Diary of DJD
by
Cris Gardner

Degenerative Joint Disease (DJD) usually starts with the inflammation of the tissue (synovial membrane) that surrounds the joint. The synovial membrane responds to injury by becoming inflamed and allows white blood cells, that are normally filtered out of the joint, to enter. The inflamed synovial membrane and white blood cells release damaging enzymes that may damage articular cartilage.

Once the articular cartilage is damaged it may progress to Degenerative Joint Disease. DJD is not correctable and the course of treatment is to manage. Early detection is the key to successfully managing DJD.

We will present an ongoing dialog taken from the diary of Cris, the proud caretaker and owner of Shadow Fax, a 19-year-old Half-Arabian gelding who has been diagnosed with DJD.

2/10/01
Dear Diary,

What a winter - it has been going on forever; horses are in most days - Shadow Fax really needs to move; wish he'd longe. I know he knows how, he just hates going in a mindless circle, so I hate to force him. Marty came over tonight; said we needed to make a plan for Shadow Fax while he's in so much; he needs to longe in the indoor to get some exercise. We'll meet at the barn at night after work and he'll lounge Shadow Fax for me. Marty - I love you, horse friends are the greatest......

2/12/01
Wonderful - Shadow told Marty he didn't want to longe - Marty told him he had to - and Shadow settled right in - got a real nice Western jog going - that has to be really good for him. After awhile, he even looked like he enjoyed it - can't wait for tomorrow night.

2/16/01
Hey - this is great - we're getting into a regular routine; even I longe Shadow and he doesn't even give me that "I don't wanna" look anymore; first we longe, and then I ride - all in the indoors, of course, weather still awful.

2/24/01 
Didn't get to longe much this past week - no matter, I rode him today, and will ride him tomorrow -still in the indoor, horses up way too much due to weather - rain, rain, rain - too slippery to let them out these days. I can tell Shadow wants to move - every time I ask him to trot, he goes into a canter don't blame him, so we canter.

2/25/01
Marty came to be barn and said we should longe - so we got Shadow from his stall and brought him into the indoor arena. He looked lame - I noticed it, soon as Marty started longing him. I told Marty to stop - it didn't look right. Marty asked me to longe Shadow so that he could watch him - said that he agreed - but it was ever so slight. Probably nothing to worry about - my mind was racing - could he have twisted something the day we were longing him and he did a quick spin around when something spooked him from behind? Could it be a stone bruise? Maybe just something like that - there are plenty of rocks in the indoor arena. We checked his legs and couldn't find anything - put him back in his stall and decided to wait a few days and see how he did - I always panic, and try not to - so, let's wait a few days and see how he is.

2/28/01
Had barn owner, Roger, look at Shadow walking and trotting; asked if he could see that Shadow was off. He said, not really, maybe ever so slightly; but if he was very obvious Sunday, and already doing that much better today, it was probably nothing to worry about! Well, good - he is pretty good about what's ailing horses, he can spot a lame horse at a mile - guess I'll just continue to not ride him for a little longer, and all will be well. Anyway, I got on him for a short while the day Marty and I first noticed it, and Marty said that it looked like he warmed out of it after a few minutes.

3/14/01
No - something is not right with Shadow Fax - I know he's been in his stall way too much and I haven't been riding him; mostly I have seen him at a walk; but when I asked him to trot tonight, that limp was back - I'm calling the vet tomorrow - 

3/15/01
Met with Dr. Ramsey tonight after work - he longed Shadow to see him move. Said that yes, he's off - then he did the hoof test - no response from Shadow - obviously not a stone bruise. Asked when he was shod last - 2 weeks ago - well, then not from a bad shoing job, obviously! Then he did the flex test - when I took off with Shadow after he did the right hind leg, the verdict was in - right hind leg was the problem.. At this point, my heart was falling - last fall, at the barn, a horse was diagnosed with DJD - he can never be ridden again. And Marty's words "He seemed to warm out of it" kept ringing in my ears - I know so little about horse health, but my now I'm getting an awful feeling about it - it was getting pretty late, and Dr. Ramsey suggested we meet tomorrow, Saturday at 9 a.m., and he'll do some X-rays. I think he is suspecting DJD as well, cause he went on to tell me about treatment for it.....but finished by saying that we will see what the X-rays show. When I came home, I called Marty - he promised to be there, so that he can explain (over and over again) what the vet is saying - I'm such a fool when it comes to medical terms.

3/17/01
I knew it, I just knew it - DJD - it felt like the end of the world when the X-rays confirmed my suspicion. I know so little about horses - but again, "He warms out of it" kept ringing in my ears - Dr. Ramsey came and took 6 X-rays of Shadows legs - then came back and did 2 more - he X-rayed both hind legs for comparison. Then afterwards Marty and I met with him in his office....bless Marty, he knew why he was there - to hear everything, the treatment options and then explain it to me - several times over. If I understand everything right, one option, according to Dr. Ramsey, is to bute him and ride, ride, ride - and eventually the bones will fuse, and the lameness will be very slight - well, the way he said that, he went through that very quickly - he knows how I feel about Shadow Fax; I think that is mostly for people who show, and just want the horse to perform at any cost - Dear Dairy, I'm so depressed let me tell you more tomorrow------

3/18/01
.....so, another option is to inject something directly into the affected joint - according to Dr. Ramsey, Shadow's problem is in a low motion joint which is good and it's only just started - it was caught early - however, this is very invasive and there is a chance of infection- his comment - but there is an other option....Adequan - a shot given once a week for 6 weeks in the neck, and glucosamine in his feed every day. 

3/19/01
Dr. Ramsey called me and said the Adequan will be here by Thursday and Shadow can have his first shot then; he told me to check on the glucosamine - should be 7500 mg...

3/21/01
Ordered the glucosamine - from State Line Tack - their own brand - 7500mg - having it shipped fast - will be here Friday - day after Shadow Fax's first shot...

3/22/01
Shadow got his first shot of Adequan - and of course I can't ride him - for how long? Dr. Ramsey said at least 5 weeks - well, I haven't ridden him since the day I first noticed he was lame - had thought I could get on him and just walk - Dr. says no - so I won't - if this treatment doesn't work, I sure don't want it to be because I didn't listen to him....Flex Formula should be here tomorrow - will start Shadow on that.....

3/29/01
Shadow got his second shot of Adequan - Dr. Ramsey didn't want to see him move after his first shot - guess he wanted to keep the way he moved before the treatment started in his mind - this time, he had me walk and trot Shadow - said he thought he looked better....

4/1/01
Well, finally - the weather is warming up - high time. 
Shadow is not eating his glucosamine; according to instructions on container, he should have 2 scoops a day for 2-3 weeks, then 1 scoop after that for maintenance. I was hoping the glucosamine would mix enough with the powder of Equi-Jewel that he would eat it....he HAS to have the glucosamine according to Dr. Ramsey! When I mixed the ground bute tablets into his feed, he ate it....of course it was only one tablet - still - bute has a strong taste. At every feed, he leaves enough feed in his bucket, telling me he is not in taking the amount he should be. First I thought that he would finish it sometime during the night, but he isn't - every evening when I get to the barn after work, the leftovers are still there.....he has to eat it...

4/5/01
Well it worked - I gave him one feeding without any glucosamine - and of course he finished it! Then I started several feedings with half the recommended dosage of glucosamine - he's getting used to the taste now - tomorrow I'll start doing twice the volume - also tomorrow is shot No. 3.....

4/7/01
Beautiful day - and Shadow is finishing his feed and getting the full dose of glucosamine. I should have thought about it in the beginning and eased him into the new taste. He got his 3rd shot yesterday - he just stands perfectly still and takes it - it must not be a painful shot at all! Good.

I try not to watch him moving - I'm afraid to. I'll wait till the shots are all over. 

I look at him, his shiny, healthy looking coat - how can this horse possibly be sick? How deceiving it seems.. the fastest horse in the pasture, the one full of life, the high stepping, snorting, alert, watching everything, self-confident, personality plus horse - it can't be true that he is the one with a decease that will change his ability to be that lively, smooth moving creature.

4/9/01
Got to the barn after work tonight - Shadow was just being brought in from the field for the evening! It was awful - used to only be able to notice his limp at the trot - tonight I could see it at the walk. I thought he was supposed to be getting better - I'll call Dr. Ramsey first thing in the morning - maybe he can stop by and have a look at him. Roger said he behaved very lively earlier in the day when he took him out to the field - so why is he limping now?

4/10/01
Dr. Ramsey said there will be days with "flare-ups" of his condition - I don't want to hear it. I thought the warmer weather would make him feel better - after all, it's been in the 80ties lately. He's in the field every other day, and up in his stall every other day - the first 10 days when he was on bute, he sure seemed to be lively to put it mildly - maybe not good for him to run that much. I'll ask Dr. Ramsey if we should give him bute on days when he is confined to his stall - day after tomorrow is his 4th shot - I'll ask him then.

4/11/01
Shot No. 4 tomorrow - brought Shadow in from the field myself tonight - walked ahead of him - never glanced to see how he was walking - am afraid to. Meeting Dr. Ramsey at 8am at the barn tomorrow.

4/12/01
Dr. Ramsey agreed with me this morning - Shadow Fax looks worse! I hate it when I'm right! 

We met in the am, I brought Shadow out of his stall, and he could see him moving his right hind leg more stiffly than he did last week. Said we might have to get more aggressive, and go to plan B, some shot that is injected directly into the hock. But first, he said, let's get together and do another X-ray - see if there is any visible change to cause him being worse - gave me 14 Bute tablets to use as I see fit. As he's in his stall every other day, and in the field every other day, I think I'll give him the bute on the days he's up - don't want him to feel better than he feels due to bute, and overdo his running in the field. Dr. Ramsey is fully booked it seems - Monday evening is the earliest he can do more X-Rays - Monday evening it is!

I felt so depressed - we caught his DJD so early - and the shots aren't working? He's WORSE? Got on the net, wrote an e-mail to the makers of Adequan - asked them if we were doing anything wrong - is anything I'm feeding him counter-acting the proclaimed effects of the product? Could they offer any suggestions? Hope somebody has a magic wand that will make Shadow all better...

4/13/01
No answer on the e-mail from the Adequan people - rained, Shadow up in his stall all day - got him out when I got there after work, walked him a little, fed him his daily carrots, and cleaned his stall while he was eating his evening hay.....

4/15/01
More rain - Shadow stall bound all day - didn't get to the barn till evening feed time - pulled him off his hay, and walked him a little outside; Sandra and Roger told me they thought he looked better, walking and trotting...

4/16/01
Tax Day - glad I did mine early and don't have to stand in line at the post office! 

When I got to the barn after work, Shadow was outside grazing with his group - so I left him there while I cleaned his stall. Dr. Ramsey will probably be late for our 5:30 appointment, and as Shadow is going to be in his stall all day tomorrow - leave him out in the sunshine till Dr. Ramsey gets here. Dr. Ramsey and I have an agreement - for routine calls, I'll wait till he can get here - a 2 hour wait is not a problem - I'll wait - but if I ever say "Get here now" - be here - I need you NOW! And he'll be here in no time...

Well, 7:30 he got to the barn - they just brought the horses in - I pulled Shadow back out of his stall - made him walk and trot for Dr. Ramsey -who said he looked better than last Thursday - confirmed by Sandra, who said he came flying at a gallop when she called the horses in for their evening meal. I didn't see it , I was busy cleaning his stall - but, according to Dr. Ramsey - let's put off the X-rays, as he seems better today! So, pray they are all right - next shot on Thursday morning as usual.

When I came home, there was an e-mail from the Adequan people - said they don't know why Shadow isn't better after the shots he has had - said, that usually results are seen after 2-3 weeks of treatments - they recommend a shot every 4 days (500 mg) for a total of 7 shots; we're doing one shot a week for 6 weeks - I'm going to call Dr. Ramsey in the morning and let him know what they said - are we spreading the shot over too many days for a result to show up? 

Wrote the Adequan people back - asking them to explain their plan (as opposed to Dr. Ramsey's) - hopefully they will answer, and if theirs make sense, when I tell Dr. Ramsey, if it makes sense to him, I know we'll switch to every 4 days and 7 shots instead of 6...

Wrote back to the Adequan producer - told them about 1 shot a week for 6 weeks - asked them to please answer my e-mail again, in case Dr. Ramsey's plan is wrong. Can't wait to see if they'll answer my e-mail again...

4/17/01
Got an e-mail back from the Adequan people - they explained that their basis for a shot every 4 days x 7 is that Adequan reaches therapeutic levels in all Synovial joints within 2 hours, and remains at that level for approx.. 96 hours - so - by repeating the injection every 4 days the therapeutic drug level in the joints is maintained a full 28 days, allowing a substantial amount of time for healing!

Hmmm - I know they are in the business of selling their products - but if this is a true and tried fact - it makes sense. 

So - called Dr. Ramsey's answering service and left a message for him to call me at his convenience - want to relay this info and see what he thinks - could it be that our treatment has been too thinly spread? If we speed it up and add a shot - will we see an improvement? I pray that this is so....

4/18/01
Dr. Ramsey called back - said he knew what the makers of Adequan were recommending - his plan came from recommendations from professors at a veterinary university in Georgia - but if I would like, we could change to every four days; said, the professors were dealing with real life - whatever I wanted to do was OK with him, but reminded me of the increased cost as well. We're meeting for shot No. 5 in the am....what to do?

4/19/01
Dr. Ramsey said Shadow looked great coming out of his stall this morning; told me to make him trot - said he could see an improvement. Told me to let him make Shadow Fax trot so that I could see it - he did look better - but I'm afraid to hope for too much - and sure enough, when I got back to the barn this evening, Shadow didn't look as good trotting as he did this morning. What an emotional roller coaster - well, anyway, we agreed to give Shadow his next shot Monday - waiting only 4 days - and then give him shot No. 7 on Friday - my hopes are dwindling...he looks better, he looks worse, he looks better, he looks worse - he's of course still getting his glucosamine every day...

4/21/01
Beautiful Saturday; went to the barn in the early afternoon; Shadow was in his stall. Took him out and hand grazed him for an hour or two, then let him into the arena to walk at will. Didn't think his right hind leg moved too well today....have only given him one bute tablet since Dr. Ramsey gave me the 14 pills to give him when I felt he needed it. Don't really want to give him the pills, am afraid it will hide his pain, and I can't really see how he is feeling. Shadow didn't seem to have pain today, he wasn't running wild and galloping, but seemed relaxed - well, plenty of clover and fresh grass where I took him to graze - must be like Baskin and Robbins 31 Flavors for me! That was a lighthearted remark - in my mind, I am very concerned about the lack of consistent improvement in him....the X-rays showed so little problem, why is this treatment not working better? I was told a couple of weeks ago that I have DJD in my neck as well - I just choose to ignore it - am I worrying too much about Shadow Fax?

4/23/01
Shot No. 6 - agreed on Friday 4/27/01 for shot No. 7 - final shot! Dr. Ramsey thinks he looks better - got rid of that "peg-legged" looks he says - me - I just cross my fingers to check the final result after shot No. 7.

4/25/01
Ordered bucket (5 lb) No. 2 of State Line Tack's glucosamine powder - told them I did the math on their bucket, and it did NOT come out to 7,500 mg of glucosamine per serving like the ad in their brochure said - only 6,362 mg - said the would check and call me back.

4/26/01
Call back on my answering machine from State Line Tack - said I was right, the glucosamine content was only 6,362 mg per serving - I will have to up Shadow Fax's 2 daily rations by about 1/4 scoop. While I appreciate the call back from them, it makes me mad that they overstated the contents in their brochure, and all the time I thought I was giving Shadow Fax the dosage advised by my vet!

4/27/01
Couldn't meet with Dr. Ramsey this morning - HAD to be at work at 8 am, as everyone else is sick or on vacation - Dr. Ramsey was supposed to give Shadow Fax his shot without me being there. When I got there after work, Roger said he thought he saw his truck - so guess Shadow got shot No. 7! Well, as per normal procedure, I started cleaning his stall, as he was out in the field - checked on him, and he looked happy, eating spring grass. A short while after I started cleaning, someone yelled "horses out" - I just knew it was Shadow's field that somehow had gotten out - sure enough, some fool left a gate open, and Shadow and his 3 pasture mates had seen their change for total freedom. We all went running out to try to get them - they were on the race track - couldn't see them, but could hear the thunder of hooves - I knew Shadow would be the first horse we would see. And sure enough, here they came hauling from the racetrack towards the barn - and Shadow in the lead! Shadow - you are the oldest, and you have DJD - wait up! Not a chance; a box wire fence had been put up in haste to prevent the horses to run any further towards the barn. Shadow ran right thru it , and the other horses followed. We finally got them cornered and halters and lead ropes put on them. Shadow has a small skin scrape in his left front leg and a scrape on his nose. Hosed his leg down and put cream on it - put cream on the scrape on his nose. Everyone said later, that is sure doesn't look like his leg is bothering him - well, that's great - but maybe adrenaline is a stronger "fix" than Adequan and glucosamine? Sunday will show! That's when I'm planning to try to ride him again. Haven't been on him since this all started, and as Marty and I are going to Lexington for the Rolex Cross Country tomorrow, I won't be here to ride him Saturday. So, Sunday it is..........the day of reality! For two and one half month, he has not been ridden, no excess weight on his back, given Adequan shots and glucosamine - what is Sunday going to show? Roger promised to check him in the morning to make sure there's no swelling in his front legs (which went thru the fence first) as Marty and I are planning to leave for Rolex at 4:30am - entirely Marty's idea! Really, I don't want to go; I want to be here and check Shadow to make sure he's OK.....but I promised I'd go - but I really want to check Shadow - somehow, I think he will be OK - I think the treatment is working - just a gut feel - Sunday will tell!

4/29/01 
So - Rolex was fun - now to the important part - MY horse! 
This afternoon was D-day - the first time riding Shadow Fax for 2 1/2 months - Marty had promised to be there to judge from the ground what SFax looked like when he had weight on his back - and he showed up at 3 p.m. as promised!

I took SFax out of his stall and let him graze on lead rope for about 1 hour before Marty got there; after all he'd been in his stall all day - wanted to let him have a chance to loosen up and relax - it was a beautiful day today! Put him back in his stall and Marty and I smoked a cigarette to get our act together - bless horse friends who understand what you are going through with a horse that means the world to you! 

Got SFax out of his stall - didn't tack him up - thought I'd let him have a chance to tell me how he was feeling about me getting on him. So - I brought him into the arena in halter and lead rope; pulled him close to the fence, and climbed up on the fence; asked him to move closer to that I could get on him - I know that if he'd resist, he would be telling me that he didn't want any weight on his back; and I know that when he moves closer to the fence, it means - "Come on, jump on - I'm fine" - well, when I said "Shadow, sweetie, get closer so that I can get on you" - he moved closer! I got on him - and we walked together - then we did a gentle trot - no resistance, no misbehavior! 

Next step - got the saddle and bit on him - walked around for a while, trotted, and at one time when I asked for the trot I got a canter! We rode - mostly at a walk - probably about 30-40 minutes - Marty said afterwards that once in a while, maybe every 5th step, he could detect a slight "off" movement of his right hind leg - but then, sometimes his left hind leg looked the same "off" - it could be, he said, just because I wasn't asking him to really work - no collection, no rounding, I just let him move - well, sloppy is what we were, really - but at this point, correct riding isn't really what I'm looking for - I just want SFax to have no pain when we ride, and hopefully continue to improve. 

Reality check here - what can I realistically expect? He is after all almost 19 years old - the Fountain of Youth hasn't been found yet - Miracles are few and far between - getting a little stiff in the joints myself - what's ahead of us? Was today just a "good day"? Is glucosamine effective as a continued treatment after the Adequan shots are finished? This has been a very, very stressful period; and it isn't over yet - is tomorrow going to be good for him? Was today anything I can count on? 

Dear Diary - you have "listened" to me lament almost every day now for over 2 months - I think it's time to move on! It's like being on a diet - don't step on the scale every single day - do it once a week or once a month - so - from now on, that's what I will do - I will give you weekly or monthly updates - cause, like today - SFax seemed fine - but he has to be consistently fine for what - a week, a month - before I can feel the treatment was effective? Who can tell me?

4/30/01
Got to the barn after work - Shadow in the field - when we went to get the horses in for the night (and feed) SFax came at a full gallop to the gate - Roger says that every time he lets Shadow Fax out in the field in the a.m. he is still flying - says he is a long, long way from being crippled - says he saw at least 10 horses at the show he went to over the weekend that looked a lot worse than SFax - so I just now decided, that I'm going to have a positive feeling about this:

SFax is going to be fine - his DJD was caught early, treatment was given right away - he was not ridden, no stress put on him - he is mentally healthy - Dear Dairy - "talk" to you in a month - and pray I have only positive news to give you!