Hock arthritis management

Season’s Bleatings

Season’s Bleatings

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First and foremost, the vet is involved but I was interested to get experiences from others in similar situation.
Vet was out on Wednesday for an unrelated matter and while he was there, I asked him to xray our mares hocks. I wasn't surprised to see arthritic changes. His recommendation in the short term is to give her bute and work her lightly, as she needs to lose weight, and he will come out for a more detailed assessment again in 6 - 8 weeks time. Dietary restrictions are already in place and she has made good progress in losing weight but we are starting to plateau a bit.
The horse in question is a 15yo ISH who has had fairly high mileage. She's had a bit of time off lately but in any case her work while with me has been light - mostly gentle schooling (and hacking when I can persuade her not to kill me - unfortunately not as frequently as I'd like).
I know joint injections are an option, but I'm concerned about the long term effectiveness of going down this route. I'd like to have a bit of an insight into what other options are potentially available.
What other ways (conventional or alternative, I'm open minded) have you lot dealt with similar issues?
 
I had a mare with spavin and in her case the vet deemed it more beneficial to Bute and ride to fuse the joint. Her jumping days ended there but she was sound for hacking and flatwork. I gave her away to a home where she is a companion to an oldie, on 24/7 turnout, and she’s doing well.
 
My pony has had hock arthritis for a few years she is 25. She doesnt jump since vet said she had it and this year no longer gallops but that is due to another injury. She is still happy hacking with trot and canter. Did a 12mile hound exercise recently. I have not had to medicate it yet, just feed cortaflex supplement. She has it on her vet file that i can get bute for her if I want, which I would consider if she struggled in winter, but so far has not been needed.
I have been told eventually they will fuse which will be less painful for her.
 
I've used well managed weight, 24/7 turnout (probably the biggest factor) and exercise to keep them going. I have used No Bute with one and I *think* it helped but it wasn't a miracle. Bute in cold, damp weather and keep them warm in winter. Also travel boots on while grooming, tacking up, etc to warm joints although I'm sure other people will be able to tell you about the more hi tech options for that. They do need a good 20 mins at least of warming up in walk.
My vet does not recommended any of the joint supplements, and also says fusion is probably a lot rarer than is claimed. But you can certainly keep them comfy for a good long while with luck.
 
Thank you very much folks, some food for thought there and useful to hear of your (non-medicated) experiences. I naively thought it would be the magic solution, but a chat with the farrier yesterday gave me more insight into the limitations and possible negatives to going down that route.
She's a lovely little mare (a bit quirky and odd though) so I want to make sure we do whatever we can to give her the best chance possible to stay in a reasonable level of work - this seems even more crucial now with arthritis.
My older boy is creaky too and always benefits from a good massage and stretch before tacking up (he mostly just hacks but agree that a decent 20min of walk really helps loosen him up). Will have to implement this for her too. :)
 
Mine suffers. She has been on off lame all blimming year, and got too fat thanks to our stupid weather and not being able to work (hard ground was a real bummer). Lengthy discussions with vet and opted for the bute route. The more I can work her, the better she is. She gets the bute 20 mins before a ride (I syringe it in, it's the only time she won't eat food - even copious amounts of garlic and peppermint) if riding (and the more of that the merrier). She also benefits, because she is borderline insulin resistant, from some fast work. I have been building up to 3 minutes of fast cantering x 2 (starting with 30 seconds), and touch wood, she has been fine.
 
I've literally just taken the decision to retire my 25 year old mare who has hock arthritis.

Diagnosed approximately 18 months ago. Discussed options with the vet who said that injections won't work as well at her age and advised targeted use of bute. He said we could try cartrophen if I really wanted to but that in his experience hock fusion was very difficult to predict especially in old horses.

So she has been on 1 bute as and when needed and before riding and I usually put fleece hock boots on her while I'm grooming/tacking up. We've had a fantastic summer of hacking which she has absolutely loved but now the damp chilly mornings have arrived she has become very uncomfortable to be ridden so I've decided it's time for her to be a much loved field ornament.
 
Didn't xray but problems first arising I think about age 20 with some saddle slippage (and saddler thinking he wasn't quite pushing evenly)

I think the year he was 22 I noticed a deterioration, but actually he hadn't had any body work for a while due to moving and him not presenting with his usual symptoms (historically right lead canter). Sent videos to vet and had physio, when vet came out to check him he looked remarkably better!
Soon after I started him on boswellia, didn't tell anyone but several experienced people said he was moving freer.

Spring of his 23rd year he seemed to deteriorate again, more problematic on flexion that before and had a speculative steroid/HA injection into lower joint with very good results (still in full work at this point).

Arguably I partly wish I'd had it injected previously as 6 months later we discovered that his opposite hind was having annular ligament issues (3x usual thickness, hock affected leg 2x usual thickness) which drove his semi-retirement to hacking and a bit of showing.

At 25 he is no longer positive to flexion on that side but is struggling with overall comfort so currently buted (for reassessment once we hit winter).

Hope that maybe helps, I think a combination of unshod/boswellia/regular bodywork for compensatory issues worked fairly well for us.
 
Mine is 8 and having quite significant problems. Not helped by a very risk averse vet (not the one who diagnosed her, who has sadly moved areas) who doesn't want to inject steroids into the joint because of the laminitis risk. I have told them I am prepared to take the risk because right now she feels horrendous to ride. Not so bad to look at on the lunge, but the minute the weight on the rider is on board then her back end doesn't move through properly. Not helped by her PSSM - in fact that might have been a contributing factor to why she had the diagnosis at 6 - but nowadays I can usually manage that to the extent I know it isn't causing the stiffness.

There are more options that steroids into the joint, but if you get an experienced vet who makes sure it actually goes into the joint, then the laminitis risk is low. You could also ask your vet to look into non steroidal injections, but I've been told these are more expensive - and hocks are excluded from my insurance.

Personally I wish I'd pushed more to have the injections when the original vet made the diagnosis. We tried cartophen, but made no real difference sadly. Physio / bodywork every 6 weeks really helps as does as much turnout as possible. I also find keeping her warm and dry (I am one of those people rugging already!) helps.
 
Mine had pretty much all of last year off due to hock arthritis.

She's 12 now and both hocks are affected. Before I had her she did quite a lot of jumping on what I think was pretty hard ground (working hunter). She was bilaterally lame and it was difficult to see what was going wrong, but she was pushing her hocks out to the side in trot and bunny hopping into canter on the worst leg.

We tried steroid injections into the joint first but they only lasted 3 months. Then we x-rayed and nerve blocked with some response in the suspensories but primarily it was the hocks.

At 11 as she was then, I didn't like the route of repeated joint injections due to the infection risk and the fact that they didn't really last very well. So we tried ethyl fusion (arthrodeosis) where the hock is injected with ethyl alcohol. This kills the nerve so no more pain, and promotes fusion of the joint over 12-18 months.

We were not able to do the right hock as the dye to test travelled upwards, suggesting that the ethyl would fuse the wrong part of the joint (this is catastrophic if it happens). However the left hock was a good candidate so we went ahead. I also had OsPhos injected intravenously (sometimes horses can mildly colic after the injection so I watched mine carefully but she was fine).

The left hock is perfect. The right hock is in good shape now - there is a slight unlevelness according to my vet, but I can't see it.

I'd go for ethyl fusion again in a younger horse, and OsPhos worked far better (with lower risks) for us than the steroid joint injections. We may try and fuse the right hock at the end of the season although as it stands my girl is sound, jumping (only little stuff because I'm scared of big things and breaking her) and yesterday we won 2 Novice dressage classes.

You may want to consider arthrodeosis because it's a one time only treatment so less risk than repeated steroid. Good luck. Hock crap is a right bloomin' nuisance.
 
My old ex-hunter developed hock arthritis at around 17. I managed him on boswellia and bute in the winter, which worked great for him.
I have my present 2 on boswellia as human research suggests that it may slow the progression of arthritis. And they have both had hard jumping in their youth.
 
Regandal said:
My old ex-hunter developed hock arthritis at around 17. I managed him on boswellia and bute in the winter, which worked great for him.
I have my present 2 on boswellia as human research suggests that it may slow the progression of arthritis. And they have both had hard jumping in their youth.
Click to expand...

Can I ask where you get your boswellia from?
 
Thanks all so much for your comments, they are so helpful and it's really good to get an insight into how others are managing.
The ethanol fusion sounds really interesting, although I've heard that if the injection fails, the joint is no longer suitable for medicating further. I guess that'll be a question for the vet when he comes back out.
Do you feed boswellia on its own or alongside bute/danilon (if/when required)? Again, that'll be something for me to chat to the vet about, but interested to know what everyone else is doing.
My main concern is that she is still relatively young, so I'm worried about the long-term effects of bute/danilon on her. Obviously her workload would be kept in line with her limitations, but it's sad to think that her best years are behind her now. She's a quirky, funny little mare, an absolute machine XC (not that she's done any proper jumping at all in the past couple of years) - just as long as she's happy, then I'm happy too.
 
If your considering ethanol fusion make sure you discuss the long term implications of it and what happens if it doesn't work. I had it done on an 8 year old, both hocks. I wouldn't have it done on a horse again. It failed and we ended up with other issues, I believe as a result. X-rays done 4 years later confirm there is no fusion in the hocks. It may work for some but arm yourself with all the facts before making a decision. I regret putting my horse through it

ETA, mine has improved and now sound finally after 5 years of being lame on an off behind. We have as much turnout as possible. I've tried most supplements available and only seen a difference with one, epiitalis. The main change I changing how he's worked and his way of going so he's using himself better
 
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ethanol fusion failed on mine to, vet who did it claims 2/10 lame in one hock only but he looks horrible on both most of the time. There is no way back and nothing more that can be done so I would treat it as an absolute last resort personally.
 
Thanks folks, that was my concern about ethanol fusion. I guess at the moment I have more questions, but will chat through with the vet in a few weeks time. At the moment our focus is getting weight off her - it's going really well so far, thankfully. :)
 
Polos Mum said:
ethanol fusion failed on mine to, vet who did it claims 2/10 lame in one hock only but he looks horrible on both most of the time. There is no way back and nothing more that can be done so I would treat it as an absolute last resort personally.
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Totally agree, mine was like this looked completely stiff all over afterward. It's taken years to get past the 'fusion' issues but with a lot of trial and error I now have a sound horse, no steroid injections, no Bute, infact no medication at all....and also no fusion !! Go figure !!
 
whiteflower said:
ETA, mine has improved and now sound finally after 5 years of being lame on an off behind. We have as much turnout as possible. I've tried most supplements available and only seen a difference with one, epiitalis. The main change I changing how he's worked and his way of going so he's using himself better
Click to expand...

can I ask how you went changing how your horse worked? I know mine isn't working properly but I'm struggling to break the soreness cycle atm
 
My horse has hock arthritis (more advanced on one side than the other) and also the start of coffin joint arthritis in his front feet. I've never tried joint injections but had good results with using boswellia and devil's claw. These days I just give him 1 danilon a day and this has really, really, helped him. He's a 18yo IDx, quite large built, he also has PPID so has to be stabled during the day in Spring/Summer which isn't ideal for an arthritic horse but he seems to be quite happy on it .

I've owned him 3 years now- the first year my daughter did a fun ride, some low level jumping and stuff with him but he let us know when it was too much so we stopped- now he's a happy hacker with the odd bit of schooling/low level pole work (to try and teach me the craft)
 
Regandal said:
My old ex-hunter developed hock arthritis at around 17. I managed him on boswellia and bute in the winter, which worked great for him.
I have my present 2 on boswellia as human research suggests that it may slow the progression of arthritis. And they have both had hard jumping in their youth.
Click to expand...
Hope this gets through but which type of boswellia is best and what dosage please?
 
Maz55 said:
Hope this gets through but which type of boswellia is best and what dosage please?
Click to expand...

most available is boswellia serrata however some is boswellia carterii (rahiiq sell this but no idea when it was last in stock). There is research behind all four species (different localities) and they all contain the same/similar compounds.
 
My first pony had a big bone spavin. He was about 25 when he became lame, and at the time we went to te best equine hospital and the recommended treatment was pin firing and blistering (back in the 80s). I don't think that treatment did anything (and I can see why it was banned afterwards!), but 2 years of field rest did.

Once he had been off for 2 years he came back into hacking work, then schooling and finally jumping.

He was still active and enjoying a bit of a jump when the mood took him until he was the wrong side of 35. Never lame again. It was melanomas that finally got him, right through his body. But at 35+ we were happy enough at that. Was PTS, still sound and looking a million dollars, but a bit breathless when led in from the field, so it was defo time.
 
My 9yo IDx has bone spavin in both hocks. To be fair he's been stiff since the age of 5 but got progressively worse around the age of 8. He has had two lots of steroid injections which helped very briefly then stopped helping! He then went on 1 danilon a day - little effect. He's now on 2 danilon a day plus equimins flexijoint and, touch wood, is better. He wears magnetic hock boots at night and I do physio exercises with him before working (and I usually use a back massager pad for 30 mins). Worrying thing is he had had very little hard fast work in his life but is prone to weight gain and at risk of laminitis so vet thinks being overweight has affected the joints. So I have made sure the weight is controlled and that he gets exercised appropriately (flatwork, no lungeing, and also hacking but mainly walk with no fast work on hard ground etc).. He is stabled 12 hours a day and out 12 hours. I should add that boswellia didn't help. At the moment if he is schooled he is still showing signs of discomfort (cornering or circling on the left rein in particular) but this improves as he is worked and warmed up (whereas before treatment / diet there would be no improvement). This discomfort is expressed as head up ears back gnashing jaws and slowing down. Once warmed up properly thankfully he is much happier and settled - he goes forward, accepts a contact and ears are relaxed. He gets physio every two weeks. I'm not sure about artificial hock fusion - I think I'd rather see how he gets on with the danilon, exercise and diet regime for now.

I measure improvement by periodically videoing him in slow motion firstly freeschooling and then on the lunge. When he is sore he drags his hind toes and doesn't track up. His canter is stilted and he keeps his hind legs straight and there is no 'spring'. He also goes predominately on the forehand presumably to take the weight off his hinds. When he isn't sore the hind toes don't drag, he tracks up and the canter strides are normal with good flexibility & spring. He carries himself normally (i.e. head in normal position). I can't see any of this at realtime speed but in slow motion the issues become dramatically obvious!
 
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