1. Hunter S. Lewis, DVM, DABVP Greene, Lewis and Associates www.greenelewis.com

2. Osteocondritis Dessicans (OCD) 1. Degenerative Joint Disease (DJD) 2. Characterized by cartilage damage, new bone formation and joint effusion. 3. Caused by “use trauma” Osteoarthritis Subcondral Bone Cysts

3. Osteoarthritis  Fetlock

4. Osteoarthritis

5. Osteoarthritis  Hock

6. Osteocondritis Dessicans (OCD) Osteocondritis Dessicans (OCD) 1. Developmental Orthopedic Disease (DOD) 2. Characterized by failure of normal bone formation Osteoarthritis Subcondral Bone Cysts Subcondral Bone Cysts

7. 3. Causes: a. Genetic predisposition b. Rapid growth c. Nutrition d. Mineral Imbalances e. Endocrine Factors 4. Can result in DJD Osteoarthritis Osteocondritis Dessicans (OCD) Subcondral Bone Cysts Subcondral Bone Cysts

8. Osteocondritis Dessicans (OCD)  Stifle

9. Osteocondritis Dessicans (OCD)  Hock

10. 1. Development Orthopedic Disease 2. Characterized by failure of normal bone formation and loss of normal bone 3. Same causes as OCD but trauma is also involved. 4. Can result in DJD Osteoarthritis Osteocondritis Dessicans (OCD) Subcondral Bone Cysts

11. Subcondral Bone Cysts Subcondral Bone Cysts  Stifle

12. Subcondral Bone Cysts Subcondral Bone Cysts  Stifle

13. Subcondral Bone Cysts Subcondral Bone Cysts  Fetlock

14. Assessment of Joint Treatment Symptom-Modifying Osteoarthritis Drug (SMOAD) Disease-Modifying Osteoarthritis Drug (DMOAD)

15. Types of Joint Treatment Oral Injectable Intra-articular

16. Types of Joint Treatment Oral 1. Glucosamin 2. Chondrotin Sulfate 3. Anti-inflammatories 4. ASU – Avocado, Soybean Unsaponifiable Extracts

17. Types of Joint Treatment Oral 4. ASU – Avocado, Soybean Unsaponifiable Extracts a.Did not improve lameness b.Reduced damage to joint c.Increased production of glycosaminoglycan d.Stimulated cell and tissue repair

18. Types of Joint Treatment Injectable 1. Adequon 2. Legend 3. Generics a. Polyglycan b. Map 5 4. Tildren

19. Types of Joint Treatment Injectable 4. Tildren  Inhibits bone resorption and may promote bone reformation  Shown effective in hock osteoarthritis and navicular syndrome  Most effective if used early in disease  Cost ??

20. Types of Joint Treatment Intra-articular 1. Corticosteroids 2. Hyaluronic Acid 3. IRAP – Interleukin-1 Receptor Antogonist Protein

21. Types of Joint Treatment Intra-articular 3. IRAP – Interleukin-1 Receptor Antogonist Protein  or ACS – Autologous Condition Serum  Blocks IL-1 release  Reduces negative effects of inflammation  Reduces pain  Improves synovial membrane health

22. Types of Joint Treatment Other 1. Extrocorporeal Shockwave Therapy 2. Surgery 3. Alternative Therapies