Your Horse’s Joint Health: A Q & A for Owners
by Boehringer Ingelheim / May 21, 2026
Joint health issues in horses are common and range in severity from reversible synovitis to career-ending cartilage degradation and osteoarthritis. It’s estimated that more than 60 percent of equine lameness is related to equine osteoarthritis (OA).1
To help horse owners understand more about joint health and how to treat and manage it, Boehringer Ingelheim teamed up with Tim Eastman, DVM, MPVM, Diplomate American College of Veterinary Surgeons. As a practitioner at Steinbeck Equine, Salinas, CA, Dr. Eastman specializes in lameness and helped develop the following Q & A guide.
Q. What are the clinical signs of joint health issues?
A. Joint problems in horses often show up as lameness, stiffness, or reluctance to move normally. Owners may notice heat or swelling around the joints, decreased range of motion, or a general decline in performance. Even subtle signs, like taking longer to warm up or being resistant during work, can indicate joint inflammation and pain.
Q. When a horse owner suspects their horse has a joint health issue, what should they do?
A. The first step is to contact their veterinarian as he or she is the most knowledgeable about joint health issues. While other service providers such as acupuncturists and massage therapists may play an important role in equine health care, joint disease should first be addressed by an equine veterinarian to come up with the best overall plan. It’s also important not to be tempted to try over-the-counter remedies without guidance, as products vary widely in quality and some may mask signs without addressing the underlying problem. Because joint issues can worsen if not addressed quickly, a veterinarian needs to provide an accurate diagnosis. To make that diagnosis, he or she will conduct a complete lameness examination and may recommend diagnostic imaging to best determine the exact cause and severity of the joint disease.
Q. If a veterinarian determines that there is a joint health issue, what’s the next step?
A. After diagnosis, the veterinarian will design a treatment plan specific to the horse, one designed to help extend the horse’s longevity and improve its quality of life. For horses diagnosed with joint dysfunction, one trusted option I use, and other veterinarians may as well, is LEGEND® (hyaluronate sodium) Injectable Solution, a therapy approved by the Food & Drug Administration (FDA) that directly targets joint inflammation.
Q. Why would a veterinarian recommend LEGEND joint therapy?
A. I am hesitant, and other veterinarians may be too, to use new products until their safety has been well-documented or they have withstood the test of time. I tell our clients that LEGEND is the only intravenous hyaluronate product that has been directly shown to decrease pain and inflammation in equine joints. Any horse undergoing repetitive exercise is likely to have synovitis, and LEGEND is ideally designed to stop that synovitis from progressing. It has been a cornerstone of my proactive lameness program for 30 years. Because I have had such success with LEGEND, I continue to use it.
Q. What is the difference between a product that is approved by the Food & Drug Administration and one that is not and why does it matter?
A. Products that are approved by the FDA have undergone rigorous scientific testing for safety, effectiveness and consistency. Non-approved products, whether those are systemic or given directly into joints, do not go through the same testing process. Oral supplements or nutraceuticals also do not have to go through the same process to prove their effectiveness. Choosing LEGEND gives horse owners confidence that the treatment is backed by strong science and trusted by veterinarians.
Q. How does LEGEND®(hyaluronic sodium) work?
A. The active ingredient in LEGEND, hyaluronic acid, decreases the presence of inflammatory mediators in the joint, improves synovial fluid quality and reduces the degree of lameness. It is both symptom and disease modifying.
Q. How is LEGEND administered?
A. One of the benefits of LEGEND is that it can be administered in two ways, which provides flexibility for your veterinarian to choose what works best for your horse. It can be administered intravenously or intra-articularly in the carpus or fetlock.
Q. What can I expect after my horse has received a LEGEND treatment?
A. Many horses respond quickly to LEGEND, showing improved comfort and freer movement within days. In field studies, beneficial effects of LEGEND were seen with just a single dose. When given once a week for up to three doses, LEGEND reduces joint inflammation and the resulting pain and lameness for at least 45 days.2,3 Performance horses often return to training or completion with greater ease, while pleasure horses may simply move more comfortably in daily work.
Q. Is there anything I should watch out for following treatment?
A. Most horses tolerate LEGEND very well. In rare cases after intra-articular injection, mild swelling or soreness can occur at the injection site. Whether given IV or IA, owners should monitor for any changes in gait, comfort or behavior and report any concerns to their veterinarian.
For full prescribing information please talk to your veterinarian or visit https://docs.boehringer-ingelheim.com/CombinedPI.pdf .
Q. How else can I support my horse’s joints?
A. LEGEND is a cornerstone of joint care, but long-term success also depends on good management. Support joint health by:
- Establishing an early and close relationship with a veterinarian
- Maintaining regular farrier care
- Providing proper training and conditioning
- Feeding a balanced diet with adequate nutrients
- Allowing rest and recovery after activity
By combining smart horse management with proven treatments like LEGEND, horse owners can give their horses the best chance for lasting soundness and performance.
Talk to Your Veterinarian
If you’re concerned about your horse’s joint health, ask your veterinarian about evaluation and treatment options. He or she will be able to develop a treatment plan to keep your horse moving comfortably, whether they are competing at the highest levels or simply enjoying life as your partner.
For more information about equine joint health, visit leadwithcare.com.
LEGEND IMPORTANT SAFETY INFORMATION: The safety of LEGEND has not been evaluated in breeding stallions or in breeding, pregnant or lactating mares. The following adverse reactions have been reported following use of LEGEND Injectable Solution: Following intravenous use: occasional depression, lethargy and fever. Following intra-articular (LEGEND Injectable Solution – 2 mL only use: lameness, joint effusion, joint or injection site swelling, and joint pain. LEGEND 4 mL and LEGEND Multi-Dose Injectable Solution are administered by intravenous injection only.
About Boehringer Ingelheim - Animal Health business
Boehringer Ingelheim provides innovation for preventing and treating diseases in animals. The company offers a wide range of vaccines, parasite-control products, and medicines for pets, horses, and livestock to veterinarians, animal owners, farmers, and governments. As a leader in animal health, Boehringer Ingelheim values that the health of humans and animals is deeply connected and strives to make a difference for people, animals, and society. Learn more at www.boehringer-ingelheim.com/us/animal-health.
About Boehringer Ingelheim
Boehringer Ingelheim is a biopharmaceutical company active in both human and animal health. As one of the industry’s top investors in research and development, the company focuses on developing innovative therapies that can improve and extend lives in areas of high unmet medical need. Independent since its foundation in 1885, Boehringer takes a long-term perspective, embedding sustainability along the entire value chain. Our approximately 54,500 employees serve over 130 markets to build a healthier and more sustainable tomorrow. Learn more at www.boehringer-ingelheim.com.
1 Okes SL, Mcllwraith CW. Review of the economic impact of osteoarthritis and oral joint health supplements in horses, in Proceedings, AAEP 2010;56.
2 LEGEND product label.
3 Kawcak CE, Frisbie DD, Trotter GW, et al. Effects of intravenous administration of sodium hyaluronate on carpal joints in exercising horses after arthroscopic surgery and osteochondral fragmentation. Am J Vet Res 1997;58(10):1132-1140.
LEGEND® is a registered trademark of Boehringer Ingelheim Animal Health USA Inc. ©2026 Boehringer Ingelheim Animal Health USA Inc., Johns Creek, GA. All rights reserved. US-EQU-0122-2026
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