Introduction
As an equine veterinarian you will be evaluating lameness cases every day. Some of these can be a real challenge to treat. Having a variety of appropriate treatment options at your disposal is of utmost importance to satisfy your clients’ needs and keep their horses performing.
Osphos has revolutionised the way the bone disease of navicular syndrome can be treated.
Learn more about Osphos and the experiences of your veterinary colleagues below.
Ashlee Watts. PhD, DVM, DACVS. Assistant Professor, Equine Orthopedics. Texas A&M University.
(Mitchell et al. 2019)
Chris Kawcak, PhD, DVM, DACVS, DACVSMR. Professor, Orthopedics & Equine Sports Medicine. Colorado State University.
On 14th May 2019 a meeting on Clodronate Use in Horses was held in Denver, Colorado, organised by LifeLearn Animal Health. A range of experienced equine practitioners and lameness specialists were invited to discuss their experience of clinical use of Osphos in horses of all disciplines. They also discussed the latest clodronate research and how this research can be utilised by practitioners to gain maximum benefit from Osphos.
Reasons to choose Osphos
Osphos
✔ Is the only veterinary approved bisphosphonate product that can be easily administered via the intramuscular route
✔ Is the only veterinary product that contains clodronate (clodronic acid), a non-nitrogenous bisphosphonate, as the active ingredient
✔ Provides clinical improvement lasting up to 6 months to horses with navicular bone disease after a single administration
Osphos is easily administered via intramuscular injection.
- The total injection volume should be divided between 2 - 3 injection sites.
- Suitable sites for injection:
1. Centre of the lower neck
2. Pectoral muscles
3. Gluteal muscles - No need for repeated IV injection or for IV catheterisation, reduces risk of thrombophlebitis and makes treatment quick and easy.
Osphos solution for injection is presented in a 15 ml vial, sufficient to treat one horse.
Recommended dosage: 3 ml per 100 kg of bodyweight, with a maximum of 15 ml per horse.
Bisphosphonate classes and how this affects use
There are two distinct classes of bisphosphonates, each class has a different mechanism of action and different side effects. It is important for veterinarians to understand the differences.
Clodronate
● As with other non-nitrogenous bisphosphonates, the primary action of clodronate is an anti-resorptive effect in bone. However there is some evidence that the clodronate molecule specifically may also possess other properties such as anti-inflammatory effects. (Markell et al. 2019). Osphos is not approved for use as an anti-inflammatory drug.
● No specific detection time has yet been published by the FEI, whereas the BHA (British Horseracing Authority) has published a stand-down period of 30 days for both clodronate and tiludronate.
Clinical studies have demonstrated that horses with navicular syndrome respond positively to treatment with Osphos.
- Frevel et al. Clodronate disodium for the treatment of clinical signs of navicular disease – a double-blinded placebo-controlled clinical trial. Pferdeheilkunde 2017;33:271-279.
Differences in lameness improvement at Day 56 after treatment
- 75 % of horses had responded positively to Osphos treatment by day 56. This was highly statistically significant compared to the control group (p = 0.0028).
- 48% of the horses treated with Osphos were sound at day 56, compared to 0% of horses in the control group.
- 66% of horses treated with Osphos maintained the improvement in lameness for 6 months. Differences in lameness improvement at day 56 after treatment.
Other studies have confirmed the positive effect of Osphos for the treatment of bony conditions associated with navicular disease.
- Mitchel et al. Clodronate improves lameneness in horses without changing bone turnover markers. Equine Vet J. 2019;51(3):356-363.
- Stoiber et al. Therapeutic options for treatment of navicular bone disease with clodronic acid under practice conditions – a retrospective case series with 35 horses. Tierärztliche Umschau 2017;9:324-330.
- Argüelles et al. Clinical efficacy of clodronic acid in horses diagnosed with navicular syndrome: A field study using objective and subjective lameness evaluation. Res Vet Sci 2019;125:298-304.
Side effects
Side effects recorded during the clinical field trial were mild and transient (Frevel et al. 2017)
For more information about incidence and type of adverse reactions please click here.
Interactions with other medicinal products
Medications such as aminoglycosides, whose toxicity can be exacerbated by a reduction in serum calcium, and medications such as tetracyclines, that can reduce serum calcium, should not be given for 72 hours after administration of clodronic acid.
Concurrent administration of potentially nephrotoxic drugs, such as NSAIDs, should be approached with caution and renal function should be monitored.
For more information about warnings and interactions please click here.
- Markell R., Saviola G., Barker E. A., Conway J. D., Dujardin C. (2019). What do we know about clodronate now? A medical and veterinary perspective. Journal of Equine Veterinary Science https://doi.org/10.1016/j.jevs.2019.102874 102874.
- Frevel M., King B. L., Kolb D. S., Boswell R. P., Shoemaker R. S., Janicek J. C., Cole R.C., Poole H.M., Longhofer S. L. (2017). Clodronate disodium for treatment of clinical signs of navicular disease–a double-blinded placebo-controlled clinical trial. Pferdeheilkunde, 33, 271-279.
- Stoiber J., Koene M., Mageed M., Swagemakers J. H. (2017). Therapeutic options for treatment of navicular bone disease with clodronic acid under practice conditions-a retrospective case series with 35 horses. Tierärztliche Umschau 72(9), 324-330.
- Argüelles D., Saitua A., de Medina A. S., Muñoz J. A., Muñoz A. (2019). Clinical efficacy of clodronic acid in horses diagnosed with navicular syndrome: A field study using objective and subjective lameness evaluation. Research in Veterinary Science, 125, 298-304.
- Mitchell A., Wright G., Sampson S. N., Martin M., Cummings K., Gaddy D., Watts A. E. (2019). Clodronate improves lameness in horses without changing bone turnover markers. Equine Veterinary Journal, 51(3), 356-363.
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