Problems attributable to clinical manifestations of pain associated with lesions of the thoracolumbar vertebral column are often reported as a major cause of poor performance and gait abnormalities in sport and race horses.1–3 These can result in a wide array of pathologic manifestations during exercise,2–4 which include reduced performance, changes in behavior, reluctance to jump, difficulties in jumping fence combinations, bucking, rearing, resistance to saddling, stiffness in the thoracolumbar or cervical regions, and ill-defined or intermittent lameness of the hind limbs. Imaging techniques have improved such that they can provide essential information on lesions that potentially are causing the pain. Currently, the combination of radiography, ultrasonography, and scintigraphy allows identification of lesions of the spinous processes, AP–SIVJs, and vertebral bodies.5–7
Management of horses with manifestations of pain associated with lesions of the thoracolumbar vertebral column primarily is aimed at removing or alleviating the pain so that they can comfortably resume regular training programs.2 This usually is achieved by local injections of corticosteroids at the site of lesions. To our knowledge, no systemically administered treatment has been scientifically assessed for use in the treatment and management of affected horses. Tiludronate is a bisphosphonate that reportedly8 is efficacious for use in the treatment of horses with bone spavin or navicular disease with osteolytic lesions. Because bone lesions are considered to be a primary cause of pain associated with the thoracolumbar vertebral column, we hypothesized that tiludronate could regulate bone remodelling and result in clinical improvement in horses with pain associated with lesions of the thoracolumbar vertebral column. Therefore, the study reported here was designed to assess the efficacy of tiludronate administered IV as a single slow-rate infusion for the treatment of horses with pain associated with lesions of the thoracolumbar vertebral column.
Articular processes–synovial intervertebral joint
Nonsteroidal anti-inflammatory drug
Score for reduction of dorsal flexibility
Region of interest
Teceos, CIS Bio International Schering, Gif-sur-Yvette, France.
Ecam Siemens Erlangen, Siemens, Saint Denis, France.
Hermes, version 3.4, Nuclear Diagnostics Ltd, Northfleet, Kent, UK.
Tildren, Ceva Santé Animale, Libourne, France.
SAS, version 8.2, SAS Institute Inc, Cary, NC.
Varela AM, Lepage OM, Garnero P, et al. Tiludronate in horses: tolerance and effects on bone resorption (abstr). J Bone Miner Res 2001;16(suppl 1):S407.
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