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Use of zoledronate for treatment of a bone fragility disorder in horses

Scott A. KatzmanWilliam R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Jorge E. NietoDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Amanda M. ArensJD Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Melinda H. MacDonaldDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Sarah M. PuchalskiDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Larry D. GaluppoDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Jack R. SnyderDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Omar MaherWilliam R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Robin J. W. BellWilliam R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Abstract

Objective—To assess clinical outcomes and scintigraphic findings in horses with a bone fragility disorder (BFD) treated with zoledronate (a nitrogen-containing bisphosphonate).

Design—Prospective uncontrolled clinical trial.

Animals—10 horses with evidence of a BFD.

Procedures—Signalment, history, and geographic location of horses' home environments were recorded. Physical examinations, lameness evaluations, and nuclear scintigraphy were performed. Diagnosis of a BFD was made on the basis of results of clinical and scintigraphic examination. Each horse was treated with zoledronate (0.075 mg/kg [0.034 mg/lb, IV, once]) at the time of diagnosis. Horses were reevaluated 6 months after treatment.

Results—Affected horses were from the central and coastal regions of California and had ≥ 1 clinical sign of the disorder; these included scapular deformation (n = 2), lordosis (1), nonspecific signs of musculoskeletal pain (1), and lameness that could not be localized to a specific anatomic region (9). All horses had multiple sites of increased radiopharmaceutica uptake during initial scintigraphic evaluation of the axial skeleton and bones of 1 or both forelimbs. Six months after treatment, clinical improvement (defined as improvement in the lameness score, resolution of signs of musculoskeletal pain, or both) was detected in 9 of 10 horses; scintigraphic uptake was unchanged (n = 2) or subjectively decreased (8). No adverse effects attributed to zoledronate treatment were detected.

Conclusions and Clinical Relevance—Treatment with zoledronate appeared to be useful in improving clinical outcome and scintigraphic findings in horses with a BFD; however, future placebo-controlled studies are necessary to accurately determine efficacy and long-term safety.

Abstract

Objective—To assess clinical outcomes and scintigraphic findings in horses with a bone fragility disorder (BFD) treated with zoledronate (a nitrogen-containing bisphosphonate).

Design—Prospective uncontrolled clinical trial.

Animals—10 horses with evidence of a BFD.

Procedures—Signalment, history, and geographic location of horses' home environments were recorded. Physical examinations, lameness evaluations, and nuclear scintigraphy were performed. Diagnosis of a BFD was made on the basis of results of clinical and scintigraphic examination. Each horse was treated with zoledronate (0.075 mg/kg [0.034 mg/lb, IV, once]) at the time of diagnosis. Horses were reevaluated 6 months after treatment.

Results—Affected horses were from the central and coastal regions of California and had ≥ 1 clinical sign of the disorder; these included scapular deformation (n = 2), lordosis (1), nonspecific signs of musculoskeletal pain (1), and lameness that could not be localized to a specific anatomic region (9). All horses had multiple sites of increased radiopharmaceutica uptake during initial scintigraphic evaluation of the axial skeleton and bones of 1 or both forelimbs. Six months after treatment, clinical improvement (defined as improvement in the lameness score, resolution of signs of musculoskeletal pain, or both) was detected in 9 of 10 horses; scintigraphic uptake was unchanged (n = 2) or subjectively decreased (8). No adverse effects attributed to zoledronate treatment were detected.

Conclusions and Clinical Relevance—Treatment with zoledronate appeared to be useful in improving clinical outcome and scintigraphic findings in horses with a BFD; however, future placebo-controlled studies are necessary to accurately determine efficacy and long-term safety.

Contributor Notes

Address correspondence to Dr. Katzman (sakatzman@gmail.com).