Dr. Caity Cosentino
Whether a horse is trained to be an athlete for competition, or just a beloved pasture pet, they can all be affected by arthritis. The pastern region of a horse, located below the fetlock and above the hoof, is a small and easily overlooked area, but can be impacted just as easily by arthritis as the more prominent joints. The term ringbone specifically applies to a form of arthritis that occurs in this region. There are two joints that can be affected. High ringbone refers to arthritis in the pastern joint, while low ringbone is in reference to the coffin joint. Either one or both of the joints can be impacted at the same time. Bony proliferation accumulates at and around these joints. Typically, horses who are middle aged are the ones at greatest risk, but it can be found in young horses as well as geriatrics. Certain conformational traits, such as being upright in the pasterns or toed in, can predispose horses to developing this painful condition. Traumas and infections in the region can also lead to this form of arthritis, or repetitive stresses on the area in competition horses, such as barrel racing, jumping and polo. This is just one reason to make sure you have a good farrier, keeping your horse well balanced. Areas where joints, tendons and ligaments are under repetitive stress may become inflamed. This inflammation causes further damage and can lead to the body creating new bone in an attempt to stabilize the joint area.
Sign of ringbone vary depending on the severity of the disease. Some horses will begin to have mild gait changes and become short or choppy in their movements, others may become overtly lame. Heat and swelling may or may not be present in the pastern region. In advanced cases, the bony proliferation can actually be felt on palpation of the area. Horses will often be lame on flexion in this area, even if there is no heat or swelling present. There are several steps in identifying and diagnosing a horse with ringbone. The first step usually begins with a clinical exam of the horse, followed by a lameness exam. Nerve blocks are usually utilized to specifically locate the region of pain. Once located, imaging is done, usually beginning with radiographs. Radiographs will definitively be able to identify both high and low ringbone and also the extent of the arthritic disease process.
Once identified, treatment can begin. Treatment of ringbone can vary just as greatly as the extent to which horses are affected by it. Horses who are not horribly painful may be able to be managed with shoeing changes, oral supplements, and topical or systemic anti-inflammatories. Products such as Legend, Adequan and Osphos may also be beneficial. Shockwave and laser therapy may be used in conjunction with these other medications. Horses who are more painful, or do not respond to the more conservative therapies may benefit from having the affected joints injected directly with medications. Extremely severe high ringbone is sometimes even treated by arthrodesis, or fusing the joint to alleviate the pain from the loss of cartilage and the bones grinding on one another.
Ringbone, like other forms of arthritis, is a progressive and degenerative disease with no cure and must be managed. Coming up with a treatment plan with both your veterinarian and farrier, will give your horse the best chance at staying comfortable and sound for as long as possible. Whether your horse is an athlete at the top of his game, or a pasture puff enjoying their time out in the sunshine, they deserve to be comfortable and well cared for. Begin with the basics by maintaining your horse at a good body weight to decrease stress on joints, keep their feet trimmed on a regular basis and feed a good quality diet for overall health. Address any concerns you may have about their health and overall comfort early. The earlier treatment is begun, the greater the chance the arthritic process can be slowed.