Tildren belong to a class of drugs called bisphosphonates, a type of drug that acts on the metabolism of bone. Tildren slows the bone remodeling process – the means by which bone tissue heal and strengthen. It was first formulated to treat Paget’s Disease and showed promise in treating osteoporosis within people. The human form is known generically as Tiludronate. From there it was easy to conclude that it might help in the veterinarian field & a French company started marketing the equine version as “Tildren” to aid in lameness issues.
Lets get technical for a moment. How does Tildren work? Tildren reduces bone absorption and increases bone density by inhibiting the activity of osteoclasts1 while generating osteoblasts2 activity. It also has anti-inflammatory affects by inhibiting secretion of enzymes that degrade the cartilage on joint surfaces. In horses, Tildren is used for a wide variety of problems including but not limited to:
- Navicular Syndrome
- Hock Disease (Bone Spavin) & Arthritis
- Kissing Spine Syndrome
- Ring Bone
“Tildren is not a cure-all, and there are still some drawbacks. The drug targets bone and, specifically, the processes that affect bone degeneration. So that means it won’t ease any lameness caused by tendon, ligament or muscle injuries. This is important to keep in mind when using the medication to treat navicular syndrome, which refers to pain emanating from the heel area of the hoof for various and often-unknown reasons. If one horse’s navicular pain is bone related he may respond well to Tildren. In another horse, however, heel pain may stem from the ligaments near the navicular bone, meaning that Tildren will have little or no effect.” Also you need to note, it’s not intended for use on horses that are still growing, or mares that are pregnant or lactating. Occasionally, some horses get a bit colicky after the administration of the IV fluid with the Tildren solution. Somewhere, I read that Tildren cannot be used while a horse is in competition as there are some withdrawal times. But if your have interest in Tildren, I would follow up with your vet on that one. I don’t believe everything I read on the internet.
Tildren is administered via intravenous infusion via catheter. It can be given in one treatment over the course of hours or as one infusion a day for ten days. Improvement in lameness can be seen with in two to four weeks and can last for as long as six to twelve months.
The effectiveness of Tildren is gaining a growing body of scientific evidence. This medication is not a passing fad. It is real, proven, and effective for keeping your almost-perfect horse perfect. Tildren (tiludronate) has been very popular in Europe and is finally making inroads in veterinary medicine with the USA. It still has not been passed with the FDA, but US vets can legally import and administer the drug if they apply for a special permit. Applications are horse and treatment-specific, so a veterinarian cannot keep Tildren on hand for “just in case” a need for it arises. The drug takes about six weeks to arrive & a single treatment can cost in excess of $1000.00. However, that price is likely to decrease once the FDA approves the drug and it becomes warehoused in the US.
Tildren truly has the marks of a revolutionary drug with equine bone and joint disease management. It seems that Tildren would allow us to treat the source of our bone related orthopedic problems verses merely trying to control inflammation and reducing pain. Time will tell.
1. Osteoclasts – These cells cause bone lysis (areas of reduced bone density), which is the removal of microscopic areas of bone. These cells start working when new spaces need to be created within the bone to increase density in response to mechanical stress. In layman’s terms, Osteoclasts are like hungry termites and digest bone. Tildren works by inhibiting the function of these cells.
2. Osteoblasts – These cells build collagen, the most basic material needed in bone formation. They cause collagen mineralization and create denser bone.
Referring to what was said earlier. “Inhibits osteoclasts and generate Osteoblast activity.” I think this makes more sense once you truly understand the balancing act that is necessary for the restructuring of bone.
*Reed DVM, Stephen. “Tiludronate.” Equus. February 2012.
*Richards, Erin. “Tildren is Making Greater Inroads in the United States.” The Chronicle of the Horse, Sept 2009.