Cortisone injections into the hock

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Fragglerock

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My horse might have this done as he has still got inflammation going on. What should it do, what risks are involved and how many times can it be done?

Are there any questions I need to be asking my vet when he calls?

Thank you.
 
hi, my horse had this done about 4 months ago now for her arthritis in her hocks.Im not sure of the technicality of it all, maybe ask your vet, The injection worked near enough straight away and she was pain free and moving a lot more free. Then she decided to have a gallop around in the field and hurt her hocks again. so she is booked in for another injection as after taking bute she hasnt come sound. my vet tells me every horse reacts to it differently some may need another in 6 months, some in 12. Good luck, I hope everything goes according to plan
 
Fragglerock said:
My horse might have this done as he has still got inflammation going on. What should it do, what risks are involved and how many times can it be done?

Are there any questions I need to be asking my vet when he calls?

Thank you.
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It really depends a lot on why you are having this done (diagnosis) and what joint you are having medicated.

Most commonly it's the small joints in the hock (tarsometatarsal) joints that are the problem and usually because of degenerative joint disease, which obviously have inflammatory changes associated with it. Assuming this is what's going on then joint medication with steroids is appropriate.

It sounds pretty dramatic but TBH this is pretty routine stuff nowadays.
the area of injection with be clipped and prepared as sterile prior to injection. Often the horse is sedated to keep them still and then one injection through the skin, into the joint, inject about 2-5mls of fluid (depends on what drugs are used) and remove. A light dressing is usually applied and removed after 24hours.

I use a regime of 3 days box rest, then straight into an increasing exercise regime in hand to start, then under saddle walking and gradually build in trot. I'll reassess the horse in about 2 week and then all being well, again in about another 4weeks.

Steroids if they work, usually have a pretty rapid response, and if no improvement is seen by the 6 week mark then it probably won't be. I sometimes see an excellent response initially and then deterioration again. These cases do not carry as good a prognosis for conservative management as those with a longer response time.

The direct anti-inflammatory effect of the steroids lasts only about 6 weeks, but often alters the ongoing inflammation of the disease process enough to keep the horse comfortable for 3-6 or even 12 months.

The injections can be repeated every three months if need be, but I would consider this too much myself. Usually no more than 6 monthly repeats would be necessary, and if they are then I would personally be questioning whether I should be going about treatment another way?:rolleyes:

Risks are minimal TBH, infection of the joint is the biggie, but is rare for the number of joint injections done and other threads have mentioned joint flare, a profound inflammatory reaction within the joint following injections. This is very unlikely also as steroids are by nature an anti-inflammatory. Either will cause a severe, non-weight bearing lameness within hours of the injection which obviously you'd call the vets for anyway. I would not let this put you off treatment; the benefits far outweigh the risks.

Best of luck.
Imogen;)
 
Thanks for all your replies.

It's not for DJD, it is because he has partly slipped the tendon off his hock and it's still moving and inflamed after nearly 4 months.

He will have further X-rays first before the vet decides what to do but it is one option he mentioned at the time.

I have just had people telling me all the horror stories of what can go wrong (regarding infection) but I feel I don't have any choice but to go with what the vet suggests anyway (and I do trust him). Thanks for making me feel a bit happier about that aspect of it anyway.

Am trying to be positive about long term prognosis but any positive feelings are diminishing day by day.
 
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Fragglerock said:
Thanks for all your replies.

It's not for DJD, it is because he has partly slipped the tendon off his hock and it's still moving and inflamed after nearly 4 months.

He will have further X-rays first before the vet decides what to do but it is one option he mentioned at the time.
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Hmm, I assume in this case you mean the superficial flexor tendon (achilles so to speak) on the point of the hock, slipped off to one side?

Where is he planning to inject it....directly into the tendon or tendon sheath? :confused: I see the logic, but it sound like the physical movement may be causing the inflammation and I'm not sure if it will work - not sure what else you can do though.

I've seen a few cases, generally the horse is panicked to start with but adjusts to an altered gait fairly quickly and is sound usually....I've not actually had experience of one with an ongoing tendon injury. :o

Anyway, best of luck and I wouldn't worry about the actual injection themselves, pretty routine and low risk. I would like to know how things go though?

Imogen
 
One of mine had cortisone injections for hock spavin, which resulted in a joint infection. He was in hospital for 9 days on a drip but fortunately came through. The weird thing is that he has been sound ever since (4yrs ago)...?!
I would be very cautious having them again, but only because I had a bad experience - I am sure that they have worked for plenty of other horses without this complication.
Good luck!
 
Should be fine, my horse has his hocks medicated for low grade Spavin, he has them done every year with long acting steroids which keeps him comfortable. He always gets an antibiotic injection at the same time too to minimise infection. Never ever had any probs with joint injections, touch wood.

He has a few days off after and then build him back up to full work over 2 weeks.

Courses of Adequan joint injections are also very good.
 
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