Hock arthritis help - steroids, ethanol or other options

[miriella]

Hi all,

Sorry if this has been posted hundreds of times! I'm in need of some advice regarding hock arthritis treatments and options. I have a 14 year old gelding with progressing arthritis in one hock. He was diagnosed 7 months ago with relatively advanced arthritis after going considerably lame. A steroid injection brought him sound for another few months. He has since developed a large splint in his opposite foreleg possibly as a result of loading from his hock. He has now become lame again. My vet has now suggested attempting to fuse the joint with an ethanol injection. I'm quite worried about this route as I'm worried it may make it worse not better. Would you risk it or continue with steroid injections? Another vet has mentioned arthramid injections, would this be a better possibility? Horse is once in a lifetime so I really don't want to risk making him worse in any way! Any help would be appreciated! Tia

 

[HappyHollyDays]

Sorry your horse has gone lame again. My 13 yr old Connie has Cartrophen every 12 weeks which increases the synovial fluid in all the joints not just the hocks as it’s intramuscular rather than into the joint itself. Arthramid which is the next stage for my boy has been discussed quite recently, if you put it into the search engine you should find the conversations which might help you.

 

[SEL]

I've had arthramid injections into hocks and it works really well. Like you my mare had one that was worse than the other (she was diagnosed young before she'd really done any work) and it may be the reason she has soft tissue damage on the opposite foreleg - hard to know for certain. Cartrophen didn't help her but we're looking into Osphos.

There's a few posts on here around ethanol injections so worth doing a search and seeing other experiences. I don't know if you could try arthramid and then later do the ethanol if you don't get the results you want - worth asking the vet.

 

[Birker2020]

Hi all,

Sorry if this has been posted hundreds of times! I'm in need of some advice regarding hock arthritis treatments and options. I have a 14 year old gelding with progressing arthritis in one hock. He was diagnosed 7 months ago with relatively advanced arthritis after going considerably lame. A steroid injection brought him sound for another few months. He has since developed a large splint in his opposite foreleg possibly as a result of loading from his hock. He has now become lame again. My vet has now suggested attempting to fuse the joint with an ethanol injection. I'm quite worried about this route as I'm worried it may make it worse not better. Would you risk it or continue with steroid injections? Another vet has mentioned arthramid injections, would this be a better possibility? Horse is once in a lifetime so I really don't want to risk making him worse in any way! Any help would be appreciated! Tia

Hi all,

Sorry if this has been posted hundreds of times! I'm in need of some advice regarding hock arthritis treatments and options. I have a 14 year old gelding with progressing arthritis in one hock. He was diagnosed 7 months ago with relatively advanced arthritis after going considerably lame. A steroid injection brought him sound for another few months. He has since developed a large splint in his opposite foreleg possibly as a result of loading from his hock. He has now become lame again. My vet has now suggested attempting to fuse the joint with an ethanol injection. I'm quite worried about this route as I'm worried it may make it worse not better. Would you risk it or continue with steroid injections? Another vet has mentioned arthramid injections, would this be a better possibility? Horse is once in a lifetime so I really don't want to risk making him worse in any way! Any help would be appreciated! Tia

I had my horse done years ago and from being unable to lift hind feet more than a few inches off the ground, the day after I picked out feet and I nearly had my eye taken out, the amount of difference in height of lifting the foot to how it was like before.
Horse went on for many years being able to do everything the same as before, same level of competition including jumping every weekend.

We had to go down the route of steroids, then tildren which didn't work before chemical arthrodesis. Best thing I ever did!

You can see my input under Birker 2020 on these threads.
https://forums.horseandhound.co.uk/search/2143131/?q=ethanol+fusion&o=relevance

Here is info about what it entails. Bit of an old article now but still the same procedure. Cost me around £300 for both hocks.

 

[ihatework]

I’d try arthramid and Cartrophen first, and only if that doesn’t help would I consider fusion

 

[Birker2020]

I’d try arthramid and Cartrophen first, and only if that doesn’t help would I consider fusion

Fusion is forever though and although nerves can regrow I think the long term research suggested this hadn't happened from what I read, it certainly didn't seem to in my horses case. The advantages out weigh the disadvantages of using it.

I know it's not everyones first choice and there are probably better things on the market now, like Arthamid.

 

[IrishMilo]

Give the polyacrylamide hydrogel injections a try - they're supposed to be very effective.

 

[wanderersmelody]

See my post from earlier today - just a word of caution on the steroid injections. I've had them done 4 times now and always been really happy. This last time though has brought on a case of acute laminitis. He's chronic lame. No pedal bone rotation though. He's a non typical lami type - not overweight, a TB etc. Maybe just ensure your horse isn't fat, or get the EMS levels checked first. Its rare I believe but its also been a real shock for me. Thought I was dong something right for him and have ended up with a more serious problem.

 

[Birker2020]

See my post from earlier today - just a word of caution on the steroid injections. I've had them done 4 times now and always been really happy. This last time though has brought on a case of acute laminitis. He's chronic lame. No pedal bone rotation though. He's a non typical lami type - not overweight, a TB etc. Maybe just ensure your horse isn't fat, or get the EMS levels checked first. Its rare I believe but its also been a real shock for me. Thought I was dong something right for him and have ended up with a more serious problem.

Sorry to hear that, its quite unusual like you say.
https://www.equipodiatry.com/news/news-essays/newsbritishsuit08-05htm This is an interesting article about a lady that wasn't told by her vet that laminitis was a risk of steroid medication.

 

[V&F]

My boy had a surgical hock fusion op done in 2019 for his arthritis (left hind). We did try osphos injection first however it was unsuccessful.

He has been back in work for around a year now and so far so good *touch wood* .
I am always careful with him and don’t over do it. He is sound enough to school (but I don’t do small circles), small jumps and hack.

I am really glad I went through with the op now and he seems very happy. I do make sure he has regular osteo visits but people are always surprised how well he tracks up and moves.

I wasn’t offered the chemical fusion as an option so not sure how it compares with the surgical fusion

 

[Birker2020]

I wasn’t offered the chemical fusion as an option so not sure how it compares with the surgical fusion

The surgical fusion is under GA which has an inherent risk of death 1 in 100. It's also thousands of pounds more expensive.
In a research paper in respect of chemical arthrodesis - chemical arthodesis using sodium monoiodoacetate was an effective treatment method for degenerative joint disease of the distal tarsal joints. The technique was performed in the sedated standing horse and required minimal equipment. Results were comparable to those achieved following surgical arthrodesis.