Osteoarthritis (OA) is one of the leading causes of unmanaged pain in dogs. While commonly considered an old dog disease, we now know dogs as young as 1 year of age can already be suffering from OA.
Osteoarthritis is an inflammatory condition that impacts all structures of the synovial joint. Synovitis, the inflammation of the synovial membrane, begins the vicious cycle that leads to advanced OA and irreparable cartilage damage. Without proper diagnosis, treatment and management, OA can severely impact a dog’s mobility and quality of life, having a severe effect on them and their owner.
Arthramid is a patented 2.5% injectable polyacrylamide hydrogel (iPAAG). Administered through intra-articular joint injection, it is integrated into the synovium of the joint, improving function and resolving lameness.
Arthramid goes beyond conventional therapies to safely and sustainably manage osteoarthritis.
- Increased load transfer capacity through the joint capsule
- Reduced effusion and decreased stiffness
- Over 80% of patients remain lame-free after one injection
Frequently Asked Questions
How long does Arthramid last?
Clinical and field data demonstrate improvement lasting 12–24 months, with some horses remaining sound for over 3 years. Duration depends on workload—performance horses may need re-treatment as per veterinary discretion.
Which horses and cases are suitable?
Arthramid is used safely in young and senior horses. Effective for OA, synovitis, meniscal injury, and tendon sheath inflammation. Not indicated for non-synovial joints (e.g., sacroiliac) or cases with active infection, cartilage fragments, or fracture.
What about older or metabolic horses?
Safe for senior or laminitic horses as Arthramid remains within the joint and reduces the need for systemic medications that affect the liver, kidneys, or GI tract.
Can young or preventative cases be treated?
Yes. Arthramid may be administered during early training in high-risk horses (e.g., racehorses or aged event horses) with diagnosed OA or synovitis as a measure to support joint health. Please see regulatory directives for further information regarding withdrawal times.
What is the recommended dosing strategy?
Supplied in prefilled 1 mL syringes. Dose typically 1–3 mL depending on joint volume, disease severity, and chronicity. If improvement is partial by 6 weeks, a top-up dose may be given.
What determines response time?
Early reduction in inflammation may appear in 1–2 weeks. Maximum integration and biomechanical support occur over 4–6 weeks. 7. What are the recommended rehabilitation guidelines following an Arthramid injection?
How should post-injection management be handled?
- 48 hours rest, ice every few hours if needed
- NSAIDs for 3–5 days
- Light turnout or hand-walking after 2–3 days
- Avoid intense exercise or competition for 3–4 weeks
How should owners be guided to ensure success?
Set clear expectations. Emphasize the need for rest and gradual return to work to maximize long-term outcomes. Encourage follow-up veterinary evaluations.
What if there is limited or no effect?
Consider diagnosis accuracy, joint localization, post-injection workload, or disease severity. Reactive joints or those with exposed bone may require stabilization or other alternatives prior to Arthramid.
What are the safety findings?
Used in tens of thousands of horses globally. Adverse events are rare and limited to mild transient swelling or effusion. Long-term studies confirm no systemic or neuro toxic effect, even after repeated treatments.
Is repeat or multiple treatment safe?
Yes. Horses have received multiple injections over years with no negative effects. The hydrogel volume is minimal and biocompatible.
Can it be combined with other treatments?
Compatible with NSAIDs, PSGAG’s, PPS, and other joint supplements. Corticosteroids should be spaced 2 weeks before or after injection to avoid altering the integration process.
What procedures should be avoided near treatment time?
Avoid concurrent intra-articular corticosteroids, aggressive laser, or shockwave therapy over the injection site for 2-4 weeks.
What differentiates Arthramid® from HA, PRP, or corticosteroids?
Arthramid is a 2.5% polyacrylamide hydrogel that integrates with the synovial membrane, forming a permanent viscoelastic scaffold. It reduces inflammation and restores joint biomechanics rather than simply masking pain.
In which joints or conditions is a flare more likely?
Coffin joints or reactive joints with subchondral bone exposure have higher risk of transient soreness post-injection. In these cases, pre-treatment with corticosteroids may be beneficial.
What are some advanced or novel applications?
Emerging evidence supports use in tendon sheaths, meniscal tears, navicular bursa, and even cervical articular facets. Outcomes depend on proper case selection and rest protocols.
How can clinicians maximize successful outcomes?
- Localize pain precisely via diagnostic blocks
- Select joints with active synovitis
- Ensure rest and staged rehabilitation
- Educate owners on realistic timelines for recovery
What safety data is available?
- 85–90% of dogs experience symptom relief after injection.
- 44% reduced or discontinued other medications, including NSAIDs.
- About 10% experienced short-term side effects, usually transient soreness at the injection site.
Which cases are most suitable for Arthramid treatment?
- Indicated for management of non-infectious joint disease, including early and late-stage osteoarthritis.
- Most suitable when lameness or OA has been localized to a specific joint.
- Contraindicated in cases with infection, fractures, or unresolved bone/joint pathology.
Can Arthramid be used before or after surgical procedures such as TPLO?
- Pre-Surgery: Arthramid is not recommended for injection into the affected limb at the time of surgery. However, injecting the contralateral (opposite) limb during surgery may provide beneficial joint support if there is evidence of synovitis or pathology in that limb.
- Timing Consideration: If surgery is scheduled at least six weeks out, injecting Arthramid into the affected joint beforehand may be considered. This allows time for integration into the synovial lining and may help reduce synovitis prior to surgery.
- Post-Surgery: Once the dog has been cleared by the surgeon for further treatment, Arthramid can be injected into the previously affected limb to address ongoing synovitis and osteoarthritis.
Can Arthramid be injected into multiple joints on the same day?
Yes, multiple joints can be injected with Arthramid on the same day in the same animal. Safety studies have shown that concurrent treatment of several joints is safe and well-tolerated.
Can Arthramid be injected with other injectates?
- Yes, Arthramid (2.5% polyacrylamide hydrogel) can be injected concurrently with other intra-articular (IA) injectates, including corticosteroids under certain conditions.
- Arthramid + Steroids: Commonly used together to provide immediate relief (steroids) and longterm stabilization of the bio-mechanics of the joint (Arthramid).
What post-injection protocols are recommended?
- Rest for 48 hours after injection. Mild local pain or swelling may occur during the post injection period.
- NSAIDs and ice may be used if needed for short-term discomfort.
- Continue with restricted exercise schedule for 4 weeks post injections. Avoid activities that would require high impact on treated joints (running, jumping, playing, or training).
- Maintain controlled leash walks during the early integration period of the first 4 weeks. Avoid rough play, running, and jumping during the first 4 weeks.
- Rehabilitation therapy may continue, but strain on the treated joint should be minimized for at least 2 weeks.
- Recheck evaluations are recommended for 4 weeks post-treatment with continued evaluation as necessary.
What are the recommended rehabilitation guidelines following an Arthramid injection?
- Initial Rest Period: For patients currently undergoing rehabilitation, it is recommended to pause all rehabilitation activities for the first 48 hours following joint injection. A gradual return to work or exercise can begin after four weeks.
- Joint Protection: To prevent additional stress on the treated joint, avoid activities that may strain the area for at least two weeks. Training programs should be adjusted based on the severity of lameness.
- Therapeutic Modalities:
- Laser Therapy and PEMF: Current data suggests avoiding the use of laser therapy and pulsed electromagnetic field (PEMF) treatments directly on or over the injected joint for two weeks postinjection.
- Shockwave Therapy: Shockwave treatment should not be applied to the treated joint for 4–6 weeks following injection. However, it may be used on surrounding tissues if needed.
How long does the effect of Arthramid last?
- Clinical studies show sustained improvement in lameness, pain reduction, and joint function for up to 12–13 months after a single injection.
- Most dogs improve progressively over the first 30–90 days, with results stabilizing and maintained through a year.
What are the common dosing strategies?
- Arthramid is supplied in pre-filled 1 mL syringes for intra-articular use.
- Recommended doses per joint:
- Large joints (shoulder, elbow, hip, stifle): 1.0 – 2.0 mL
- Medium joints (carpus, tarsus): 0.5 – 1.0 mL
- Small joints (inter-phalangeal): 0.25 – 0.5 mL
- The exact dose is determined by the veterinarian, depending on joint volume and severity of disease.
When can Arthramid be re-injected?
- Most patients experience long-lasting relief from a single treatment.
- Reinjection may be considered if:
- There is only partial response after the first injection (this often is related to less volume being put in due to severity of disease), or
- Clinical signs return
- Many dogs do not require reinjection and can reduce or discontinue systemic analgesics.