title: Multivariable analysis of factors influencing outcome of 2 treatment protocols in 128 cases of horses responding positively to intra-articular analgesia of the distal interphalangeal joint.
abstract: BACKGROUND
  There is limited knowledge available of factors influencing response to treatments of the DIP-joint in horses with lameness responding to diagnostic analgesia of the DIP-joint. For this reason a multivariable statistical analysis was performed.
  
  
  OBJECTIVE
  Horses with lameness reduced by > or = 75% 10 min after intra-articular analgesia of the DIP-joint, can be treated successfully by intra-articular medication of the joint. Multiple factors influence the response to treatment.
  
  
  METHODS
  The study was performed retrospectively based on clinical records of horses treated with either polysulphated glycosaminoglycan (PSGAG) or methylprednisolone acetate (MPA) in the DIP-joint between January 1996 and January 2003. Information was collected from clinical records and from the owners of the horses via a detailed questionnaire, in which they described their perception of the outcome a minimum of one year after treatment. Allocation of the horses to the 2 treatment groups was done mainly because of a change in treatment policy. In Regime A all horses received 3 intra-articular injections of PSGAG approximately 8 days apart, whereas in Regime B all horses received a single intra-articular injection of MPA as a first treatment. If the horse did not improve sufficiently to return to work by 4 weeks, a series of 3 intra-articular PSGAG injections was administered.
  
  
  RESULTS
  Of the horses receiving Regime A, 67% had a successful outcome, compared with 46% of the group receiving Regime B. A significantly better result was obtained in dressage horses than in jumping horses (eventing and showjumping). Other variables such as age, duration of lameness, distribution of lameness, degree of lameness, response to DIP-joint analgesia and radiographic observations were also associated with success of treatment.
  
  
  CONCLUSIONS
  There is a rationale for using either PSGAG or MPA intra-articularly in the treatment of lameness, reduced > or = 75% within 10 min of analgesia of the DIP-joint.
authors: Willesley Equine Clinic Ltd., Tetbury, Gloucestershire, GL8 8QU UK.
authors: K K
authors: KK
authors: Kristiansen
authors: S E
authors: SE
authors: Kold
mesh_terms: D000698:Analgesia / Q000379:methods / Q000662:veterinary*; D000772:Anesthesia, Local / Q000379:methods / Q000662:veterinary; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005260:Female; D005534:Foot Diseases / Q000188:drug therapy / Q000517:prevention & control / Q000662:veterinary*; D006025:Glycosaminoglycans / Q000627:therapeutic use; D006734:Horse Diseases / Q000188:drug therapy* / Q000517:prevention & control; D006736:Horses; D007270:Injections, Intra-Articular / Q000662:veterinary*; D007592:Joint Diseases / Q000188:drug therapy / Q000517:prevention & control / Q000662:veterinary; D007794:Lameness, Animal / Q000188:drug therapy / Q000517:prevention & control; D008297:Male; D008775:Methylprednisolone / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077555:Methylprednisolone Acetate; D015999:Multivariate Analysis; D010146:Pain / Q000517:prevention & control / Q000662:veterinary; D012189:Retrospective Studies; D013997:Time Factors; D014033:Toe Joint / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D006025:Glycosaminoglycans; C013786:A73025; D000077555:Methylprednisolone Acetate; D008775:Methylprednisolone