Joint injections? Pros and cons for veteran horses

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TillyTrot

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Hi,

My mare, now 25 years of age, has been increasingly loosing her range of movement in her right hind leg over this past year.

It is a lot worse than her left hind which the vet says is suggestive of an injury. The range of movement particularly the lifting action is now limited to the point my farrier and I can no longer lift up her right hind leg to shoe and pick out her feet, but yet she can walk, trot and canter fine just with reduced lifting action of the hock.

I had my vet out to her who was unable to do a flexion test due to the fact he couldn't get her to lift up her leg to do it. He then did nerve block injections in her fetlock and hock and she was still lame suggesting the problem was above the hock.

My vet wants to now xray the hock and stifle area, but I'm not sure what benefit this will have especially if the problem is in the hip joint which he said they are unable to xray. From this I asked what the benefit would be to xraying and how this could help towards successfully treating it at her age.

The vet said they would be able to locate where the problem is and give her a joint injection which should show results in a week and then another if no result. I have read a lot about the complications of using steroid injections and I am reluctant to go ahead with it.

Has anyone experienced joint problems like this with an elderly horse? How did you manage it?

Has anyone had experience of using joint injections on an elderly horse and were they successful?

Any advice would be much appreciated :)

Thank you
 
I have, with success.

I think you have to be mindful that any injection into a joint carries it's own risks regardless of the age of the horse. My horse has been done both at home and in hospital. Cleaning the area is key as is having the right vet doing it.

My own view, and it won't be many peoples view, is anything that can be done to keep an old horse comfortable and able to achieve a good quality of life is worth the risk. I would sooner try than leave the horse in pain. The risk of a laminitis episode has to be considered.

Should it fail then facts must faced for the future comfort of the horse. There is no cure for old age, but there certainly are tools to help keep the veteran horse happy and comfortable.
 
My 20 yr old mare was supposed to have corticosteroids injected into her sacroliac joints today, but both vet and I were extremely concerned about the possible lami risk. She is a good weight, but has cushings and this is a difficult time of year for her in terms of management. So obviously the risk of lami is one of the downsides!

She was supposed to have a trio of drugs injected, including the corticosteroids, but in the end just had the other two, which don't have any lami risk. But the vet did say that the improvement was unlikely to be as noticeable as if she'd had the corticosteroids - one of the benefits is obviously a dramatic pain relief. But they don't last forever, and the amount of time can vary from horse to horse.
 
My older boy who is now 20 has had both hocks and coffin joints injected over last couple of years and they have really helped him maintain a light hacking life. The results were almost immediate. Would probably do it again if needed if was in his best interests
 
Thank you all for your advice, it seems like the joint injections have benefited your horse's which has made me reconsider getting them for my mare.

I have read that in the long term steriod injections can deteriorate the health of the joint so I was wary of going ahead with it.

At the end of the day my mare has given me so many years of enjoyment I want to return the favour to make sure she is comfortable and enjoys her senior years!

Do any of you use bute to manage it? This was another option but I was worried about it affecting her liver in the long term, it's hard to know what to do for the best.
 
Hello there, this may be long but I hope it is of some use.

I had my 30+ horse injected (yes, really!) after a vet recommended the treatment after seeing my veterans decreasing mobility + increasing lameness. Some argued it was just because my vet would profit from it, however he gave me a large discount on injections, so I doubt it was the case. ;)

My boy had 'Bute on and off - I was very wary about using Steroids. I did not want to increase the 'Arthritis'. Afterall, they do wear off, and at his age, my options were either a possible longer life with low-ish lameness or a period of time without lameness, and then perhaps feeling the lameness even more and risk shortening his life.

There was a lot of talk about it and he felt that although many would think/say "If he's that lame at that age, put to sleep" however he saw the spark and life in my boy and suggested it was worth at least one go.

I believed the problem was in his stifle or hip region, which like you, if it was in his hips - it would be a very difficult place to treat, and going to the clinic for Radiographs would be a bit much for him, let alone ever trying to treat it. He was not crippled, hobbling lame. However it was noticeable.

I wanted to at least know which part of his leg we were dealing with, though both hinds aren't great. He had nerve blocks done in each joint - to which we discovered he was pretty sound up to his stifles with some unsoundness in his hip/back also. So, he had each part of both stifles injected.

He was very sound for 4ish months, very bouncy and happy and didn't need 'Bute. He was on box rest which was a bit of a struggle for him (He will either be quiet and sleepy or hyper by nature.) though he did cope with his walks and it soon passed. As they wore off, it came back in his left leg stronger (his most affected leg) however he still had his spark. He had another round of steroids at this point, which was a repeat of the above. Box rest and they lasted most notably for around 3/4 months.

When my vet came back out, he first said "I saw the name today and wondered how he'd do with another round" yet he couldn't see notable lameness in his right leg, only his left again, so he decided to only inject the left. I had already discussed that with my horse having Cushings - we were risking it enough with laminitis and he'd had a good near-year having a super mobile life, and that I'd rather he went out that way. Plus, their effectiveness decreases with time and the joints can suffer from the use. They act to reduce the inflammation.

The next day after his injections, I found him laying down in his stable and seemed very quiet. No heat, but off colour. It was him saying it was enough. He had no more steroids after this. They took around 4 months to wear out, though he retained his 'extra sparkle' that he'd picked up. I had 'Bute for any bad days, though in fact didn't need them that often for the next year. He decided to display his good-feelings by regularly switching fields over the fencing, galloping across a stubble field twice and jumping his stable door.

It's been 3 years since he had his injections - he is still going and is mobile. He does have 'Bute for bad days, however we are lucky and I believe a rarer case in that he isn't needing it full time. Usually they would need it by now at an advanced age for most horses. He is stiff in a morning and after a day of galloping around the field after my youngster, he will come in pretty sleepy - however, some of this is attributed to his Cushings, which is also treated.

He has other supplements, however I have stopped his joint supplements for the last year/18 months due to them no longer being able to "support" or "prevent" the advanced joint condition that he has. I am very careful when he gets Bute as he has previously had digestion problems and I want to keep him as free from additional problems as possible. You can use Danilon at twice the price of Equipalazone which I believe is a little more forgiving on their system, though not always.

As previously mentioned, the effectiveness varies greatly from horse to horse, seasons and other influencing factors and diseases. I too read up on promising cases, however there are always going to be horses it just does not help. Two horses I groomed for did not respond at all to corticosteroid injections in their Hocks, one was euthanized and the other lived on 'Bute for 4 years.

My main suggestion is think very carefully and weigh up every option you can. Even write it out for every pro and con you can, don't convince yourself one way or the other until you've had chance to properly talk about it with your vet. If you go for it, be honest with yourself about how they are doing on the Injections. Take videos, get someone else to look at them etc. My final deciding factor was wanting to see him enjoy a 'Bute free, pain free life, even if it would only be for a few months. If he could have that with everything going right for him - I would be so very happy. It is just still such a risk and if he were at the same point of lameness now, I of course would not do it due to him being even more advanced, and although his Cushing's is treated, It would feel like too much of a risk.

The big questions to think about are the cost - Just the nerve blocks, initial injections and first things came to around £700. Though I had discounts, it still came to over £1,100 (I'm sure it was more, but I don't have the invoices to hand) to give him his near-year of soundness. I am glad I did as it seemed to give him an extra boost that lasted a very long time and give his joints a 'rest' from the constant inflammation. It's just a lot of money to pay for if it doesn't work.

Also, consider the box rest. They do not have to have it, however their effectiveness is reduced if the horse is allowed to gallop and frolic all day long from the day they are injected. Also, it is a good thing to be positive, however there is always the chance they will not respond to it, or in other cases, they may come down with Laminitis. Would you be able to deal with that, etc.

It can be difficult with opinions too, as many vets & general busybodies do tend to come out with how if the horse is of 'age' then if they cannot have their pain controlled by normal easy methods, they should be put out of their suffering. We do know our horses best and know when their spark is there or if it has faded. Just be wise about it. We can take risks, but be prepared either way.


Sorry for the very long very rambly post, I wish you the best whatever you choose. :)
 
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My boy is in his late teens. He had an injection in his hind fetlock which was fine. A year later, same vet, same fetlock, same injury and he reacted to it. On three legs. Flushed joint, a stay in hospital and box rest etc. If he goes lame would I risk it again? No way.

A friend also had hers injected and it caused laminitis. She won't go that route again either.
 
HashRouge said:
My 20 yr old mare was supposed to have corticosteroids injected into her sacroliac joints today, but both vet and I were extremely concerned about the possible lami risk. She is a good weight, but has cushings and this is a difficult time of year for her in terms of management. So obviously the risk of lami is one of the downsides!

My 25 year old has cushings and arthritis in his hocks. I use a specialist equine practice which receives referrals from vets all over the county. I was assured that a steroid injection into my geldings hocks would not put him at any greater risk of developing laminitis than any other non cushings horse. An injection into the joint capsule was quite different to one into the bloodstream which they would not consider for a horse with cushings. I went ahead with the treatment and the improvement was remarkable and I will treat him again when it is needed.
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