Hock Injection Options - Arthramid and/or Steroids

[Myotto]

My 10 year old warmblood gelding is going into the vets on Wednesday for hock injections. He usually has them injected with steroids every 6 months as by this point he has usually gotten quite stiff and short behind. There's always a huge transformation in performance afterwards.

I'm wondering whether to switch to Arthramid this time but the cost difference is huge. His last round of steroid injections cost £311 but Arthramid is going to cost £853 all-in for both hocks. The vet also said that they often inject steroids and arthramid at the same time as the steroids offer an immediate effect.

I should also say that my horse has EMS which is well controlled but there is always a risk with steroids.

Really not sure what to do as the combined cost is over £1,100. Obviously, I want to do the best for my boy but I don't have a bottomless bank account and the insurance no longer covers hocks.

Has anyone else taken the combined approach, and if so, was it worth while?

 

[Hormonal Filly]

My vet said steroids degrade the joint, but Arthramid lubricates it and doesn’t have any detrimental effects. He prefers to inject with Arthramid.

Can you shop around, my mares hock was injected post surgery with Arthramid at my yard.

 

[Myotto]

My vet said steroids degrade the joint, but Arthramid lubricates it and doesn’t have any detrimental effects. He prefers to inject with Arthramid.

Can you shop around, my mares hock was injected post surgery with Arthramid at my yard.

Yes, I've read that. Its actually cheaper to take him into the practice this time as there are 2 other horses going in and we can share the fuel rather than paying call out. Have you seen good results with arthramid?

 

[Tiddlypom]

I’ve had a really good response in my 17yo PPID mare using arthramid + steroid jabs. My vets do the double jabs routinely now as they find them to be the most effective.

My mare isn’t insured either, but it had been very well worth it. Her previous arthramid only jab in 2020 had also lasted pretty well, but she didn’t get steroids in her hocks too then as she had them in her SI joint.

 

[Julia0803]

My cob has been having arthramid for a while now.

The big plus is that is is supposed to last approx 2 years. So when first weighing up our options my vet said it is more expensive initially but over the same time period it works out cheaper as you might have to repeat the steroids multiple times.

The first time my cob had the arthramid he had short acting steroids in the the joint at the same time, but more recently my vet said they (personally) don't do that any more due to new research saying it's unnecessary. However, I know some local practices still use the short acting steroids at the same time, so I think it varies by practice.

The arthramid injections have been a game changer for my boy, and have meant he pretty much carried on 'as a normal horse' and the vet said he could carry on with his usual activities (which at the time was PC/DR/SJ/ hacking etc).

The only negatives I have experienced or heard of are as follows...

Last December, I felt like we had lost some oomph behind. Nothing dreadful, but it had been almost 2 yrs to the day since the last injection so we redid them. Seemed to go well, nothing unusual, back into work as expected and felt great... until June. At first I thought maybe the hard ground/heat (he struggles in the heat)/possible saddle issue. Had the saddle checked out, reduced workload down to just walking hacks etc, but no huge improvement. Had our usual routine physio and she said his hocks were significantly sticky in comparison to how he'd felt 4 weeks ago. He had laser treatment for a week but no improvement so vet back out.

He said he was very slightly short, nothing major but it seemed the arthramid had worn off. By this point it was July. He said it's unusual but sometimes happens. He is a performance specialist vet so does a lot of arthramid. He said he'd had a few clients where occasionally it hadn't lasted as expected, but with no obvious reason. Some clients had been re-injected and then carried on and been great for another 2 years... others needed topping up at more regular intervals.

He was reinjected then, in July. So far so good. I've got all my extremities crossed because I can't really afford arthramid every 6m! He feels really good at the moment, is quite fit and in medium work. I'm hoping it was a one off blip and he is good for another 18m+.

The only other 'bad' experience I've heard is of a livery on our yard. She had previously treated her horse with steroids and had been happy with the results. About a year or so later it needed repeating and after seeing several people on our yard have good results with arthramid she decided to go with that, rather than steroids again. She said there wasn't a huge improvement, but was giving it more time (as the arthramid takes longer to work than steroids). A few months later she had the vet back as he was by then definitely NQR. Completely separate to the hocks, he had some adhesions/scar tissue on a tendon from a previous surgery which were injected with steroids. When the vet came back to review and was happy with the lower leg, but felt the hocks were still a bit sticky they decided to go with steroids into the hock again rather than retry the arthramid, as they knew it had worked well for him previously and was obviously much cheaper.

So, in short I've found arthramid great, I know lots of people that have had similar experiences and also found it brilliant. But for some reason it doesn't work on everything, and weirdly seems to have the very occasional blip, and not last as expected.

 

[Hormonal Filly]

Yes, I've read that. Its actually cheaper to take him into the practice this time as there are 2 other horses going in and we can share the fuel rather than paying call out. Have you seen good results with arthramid?

Yes, excellent results although she is only a 5yo but had a chip removed from her hock which is why it was medicated.

Similar experience to @Julia0803, she first had Arthramid injected in March following surgery but she was stiff in her hock 3 months later. My vet did another dose of Arthramid then and touch wood since then she’s moving really well. Can’t tell a difference between hocks when she’s moving, even considering she’s been in a lot of work. Instructor on the weekend said how lovely she moves behind.

He did say sometimes it doesn’t ‘take’ and other times a dose lasts a long time. He didn’t know why. I’m also hoping I can annually inject at most.

 

[Grassy]

I’ve had amazing results with arthramid, she’s 18 & literally feels like a brand new pony. Highly recommend

 

[Myotto]

Yes, excellent results although she is only a 5yo but had a chip removed from her hock which is why it was medicated.

Similar experience to @Julia0803, she first had Arthramid injected in March following surgery but she was stiff in her hock 3 months later. My vet did another dose of Arthramid then and touch wood since then she’s moving really well. Can’t tell a difference between hocks when she’s moving, even considering she’s been in a lot of work. Instructor on the weekend said how lovely she moves behind.

He did say sometimes it doesn’t ‘take’ and other times a dose lasts a long time. He didn’t know why. I’m also hoping I can annually inject at most.

Do you think that it would be beneficial then to have steroids and arthramid at the same time or maybe with a small gap in between. That way the the steroids will act quickly on the discomfort and while the arthramid takes effect over the 2-4 weeks?

 

[Hormonal Filly]

Do you think that it would be beneficial then to have steroids and arthramid at the same time or maybe with a small gap in between. That way the the steroids will act quickly on the discomfort and while the arthramid takes effect over the 2-4 weeks?

My vet really doesn’t like steroids at all, especially on a younger horse. He told me to do lighter work for a couple of weeks and see how she goes.

It sounds worth a try if others have had good outcome.

 

[Zoeypxo]

I would absolutely go for the Arthramid in your case.

I used to do yearly steroid into my mares mild hock arthritis but found my most recent one started to wear off after the 6 month mark.

Decided to try Arthramid august 2022 , no issues since then and not looking like they need re doing anytime soon, very happy!

 

[Love]

I am 6 weeks post Athramid in my geldings hocks with mild arthritic changes but the difference is huge. (As an aside - we are still up and down with a slight suspensory issue in front which was likely caused initially by the hock OA but the hocks themselves feel great). It is much slower to see a difference than with steroids (I even posted a couple of times about this but many posters reassured me to just give it time and they were right) but the results are said to be much longer lasting. I'm feeling hopeful.

 

[Myotto]

I am 6 weeks post Athramid in my geldings hocks with mild arthritic changes but the difference is huge. (As an aside - we are still up and down with a slight suspensory issue in front which was likely caused initially by the hock OA but the hocks themselves feel great). It is much slower to see a difference than with steroids (I even posted a couple of times about this but many posters reassured me to just give it time and they were right) but the results are said to be much longer lasting. I'm feeling hopeful.

Its strange how quickly my horses hocks problems resurface each time. He was last injected with steroids about 5 months ago and everything was feeling great until a few weeks ago when he really started to go down him (literally!!). He is very stoic and will always try and work through pain and stiffness but he is getting heavier and heavier in front, doesn't want to turn on a circle etc and gets grumpy if I tap him up with the whip. Clearly he is struggling to engage behind. He never shows any acute lameness though. It always seems to manifest itself with short stride behind and severe drop in performance and willingness. He also goes very quiet in the stable. Was it similar for your boy? Xray changes are minimal but they do say that the x-ray findings don't always correlate with the symptoms.

 

[AandK]

Do you think that it would be beneficial then to have steroids and arthramid at the same time or maybe with a small gap in between. That way the the steroids will act quickly on the discomfort and while the arthramid takes effect over the 2-4 weeks?

My horse had steroids, then Arthramid 2 weeks later (just one hock though, he has arthritic TCJ due to an injury), previously he'd had steroids and HA in that hock. My vet did not want to do them together. The Arthramid has made a difference, I will be doing it again in March.

 

[Myotto]

My horse had steroids, then Arthramid 2 weeks later (just one hock though, he has arthritic TCJ due to an injury), previously he'd had steroids and HA in that hock. My vet did not want to do them together. The Arthramid has made a difference, I will be doing it again in March.

How long do you think the Arthramid is proving relief for? I'm hoping for at least 12 months. Some say it works for up to 2 years.

 

[Zoeypxo]

How long do you think the Arthramid is proving relief for? I'm hoping for at least 12 months. Some say it works for up to 2 years.

Im currently at 15 months with no reoccurring symptoms so far. Im hoping for 18-24 months but we will see

 

[AandK]

How long do you think the Arthramid is proving relief for? I'm hoping for at least 12 months. Some say it works for up to 2 years.

He had it done in March, so not that long ago but still all good at the moment! I want to repeat in March and see how he gets on after, with a view to maybe waiting a bit longer next time. Steroids and HA lasted about 7 months.

 

[Myotto]

He had it done in March, so not that long ago but still all good at the moment! I want to repeat in March and see how he gets on after, with a view to maybe waiting a bit longer next time. Steroids and HA lasted about 7 months.

So you're not repeating in March because it hasn't held for long enough? It's just preventative and making sure the problems don't have a chance to come back before the next treatment?

 

[AandK]

So you're not repeating in March because it hasn't held for long enough? It's just preventative and making sure the problems don't have a chance to come back before the next treatment?

As long as there are no issues between now and March, it will be a preventative measure.

 

[Sossigpoker]

How long do you think the Arthramid is proving relief for? I'm hoping for at least 12 months. Some say it works for up to 2 years.

We are at 12 months now and to quote my vet last week " he looks the best he's ever looked".
I do manage his turnout and exercise and physio etc very carefully though.

 

[Myotto]

We are at 12 months now and to quote my vet last week " he looks the best he's ever looked".
I do manage his turnout and exercise and physio etc very carefully though.

Do you mean that you maximise his turn out time? I would prefer my boy to be out more but he has EMS and struggles with the sugar and starch in grass. The grass has been particularly bad for him this year as everywhere is so green and luscious!!!

 

[Myotto]

Update on my Arthramid journey. We are now two weeks post injection into both hocks and I'm seeing some minor signs of improvement. At about day 10 my horses mood has started to improve. He has been very depressed for the last month or so. He is also more willing to lift his back legs, back-up, move forward and is resting his hind legs less. I've rested him and just hand walked him each evening for about 15 minutes. I got him to do a very short trot on the lunge yesterday and he is happier to move and is not lame as such or toe dragging but is still a bit short behind. I'm hoping that this will improve over the next couple of weeks. Has anyone else had a similar experience?

 

[Zoeypxo]

Update on my Arthramid journey. We are now two weeks post injection into both hocks and I'm seeing some minor signs of improvement. At about day 10 my horses mood has started to improve. He has been very depressed for the last month or so. He is also more willing to lift his back legs, back-up, move forward and is resting his hind legs less. I've rested him and just hand walked him each evening for about 15 minutes. I got him to do a very short trot on the lunge yesterday and he is happier to move and is not lame as such or toe dragging but is still a bit short behind. I'm hoping that this will improve over the next couple of weeks. Has anyone else had a similar experience?

That sounds positive, in my experience the improvement will be alot more visible at the 4-6 week mark.
Mine started feeling better after a week and was great by a month

 

[visa_bot]

I have had great results with Arthramid on its own. I wouldn‘t bother with steroids as well. It does take a bit longer to work but I did a coffin joint once, well over 6 years ago. A fetlock over 4 years ago. I have also used with success in a tendon sheath but that took multiple injections. My mare has EMS and I wouldn’t risk steroids.

 

[SEL]

I'd agree with the 4-6 week mark showing improvement but it's worth a physio session to release any tension he's got from when his hocks were sore

 

[Sossigpoker]

Do you mean that you maximise his turn out time? I would prefer my boy to be out more but he has EMS and struggles with the sugar and starch in grass. The grass has been particularly bad for him this year as everywhere is so green and luscious!!!

In the winter yes, but I find that too much turn out isn't great for him as I don't think he lies down to sleep in the field ,.so in the summer I bring him in during the day.
I manage him according to how he's feeling and the ground conditions, at the moment he's out 6-7 hours per day and is exercised most days
Basic lateral work is very important to keep him supple so even if hacking just around the village, we'll do some leg yield and shoulder in along the way.

 

[Sossigpoker]

Update on my Arthramid journey. We are now two weeks post injection into both hocks and I'm seeing some minor signs of improvement. At about day 10 my horses mood has started to improve. He has been very depressed for the last month or so. He is also more willing to lift his back legs, back-up, move forward and is resting his hind legs less. I've rested him and just hand walked him each evening for about 15 minutes. I got him to do a very short trot on the lunge yesterday and he is happier to move and is not lame as such or toe dragging but is still a bit short behind. I'm hoping that this will improve over the next couple of weeks. Has anyone else had a similar experience?

Sounds like it's starting to kick in!
Rehabbing him will be important to gey done right , but sounds like you're starting slow , which is great.
My vet and I also observed a visible change in my horse's demeanour once it kicked in,at first his eyes and face relaxed and later on he became much calmer in general.

 

[Myotto]

My horse is almost at the 4 week mark post anrthramid and his hocks seem better but he still looks like he’s holding a lot of tension in his body. His back and shoulders seem particularly tight and sore. Physio is coming Thursday so hopefully that will help. Did anyone notice any particular areas of compensatory pain from hocks?

 

[Zoeypxo]

My horse is almost at the 4 week mark post anrthramid and his hocks seem better but he still looks like he’s holding a lot of tension in his body. His back and shoulders seem particularly tight and sore. Physio is coming Thursday so hopefully that will help. Did anyone notice any particular areas of compensatory pain from hocks?

Sacroiliac joint for me, lumbar is also common

 

[Sossigpoker]

My horse is almost at the 4 week mark post anrthramid and his hocks seem better but he still looks like he’s holding a lot of tension in his body. His back and shoulders seem particularly tight and sore. Physio is coming Thursday so hopefully that will help. Did anyone notice any particular areas of compensatory pain from hocks?

Yes sacroiliac and lumbar. And genetal tension and soreness all around.

 

[Tiddlypom]

My horse is almost at the 4 week mark post anrthramid and his hocks seem better but he still looks like he’s holding a lot of tension in his body. His back and shoulders seem particularly tight and sore. Physio is coming Thursday so hopefully that will help. Did anyone notice any particular areas of compensatory pain from hocks?

Yes, lots. It’s due to the holding himself wonkily from when his hocks are sore.

A really good body worker is essential for post joint medication rehab, or the horse will continue to move wonkily. My chiro vet likes to see them 2 or 3 weeks after joint jabs.

It’s not impossible that the SI may benefit from being medicated too, but hopefully you can get away without it.

Good luck.