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 CustomerCare@SmartPak.com
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.


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