the horse
will use more of the upper limb musculature, fore and hind,
and also, in the process, use their top line and
core strength to do that. And incorporating those items– ground poles, cavaletti–
are a real strong way to build that core strength. DAN: And is this
something that people should be doing
at a walk to start and then increasing
gaits from there? DR ANDY KANEPS: Yes, absolutely. And what I refer
you to is– there are several texts out that
talk about the use of cavaletti in training. And they’ll give more
specific information on interval of the
poles, how many poles to have in a row, how
often to do the exercises, and for how long. And so I refer you
to those resources to get more specifics. DAN: Yeah, I know we definitely
have some blogs on our website that talk about ground poles and
exercises and different things that our Customer Care team
does with their horses. So we can definitely
make sure to reference some of those for you guys. DR ANDY KANEPS: Good– good. Another type of
exercise aid that will help build
core strength are– there are several
types of systems that stimulate the nervous
system to activate their core musculature. There’s one with a band that
goes around the belly and then around the hind legs. There’s another that
uses bungee-type stretchy cords through the bit. Systems like that,
if used correctly, can really do a tremendous
job at building core strength. Again, that’s a
really important part of keeping a horse happy and
fit, especially as they age. DAN: Perfect, so we
definitely would recommend for her to do some joint
mobility, some core exercises, just overall conditioning
to help her horse, as he’s getting a
little bit older there. DR ANDY KANEPS: Yep, absolutely. DAN: Perfect– awesome. All right, so on to
question number five. This was submitted
by Connie on our form at
SmartPak.com/AsktheVetQuestions. And Connie says, “My horse is
an 11-year-old off-the-track thoroughbred who has issues
with his sacroiliac joint and an old injury
in his left stifle. We are working to build
his muscles and top line for strength and take time
to properly warm him up.” It’s like she heard
your earlier questions. “What are some good exercises
or healthy practices to keep him more
comfortable during work?” DR ANDY KANEPS: Well, it
sounds like she’s already started a lot of– DAN: She’s watched
our earlier videos. DR ANDY KANEPS: –what
we’ve just discussed. And a lot of people don’t
mention their warm-up. Almost everyone does it,
but I don’t want to– well, I do want to
overemphasize warm-up. Because if you’re doing a
good job of building top line strength and using, possibly,
some of the things that we’ve just discussed– like
the ground poles, Cavaletti, and then some of the
stretchy band type devices– that’s great. But always remember to warm up. And for 10 to 15 minutes
of loose free work, do your training
or intense riding. And always allow 10 to
15 minutes of cool down, especially now as the
weather’s getting colder. But if you’re watching this in
July, forget I just said that. But the cool down is
also really critical. Then the other things that
she can do to help her horse are to maintain a good basis
of nutrition and supplements. And supplements vary
on what type of feeds the horse is
getting and if there are any special needs, such
as, in this particular horse– the potential of a stifle
in the sacroiliac area. Supplements that help
maintain joint mobility– that maintain joint flexibility–
are really important. DAN: No, absolutely. And I think, like
you said, she’s doing so many great things. DR ANDY KANEPS: Yeah. DAN: And to the part
with the warm-up– I think a lot of
us riders– we want to get on and just get going. DR ANDY KANEPS: That’s for sure. DAN: And a lot of people
will do something like– “Oh, I’ll lunge my horse
first,” which isn’t always necessarily the best warm-up,
because sometimes your horse doesn’t lunge very
nicely or quietly. So making sure you’re doing
something that’s actually productive and a nice easier
warm-up for your horse is– DR ANDY KANEPS: Yep. DAN: –what you’re referring to. DR ANDY KANEPS: That’s right. They need to be relaxed during
the warm up and not pushed in any way. If lunging works for
you and your horse is comfortable with it– fine. But many horses,
like you’re saying– are less than happy
about lunging. DAN: Yeah. Well, Connie, it sounds
like you’re already off to a great start. So hopefully, some of
these extra little tips will help you out. So onto our bonus question– we normally do five. But since we have
you here this month, we’re going to take advantage
of it and do a sixth one. So our bonus question
was submitted by JenSalvatore21 on YouTube. And she says, “Hi, Dan.” Hi, Jen. “What’s the difference
between joint injections done in the muscle vein and
joint injections in the joint? What types of issues
are better treated with what injection sites?” DR ANDY KANEPS: OK, that’s
a really good question, Jen. Joint injections–
a whole variety of different
medications that we can administer in a joint
only treat that joint. So that’s the important part. There are similar
products we put in joints that are also
available for injection in the vein or in the muscle. Those products go
throughout the body. And they go throughout
the body, and it’s been verified that
these products go to joints in need that have
slight inflammation in higher concentrations
than other joints. So when I first heard
of intramuscular or intravenous joint products,
I go, “How is that possible? This is a big horse. We’re putting a small quantity
of medication in the vein or in the muscle. How can it possibly
do anything?” But several of the
products underwent research to answer that
question specifically and showed that effective
levels of those drugs are in the joints. DAN: Hm. DR ANDY KANEPS: So IV
or IM administration goes throughout the body. Joint injections only
go into the joint where they were administered. DAN: So perhaps, if you
have a horse– you’re not quite sure exactly where
the issue is specifically– doing something
with intramuscular might be helpful, because
that’s going to go specifically to where it’s needed. DR ANDY KANEPS:
That’s very true. That’s very true. The thing is, there’s
still no better method to treat a joint problem that’s
existing in a particular joint than injecting that joint. The positive effect of the
intravenous and intramuscular products is not as
intense a response as for a joint injection. But again, we’ve discussed the
advantages and disadvantages. If you have multiple joints
in multiple locations, going with a IV or IM product
can be very beneficial. DAN: And this is something
they would obviously be working with their vet with. They’d come in and do flexions– DR ANDY KANEPS: Have to do that. DAN: –and really
figure out exactly what the best plan would be. DR ANDY KANEPS:
Yes, that’s true. DAN: Of course–
well hopefully, that was very helpful for you guys. Well, that is it for our
questions for this month. Thank you so much for
coming in to help us out. DR ANDY KANEPS: You bet. Thanks, Dan. DAN: Thank you. And of course, if
any of your questions were answered on
this episode, make sure to reach out
to our Customer Care team at
[email protected] to claim your gift card. Now, Dr. Lydia Gray will
be back with us next month and ready to answer your
next five horse health related questions. So make sure you
keep asking those. You can submit your questions
on YouTube, Facebook, Instagram, Twitter, our blog,
and the form at SmartPak.com/AsktheVetQuestions. Just make sure to use the
hashtag #AskTheVetVideo. So until next time,
make sure to subscrube and have a great ride.

4 thoughts on “Ask the Vet w/ Dr. Kaneps – Joint injections, swollen joints, osteoarthritis & more! – January 2019

  1. My horse is a 13 year old quarter horse and I’m planning on breeding her in the next couple of years. How do I know if she is ready for breeding? What steps should I take with my vet to get my horse ready? #Askthevetvideo

  2. I have a 15 y/o arab cross mare. She has always been sassy, but she on and off in the last year has been very buddy/barn sour. It's on a trail we do often, sometimes she acts up, sometimes not and she just starts to back up, which is dangerous because one side is a ditch and the other is a big hill. Then recently she bucked (which isnt that odd for her attitude) and tried to gallop home, which is unusual. She is on via calm which helps her nerves, but I wonder if there could be any underlying health issues that could cause this? I have asked my vet about her eyes with spooking and he said it must be "between the ears"😂 Is there anything i should be concerned about? Thanks! Love the videos as always❤ #Askthevetvideo

  3. My 15 y/o arab cross is a VERY easy keeper. Even in consistant work, aprox. 4-6 days a week in the summer she still blows up like a balloon. Resulting in the struggle of using a grazing muzzle. Because of her petite arab face it's hard to find a muzzle that doesn't rub and unfortunately we do not have a dry lot, just our seeded pastures. Is there any other options to help her keep weight off? Thanks!❤ #Askthevetvideo

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