Hock arthritis and long term management

[Traks]

Hi there, just wondering what others have done with long term management of hock arthritis?

Our almost 15yr old pony had hock arthritis diagnosed last year in January, bilateral with the off hind being the worst. She had Arthramid injections to both hocks in February and was massively improved. She does mainly pony club jumping, rallies and hacking your typical pony club pony! She struggled a bit on the hard summer ground and started refusing jumps but we put it down to the hard ground and she was generally a lot better on a soft surface.

Fast forward to November, physio said she looked great compared to January but recommended a course of cartrophen to help her over the winter (was stabled a lot as last yard had minimal turnout) so we had that and she’s been looking very well indeed. Had the vet do a lameness check on her and he said she actually looked good, failed a flexion test but said for riding and what we were doing she’d be fine.

In December she Started refusing jumps at competitions (70-80cm) but never refused at home, lessons, clinics, arena hires etc so we carried on but stepped down the height back to 50-60cm competitively for now and seeing how she goes…never really got to the bottom of why she refuses at competitive things bar picking up on tension/nerves? She refused again on Sunday at a couple of fences at 60cm which she could really trot over so something is clearly not right.

Anyway today she’s clearly very stiff and unsound particularly on that same leg. I’ve got the physio tomorrow by chance anyway so I’ll ask her to see what she thinks and call the vet tomorrow…

Insurance has paid out for arthritis and it’s now excluded so anything more we have to pay for ourselves. The vet did suggest some steroid injections into the hocks of things deteriorated further as Arthramid is so expensive….so I’m guessing this is our next step? I know steroids only work for 3-6 months so I would hope that this might help her in the short term.

Prior to the new lameness we were actually planning on moving on after the summer and getting something bigger and more competitive for my daughter. Obviously with full disclosure, although we hadn’t decided if we were going to go down the loan route or sell her (we are at livery and will struggle to afford 2). I guess can add retirement to the list of options

How long has your steroid management worked for? I suppose it depends what you are doing and how bad the arthritis is! I just wonder if we are doing too much with her although the vet said in December we weren’t but I’m not so sure..

Thank you!

 

[Tiddlypom]

I’d head straight to re medicate with Arthramid plus steroids simultaneously in both hocks (the gold standard) , then reassess after that.

Ask your vets how much they will charge, I self insure and it wasn’t silly money when I had just that done with mine.

Whatever you do, you can’t leave her in pain.

 

[Traks]

I’d head straight to re medicate with Arthramid plus steroids simultaneously in both hocks (the gold standard) , then reassess after that.

Ask your vets how much they will charge, I self insure and it wasn’t silly money when I had just that done with mine.

Whatever you do, you can’t leave her in pain.

No of course, oh ok I’ll ask then I just assumed it would be best part of £1k again! She had to have it done under xray as they struggled to inject into her hocks as the joint space was so narrow so that added to the bill.

We’d never leave her in pain, will do whatever she needs to be comfortable

 

[Tiddlypom]

ETA Dug out old post of mine.

I recently posted this on another thread. Bilateral hock jabs with arthramid + steroid on my wonky uninsured 17 yo Cushing's mare cost £889.56 in clinic in early Feb '23 (no call out fee). Excellent results, her whole demeanour has changed for the better.

 

[Traks]

ETA Dug out old post of mine.

Oh brilliant thank you!

 

[Nicnac]

Mine was treated with arthramid and tildren for a few years. Also gave Hy50 jab every 3 months. Can't have steroid injections as has had lami and now has cushings. He's out on loan to a hacking home for past 2 years and just has bodyworker (osteo) to keep him ticking over. He wasn't comfortable jumping nor dressage. He no longer needs any meds for arthritis as lives out and is comfortable hacking even up and down hills. He'll be 19 this year.

 

[Widgeon]

I’d head straight to re medicate with Arthramid plus steroids simultaneously in both hocks (the gold standard) , then reassess after that.

Ask your vets how much they will charge, I self insure and it wasn’t silly money when I had just that done with mine.

Whatever you do, you can’t leave her in pain.

I would do the same, until recently my cob (17 now) was having an annual steroid injection into his "bad" hock (the other one is fused and doesn't seem to be an issue) which kept him comfortably sound for hacking and the odd bit of schooling and jumping. I would've gone for Arthramid too but there was no space in the joint unfortunately.

I was paying for the steroid jab myself - I paid about £320 in mid-2025 for two injections into different areas of the problem hock. So not bank busting by any means, particularly when you consider the benefit it was giving. Even if you doubled that for both hocks and added a bit for Arthramid as well, it still wouldn't be horrific.

ETA like your horse there is practically no space in my horse's hock to get the needle in. However we did a set of x-rays on diagnosis so the vet knows exactly where to put it. We have to have "my" vet to do it because the others, although they are very good vets, are not so familiar with the anatomy of my horse's hock!

 

[Traks]

I would do the same, until recently my cob (17 now) was having an annual steroid injection into his "bad" hock (the other one is fused and doesn't seem to be an issue) which kept him comfortably sound for hacking and the odd bit of schooling and jumping. I would've gone for Arthramid too but there was no space in the joint unfortunately.

I was paying for the steroid jab myself - I paid about £320 in mid-2025 for two injections into different areas of the problem hock. So not bank busting by any means, particularly when you consider the benefit it was giving. Even if you doubled that for both hocks and added a bit for Arthramid as well, it still wouldn't be horrific.

ETA like your horse there is practically no space in my horse's hock to get the needle in. However we did a set of x-rays on diagnosis so the vet knows exactly where to put it. We have to have "my" vet to do it because the others, although they are very good vets, are not so familiar with the anatomy of my horse's hock!

Yes it was tricky, they tried to do it on the yard but they couldn’t get a needle in so had to take her to the vet hospital and they did it there with the X-rays on the spot etc.

Will see what the vet says, I’m just so worried about making her worse and constantly questioning if we should even be jumping her now etc…I just want someone to tell me nope, that’s it I’d still to hacking etc now…I really don’t want want to part with her but if she needs to be in a less active and competitive home then we will obviously make that decision… she’s such a fab pony in every way so it’s so hard x

 

[Widgeon]

Will see what the vet says, I’m just so worried about making her worse and constantly questioning if we should even be jumping her now etc…I just want someone to tell me nope, that’s it I’d still to hacking etc now…I really don’t want want to part with her but if she needs to be in a less active and competitive home then we will obviously make that decision… she’s such a fab pony in every way so it’s so hard x

I suspect it'll be a trade off - i.e. you can keep jumping her without necessarily causing her pain but the joints won't last as long. Whereas if you just hack the deterioration might be slower and she'll stay sound longer. Talk to the vet, I hope they're helpful because it's a fair question.

 

[SEL]

I'd go straight to arthramid - steroids did nothing for my mare.

 

[SpeedyPony]

In addition to hock injections, it might be worth considering a top up of the cartrophen (my old boy has a dose every three months).
I've also found he responds well to boswellia, he gets riaflex joint supplement and collagen as well (not sure how much difference those last two make, but they won't do any harm) and, when he was shod, he had pads put on his hinds, which made a fair difference to his comfort.

 

[Traks]

In addition to hock injections, it might be worth considering a top up of the cartrophen (my old boy has a dose every three months).
I've also found he responds well to boswellia, he gets riaflex joint supplement and collagen as well (not sure how much difference those last two make, but they won't do any harm) and, when he was shod, he had pads put on his hinds, which made a fair difference to his comfort.

Thank you I will ask about this too, she is unshod behind at the moment so I wonder if this is something else to consider? She is on a joint supplement she has been since we got her a few years ago x

 

[Tiddlypom]

There was very little joint space left in one hock for the Arthramid so the vet did x Ray her to assist the placing of the needle, and btw she didn’t charge me for for the x rays as they weren’t in the original quote. I’d have paid up for them, no quibbling, but they were down as FOC on the invoice.

 

[Traks]

There was very little joint space left in one hock for the Arthramid so the vet did x Ray her to assist the placing of the needle, and btw she didn’t charge me for for the x rays as they weren’t in the original quote. I’d have paid up for them, no quibbling, but they were down as FOC on the invoice.

That’s very good of them! I wonder how narrow is too narrow if that makes any sense? If the joint has fused I suppose? X

 

[SpeedyPony]

Thank you I will ask about this too, she is unshod behind at the moment so I wonder if this is something else to consider? She is on a joint supplement she has been since we got her a few years ago x

If she's unshod behind that's probably more help than pads would be in terms of minimising concussion, we went for pads and shoes for the old boy when he was doing enough roadwork to need shoeing behind as a way of limiting the extra concussion caused by the shoes.

 

[Traks]

If she's unshod behind that's probably more help than pads would be in terms of minimising concussion, we went for pads and shoes for the old boy when he was doing enough roadwork to need shoeing behind as a way of limiting the extra concussion caused by the shoes.

Ah ok thank you, I do remember the farrier saying something about being unshod behind being helpful.
Now I think about it we have been doing more roadwork hacking the past month since we moved yards and a fair few more hills so I wonder if that has had an effect too?

To be honest it’s probably obvious now the Arthramid has worn off, in my head I was hoping it would last a little longer! 13 months isn’t too bad. She’s jumped once or twice a week so hopefully we’ve not made her significantly worse

 

[Widgeon]

That’s very good of them! I wonder how narrow is too narrow if that makes any sense? If the joint has fused I suppose? X

I was under the impression that if the joint has actually fused it shouldn't be a problem any more - my horse has one fused hock and it doesn't cause him pain. It's the other one - that won't quite fuse (we don't really know why) but is incredibly tight - that causes the problems.

Re shoeing behind, I had this conversation with my farrier at the time - plastic shoes, pads etc? - but we concluded that the best thing would be to go barefoot behind. It definitely helped.

If you've got 13 months out of any kind of treatment I'd say that's pretty good!

 

[Traks]

I was under the impression that if the joint has actually fused it shouldn't be a problem any more - my horse has one fused hock and it doesn't cause him pain. It's the other one - that won't quite fuse (we don't really know why) but is incredibly tight - that causes the problems.

Re shoeing behind, I had this conversation with my farrier at the time - plastic shoes, pads etc? - but we concluded that the best thing would be to go barefoot behind. It definitely helped.

If you've got 13 months out of any kind of treatment I'd say that's pretty good!

yeah I was being greedy and wanted 18 months! She did have some cartrophen in December too which definitley kept her ticking over the winter months. Vet coming on Monday as the one I usually see isn't available till then, will give her some bute and rest her till then and continue with normal turnout etc

 

[Widgeon]

She did have some cartrophen in December too which definitley kept her ticking over the winter months.

That's really good, mine had cartrophen but I was never quite sure how much it helped him (if at all). It's so useful to know in your own mind what does and doesn't help your horse.

 

[Alibear]

According to my vet joint space needs to be 2ml or more for arthramid due to the viscosity of the gel and hence the needle size required. Under 2ml steroids is the best option if cartrophen hasn't shown any improvement. So as others have said a top up catrophen could be worth at try.

 

[KikiDee]

I think 12-18 months with Arthramid is pretty normal so she likely just needs remedicating rather than worrying the treatment is no longer working for the progression of the arthritis.

I once asked my vet if it was ethical to be medicating my horse at the time to allow him to continue jumping and her fairly blunt response was "we basically medicate horses SO they can continue working".

I'm fairly pragmatic with my horses, if I can continue them in their job comfortably with the appropriate medical intervention then I will do so, once I can no longer keep them completely and consistently sound with routine vet care then I step it back. Of course it probably shaves a few years off how long they can keep doing the job - but they stay with me for life so if they retire 2-3 years earlier then so be it. Personally I find it sadder to see horses struggling with mild ongoing arthritis that have been semi-retired to hacking/flatwork with no medical intervention than to see a horse medicated and continuing its work. Of course you can do both, but I find people are more rarely prepared for the expenditure on a horse that has been retired to hacking.

 

[Traks]

Physio saw her today who said she is very sore over back behind the saddle area and has some muscle atrophy there, very tense and sore when she was fiddling with her back legs. It did ease off with treatment a bit by the end but she agreed she is quite stiff on that same leg and thought the vet best look at it. She suspects it’s all hock related too… she’s had a bit of Danilon tonight and the next couple of days then will stop it before the vet comes Monday to have a good look. She had a quick look at the saddle too and thought it looked ok from her experience but we will obviously get that looked at too in case.