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Horse or Equine TMJ and Joint Problems

 TMJ and joint problems in horses are issues I have seen in many horses.  Signs that your horse could be having TMJ problems are numerous. 

They may include:  

feeling heavy in your hands      

pulling the reins out of your hands

head twisting, head tossing, or head shaking (causing riders to think the horse doesn't like the bit)

stiffness in it's neck or back (causing riders to think that the saddle doesn't fit)

sometimes even balking, rearing, bucking, or other violent behaviors

     The main cause of TMJ problems sometimes start with dental work.  Your horse MUST have it's teeth floated by a veterinarian.  The natural wear and tear and growth of teeth, makes this necessary.  However, having the jaw placed in the spectrum that clicks as it opens can cause the TMJ to become sore and get out of it's natural alignment.  For horses that must go "on the bit," this places additional stress on the TMJ.   This joint can cause the horse an enormous amount of pain, which if it's gone on for a while, can be intolerable. 

   It's not your fault, most riders have never heard of this before.  Many vets do not realize the pain and behavior problems this small joint can cause.  The great thing is that it is an easy fix.  Please read on.

    What is the TMJ?  This is the Temporal Mandible Joint.  "The mandible (lower jaw bone) of the horse is the largest bone in the face.  When seen from the side, it is shaped like a boomerang, one end at the mouth, the other in the area of the cranium.  Here it articulates with the temporal bone, at a joint formed by the temporal fossa and the coranoid process." (The illustrated Veterinary Encyclopedia for Horsemen, p. 319)  It is located behind and just above the eye on both sides of the face.  

    How do I know if my horse's TMJ is sore?  Besides the symptoms I mentioned above, there are 2 ways to check the TMJ.                              

 -If you look where the brow band would meet the cheek piece if a bridle was on, you will find two bumps.  These are the two bones of the TMJ.   Just below these two bones, as you run your fingers toward the mouth, you can feel two nerves that run down the side of the horse's face.  This is where you can check if your horse has a sore TMJ.  If you press on these two nerves, just below the two bumps, there should not be any reaction.  This would mean the TMJ is normal.  However if you press here and your horse slowly moves away or tilts it's poll away from the pressure, your horse does have a sore TMJ.  Be careful, some horses are so sore, they will move away very quickly and violently.                     

-A second test is to stand in front of the horse and try to slowly slid the lower teeth back and forth.  You should be able to slide the jaw at least one tooth to the right and one to the left.  If not, there is a TMJ problem

    What do you do if your horse has a sore TMJ?  The first thing is to find a veterinarian chiropractor who is familiar with this joint.  Some of them are and some are not.  If you cannot find one who is, but is willing to learn about this problem, I would be happy to put them in touch with a vet or explain to them how to adjust the TMJ.  It is relatively easy once you know where to place your hands.  If however, your horse's chiropractor does adjust the TMJ and it is still sore, your veterinarian may need to inject the joint.  This is usually a one time injection of Legend and cortizone.   My vet would be happy to share with your vet the dosage and placement of the injection.  Simply contact me, and I will give you my vet's phone number.  Your vet will need to call him and he will be happy to share the exact dose, type, and location of the injection.  This procedure takes a few minutes and is usually a one time treatment.  It could make a world of difference in your riding and your horse's comfort and ability to perform movements. Your horse's behavior could completely change overnight.

    The correct alignment of the TMJ is extremely important for all horses.  But it is critical if we expect our horses to perform in a correct manner. 

   I cannot express enough how this small joint can cause many horses extreme pain and lead to bad behavior.

Here is a video that might help.  http://youtu.be/fmPvt43fTtg   I like about 2 minutes into the video where it shows how to manipulate the jaw.  However, I do not stick my finger in the horses mouth.  I like to keep the mouth closed and then push straight sideways.

 

    Hocks and Joints

    Another problem for performance horses are sore hocks.  It is very hard for a rider to feel a hind end lameness.  It is also hard to see a hind end lameness unless you have developed an eye for it.  Usually, the rider feels that the horse is not pushing from behind like it used to or it's just hard to get the horse to go forward on it's own.  The easiest way is to do a flex test on the hocks.  This is a two person job.  One to be at the head of the horse ready to trot him off immediately after the second person flexes the hocks tightly for at least 60 seconds.  If the horse take even one bad step, you could have hock problems.  There are various treatments available to discuss with your vet.

    A very effective treatmentis to have a vet inject the horse's hocks.  "Corticosteroids are the most potent anti-inflammatories."  (USDF Connection, Feb. 2004, pg. 41.) Most working horse's need their joints injected every 6 - 12 months.  It is extremely effective.

     There is another option available that utilizes the horse's own cells to aid in the healing process.  This process is known as IRAP or interleukin-1 receptor antagonist proteins.  IRAP was developed in Europe as a treatment for osteoarthritis.  The vet draws the horse's blood in a special tube.  The blood is processed to produce regenerative and anti-inflammatory proteins, which are injected back into the horse's joints.  

     Extracorporeal shock wave therapy or ESW can very effective when used on bone changes and tendons and ligaments where they connect to the bones.  A specific sound wave is used to penetrate the body and release energy.  This energy stimulates the body's own healing process. ESW can significantly reduce lameness and synovial fluid in the lower joints of the hock and in the rear third of the heel associated with soft tissue trauma.

    New to the joint world is Tildren.  This helps with bone damage such as Navicular and Ring bone.  This kills the cells that are damaging the bone and promotes the healing cells.  This is usually given once a year.

   Joints need daily maintence. 

    Of course, maintenance of the joints is extremely important.  There are two things that are a must.

    First is Glucosamine which helps keep cartilage healthy.  "Glycosaminoglycans inhibit the enzymes that damage cartilage."  (USDF Connection, Feb. 2004, pg. 41.)  Studies have proven that the use of intramuscular injections do help to maintain healthy joints.  There are three on the market; Adequan, ChondroProtec, Acetyl-D-Glucosamine 20%. You can obtain these from your vet or have your vet write you a prescription.  They should be given every four  to seven days.  There are several companies that you can purchase your glucosamine, I have found Precision Pharmacy a reliable source for Acetyl-D-Glucosamine 20%.  Their contact information is listed on the Ulcer page of this web site.

      Daily Glucosamine can be added to the feed.  There are a lot of products that have not been tested for there effectiveness.  One product that has is Cosequin.  I use the Cosequin ASU. New research on using a supplement with avocado and soy, which is thought to somewhat decrease interleukin-1 levels and cartilage disease scores. 

    The second, and I feel most important is Hyaluronic Acid.  It "binds to proteoglycans and prevents the leakage of cartilage components.  It stabilizes cell membranes." (USDF Connection, Feb. 2004, pg. 41.)  This is extremely important to maintain healthy fluid in the joints.  A study in Great Britain has shown that feed through Hyaluronic Acid DOES get absorbed by the horse and DOES enter the joints.  I am currently using LubriSyn.  It's not cheap, but I know this is working with my mare.  While injecting her joints, several now have fluid in them, where they were dry before.  The cheapest place I have found it is on www.amazon.com  I take the HU version myself and I know it works.

    I have found a new product call Pentosan.  It is injected 6 cc IM and is supposed to help the cartilage, help the HA, and  reverse joint damage.  Here is a video link for more info  http://youtu.be/CN3DX6zyqXw  I have just started this product, but it was highly recommended by several vets I spoke to.  If you can get a vet to call you a prescribe it, you can get it at www.WedgewoodPetRX.com

 

  There are several natural foods you can feed.

   Dried cabbage and Kale, can help your horse produce it's own Glucosamine for it's joints.  The cabbage is full of the amino acid, L-Glutamine, this along with Kale (sulfur), is what the body uses to make joint fluid.  You feed 1/2 cup of dried cabbage/Kale. I have found this to be the effective.  You can get the dried cabbage at www.harmonyhousefoods.com or dry your own.  I use this along with joint supplements. I have seen great results in feeding this way.  I have been able inject her joints less often.

   New research has found that the herb Rosa Canina, or better known as Rose hips, can reduce inflammation in the joints.  The research in a double blind study showed horses given 210 grams of Rosa Canina every day showed better movement and less pain than horses who did not receive the herb.  This herb has shown to be effective in human studies and now it has been shown to be effective in horses too.  You can get it in powder and give 2 - 4 tablespoons per day from www.glenbrookfarm.com/herbs.

    Another great anti-inflammatory is Fenugreek.  I feed 2 tablespoons per day.  This is also from Glenbrook.

     Research has proven efficacy of the use of omega-3 fatty acids to inhibit enzymes that break down the cartilage matrix. In a three- to four-month period, horses supplemented with omega-3 fatty acids seemed to have less stiffness and pain related to osteoarthritis. You can add Omega- 3 to your horses system, by adding 1/2 cup ground Chia seeds, 1 cup of ground flax, and/or Stablized Rice Bran.  I grind the seeds myself with a small coffee grinder.

   A great healing food for all athletes are raw hulled pumpkin seeds.  They are high in nitric oxide which will heal anything that needs it.  You can get the  pumpkin seeds from www.bulkfoods.com  Soak a 1/2 cup in water for 8 hours, drain, then feed the following day. You can soak them with the soy beans.  I eat some myself and give a few to my dogs too.  If you don't want to deal with seeds, you can order pumpkin seed powder from Glenbrook.  I give 2 tablespoons.

    Natural sources of Vitamin C.  This is great for healing everything.  There are several ways to feed this.  You can slice Oranges, feed Orange peel powder, Grape seed powder, Green Tea powder, Turmeric powder, and/or Barley grass.  Do not use synthetic Absorbic Acid.  It is not digestable.

    Here is what I feed my athletic horses to help them perform at their best.   I split these amounts and feed AM and PM.  You can decide to feed whichever you would like.  As with all feed changes, you should take 7 - 10 days to work up to the suggested amounts.  

Foods and supplements to help athletic horses:

1 or 2 squirts of LubriSyn (Hyaluronic Acid increases joint fluid) 

1 or 2 scoops Cosequin ASU (promotes healthy Cartilage)

1/2 cup soy beans (soaked/drained) or 4 cups Soy Bean meal (high protein for amino acids),  

4 cups Rice Bran (Omega 3's)

1/2 cup ground Chia seeds (Omega 3's)

1 cup ground flax seeds ( Omega 3's),   

1 dried leaf of Kale (anti-inflammatory)

1/2 cup dried cabbage (L-Glutamine makes glucosamine for the joints)

2 Tablespoons of Fenugreek (anti-inflammatory)           

2 Tablespoons Rosehips (rosa canina) powder (anti-inflammatory)

1/2 cup soaked pumpkin seeds or 2 T of powder (heals everything)

1/2 Orange, Orange peel powder  (Vit. C)

1 cup of Barley grass (Vit. C)

     It is important for the soundness of the horse to do everything that we can to help them perform.  Most "horse" products on the market are expensive with a 200 - 500% mark up and recent studies have shown that many do not even contain the amounts of additives they claim.  With the above things, I believe they help the joints, thus my horse is staying more comfortable, performing better, and having a longer career.