Autologous conditioned serum (ACS) and autologous protein solution (APS) are newer therapeutic options for osteoarthritis (OA). Co-culture of cartilage and synovium stimulated with IL-1β produces a similar physiologic response to tissues from naturally-ocurring OA. The study objective was to investigate the effects of ACS, APS, and triamcinolone (TA) on inflammatory and catabolic gene expression of inflamed joint tissues in co-culture. Blood was collected and processed for ACS and APS from six horses. Cartilage and synovial explants were harvested from the stifle, placed in co-culture, and treated as: (1) unstimulated control (2) stimulated control (3) ACS at 25% v/v (4) ACS at 50% v/v (5) APS at 25% v/v (6) APS at 50% v/v, (7) TA (10 −6 M). Treatment groups 2-7 were stimulated with IL-1β (10 ng/ml). Cultures were maintained for 96 hours, and then both media and explants were harvested for measurement of gene expression and protein. IL-1β stimulation significantly increased IL-1β (p = 0.029), IL-8 (p = 0.011) and MMP-3 (p = 0.043) expression in synovium and IL-1β (p = 0.003) and TNF-α (p = 0.001) expression in cartilage. Treatment with 50% ACS and APS v/v downregulated IL-1β expression in cartilage more than TA treatment (p = 0.001 and p = 0.0004) and APS downregulated MMP-1 expression in synovial membrane (p = 0.025). Treatment with ACS and APS caused a trend in upregulation of IL-10 expression in synovium and type II collagen and aggrecan expression in cartilage. PGE 2 media concentrations were significantly reduced following treatment with APS (13.7-fold decrease, p = 0.0001) and ACS (4.13-fold decrease, p = 0.024); while TA did not reduce PGE 2 significantly (2.3-fold decreased p = 0.406). As disease-modifying therapies, ACS and APS modified the cellular response from synovial membrane and articular cartilage. ACS and APS may offer an improved strategy to improve clinical signs of horses with naturally occurring OA, compared to TA treatment.

There are several non-steroidal intra-articular therapeutics (NSIATs) available for use by equine practitioners for the treatment of performance-limiting joint-related pathology. Information is limited on perceived clinical efficacy, recommended treatment protocols, and associated complications. Our objective with this cross-sectional survey was to investigate the current clinical usage of NSIATs by equine practitioners. An electronic cross-sectional convenience survey inquiring about the use of steroidal and NSIATS (platelet-rich plasma, autologous conditioned serum, autologous protein solution, cellular therapies, and polyacrylamide hydrogel) was distributed internationally to equine practitioners. A total of 353 surveys were completed. NSIATs were used by 87.5% of the participants. Corticosteroids and hyaluronic acid remain the intra-articular therapeutic of choice among practitioners, followed by autologous conditioned serum, platelet-rich plasma and autologous conditioned protein. Polyacrylamide hydrogel was the least used. Practitioners were more likely to use NSIATs if their caseload was > 50% equine (P < 0.001), they treated more than 10 horses intra-articularly per month (P < 0.001), and horses treated were considered English sport horses (P = 0.02). Years in practice and practice location did not influence the use of NSIATs. One of the most common reasons why NSIATs were chosen was to treat acute articular pathologies. As survey limitations, answers to questions regarding clinical response and complication rates were based on subjective estimation and practitioners recall, not clinical records. In conclusion, corticosteroids remain the most widely used intra-articular therapeutic. Among the NSIATs, blood-based products are more commonly used by practitioners, followed by cellular and synthetic products. Equine practitioners frequently use NSIATs, choosing to treat acute joint pathology more than previously reported.

OBJECTIVE To determine whether addition of epinephrine to a lidocaine solution would prolong and potentiate the efficacy of a palmar digital nerve block (PDNB) in horses. ANIMALS 6 adult horses with naturally occurring forefoot lameness. PROCEDURES Initially, a PDNB with a 2% lidocaine solution was performed on the affected foot of each horse. Three days later, the PDNB was repeated with a 1% lidocaine solution or a 1% lidocaine solution containing epinephrine (dilution, 1:200,000). After another 3-day washout period, the PDNB was repeated with the treatment opposite that administered for the second PDNB. Gait was analyzed with a computerized lameness analysis system and heart rate and extent of skin sensation between the heel bulbs of the blocked foot were evaluated at predetermined times for 2 hours after each PDNB. RESULTS Efficacy and duration of the PDNB did not differ significantly between the 2% and 1% lidocaine treatments. The addition of epinephrine to the 1% lidocaine solution improved the efficacy and prolonged the duration of the PDNB. It also resulted in a positive correlation between skin desensitization and amelioration of lameness. Median heart rate remained unchanged throughout the observation period for all 3 treatments. No adverse effects associated with the PDNBs were observed. CONCLUSIONS AND CLINICAL RELEVANCE Addition of epinephrine (dilution, 1:200,000) to a 1% lidocaine solution improved the efficacy and prolonged the duration of a PDNB in horses with naturally occurring lameness and might be clinically useful for lameness evaluations and standing surgery of the forefoot of horses.

Conidiobolus coronatus is one of the most commonly identified upper respiratory fungal pathogens in horses. This article includes a review of clinical signs, diagnostics, treatment and outcomes in previously reported cases of equine conidiobolomycosis, as well as six additional cases seen at our hospital. Each of the six horses presented with a complaint of serosanguinous or haemorrhagic nasal discharge and conidiobolomycosis was confirmed by histopathology and fungal culture. Five horses recovered after administration of antifungal drugs alone (n = 4) or in combination with extensive nasal septum resection (n = 1). Surgical treatment alone was ineffective. One horse was euthanised without treatment because of the extent of the disease.

The HHS may not be as discriminatory as other instruments at assessing patient activity levels after THA.