Regional Tiludronate for Navicular Syndrome

Tiludronate is a bisphosphonate medication used to prevent the loss of bone density by decreasing the activity of osteoclasts, cells that cause bone resorption when active. The drug is approved for the treatment of navicular syndrome when given systemically by intravenous injection, however this study examined the benefits of administering tiludronate by regional limb perfusion — a technique where the medication is injected into a vein in the lower limb while a tourniquet holds the injected solution in that part of the leg for 30 minutes. Subjective lameness scores and peak vertical ground reaction forces for the more severe lame limb were compared over time between two groups of horses treated with different dosages of tiludronate and a placebo control group.

No difference in subjective lameness scores or average peak vertical ground reaction forces was detected over time within any of the treatment groups. However, the horses treated with the higher dose of tiludronate had higher ground reaction forces, 120 following treatment compared with controls and the horses treated with the lower dose. This is objective evidence that horses were less lame when treated with the higher dose, but the authors are quick to point out that this improvement was only marginal when compared to the expected improvement with traditional shoeing and anti-inflammatory injections into the coffin joint, two treatments that were also simultaneously used for all the horses in the study. The authors concluded regional limb perfusion offers little extra benefit to a single…