Texas Equine Veterinary Association

www.texasequineva.com • 24 • Monitor clinical response. After injecting Osphos, I recommend clients give the horse some light work and watch the response over the next six to eight weeks. If there's no positive response or if the horse worsens, I look at a change in course. Before administering treatment on any horse with any product, I discuss the potential benefits and challenges with clients. With Osphos specifically, I share the information below and ask clients to strictly follow the steps: • Pause NSAID use. Bisphosphonates can affect the kidneys, especially if used with nonsteroidal anti-inflammatory drugs (NSAIDs). I advise my clients to stop giving NSAIDs four to five days before we inject Osphos and to keep the horse off NSAIDs for up to two weeks afterward. • Hand walk the horse for 15 minutes immediately following injection. This helps minimize the sensitivity horses may experience. • Observe the reaction. We watch the horse to make sure it's not experiencing any side effects beyond some potential transient stinging. I've administered thousands of doses of Osphos, and I've never seen a horse develop a serious case of colic or experience any level of renal failure. • Call me in six months. My practice sends a six- month reminder after an Osphos treatment, and about 70 to 80 percent of clients respond. When we talk, we openly discuss how the horse is doing. This conversation lets me know when clients are pleased with the results, and sometimes we decide to administer a follow-up dose. Once in a while, a client will say the product hasn't made much difference in the horse. I welcome this discussion too, because it tells me we may need to look further into a soft tissue issue, for example. Why bisphosphonates? I didn't buy into Osphos immediately after it was launched five years ago. I'm a creature of habit who leans toward pessimism about new products. I don't want to be the first—or last—to jump on board. I like a product to be on the market for a while so I can monitor the incidence of side effects and negative responses. I tried Osphos in just a few cases at first, measuring my patients' results as well as results in the overall market. As my confidence in the safety and efficacy improved, my use of Osphos grew exponentially. I like that it is a trusted, FDA-approved tool backed by science rather than hearsay. Osphos has dramatically improved navicular prognoses in my patients, and I consider it to be one of the most significant advancements in equine sports medicine. Problem-solving with clients around issues like navicular is what drives me. I thoroughly enjoy working as a team with clients to get their horses performing to potential. Through tending to a horse's needs year after year, I develop a relationship with the horse and its owners. These personal relationships are important to me. Finally having a tool to treat navicular is a relief for me and my clients, and it makes my relationship with clients even stronger. Brief summary: As with all drugs, side effects may occur. In field studies and post- approval experience the most common side effects reported were signs of discomfort, nervousness, and colic. Other signs reported were: renal insufficiency/ failure, anorexia, lethargy, hypercalcemia, behavioral disorders, hyperkalemia, hyperactivity, recumbency, hyperthermia, injection site reactions, muscle tremor, urticaria, hyperglycemia, and fracture. In some cases, death has been reported as an outcome of these adverse events. The safe use of Osphos has not been evaluated in horses less than four years of age or breeding horses. Osphos should not be used in pregnant or lactating mares, or mares intended for breeding. NSAIDs should not be used concurrently with Osphos. Concurrent use of NSAIDs with Osphos may increase the risk of renal toxicity and acute renal failure. Use of Osphos in patients with conditions affecting renal function or mineral or electrolyte homeostasis is not recommended. Refer to the prescribing information for complete details or visit www.dechra-us.com. This article was sponsored by TEVA Platinum Sponsor, Dechra. As a part of the Platinum Sponsorship package, sponsors are offered one magazine article per year. If you would like information on sponsorship packages, please contact info@texasequineva.com My favorite case: A client came in with a very nice 15-year-old Quarter Horse that had developed foot soreness. I did the typical workup. Even though the radiographs weren't bad, the history, blocking pattern and hoof tester results pointed to forelimb heel pain. The client immediately asked if it was time to retire the horse. I encouraged him to give Osphos a chance first. He agreed. I administered Osphos to the horse and didn't hear from the owner for a couple months. Then he called out of the blue and said, "Hey, I just want to thank you. I went roping this weekend and made five thousand dollars on that old horse we gave Osphos to." Hearing the horse performed well and they could still compete together made me feel so good. The same client now brings me all his horses for evaluation, and his first question is always, "Does this horse need Osphos?"

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