Is the Use of Bisphosphonates Putting Horses at Risk? An Osteoclast Perspective.
Authors: Vergara-Hernandez Fernando B, Nielsen Brian D, Colbath Aimee C
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary: Bisphosphonates and Equine Bone Health Bisphosphonates are increasingly used in equine practice to manage conditions like navicular disease and bone spavin, but their mechanism of action—suppressing osteoclast activity to reduce bone resorption—raises concerns about long-term skeletal integrity, particularly in young, growing horses undergoing exercise. Vergara-Hernandez and colleagues conducted a comprehensive review of osteoclast biology and bisphosphonate pharmacodynamics to assess whether current equine dosing protocols might compromise bone remodelling and fracture healing in immature animals. Their analysis reveals a critical evidence gap: whilst bisphosphonates accumulate preferentially in high-turnover bone regions (notably growth plates and areas under repetitive loading), virtually no research has examined their effects on growing, athletic horses under two years old, leaving practitioners without data on whether suppressed osteoclast function could mask microdamage progression or delay stress fracture healing without clinical pain signals. The authors highlight that impaired bone resorption during skeletal development and intense training could predispose young horses to accumulating structural defects that manifest only after significant mineralisation changes occur. For farriers, veterinarians, and trainers managing performance prospects, this underscores the need for cautious, evidence-based protocols around bisphosphonate use in horses still completing skeletal maturation and calls for prospective research before widespread extra-label application becomes standard practice.
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Practical Takeaways
- •Exercise caution with bisphosphonate use in growing horses, as impaired osteoclast function could lead to hidden bone damage without pain signals to alert practitioners
- •Young athletic horses (under 2 years) receiving bisphosphonates may be at particular risk; consider alternative therapies and monitor skeletal development closely
- •Future research is urgently needed to establish safe dosing protocols and identify contraindications for bisphosphonate use in immature, working equines
Key Findings
- •Bisphosphonates may impair osteoclast function, potentially resulting in skeletal microdamage and impaired healing without associated pain
- •Bisphosphonate uptake in bone is determined by blood supply and bone turnover rate, leading to uneven skeletal distribution
- •Critical knowledge gap exists regarding biological impacts of bisphosphonate use in exercising horses under two years old
- •The combination of bisphosphonate use with growth and exercise in young horses may heighten risk of adverse skeletal effects