Hock arthritis, symptoms, injections and after plan

[Horsekaren]

The Cobby is booked to have his hocks injected on Friday. I understand it is quiet a common thing so im looking to hear peoples experiences.

The boy is 10, he has been short behind, hoppy, trantering, bucking, unable to flex on the left rein and finally chucked me over his head about a 3 weeks ago as to say enough! I had my chiro / vet out who said she didnt want to touch him as he was sore over the back of his back (behind saddle) and his croup. He seemed incredibly sore when touched so she suggested i have him xrayed for Kissing spine which came back clear as did his fetlocks and stifles.
(those that follow my posts will know he has been short for a while but has never failed lameness or flexion tests)

The Xray showed mild arthritis, which was worse in the left hock so he will be having both injected. Vet has said he will need to be in for 2 - 3 days so i have borrowed a stable but i am a bit worried about this. When he went for his xrays he was rearing up at the door and just was not a happy boy. Does anyone know why the box rest is needed, is it for infection or for the injections to settle? Vet has said they can give me some sedaline to calm him but i dont know how long this works ect.

He hasnt been ridden for 3 weeks, i walk him in hand every other day but im not sure if this is good or not, he seems stiff when he does nothing.

After that ramble does anyone have experiences with the injections? what were the symptoms your horse showed? was there back pain? Good and bad stories? how long did it last? how soon an you tell if its worked? should i be expecting him to no longer be short behind?
How long do i wait?
The plan is to see if this works and if not we will do nerves blocks higher up see if there is an issue in is sacroiliac.

Also can anyone suggest a good calmer for box rest, i really need to zonk him out as he is going to be very upset being locked away.

This is entirely new to me but luckily this will go through insurance so i have a time limit if the issue is higher up.

 

[SEL]

HK - my Appy had hers done last year. The box rest is both to reduce the risk of infection and also because movement can make the substance leak out of the joints and it needs to stay in while the needle hole heals.

Saying that we managed less than 24 hours before she was spinning in the stable and making it worse, so she went out. I kept the bandages on her legs and she was a lot calmer out. The weather was dry too so that helped.

Didn't really work for the Appy. I managed to get her back in work briefly with a lot of on-ground rehab but she wasn't right behind and struggled under saddle. Vet #1 suggested hacking in walk and on Boxing Day she had an absolute meltdown humping her back so I took her back to the yard, got my OH to video her and engaged a new vet. I've been on her briefly twice since and she's fine in walk but feels like she's forgotten where her back legs are if I ask for trot.

I've had Tom Beech out twice and him and vet #2 both believe the problem is actually up in her sacroiliac region and a rectal ultrasound has been recommended. We should have done it earlier in the year but neither Tom or my own vet really believed she was that bad so we went through months more rehab type stuff, bute trials etc before Tom came back for his second visit and said she needed a scan.

Another horse on the yard had its hocks injected the same week and is out winning at novice dressage now. She saw a real improvement within a month - so that also helped me realise that hocks were unlikely to be the primary cause for mine. If they are the primary problem for yours then hopefully you should see a benefit quickly, but I would recommend some bodywork too because he will have been holding himself badly to compensate for the pain. Good luck!!

 

[SadKen]

I had my girl's hocks injected with steroid when she couldn't canter properly and became reluctant to jump. She was also incredibly tight through her back due to altering her way of going to preserve her hocks; we had chiro treatment for this. She had arthritis in the medial joint of the hock on both sides. The steroid lasted for 3 months before we started to see issues again. You should see a swift (couple of days) improvement after steroid injections and the horse should be able to resume normal work and in our case for the 3 months it was as though there was no arthritis.

Keeping in is to reduce the risk of infection; I only needed to keep in for 24 hours though. You definitely do NOT want infection in the joint space.

As I was disappointed at the timescales for the steroid lasting (and concerned about the risk/cost of re-injecting 4 times a year - she was only 11) we went down the route of arthrodeosis which is the same procedure but the injection is with ethyl alcohol rather than steroid, killing the nerve. I had both done with a skilled vet (there are risks) and both hocks are now very good with no issues, and the xrays are clean as the insult to the joint has resulted in the bone adapting in a better way. Again, she was in for 24 hours then turned out and good to go.

I think we were unlucky with the steroid timescales as other horses on the yard have had steroid last for a year or more.

You're better off keeping an arthritic horse moving so they don't stiffen up, so I think you're right to walk him.

 

[ester]

Keeping in is as much to do with limiting moving so as not move the steroid out of the joint space as it is reducing infection risk. - I've been on enforced rest myself after a SI joint injection on Friday lol.

Improvement does occur over the period of about a week, it can vary with F I definitely saw an improvement in a couple of days but that wasn't the full improvement.

 

[ihatework]

Give him a load of Sedalin and keep him in for 48h, don’t walk him out in that time. This is less about infection risk (although obviously that is there - but if you get infection it’s generally at the time point of needle entry).
The immobility is to keep the steroid in the joint space.
It’s worth considering Cartrophen and potentially arthramid injections too.
It wouldn’t surprise me if you end up with at least one SI injection given this has been ongoing quite a while.

But the good news is, in most cases, this is completely manageable for what you want to do.

 

[Pinkvboots]

I would sedate him with sedalin while his in get a few tubes from your vet, if they are injecting steroid some vets want them in as there can also be a laminitis risk.

 

[Bernster]

Hocks seem to respond well to steroid injections and it's fairly common and effective in a lot of the cases I know about. Mine lasted a couple of years after steroids but she had multiple issues so wasn't in full work a lot of the time and is now semi retired. She was short behind but was being treated for KS at the time so difficult to know which symptom was down to which issue! If it's just hocks, I think the prognosis is pretty good.

 

[LaurenBay]

Most Horses get on well with steroid injections, but there is a risk of laminitis, hence the need for boxrest after to keep them off the grass. Ruby had 2 lots of injections and didn't get lami. If he reacts well to the steroids then you will most likely need to keep on top of them as they do not last forever. You can look at Catrophen also for between the steroids (this will be injected by yourself)

The symptoms were quite extreme. My lovely sane Horse, turned into a horror. She kicked at other Horses, began rearing and was scared of everything, the last straw was when she threw us into a ditch (twice) and knocked over a walker out on a hack. I got her saddle,teeth and back checked. Teeth and saddle fine but her back was sore. My vet came and diagnosed arthritis in both hocks treatment began on her sore back, vet and pysio said its because of the pain in the hocks, she could not carry herself properly and therefore over a length of time she caused a lot of muscle damage trying to compensate for her back end. Once she was injected with the steroids, I was back on board a week later. All was fine for 3 months and my sane loving Horse was back. Unfortunately the bad behaviour started to come back, vet called, Ruby was lame again and the injections had worn off. We tried them again, this time along side a Tildren drip, this only lasted a few months also. Steroids did not work for her. I tried several supplements and none really made much difference. We did go on to try other methods and treatments, but sadly it was not a positive outcome for her. But for most Horses steroids work wonders, so please do not give up hope based on my story.

As for long term management, he already lives out 24/7 which IMO is the best management for an arthritic Horse. Try not to use cold water on his legs in winter. Keep him warm. Be mindful of the ground (some noticeably struggle with hard ground) In time the hocks will fuse on their own, which means no more pain. There is no time frame for this though and it will happen on its own naturally.

Feel free to PM me if you need any advice.

 

[Toby_Zaphod]

Be prepared to find you have a new horse after the medication. We have a 16h3" show jumper who started to lose performance & eventually we realised that he had some lameness in a front leg. We took him to a specialist vet for investigation & we found he#d got arthritis in a coffin joint. When injecting the vet found that the fluid in the joint had next to no viscosity. He injected the joint & also injected the hocks, his joints were bandaged for 24 hours & he was box rested for a couple of days. He was then turned out & for a week we only exercised him in straight lines & only walking. After about a week we went to normal exercise regime & he has been fantastic, he's like a new horse. We have him medicated about every 12 - 15 months & this really helps him. The vet is extremely satisfied with how he's going now, he was checked a couple on months ago & he passed a full lameness work up including flexion test. The vet did say however that some horses do not respond as well as others, we have been very fortunate.
As for box rest, I go with what the vet says, he's the professional however sometimes I wonder if it is the best idea with a lame horse as they are going to twist & turn in there & hay be able to move easier without the turning in a paddock?

 

[Horsekaren]

Thanks for the responses, i am really keeping everything crossed it is just his hocks and not further up but my gut is telling me its not going to be that simple. He has been lovely on the ground (last time he was poorly it was a miracle i lived through it lol)
He is happy eating, happy out, comes running ect but over the last few months he has been telling the other horses off for going near his back end, even grooming, if they go to far back he will tell them off so i know its sore if its not just me he is telling. Whether that is just because of sore muscles from hocks is yet to be known.

My biggest worry is that he will feel a bit better himself but feel great to me, i'll think we have cracked it but then there is an issue rumbling higher up which i will only have a year to get to the bottom of. I guess i find it hard to believe that sore hocks can cause them to lock there neck, and cause that much pain over their back. I know im not built like a horse but if i had a sore knee i wouldn't feel it in my shoulder, hard to get my head around.


As for the box rest i am dreading it, when he is upset he will rear his front hooves over the weave grill which is dangerous and must put a lot more pressure on his hocks. Then i worry if he is too sedating he doesnt lock his front legs and rocks back and then falls down which again will not be good for hocks. There will be no other horses in so he will find it very stressful.

 

[LaurenBay]

Hocks can and do have a knock on effect of the whole body. If you think about it, the hocks carry a lot of the weight on the back end, if that is sore then the Horse will overcompensate and use the front as much as possible. Over an amount of time these muscles will start to get very very sore. I would ask your vet to recommend a good physio (you can claim on insurance but check with the physio first as they need to have a certain qualification I believe in order to claim) He will need regular physio to help his muscles re cover. There will be tones of things you can do with him too (the physio will show you stretches and exercises to do at home)

 

[ester]

Sedalin really isn't strong enough to have them fall down

 

[Tiddlypom]

Yes he must be kept in for 48 hours as others have said, so that the steroid doesn’t dissipate.

I had my chiro / vet out who said she didnt want to touch him as he was sore over the back of his back (behind saddle) and his croup. He seemed incredibly sore when touched so she suggested i have him xrayed

So has his back been treated by a body worker at all? Was this a chiro vet? I’m surprised that treatment under sedation hasn’t been mooted, he will still be sore in his back after the hocks jabs even if it is ‘only’ hock arthritis.

My mare has bilateral hock arthritis and has had her hocks jabbed for it. Whilst the jabs were effective, my chiro vet found that my mare was still tense and sore in her SI region because of all the previous wonky moving. She finally had both sides of her SI joint medicated a month ago (should have done it ages ago) and she’s much happier.

 

[TotalMadgeness]

My 9yo was diagnosed last year. He was never quite right from when I first bought him at 5 but this was put down to being green, then laminitis and also a twisted left fore.

His main symptoms were:
Tight / sore on his back behind saddle
Girthy
Croup high, large round largely flabby bottom (muscles not being used properly)
Hated walking downhill - reluctant / short / stuttery strides. When the bone spavin kicked in seriously he simply refused to walk downhill.
Anxious in school.
Tripping over poles
Reluctant to hold hind foot up (right) when picking out hoof - lifts it up fine but has to put down or lean on you soon after. Other feet he holds up fine.
Bad canter - especially on left rein - would hump back and 'buck' into transition. General reluctance to canter.
Reluctant to go forward - any gait.
Reluctant to take a contact.
When standing he'd stand with both hind feet under him.
When moving he was very much on the forehand (presumably taking weight off hind legs).
Toe dragging (hinds)
In canter holding hind legs very straight - no flexibility & just not striding correctly.
Neck very stiff to the point we thought he had arthritis in his neck!

Injected twice - first day after his box rest he was feeling really well - a very happy horse! He bounced & squeaked downhill and became very forward going - ears pricked, happy to take a contact and enjoying his work.
Unfortunately the injections didn't last so he is now on 2 x danilon a day. He is still not perfect but definitely working much better than before and much happier in himself. He has gone from poor dressage scores at Prelim i.e. under 60% to high 60's and he has lost the croup high/flabby bum and started to change shape. He has just started Novice level - and so far so good!! He no longer stands with hind legs under him and he doesn't go on the forehand anymore and his neck is nicely flexible.

Management wise:
Danilon twice a day.
Joint supplement given.
He is no longer jumped, lunged or trotted over cavalletti. Too much concussion!
We do a lot of hacking out instead and very little schooling under saddle. No fast work on roads or hard ground (concussion again).
He sees a physio once a month, wears magnetic hock boots in the stable & we do physio exercises every second day or so using an equicore.
His weight is kept down (restricted grazing etc).

 

[Horsekaren]

Sedalin really isn't strong enough to have them fall down

He will do this when he is dozing with no sedation, he has always struggled with this, not so bad now but i worry if he is sleepy he will do this.

Yes he must be kept in for 48 hours as others have said, so that the steroid doesn’t dissipate.So has his back been treated by a body worker at all? Was this a chiro vet? I’m surprised that treatment under sedation hasn’t been mooted, he will still be sore in his back after the hocks jabs even if it is ‘only’ hock arthritis.

My mare has bilateral hock arthritis and has had her hocks jabbed for it. Whilst the jabs were effective, my chiro vet found that my mare was still tense and sore in her SI region because of all the previous wonky moving. She finally had both sides of her SI joint medicated a month ago (should have done it ages ago) and she’s much happier.

Did they find an issue in her SI? ive been told you cant really see it on xrays ect so i presume its a lot of guess work. That is good to know, as i said i feel it is higher up as well.

 

[ester]

still better than him attempting to climb out.

 

[Horsekaren]

My 9yo was diagnosed last year. He was never quite right from when I first bought him at 5 but this was put down to being green, then laminitis and also a twisted left fore.

His main symptoms were:
Tight / sore on his back behind saddle
Girthy
Croup high, large round largely flabby bottom (muscles not being used properly)
Hated walking downhill - reluctant / short / stuttery strides. When the bone spavin kicked in seriously he simply refused to walk downhill.
Anxious in school.
Tripping over poles
Reluctant to hold hind foot up (right) when picking out hoof - lifts it up fine but has to put down or lean on you soon after. Other feet he holds up fine.
Bad canter - especially on left rein - would hump back and 'buck' into transition. General reluctance to canter.
Reluctant to go forward - any gait.
Reluctant to take a contact.
When standing he'd stand with both hind feet under him.
When moving he was very much on the forehand (presumably taking weight off hind legs).
Toe dragging (hinds)
In canter holding hind legs very straight - no flexibility & just not striding correctly.
Neck very stiff to the point we thought he had arthritis in his neck!

Injected twice - first day after his box rest he was feeling really well - a very happy horse! He bounced & squeaked downhill and became very forward going - ears pricked, happy to take a contact and enjoying his work.
Unfortunately the injections didn't last so he is now on 2 x danilon a day. He is still not perfect but definitely working much better than before and much happier in himself. He has gone from poor dressage scores at Prelim i.e. under 60% to high 60's and he has lost the croup high/flabby bum and started to change shape. He has just started Novice level - and so far so good!! He no longer stands with hind legs under him and he doesn't go on the forehand anymore and his neck is nicely flexible.

Management wise:
Danilon twice a day.
Joint supplement given.
He is no longer jumped, lunged or trotted over cavalletti. Too much concussion!
We do a lot of hacking out instead and very little schooling under saddle. No fast work on roads or hard ground (concussion again).
He sees a physio once a month, wears magnetic hock boots in the stable & we do physio exercises every second day or so using an equicore.
His weight is kept down (restricted grazing etc).

That great you have found something that works.
i have been wondering if it could be in his neck too!
He isnt standing with his hinds under him, he stands with them quiet out behind him, almost like a suttle showing pose, the other horses dont stand like that so its not normal.

Haha i hope he feels happy lol not to happy that i struggle to keep him as i turn him out down the lane lol!

 

[ester]

Have you read the recent posts from alexhyde about skylla, they are interesting from a standing posture point of view.

 

[Michen]

Why don’t you have the injections done at hospital and keep him there for a couple of days if you are worried? Some policies will pay for it- the livery at hospital that is.

 

[Tiddlypom]

Did they find an issue in her SI? ive been told you cant really see it on xrays ect so i presume its a lot of guess work. That is good to know, as i said i feel it is higher up as well.

The chiro vet found the pain in her SI region. Regular vet was happy to go ahead and do the SI medication on chiro vet’s recommendation.

I posted about it on the Skylla/Alex Hyde thread. We have the same chiro vet.

https://forums.horseandhound.co.uk/threads/skylla-update.776832/

And here’s a pic showing the start of my mares’s post SI medication rehab. You can see the clipped area on her loins where they injected her. ester, have you been given similar exercises to do ?

 

[SEL]

Why don’t you have the injections done at hospital and keep him there for a couple of days if you are worried? Some policies will pay for it- the livery at hospital that is.

That's definitely an option I'm considering when mine needs her SI doing (which we are delaying because the vets have had so many laminitis cases this year). Some horses settle better when they can't see all their friends going out to the field and don't understand they can't join them.

 

[ester]

lol someone said that on facebook TP, when am I starting pole work.

 

[TotalMadgeness]

The chiro vet found the pain in her SI region. Regular vet was happy to go ahead and do the SI medication on chiro vet’s recommendation.

I posted about it on the Skylla/Alex Hyde thread. We have the same chiro vet.

https://forums.horseandhound.co.uk/threads/skylla-update.776832/

And here’s a pic showing the start of my mares’s post SI medication rehab. You can see the clipped area on her loins where they injected her. ester, have you been given similar exercises to do ?

View attachment 34080

I use the equicore with my boys too - has made a big difference!

 

[cundlegreen]

That great you have found something that works.
i have been wondering if it could be in his neck too!
He isnt standing with his hinds under him, he stands with them quiet out behind him, almost like a suttle showing pose, the other horses dont stand like that so its not normal.

Haha i hope he feels happy lol not to happy that i struggle to keep him as i turn him out down the lane lol!

That stance would say ulcers to me probably due to the pain. I also found that injections didn't work with my 7 yr old eventer, so managed her carefully. Always turned out but on restricted grazing as shes a fatty. No work or jumping in a school just lots of steady fittening work in straight lines. 5 years on, she's up to Intermediate event level and never had any medication at all. The hocks will remodel and then your horse will move, and feel better. I think surfaces have a big affect on this condition. I stay off them whenever I can with my mare.

 

[Nudibranch]

Hmm..good or bad experiences. Well, I had a 7yo pts with hock arthritis and SI and neck issues. He was an extreme case though and had never even set foot in a school so it was just pure bad luck.
I did suggest yours was showing signs of something similar (as did others) but was told "there's always one"...that was probably a year ago? So he's been working in the school all that time?

 

[Horsekaren]

Hmm..good or bad experiences. Well, I had a 7yo pts with hock arthritis and SI and neck issues. He was an extreme case though and had never even set foot in a school so it was just pure bad luck.
I did suggest yours was showing signs of something similar (as did others) but was told "there's always one"...that was probably a year ago? So he's been working in the school all that time?

hmmm i think i said that as every time you said something it was more along the lines of calling me an idiot, not sure if it was you or someone else but i remember one comment saying along the lines of "i didn't think there was much worse things than being dead but id rather that than being HK's horse" which when your trying to do everything right was a big kick in the teeth.

Yes he has been worked on surfaces in this time as he has never been lame, it has only been the last few 4-5 weeks that something was clear (still not lame but not happy)

He has been doing so well since moving him, it might be that this has been the rumbleing issue all along but as i'm sure everyone can sympathize with when nothing is found it is too expensive to scan prod and poke ect when there are no clear signs other than being a bit short behind and being told thats normal for his type.

Anyway, i am sorry to hear about your 7YO's luck, i really hope our case isnt that

Can i ask what were the SI and neck issues found? was that also arthritis? and how did they find it?

 

[Horsekaren]

That stance would say ulcers to me probably due to the pain. I also found that injections didn't work with my 7 yr old eventer, so managed her carefully. Always turned out but on restricted grazing as shes a fatty. No work or jumping in a school just lots of steady fittening work in straight lines. 5 years on, she's up to Intermediate event level and never had any medication at all. The hocks will remodel and then your horse will move, and feel better. I think surfaces have a big affect on this condition. I stay off them whenever I can with my mare.

thats great to hear, do you now ride on surfaces or is it all still avoiding them?
I really dont think it is ulcers, i cant say for sure but i have had him scoped in the past and nothing was there and he was a lot more expressive and grumpy at that time. To me it looks like he is putting them out and pushing he weight forward, if that makes sense.
It is also only under saddle where it is more apparent (i recently changed saddle so i think this may have been the main agrivator, yesterday i walked him hacking in hand for 40 mins with his hoof boots on and he was happy as larry, active, marching and content, he will use his hind as we walked past a plastic cow and all the weight went to his hinds, his front was almost floating in a stallion like i want to mount the plastic cow like prance lol so he can but he is just avoiding it.

If there is more to it than the hocks (no doubt i'll be posting videos on here to help me spot things) then i will likely have him reffered to get to the bottom of it.

My plan after the injections is to stay out of the school, avoid circles and just get going in straight lines, long reining, absolutely no lunging unless i am looking to see how his is moving, no jumping and just lots and lots of walking. I know i will need to school at some point so i can see if he is still struggling but i'll talk to my vet about when to do this.

 

[Tiddlypom]

Very sore in his back after a new saddle was fitted? That may be highly relevant. Still not sure how he was too sore to treat, though.

 

[TheMule]

I think last time you posted he was going to have a full work up? It doesn't sound like he has had this? By all means go ahead and do the hock injunctions first but I wouldn't really be expecting that to solve your problem. He will need intensive Physio alongside the hocks at the very least. Is he insured? I would be pushing for the bone scan if so

 

[Horsekaren]

Very sore in his back after a new saddle was fitted? That may be highly relevant. Still not sure how he was too sore to treat, though.

exactly! but it was the same tree as his other saddle just a different shape, it felt like it moved back and the saddle cloth would slip back, i am sure this has played a part but as the Chiro said he isnt sore under where the saddle sits it was all behind the saddle. the time before she came and he was a bit sore under saddle, two muscles were in spasm and they were fine when she came back so its a bit hit and miss as to what is causing the back pain.
Her reason for not treating him ( she did say she could make him feel better) but she thought there was an underlying issue so didnt want to interfere until he has been xrayed.

on another note, with your equicore (i got one a few months back i have used once) how do you stop the resistance band around the hind for rolling into a string? did yours ever do that?