A lot of people ask what the treatment is that Metro had on his knees that made such a drastic turnaround in his soundness. Well he is far from sound, but the bone growth in his knees is not life threatening anymore. The drug is called Tildren. It is manufactured in Europe and is not yet approved by the FDA yet in the United States. But with a special license, it can be imported and prescribed by a veterinarian. He got one treatment a month on each leg for 3 months. Now that it has reversed the bone growth in Metro’s knees, we are treating him every 3 months to try to keep it from coming back.
I have listed his treatment below in Dr. Kim Brokaw’s words for anyone who thinks it might help their own horses, so they can pass on the information to their veterinarian. Or contact Dr. Brokaw at Walkersville Veterinary in Walkersville, Md.
Metro has osteoarthritis (degenerative joint disease) in his knees. He had a couple of chips/fractures during his racing career. While he had surgeries, he still developed osteoarthritis. Initially we treated his joints with steroids and HA, chondroitin and PSGAGs but were no longer seeing as much effect, hence why his owners consented to try the unproven medication (Tildren) to try and give him relief. Tildren is a bisphosphonate that has been shown to help horses with navicular disease, hock arthritis, and ringbone. Human studies have shown bisphosphonates to help with knee pain and arthritis.
The problem is that the carpus (knee) is a high motion joint. When the space fills in with bone there is pain, inflammation, and progressive loss of range of motion with the horse eventually losing ability to flex or fully straighten his knees. At this point in treatment Metro is now able to stand with knees fully extended (ie straight) and we are seeing decreased lameness and have resumed light riding. However, there is still loss of range of motion and while improved with the Tildren he is still not sound.
Metro is sedated with a combination of Dormosedan and butorphanol. A tourniquet is applied with a sphygmomoter. A butterfly catheter is placed in the cephalic vein and Tildren in saline is injected. The tourniquet remains in place for 30 minutes.