From the FDA Drug Label
Indications: Hyalovet is indicated for the intra-articular treatment of carpal or fetlock joint dysfunction in horses due to acute or chronic, non-infectious synovitis associated with equine osteoarthritis. The FDA drug label does not answer the question.
From the Research
Severe osteoarthritis of the big toe should be managed with a combination of conservative treatments, prioritizing oral NSAIDs like ibuprofen or naproxen for pain management, alongside topical NSAIDs, proper footwear, custom orthotic inserts, physical therapy, and activity modification. The goal of treatment is to reduce pain, maintain function, and improve quality of life. Key considerations include:
- Pain management with oral NSAIDs like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily), taken with food to minimize gastrointestinal side effects 1.
- Topical NSAIDs such as diclofenac gel 1% applied to the affected joint 3-4 times daily for localized relief with fewer systemic effects.
- Wearing proper footwear with a wide toe box, stiff sole, and rocker bottom design to reduce joint motion and pain during walking.
- Custom orthotic inserts with a Morton's extension to further limit toe joint movement.
- Physical therapy focusing on gentle range-of-motion exercises and toe strengthening to maintain function.
- Activity modification to avoid high-impact activities and toe-bending movements.
- For acute flare-ups, ice application for 15-20 minutes several times daily can reduce inflammation.
- If conservative measures fail, corticosteroid injections may provide temporary relief, though they're typically limited to 3-4 injections per year 2.
- In advanced cases with significant pain and functional limitation, surgical options including cheilectomy (bone spur removal), joint fusion (arthrodesis), or joint replacement may be considered, as discussed in recent reviews on osteoarthritis management 3, 4. The most recent and highest quality study 3 emphasizes the importance of understanding the mechanisms of action of different analgesics in the context of osteoarthritis-related pain pathophysiology, supporting the use of NSAIDs as a first-line treatment for severe osteoarthritis of the big toe.