Decision between fusing hocks or stem cell treatment - experiences?

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PaulnasherryRocky

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Hi All,

I have a 5 year old criollo X TB that sadly has had some rough luck in his little life so far!

Sorry if its long - bit of back story first:
I've owned him since he was 10 months old, he had OCD surgery on both stifles as a yearling - this was successful surgery and xrayed again as a 4 year old and stifles are both still fine.

The Xrays did show mild hock arthritis though, which we injected with Arthrimid twice which worked well, well enough to have him backed as a 5 year old by Sophie Seymour (On a separate note, if anyone is looking for someone to professionally back their youngster, she's fantastic).

However, his rising 6 now, the arthrimid has worn off faster this time, and i've stopped riding him as I feel he is too uncomfortable in his back legs to ride. Despite his brain LOVING going out and about, his body can't keep up.

The options I've been given to weigh up is either:
-Fuse the hocks
-Go down the stem cell treatment route

Has anyone experience with either of these?
At the moment, I just want him to be comfortable and pain free. Though as he is young - being able to ride him again in future would be lovely. Only for hacking and holidays etc - no competitions!

Also - does anyone know a rough cost for each of the options? Due to his past, his back legs are no longer insured so I will need to save up

Thanks in advance!
 
not arthritis, but one of mine had stem cell treatment in her medial meniscus in both hinds last year and made a brilliant recovery, she actually came sound and was signed off sooner than the vets would’ve expected and is now in full work with no limitations on what i can do with her going forward.

i’d definitely be happy to use it again
 
dottylottie said:
not arthritis, but one of mine had stem cell treatment in her medial meniscus in both hinds last year and made a brilliant recovery, she actually came sound and was signed off sooner than the vets would’ve expected and is now in full work with no limitations on what i can do with her going forward.

i’d definitely be happy to use it again
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Thanks @dottylottie - I'm so glad to hear it worked! Did it require much box rest? and have they said if this is a treatment that will need to be repeated, or is it a one time thing?

As this is my other issue. He does not boxrest well - I think the arthrimid wasn't as effective the 2nd time round due to him double barreling the stable wall multiple times soon after he came round from the sedation. We had to turn him straight out in the end as he was doing more damage in!
 
A friend had her horse's hocks alcohol fused, via a large vet hospital vet. Worked really well.

If arthritis is in a joint that can be fused without lose of mobility in hock (sounds like yours is) then fusion if works, is a really good long term solution.

I would be suprised if stem cell make that much difference in hocks if 2 rounds of arthramid have not been successful long term.

I would ask your vet - how many horses he has treated hocks with stem cells and had long term success? And how many horses he has fused hock joints successfully?
 
Fieldlife said:
A friend had her horse's hocks alcohol fused, via a large vet hospital vet. Worked really well.

If arthritis is in a joint that can be fused without lose of mobility in hock (sounds like yours is) then fusion if works, is a really good long term solution.

I would be suprised if stem cell make that much difference in hocks if 2 rounds of arthramid have not been successful long term.

I would ask your vet - how many horses he has treated hocks with stem cells and had long term success? And how many horses he has fused hock joints successfully?
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Thanks, that's really useful to know too.

I'm more leaning towards fusing because it seems more long term

I have just joined a new vets practice due to my old one shutting down (Chiltern), so I haven't discussed it with them fully yet. My plan in the new year is to get fresh xrays and go from there - but as many experiences I can hear from others on each treatment in the meantime will definitely help. I'm interested to hear in long term effects which is why I'm thinking fusing - i only know of people around me that have recently had the stem cell treatment, so can't comment on if its a long term fix or repeatable.

The people I know that have had the stem cell treatment have much higher career hopes for the horses than I do though in terms of dressage and endurance etc which explains their decision - I'd just like to go for a an hours hack a few days a week really, he doesn't need to move perfectly, just comfortably!
 
Sadly I had a horse that had fusion which failed in one hock - worked OK in the other.

After maxing out the insurance limit (£8k! - but that did include all the lameness work ups and diagnosis, and some rehab, not just the fusion in both hocks) the decision was made to field rest him - just in case it fused after a long rest.
It didn't so he was PTS.

Once the cartilage is melted by the alcohol then the bones have to rub together until they fuse. This is an extended rehab period and lots of box rest.

If for whatever reason they bones don't fuse, you're left with bones rubbing against each other forever - which is clearly unsustainable.

If he is field sound now enough to retire - then I would leave him be, personally.
If he's had all these issues so far having done very little - the most likely way of keeping him pain free is likely very early full retirement. Sorry.

Perhaps ask your vet what their success rate is with fusion - how many come back into work, how many are OK to be retired and how many end up eventually PTS. So you can make an informed choice.

I think fusion was seen as a wonder cure at one point but a good percentage of failures now mean it's less popular - because if it doesn't work then you have to PTS, there is no reversing it.
Other treatments if they don't work, you haven't made it worse.
 
stem cell treatment worked for my gelding and gave him a ridden career

however your horse sounds a lot like my mare. cartrophen made the biggest difference, however i chose to fully retire her but keep up treatments as needed. shes now happy/comfortable as a field ornament at 13.

the problem is when a horse has issues, one leads to another, they compensate in other parts of the body etc, so you fix one part and something else breaks
 
Polos Mum said:
Sadly I had a horse that had fusion which failed in one hock - worked OK in the other.

After maxing out the insurance limit (£8k! - but that did include all the lameness work ups and diagnosis, and some rehab, not just the fusion in both hocks) the decision was made to field rest him - just in case it fused after a long rest.
It didn't so he was PTS.

Once the cartilage is melted by the alcohol then the bones have to rub together until they fuse. This is an extended rehab period and lots of box rest.

If for whatever reason they bones don't fuse, you're left with bones rubbing against each other forever - which is clearly unsustainable.

If he is field sound now enough to retire - then I would leave him be, personally.
If he's had all these issues so far having done very little - the most likely way of keeping him pain free is likely very early full retirement. Sorry.

Perhaps ask your vet what their success rate is with fusion - how many come back into work, how many are OK to be retired and how many end up eventually PTS. So you can make an informed choice.

I think fusion was seen as a wonder cure at one point but a good percentage of failures now mean it's less popular - because if it doesn't work then you have to PTS, there is no reversing it.
Other treatments if they don't work, you haven't made it worse.
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Thanks for taking the time to tell me your experience - it has given me lots of extra questions to ask the vet that I wouldn't have considered before. (I guess I hadn't thought about if fusing fails what would the result be - in my head I just assumed it couldn't be worse than it is already!)

I think his aversion to box rest is the biggest problem for me at the moment - whatever treatment I do will require it, but its just such a nightmare for him! even sectioning off part of the paddock and putting him with a friend doesn't work - he just runs through fences or attempts (and fails) to jump out to get back to the herd.

lots to consider, thanks again for replying
 
PaulnasherryRocky said:
Thanks for taking the time to tell me your experience - it has given me lots of extra questions to ask the vet that I wouldn't have considered before. (I guess I hadn't thought about if fusing fails what would the result be - in my head I just assumed it couldn't be worse than it is already!)

I think his aversion to box rest is the biggest problem for me at the moment - whatever treatment I do will require it, but its just such a nightmare for him! even sectioning off part of the paddock and putting him with a friend doesn't work - he just runs through fences or attempts (and fails) to jump out to get back to the herd.

lots to consider, thanks again for replying
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Held probably box rest away from home, in a box rest yard, where he can see others, high door and no field options. There as sometimes reasonably priced box rest rehab yards, where can send for a few months. (Mine doesnt stable at home, but is ok in camps etc, so I have a box rest yard in mind in my area if needed)
 
Fieldlife said:
Held probably box rest away from home, in a box rest yard, where he can see others, high door and no field options. There as sometimes reasonably priced box rest rehab yards, where can send for a few months. (Mine doesnt stable at home, but is ok in camps etc, so I have a box rest yard in mind in my area if needed)
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Very true - he was fine at the yard he went to when he was backed, so a different environment could certainly help (I just need to save up even more!)
 
PaulnasherryRocky said:
Very true - he was fine at the yard he went to when he was backed, so a different environment could certainly help (I just need to save up even more!)
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Mine I think is not okay staying in (with horses opposite and next door), IF he knows where his field is.

If he has neighbours (ideally ones he can touch) and no idea where fields are then seems fine stabled.

I had an emergency vet visit recently and one symptom (there were others) was he was standing quietly in stable for 5 hours!
 
I had a horse have surgical fusion, he was on the older side but it gave him years of soundness afterwards. It was quite expensive though, I think it came to £5k but there were lameness work ips etc included. There is a month's box rest after because they drill into the bone and you have to have bandages and keep it clean. Although that sounds brutal my horse was on one bute a day right after and never seemed uncomfortable. I was given an 80% chance of it working.
 
I have a 4yo whose hock was irrevocably damaged as a foal and has fused naturally. If it hadn’t fused my vet was considering a specific type of steroid to encourage it to do so in a non painful way. He was on danilon while it fused but is now perfectly happy without. I don’t plan bringing him into work though.
 
PaulnasherryRocky said:
Thanks @dottylottie - I'm so glad to hear it worked! Did it require much box rest? and have they said if this is a treatment that will need to be repeated, or is it a one time thing?

As this is my other issue. He does not boxrest well - I think the arthrimid wasn't as effective the 2nd time round due to him double barreling the stable wall multiple times soon after he came round from the sedation. We had to turn him straight out in the end as he was doing more damage in!
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she was on box rest for a bit, sorry i cant remember the exact amount of time! but i did turn her out in a pen long before the vets wanted me to, because she was clearly upset and being a menace to walk. one time thing for her injury, i would imagine it’s the same for arthritis but i’m not 100%!

like your boy she was booting the walls, i figured a jump about in the field had to less damaging to her stifles than kicking a solid wall!
 
Tidy_rabbit said:
I had a horse have surgical fusion, he was on the older side but it gave him years of soundness afterwards. It was quite expensive though, I think it came to £5k but there were lameness work ips etc included. There is a month's box rest after because they drill into the bone and you have to have bandages and keep it clean. Although that sounds brutal my horse was on one bute a day right after and never seemed uncomfortable. I was given an 80% chance of it working.
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Thanks - that sounds like it was successful! I think the price is about as I expected, as thats roughly what his OCD surgery cost as well when he was younger
 
I have a pony who had a surgical fusion in one hock in Summer 2019 (due to injury he had pretty severe arthritis in the hock - injections didn’t help) he was around 14 at the time.

He was on box rest for around a month, then box rest with hand walking for a couple of weeks then small paddock turnout.

He came back into work Feb 2020 and has been doing pretty well since (had a few other issues but not related to the surgical fusion)

Since the surgery he is pretty much a happy hacker with a bit of schooling as don’t want to push him.

The cost of the surgery was around £4.5K however he had to have a fair amount of vet visits after and was on bute for around 3-6 months whilst it healed. Including the initial investigations before hand I didn’t have much change from £10K at the end of it.

Hope that helps 😊
 
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