Tildren Part III: The fine print of Tildren

"What the large print giveth, the small print taketh away."

Tom Waits

[Tildren parts one and two are worth reading before you read this...]

Good results are being achieved with Tildren, and there's quite a buzz in the horse world it's true. But before you launch a campaign to get treatment for your horse, consider these caveats...

1. It's not cheap. Regional perfusion (one limb) can cost hundreds of dollars while systemic injection/infusion can cost $1000.
   
2. It's not usually a one-time treatment (the effect lasts about six months)
   
3. It doesn't work for every horse.
4. Improvement may or may not be permanent.
5. It works more on cancellous (spongy) bone than cortical (hard) bone.
   
6. Bone does become more dense but the quality may be lessened (more brittle)
   
7. Damaged bone may also be slower to heal in the case of a fracture, and Tildren should never be given to a horse with an injured bone (e.g., a fracture).
8. The long term effects of the drug are unknown.
9. The product should not be adminstered to hypocalcemic horses, horses with heart problems, or horses under the age of 3.
   

Some are more concerned than others...
A few years ago when I had dental surgery, my surgeon told me that because I was on Actonel (a cousin of Tildren) , there was a risk that the surgery would cause necrosis (death) of my jawbone. A slight risk, but enough that he made me sign a paper. It seems that this class of drugs --bisphosphonates--can interfere with the healing of fractures/bone damage, and after ten years of use on wide swaths of the humanpopulation, there are some scaryemerging issues. While I haven't read any definitive articles on risks for horses, the subject comes up in informal and personal communications of veterinarians and experts.

COTH poster RAyers is an equestrian with a *background in bone pathology -- the right pedigree to have an opinion -- and he's not in a hurry to recommend Tildren. He cautions eventers about use of Tildren in event horses. The bone regrowth Tildren brings may not be of comparable strength and longevity, which is bad news for horses who gallop, jump, and otherwise strain their bodies to the utmost. No one really claims to know for sure what the quality of Tildren-enhanced bone is like. Read the Tildren thread below for details.

*Dr. Reed Ayers, an eventer, is a professor in Biomaterials at the Colorado School of Mines and a Clinical Professor in the Department of Orthpaedics at the CU medical school

RESOURCES

Tildren news from Steinbeck Equine

Tildren® 500 mg lyophilisate for solution for infusion

Chronicle thread (answers from RAyers)
http://www.chronicleforums.com/Forum/showthread.php?t=220202&highlight=rayers+tildren