Advice on getting all 4 steroid injections together in hack and coffin joints

[LibbyC]

Hi there . I am seeking information about the advice you have received from vets when you are considering having your horse's hocks and coffin joints injected with steroids. Whilst I am interested in hearing the advice you received if you are having either the coffins or the hocks done, I am particularly interested in whether you have experience of all 4 being done at the same time (or considered) . Or if you were advised to have a gap between the procedures. It would be helpful if you have first hand experience and are happy to mention specific vet's - or the practice concerned. My horse is a 14 year old part bred Welsh horse, slightly overweight and unfit, as she has been out of sorts with a skin complaint. Many thanks

 

[Birker2020]

When I had the previous horses coffin joints done they were done seperately, the worst was done first on the near fore in the September and then the off fore in the October.

No vet worth his salt would offer all at the same time, its simply too dangerous as steroid can bring on laminitis even in a horse not classed as being at risk of laminitis. They can also be an additional risk of a bacterial infection because steroids can supress the horses immune system.

And I always made sure that any joint medication my horse received was carried out at the vet practice rather than a dirty dusty yard as there is always a chance that dirt can be carried into the joint being medicated. The horse may not show any sign of a joint infection until 7 - 10 days after the procedure.

 

[MidChristmasCrisis]

Seperate injections would be my gut instinct…fear of steroid induced laminitis behind that decision. Never been in that specific scenario so just my thoughts.

 

[HelenBack]

When I had the previous horses coffin joints done they were done seperately, the worst was done first on the near fore in the September and then the off fore in the October.

No vet worth his salt would offer all at the same time, its simply too dangerous as steroid can bring on laminitis even in a horse not classed as being at risk of laminitis. They can also be an additional risk of a bacterial infection because steroids can supress the horses immune system.

And I always made sure that any joint medication my horse received was carried out at the vet practice rather than a dirty dusty yard as there is always a chance that dirt can be carried into the joint being medicated. The horse may not show any sign of a joint infection until 7 - 10 days after the procedure.

Same as this except my horse had his hocks and stifles done. I think they were done about two weeks apart but it might have been more than that, I can't really remember now.

I also had mine done at the vets for the same reason although they will do them at the yard for people who don't have transport.

 

[SEL]

My mare is a good doer and the week before scheduled injections we ran bloods for insulin levels and also checked cushings status. Only when those were in normal range did we go ahead.

It was hocks and SI for her and we did them separately to reduce the risk. Hocks were done at the yard, but SI needed the ultrasound and I think they put the horse in stocks to reduce kick risk to the vets so that was at the hospital.

 

[Tiddlypom]

Nantwich equine vets would definitely not medicate 4 joints with steroids on one day. It would be two joints, a gap of several weeks (can't remember exactly how long) then the other two.

They will, however, give 2 x steroid jabs and 2 x gel jabs on the same day, as the gel injections do not have the lami risk that steroid jabs do.

Additionally, as you post that your mare is 14, overweight and has a skin complaint I would definitely get her tested for Cushing's before you embark on any steroid jab course. Or indeed anyway. Once their ACTH levels are under control, Cushing's horses can have steroid joint injections, but an undiagnosed and untreated case would have a much elevated risk of suffering lami.

My advice is to always opt for gel injections over steroid if possible. They last longer and are safer due to not having the lami risk. Gel injections are, though, too viscous and therefore not suitable for eg SI joint medication.

 

[Birker2020]

My advice is to always opt for gel injections over steroid if possible. They last longer and are safer due to not having the lami risk. Gel injections are, though, too viscous and therefore not suitable for eg SI joint medication.

I didn't know this. I assumed you are talking about Arthramid - I know it is a very good method but again assume this is only used where the SI had dysfunction due to arthritis and not strain of the ligaments.

 

[PinkvSantaboots]

I would have gel instead of steroid now and I would definitely test for cushings and ems before using any steroids, I tested for both with my 14 year old mare and she tested positive for both so she didn't have them.

I wouldn't have that many in one go either I would leave it at least a few weeks and only do one area at a time.

 

[Tiddlypom]

I didn't know this. I assumed you are talking about Arthramid - I know it is a very good method but again assume this is only used where the SI had dysfunction due to arthritis and not strain of the ligaments.

According to my vet, who is an Arthramid fan, it isn't suitable for use in the SI region.

She's used Arthramid successfully on front coffins and hocks in of my horses, and just hocks in the other horse. Both horses have also had successful and long lasting SI joint medications done with steroid in Aug '20, along with a lot of in hand rehab work and chiro vet work since then.

Last time I checked in with my regular vet she'd never had a case that had failed to respond well to Arthramid.

 

[Auslander]

My vet would not do 4 steroid jabs at the same time, because of the laminitis risk. My horse has his hocks done, and one knee, and she will not do them at the same time.

 

[Equi]

My vet did two at one time in hocks but would not even consider doing fetlocks at the same time. Minimum 4 weeks later.

 

[misst]

Our lad had coffin joints done at different times and even then he showed signs of huge increased thirst and urination after the 2nd one. He was a fit slim 9yo TB. Vet was wary after this of giving any more steroids. He did not go on to develop lami but if he'd been overweight or older maybe he might have.

 

[LibbyC]

Thanks for everyone for their help and advice. It is much appreciated and will take on board the input. She has been tested for Cushings as part of the ongoing care of her skin diagnosis and does not have it, so that is one less thing at least!