LAMENESS AND POOR PERFORMANCE
It has been reported that about 90% of poor performance cases can be attributed to lameness, either clinical (obvious lameness) or sub-clinical (lameness not readily visible under normal exam conditions).
It is logical that noticeable lameness causes horses to perform below their potential, but sub-clinical lameness can be an even greater problem. Clinical lameness can be quickly recognized, investigated, and corrected. In horses with sub-clinical lameness, however, the disease process remains undetected and untreated. It is allowed to progress, resulting in irreversible damage to the structure of joints, secondary lameness, muscle pain, behaviour problems, impaired performance and economic losses.
Early diagnosis and intervention can stop minor problems from deteriorating, preserving long term soundness and maximizing performance.
Most of my clients present every horse in their stable, on a regular basis, for physical exams. This enables the identification of subtle or sub-clinical problems.
Clinical Lameness
A horse is clinically lame if it has a visible limp or asymmetric gait. It will try to lift its weight off the sore leg and place more weight on the sound legs. A “head-nod” results. (When the sore front leg hits the ground, the horse lifts its head up to shift weight to the back legs and off the sore front leg. When the sound front leg hits the ground, the head nods down, loading that leg excessively.) Sometimes, when a horse is very lame in a hind leg, the horse will nod its head down to shift weight onto the front legs and off of the hind legs. Sometimes, a horse with a sore hind leg will lift its pelvis higher on the lame side (called a hip-hike).
Lameness is only visible (clinical) when one leg is relatively more painful than the opposite leg. Both legs can be sore, but as long as the pain is unequal, the horse will protect the more sore side and the head nod will be evident. There are various degrees of clinical lameness ranging from an inconsistent or almost imperceptible limp to an inability to bear any weight at all on the affected leg.
Sub-Clinical Lameness
Sub-clinical lameness is lameness that you can not see under normal conditions. Bilateral lameness, lameness in all four legs, and lameness that only manifests under extreme stress or speed is sub-clinical.
Bilateral lameness is often inapparent. If a horse’s legs are equally sore, he will not favor one and will not limp. Instead, he will shorten his stride, develop back or muscle pain, perform below expectations, make breaks, “stop” in the last part of a race, refuse jumps, make mistakes of stride in dressage tests, tie up, blow after working, have a longer than normal recovery, or develop behaviour problems such as pulling, bucking, and rearing. Many horses just develop a poor attitude to work. “Bleeding” or Exercise Induced Pulmonary Hemorrhage and dorsal displacement of the soft palate (“flipping the palate”) are common presenting complaints.
Some lameness only shows up at high speed or under extreme stress such as in the last part of a race. Some will manifest only with a rider or doing particular movements like flying changes or lateral work. Some will appear on a lunge line or on particularly hard, soft, or irregular or unstable footing. Some only present in the cart and not in-hand. Once again, these lameness cases are often presented for performance and behavior problems, back, or other muscle pain.
Lameness In My Practice
In my practice, the majority of horses presented for lameness or performance problems have one or more of the following: 1) foot pain including sole bruises, abscesses and, corns; 2) arthritis (joint inflammation); 3) tendonitis (a bowed tendon) or; 4) suspensory desmitis. Bowed tendons and suspensory desmitis present as clinical lameness and there is obvious pain, heat, and swelling. By far, the most common sub-clinical lameness or performance problems involve joint and foot pain. In many cases these conditions are both present.
Arthritis
Arthritis is a term that means “joint inflammation” (arth-joint, itis – inflammation). Inflammation occurs in joints when they are placed under stress in excess of what they have adapted for. This stress can be sudden and severe (stepping in a hole, taking a bad step on poor footing, or some other accident), or it can be repetitive and low grade (wear and tear).
Horses are designed for eating grass and running away from the occasional predator. They are designed to land flat on their feet, load bones and joints evenly from side to side, and break over the middle of their toes. Unfortunately, not many horses have perfect conformation, perfect hoof balance, or work on perfect footing so stress is not distributed evenly. They are not born readily adapted for repeatedly pulling a sulky or carrying a rider around a track at top speed or over jumps. The idea behind training is to gradually increase the stress on a horse causing them to adapt to the work we expect them to do. In short, training a young horse or training a more mature horse down to race after a spell is constantly placing their joints under stress they have not adapted to. Therefore, inflammation occurs on an ongoing basis in most horses in training.
Joints are made up of the ends of two or more bones which are covered with cartilage and joined together by the joint capsule. The joint capsule is lined by the synovial membrane. This membrane is very important as it produces the synovial fluid (joint fluid) that lubricates, protects and nourishes the joint cartilage. In a healthy joint, synovial fluid is thick like syrup. It is replaced every 24 hours or so on an ongoing basis.
Inflammation in joints begins with synovitis and capsulitis. In synovitis and capsulitis, enzymes are produced that breakdown joint fluid, making it thin and watery. It no longer lubricates and protects the joint properly. With a lack of nourishment and lubrication, the cartilage surface of the joint becomes abraded. Over a more extended period of time, the sub-chondral bone (bone underneath the cartilage in the joint) begins to change.
Over time, then, synovitis and capsulitis will progress to sub-chondral bone disease and osteoarthritis. This entire process is referred to as arthritis or degenerative joint disease (DJD). X-rays only show bone, so relatively advanced DJD is the first stage that is reliably visible on radiographs.
It is much better to identify and treat joint problems before they are visible on radiograph. If inflammation is stopped, the synovial membrane will make new fluid that will remain thick and sticky. If the breakdown of synovial fluid is the only damage that has occurred, a completely normal joint environment will be restored. If the cartilage surface has been damaged, some treatments can provide repair, and a normal joint can be created. Once bone has changed, however, it cannot be reversed. Thick, healthy joint fluid will stop rough bones from rubbing together in the joint, and DJD will be arrested, but a truly normal joint cannot be restored.
Treatment
Since the primary goal of therapy is to stop inflammation and to stop the progression of degenerative joint disease, the treatment of choice in most cases is intra-articular cortisone. Cortisones are very effective anti-inflammatories, and remain the treatment of choice in human medicine for intra-articular therapy.
There are several different types of cortisone that can be used in joints. Controlled studies have shown that all cortisones reduce inflammation and that most improve the health of joint cartilage. Triamcinolone (Vetalog, Kenalog, or Kenacort), Isoflupredone (Predef 2X), and Betamethasone (Celestone Soluspan) have all been shown to be safe or beneficial for joint cartilage. Methyl Prednisolone (Depo-Medrol or Vetacortyl) is likely safe in low doses, but can impair the healing of joint cartilage if given too frequently or in large amounts. Triamcinolone has been anecdotally linked to laminitis, but the relationship has not been confirmed. It has never been caused in healthy horses at normal doses and has not been caused experimentally using doses up to six times those commonly used.
NSAIDS like Bute and Banamine tend to kill pain better than they reduce inflammation in joints, so they are not a sufficient treatment in most cases.
Once inflammation is resolved and DJD is arrested, the second goal of therapy is to restore a normal joint environment. Hyaluronic acid (HA) is a building block for thick joint fluid, so supplementation may be useful. HA can be administered directly into a joint, however, it does not work very well if there is a great deal of inflammation present and it is generally used in joints along with cortisone. Studies have shown that IV HA (Hyonate or Legend) is as useful as intra-articular treatments, and recent research indicates that oral administration of HA may be helpful.
If cartilage damage has already occurred, then it can be beneficial to treat horses with a product that can stimulate joint repair or provide the building blocks for cartilage repair. Adequan, Glucosamine Sulphate, and Pentosan may be used for this purpose. Glucosamine Sulphate supplementation increases the body’s production of hyaluronic acid as well.
Additional medications are available to treat arthritis including some homeopathic treatments that reduce inflammation and stimulate joint healing. The homeopathic medications I mainly use are Traumeel and Zeel.
Finally, the third goal of therapy is to prevent reoccurrence of lameness. Adequan, Glucosamine, or Pentosan can be given regularly to reduce inflammation and repair cartilage. They can keep inflammation at bay in sound horses in training, and they can increase the interval between joint injections in horses with lameness problems. Optimal shoeing and good footing are of utmost importance, and adjustments to the training regimen may be helpful in some cases.
Summary
- The products of inflammation are enzymes that damage the joint.
- Early diagnosis and treatment will preserve normal joint structure and function maximizing long term soundness and performance.
- The first goal of therapy is to stop inflammation and, therefore, to stop the progression of degenerative joint disease.
- The second goal of therapy is to restore the most normal joint environment possible.
- The third goal of therapy is to prevent reoccurrence of the problem.3
Dr Corinne Hills, Pro-Dosa International Ltd., 34 Ryan Road, RD 4, Pukekohe, New Zealand.
Phone: +64 27 238 8482 Email: info@pro-dosa.com Website: www.pro-dosa.com FB: ProDosaBoost
THINK ALL “BOOST” PASTES ARE THE SAME? THINK AGAIN!
Download the PDF Article Here Think Again
The composition and balance of nutrients included as well as the safety and quality of each product is different, so buyer beware!
Recently, we have noticed a number of copy-cat “boost” products appearing in the marketplace. Some have chosen the same colours and package appearance or promotional text, and all have chosen a similar name and appear to have copied part of our formulation (the less expensive parts, anyway). None of these products have included the complete formulation contained in a Pro-Dosa BOOST, but they think you will be fooled by an only partially complete product that looks and sounds similar and sells at a lower price. I think, horsemen should think about why someone would do that.
It is said that the sincerest form of flattery is imitation. It does appear that some of our new competitors have recognised Pro-Dosa BOOST is of exceptional quality and composition, and they can’t compete with that. Instead, they hope to be mistaken for the same thing at a lower price. Since I didn’t make Pro-Dosa BOOST to be a cheap product with a large profit margin, I know they can’t make a similar quality product, any less expensive. They have to make a less-complete, poorer-quality supplement instead. While I suppose I should be flattered, instead, I am concerned about how many horsemen will think they are feeding my product, when they’ve bought a “copy-cat” by mistake. How many horses will be fed supplements that aren’t complete, balanced, or safe enough? How many people, feeding a copy-cat they think is ours, will think our product isn’t as good as it used to be when they don’t get the observable effects they have been accustomed to when feeding the original, tried and tested, Pro-Dosa BOOST, established in 2001?
WHAT DO YOU NEED TO REMEMBER ABOUT PRO-DOSA BOOST?
In order to achieve optimal metabolism, performance, recovery, and health, it is necessary to provide a broad spectrum of nutrients, in bioavailable forms, in ideal balance with each other and with the cofactors necessary for their absorption and function. The doses provided must reflect the requirements of horses under stress due to travel, hard work, racing, competition, and illness, as the administration of only some of the nutrients required or feeding quantities below or above requirements may result in imbalances that actually impair absorption and function. With this in mind, I developed Pro-Dosa BOOST to provide complete, balanced, and bioavailable nutritional support.
Because I made Pro-Dosa BOOST for the stables I had worked for in my veterinary practice, for years, I didn’t make it with profit margins or easy marketing in mind. I made it to make a difference to my patients and to make things easier and less expensive for my clients, who were my friends and not just face-less consumers, I didn’t know. I looked up the nutrient requirements published by NRC, and then I looked up other nutrition research and texts to fill in requirements not available through NRC. I compared those to what I had been providing for my patients in injectable form, and I referred to veterinary pharmacology texts and talked to exercise physiologists. I came up with a profile and doses of nutrients that, I believed, would be the most scientific and practical for competitive horses in my veterinary practice. I didn’t worry about whether or not horsemen would immediately understand the formulation or recognise the importance of some of the less familiar sounding nutrients. I focused on making a difference to equine health and welfare.
As a veterinarian, my clients trust me to provide safe, secure, efficacious, and ethical treatments for my patients. Product quality, therefore, had to be of paramount importance. I decided to make Pro-Dosa BOOST out of human food or pharmaceutical grade nutrients that would meet much higher purity standards than animal feed grade nutrients.
I thought it was important to measure the concentration of nutrients in the final product, because I wanted to be confident that I would be providing my patients the correct doses of each nutrient, not more or less, for best effect, and for their health and safety. If insufficient doses are given, then no impact or a negative impact on the overall health of horses may result. If you are buying a supplement that doesn’t contain what the label says, then at best, it’s a waste of money. At worst, it could be detrimental to your horses’ health. At the same time, giving too much of some nutrients is dangerous. Many horsemen will recall the tragic story from a few years ago about the group of polo ponies who died as a result of eating a feed supplement that contained ten times the amount of selenium that it was meant to, when an error was made in production of the product. I wanted to make sure that would never happen to a horse fed Pro-Dosa BOOST.
Finally, I wanted to be certain that I would not inadvertently cause harm though contaminants. I made my production and product tracking procedures as safe as possible by registering my facility in the NZ government inspected and certified GMP program. I used hazard analysis principles (HACCP) in developing methods of raw materials procurement, manufacturing, and finished product quality and safety assurance. I decided to submit all finished product for analysis for naturally occurring prohibited substances that may contaminate feed grade nutritional products and cause positive drug tests, and I submit all finished product for microbial culture to ensure it is sterile. Finally, I validated (proved) that my processes were consistently effective in producing a quality, sterile, and safe product that horsemen could feel confident and secure feeding to their horses. I wanted them to know that they could trust Pro-Dosa BOOST to be providing exactly what they were paying for and what their horses actually need to perform and recover at their best.
Think about what you are spending your money on and learn to read labels critically. Read my series of blog articles on “Reading Labels”, and please do contact me if you’d like help with general nutrition or comparing supplements and feeds.
With the rules of racing or competition quite variable from place to place and changing all the time, it is very important to consider the specific regulations that apply to you, in your sport, and in your part of the world before feeding Pro-Dosa BOOST according to label directions. If you are not allowed to “administer” anything on the day of racing or competition, consider the other ways and times you might be able to incorporate Pro-Dosa BOOST in your management system to ensure your horses are at their best when training, competing, and travelling.
- Feed Pro-Dosa BOOST rather than applying it to your horse’s tongue.
Pro-Dosa BOOST is comprised of a broad range of highly purified nutrients, in good balance with each other, and in quantities that reflect the increased requirements horses have when they are under the stress of hard work, illness, or travel. It is designed to support normal metabolism, health, performance, and recovery. The composition, therefore, is not a problem for horses racing or competing in equestrian sports.
The route of administration can be an issue in some racing jurisdictions. In many countries, Pro-Dosa BOOST can be applied on the tongue, directly from the tube. In some, NOTHING can be administered on the day of racing; not even water. In those places, horses can often be provided with Pro-Dosa BOOST mixed in their feed. It is in a molasses gel, so most horses will eat it happily enough when offered in that manner. In others, it can be fed on the feed on race day, but only if it is normally fed between races as well. Please check your administration rules before deciding how to incorporate Pro-Dosa BOOST into your management system.
If you can’t even feed it on race day, Pro-Dosa BOOST can still be useful in managing your horses.
- Use Pro-Dosa BOOST to support recovery from work prior to racing.
Give a half or a full tube of Pro-Dosa BOOST immediately after the last fast-work prior to racing. You can adjust the quantity depending on how hard the horse has worked, the needs of the individual horse, the climate, and how far they will travel, or how challenging race day will be.
Good horses and problem horses will usually benefit from a full tube. Horses that do well, no matter what you do with them, will mostly be fine with a half. If you aren’t allowed to feed Pro-Dosa BOOST on race day, give the full tube post workout.
This portion will help to ensure that horses will recover more completely from their last fast-work before racing. Studies have shown that it can take up to four days for muscles to recover from hard work, and many horses will have their last fast-work session only a couple of days before racing.
Muscle cells take up amino acids much more efficiently for about an hour after hard work. If you can get a broad range of amino acids, in appropriate ratios for protein synthesis, into them during this narrow window of opportunity, you can make a difference to muscle cell recovery. Think of it like the protein shake a body builder would have after they finish a workout at the gym.
Of course, Pro-Dosa BOOST isn’t just amino acids. It also contains electrolytes, vitamins, and trace-minerals. Pro-Dosa BOOST contains the nutrients necessary to support normal appetite, nerve cell function, red blood cell production, muscle cell recovery, and electrolyte balance.
- Use Pro-Dosa BOOST to help horses in hard work to maintain normal appetite, body condition, and performance over a long season.
Give a half or full tube of Pro-Dosa BOOST immediately after each fast-work. Most trainers use Pro-Dosa BOOST this way in their horses. They believe they get more starts per preparation and more consistent performance throughout the season. For horses that struggle to maintain body condition during a long season, using Pro-Dosa BOOST this way can help to keep them eating normally, support muscle cell recovery, and help them to maintain muscle mass.
- Use Pro-Dosa BOOST to help horses recover from a race.
Give a half or full tube of Pro-Dosa BOOST immediately after returning home from a race.
While you may be outside the window for making the biggest difference to muscle cell recovery, you can still make a difference to how well your horse will eat, drink, replenish reserves, and recover.
Horses that have a hard run may not eat up well, and if they don’t eat, they won’t back up well. Pro-Dosa BOOST will support normal appetite and encourage them to clean up their feed when they get back home or to their stable. If you are allowed to feed them a syringe of BOOST prior to racing, they won’t need this dose afterwards. If you can’t feed them Pro-Dosa BOOST before racing, be sure to give this post-race dose when you get home.
- Use Pro-Dosa BOOST for travel.
Give a full syringe of Pro-Dosa BOOST prior to travel, and for longer journeys, give a syringe upon arrival.
We recommend Pro-Dosa BOOST for travel, especially when travelling over a long distance or over multiple days. Always have fresh water available and make regular water stops along the way. (Please consider any rules of competition that may apply before feeding Pro-Dosa BOOST as directed).
Providing your horse with one tube of Pro-Dosa BOOST, at least 2 – 4 hours prior to loading them on the float (or if you are leaving early in the morning, it can be given the night before, instead), will help them arrive at your destination in the best possible condition. If travel exceeds 8 hours, give another portion upon arrival, as long as that doesn’t contravene your rules of competition.
Using Pro-Dosa BOOST before travel will not only help protect muscles from oxidative muscle cell damage during travel, but it will also help support normal appetite. This can be especially important when horses are to be stabled away from home, in a new environment. This is ideal for horses traveling further afield and when racing in big campaigns.
- Use Pro-Dosa BOOST the day before racing.
From our cobalt clearance study, we found that Pro-Dosa BOOST had an impact on horses for around 18 hours; much longer than the 8-12 hours we had originally expected. If you are able to give a dose of Pro-Dosa BOOST the night before racing, you could reasonably expect the same results as you see when feeding it on race day. Please check the rules of competition that apply to you.
- Use Pro-Dosa BOOST as a health tonic.
Provide half a tube every other day to horses that may require more nutritional support when under the stress of illness.
Peak performance depends on the supply of energy to drive and fuel the working muscles. Providing almost three times as much energy as oats on a weight basis, oil offers many advantages in terms of energy efficiency. For both digestive and metabolic efficiency, oil is superior to grains and protein. In fact, the efficiency of ATP synthesis (i.e. the currency of energy), is around 39% for oil and 20% for carbohydrates.
In addition, calmness, as measured by spontaneous activity and reactivity (spook tests), is lower when diets are fortified with oil. Oil-enriched diets reduce the amount of metabolic heat generation, both at rest and during exercise and for the racing standardbred, this reduction in heat load can provide a competitive edge. The lower heat load lessens the need for sweating, reducing fluid loss during exercise. Studies have traditionally shown that oil-enriched diets affect working muscles by increasing oxygen uptake, increasing fatty acid utilization, sparing muscle glycogen during low intensity exercise and increasing glucose availability during intense sprinting exercise. Fat supplementation also reduces heat production, improves hydration and perhaps most importantly, improves the power : weight ratio.
Overdoing oil can result in decreased glycogen stores in the muscle, meaning the horse could “hit the wall” sooner, or have nothing left at the end. However, this does not happen until oil comprises more than 8-10% of the total diet – including hay, chaff and concentrate. So, for a 450kg horse eating 10kg of feed, oil intake would have to exceed 800-1000ml a day before there was any interference with muscle glycogen.
However, not all oils are created or utilized equally. Cold pressed oils are far healthier than solvent-extracted oils. Cold-pressed canola contains vitamin E, Coenzyme Q10, lipoic acid, omega-3 essential fatty acids and other very potent natural antioxidants. Without the addition of EPA and DHA, up to 10 times more oil is required to achieve the same levels of omega 3 activity, so for both ourselves and for hard-working horses, it is important to check that EPA and DHA are present in the oil. The maximum benefits from oil occur after two to three months, so it is best to introduce oil-enriched feeds and Omega 3 supplementation early in the program. This will allow sufficient time for metabolic adaptation to occur and ensure that the benefits of fat supplementation are realized when they are needed most.
The ratio of muscle to body fat affects the power to weight ratio – so when we want topline in a racing standardbred, we must use the combination of work and diet that will promote muscle building and not fat deposition. Just as occurs in humans, the finer details of the diet affect body composition. In addition to the type and intensity of exercise, the amount of muscle development is determined by the amino acid composition of the feed protein. Soybean meal, lupins and lucerne are well known as good sources of protein and this is because they are high in lysine.
Lysine and methionine are just two of the essential amino acids that make up protein. Just as branched chain amino acids have been found to be important in horses, on-going equine nutrition research has shown that other amino acids, including threonine are important for muscle building. Regardless of the percentage of protein in the feed, if there is not enough of each amino acid a limit will be put on muscle development and the horse will lay down cover (fat) instead of muscle.
But even if the feed contains good levels of lysine and other essential amino acids, for several reasons, they may not be available to the horse. Some feed processing techniques, such as dry-extrusion, rely on high temperatures and shearing forces which can damage lysine and other amino acids. Steam-extrusion includes moisture in the cooking process and losses are negligible and digestibility increases to over 90%.
As well as a sound daily nutrition program, strategic timing of meals pre- and post work can impact profoundly on the development of muscle power. Muscles consume vast amounts of anti-oxidants and essential amino acids during work and at the microscopic level, small strains, rips and tears occur. Correct composition and timing of feeding can take advantage of the window of opportunity created by the raised hormone levels and increased blood supply that accompany exercise. To be effective and hasten muscle recovery, the concentrate must provide anti-oxidants, amino acids and be consumed no more than two hours before or one hour after work.
The effectiveness of the diet is measured in terms of metabolic efficiency, i.e. the maximum output with the minimum production of undesirable products such as manure, acid and heat. To increase power for work, diets need to be designed to influence muscle fuel levels. But the feed chosen also influences the power : weight ratio (ratio of muscle to fat), thermoregulation (heat production and hydration) and mental attitude – all of which impact on performance and fatigue.