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For today’s topic, we will discuss Ringbone! For any readers not familiar, this condition affects the coffin joint. The coffin joint is the joint in the foot of a horse that connects the lower-most bone in the hoof (referred to as either the coffin bone or the pedal bone) with the bone right above in, called the Pastern Bone.

Ringbone is a painful condition caused by bone growth in the coffin joint, similar to osteoarthritis. For more information on osteoarthritis in horses, check out our blog post on it! Ringbone can affect horses of any breed, age, or discipline, but it most often effects mature horses who have experienced intensive training. Ringbone most commonly effects the front legs of a horse, but it can also affect the hind legs.

High and low ringbone

A horse can experience ringbone in multiple parts of the coffin area. If the growth occurs in the pastern, the horse will likely be diagnosed with high ringbone. Alternatively, if the growth occurs in the coffin bone, the horse will be diagnosed with low ringbone. While both conditions are similar, low ringbone will cause a moderate lameness even in early cases, where as high ringbone may only cause a mild lameness. In advanced cases, the horse may have more severe lameness and pain.

Diagnosis of either type of ringbone will require a lameness test from a veterinarian, including flexion tests to localize the source of the pain. At this point, the veterinarian will likely take radiographs to identify the extent and direction of the bone growth.

Treatments for ringbone

Unfortunately, ringbone cannot be reversed, but it can be limited. A large part of treating ringbone in a horse is focused around limiting the advancement of the condition, and managing the horse’s pain.

  1. Managing your horse’s weight can make a huge difference in the pain of the horse and the progression of the disease. An overweight horse will place more weight on the effected joints, which can also lead to additional problems. For more information, read our post on equine laminitis.
  • Routinely work with your farrier to regularly trim the horse’s hooves, and appropriately shoe the horse. This can limit the pain by changing the distribution of the weight of the horse to be more equally balanced, and reduce the pressure that is on the pastern bone. This treatment is most effective if applied in early cases, and may require the farrier and the veterinarian to work together to determine the best shoeing options for the horse.
  • Feed supplements designed for joint support can help reduce inflammation and support healthy cartilage growth. We recommend using supplements that include glucosamine, chondroitin sulfate, Omega-3s, MSM (methylsulfonylmethane), and hyaluronic acid.
  • Anti-inflammatory drugs, such as NSAIDS are an excellent resource for managing pain. However, a veterinarian may prescribe other drugs, such as phenylbutazone.
  • Corticosteroid injections, hyaluronic acid injections, and in Europe (due to pending FDA approval in the US), polyacrylamide hydrogel into the joint.
  • Bone Remodeling medications, such as Osphos and Tildren, which bind to calcium and inhibit bone resorption.
  • Surgery – reserved for severe cases where horses have not responded to the previously mentioned treatments. The surgery, called arthrodesis, fuses the joint. The recovery for this kind of surgery can take six months to a year, and it often alters the gait of the horse. There is only a 50% chance of the horse returning to its full performance that it had prior to experiencing ringbone. However, it does resolve the pain of the horse and can help the horse to still have an active and fulfilling life.

Undoubtedly, early treatment of ringbone results in a better prognosis and is often most helpful. If you suspect your horse may have ringbone, or may not be feeling well in general, it may be time to call your vet.

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