Arthritis in both hocks - what next?

emfen1305 said:
Thank you for taking the time to explain it, when i was researching it all it seemed some went straight for the fusion and I wondered why this was never offered to me as an option but I suppose my boy's is currently very mild so seemed a bit of a drastic approach! It seems from earlier posts the Tildren has some not great side affects so I don't really want to opt for that if the time comes when the steroid injections stop working. Did you go straight for the infusion or did you have steroids, tildren and then infusion?

Do you know roughly how much the infusion costs? My insurance will run out and then I'll be excluded so want to know whether it is worth getting the infusion done before it runs out. If he stays OK on the injections I won't rush but I know it will get worse and want to give him the best possible chance while I have the insurance!
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Hi Emfen1305 - we had the steroid injections first. Then we had three lots of Tildren within the twelve month insurance claim period. Then about three years later we went for the fusion as my friend had just had it done with her horse and when I enquired if it were possible with my own, my vet said it would be a good idea.

The Tildren was £700 a time (around 2009/2010). The fusion was £300 for both hocks (around 2011/2012) from my vets in Warwickshire. That was me transporting him to them, and included the contrast xrays, injection, technique, sedation - the whole shooting match.

The only disadvantage of having Tildren that I can see was slight transient colic and an awful lot of wee the next day, both of which are nothing life threatening or to worry about. The risk of colic can be reduced by the infusion rate increasing in duration from thirty mins to an hour or more. It did make him depressed at the time, but what is a days depression, bit of tummy ache or a stable of wee when you consider how much more comfortable they can be.

With the chemical arthrodesis (fusion with ethanol) there is no steroid so the horse can be turned out the next day as there is no risk of laminitis. Emfen1305 its a relatively quick rehab programme in terms of what you can do with your horse, you can move up the gears swiftly to increase the rate of fusion of the hock joint which will then stabilize the hock. Once the horse has had the procedure done the nerves inside are destroyed so there is no pain (or this is what I believe is correct). So sensation is felt outside as normal but the pain goes immediately inside the joint. My horse could lift his hind feet the following day so much higher to pick them out then ever before, he was immediately happier and his action improved considerably.
 
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applecart14 said:
Hi Emfen1305 - we had the steroid injections first. Then we had three lots of Tildren within the twelve month insurance claim period. Then about three years later we went for the fusion as my friend had just had it done with her horse and when I enquired if it were possible with my own, my vet said it would be a good idea.

The Tildren was £700 a time (around 2009/2010). The fusion was £300 for both hocks (around 2011/2012) from my vets in Warwickshire. That was me transporting him to them, and included the contrast xrays, injection, technique, sedation - the whole shooting match.

The only disadvantage of having Tildren that I can see was slight transient colic and an awful lot of wee the next day, both of which are nothing life threatening or to worry about. The risk of colic can be reduced by the infusion rate increasing in duration from thirty mins to an hour or more. It did make him depressed at the time, but what is a days depression, bit of tummy ache or a stable of wee when you consider how much more comfortable they can be.

With the chemical arthrodesis (fusion with ethanol) there is no steroid so the horse can be turned out the next day as there is no risk of laminitis. Emfen1305 its a relatively quick rehab programme in terms of what you can do with your horse, you can move up the gears swiftly to increase the rate of fusion of the hock joint which will then stabilize the hock. Once the horse has had the procedure done the nerves inside are destroyed so there is no pain (or this is what I believe is correct). So sensation is felt outside as normal but the pain goes immediately inside the joint. My horse could lift his hind feet the following day so much higher to pick them out then ever before, he was immediately happier and his action improved considerably.
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Thank you :) I don't think Tildren would be an option for us at that price assuming it is similar if not more now but the hock fusion sounds affordable (again, assuming it has gone up slightly) so that could be an option. My boy is 9 so still relatively young so I would like to give him the best chance at a full recovery. I don't have ambitions of becoming an eventer but low level showing, jumping and some fun rides are what we like doing so if we can get back to that I would be over the moon.

He is currently on his second week of just being turned out and brought in with no extra work and I can already see an improvement in his hock action just going to and from the field. He is much happier in himself, playing in the field with his friends and back to his cheeky and playful ways, something very much missed when he was at his worst. He was never even slightly lame he just looked stiff and was unwilling to move forward so I am hoping the injection will last until I can make a decision about what to do. My vet is due out to see him at the beginning of March so I will definitely be discussing fusion as a possible next step as it seems the most sensible thing to do if the arthritis is only going to get worse anyway!

Thank you for your comments!
 
My mare was diagnosed with arthritis in both hocks in May 2015. We initially had the steroid injections which worked for 5 months. We then had another set of steroid and a Tildren drip in the same visit. Unfortunately neither did anything to help and even on daily bute my Horse was miserable to the point I wanted to retire her. My vet wanted her to have the surgery to drill the bones. I declined as it is not 100% garunteed to work, it was too pricey for it to only have a chance of working and too much pain for my Horse. My vet practice doesn't do the alcohol infusion. But they did inject another alcohol (not sure what called) which kills the nerve endings so the Horse cannot feel any pain. She had both done together 2 weeks ago and is now sound (not had bute in over a week either). What works for some Horses doesn't work for all I'm afraid so it's really trial and error. Good luck.
 
Tildren can cause excessive drinking I have seen this twice .
Both horses were fine but need veterinary follow until they stabilised .
This is not weeing a bit more than normal ( which they do as the body processes the drug )this drinking bucket after bucket of water in the 48 hours following being given the drug .
 
Sorry to hear about your horse OP. Try not to worry too much as its a very common condition. With one of my lads, he seems to get worse in winter. He has had two lots of steroids into both hocks and I previously had a mare who had the ethanol. If you want that, change vets. Many do it. It didn't work for mine though.
It's all about management really. My lad has the back on track hock boots and I have just installed a solarium for him when it's bitter. Out 24/7 and unrugged where possible to get him to move around a bit more to warm up, though that's a balance as cold and damp makes him more stiff. Losing weight helps, not easy as mine is a heavy horse. Finally turmeric, linseed and pepper made up like a pot noodle with hot water and tipped into his feed has started to help ... It didn't work when I used cold water. Plentiful hacks to stop stiffening up ..... and on worst days, nothing comes close to increasing his comfort than danillon.
 
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