Lame and injecting hocks

[Polos]

What is everyone’s experiences of injecting hocks?

horse is kept on livery but due to work/ career development commitments I can’t see said horse every week.

YO called me 2 weeks ago as he was a bit off behind on the lunge. We did box rest and Bute for a week but it didn’t make much difference so vet came out and has recommended hock Injections and box rest as he’s 3/10 lame behind. (I haven’t got the full story of vet visit as this was just a quick text conversation but I will find out more in person tomorrow)

horse is 13/14 (need to actually check passport haha). Is this too young for hock injections? He has a relatively quiet life at the minute of turnout in the week and lunging and flat/pole work/walk hacks at the weekends. We go to a show maybe once or twice a year and pop round 90cm-105 but we did compete up to 1.30 up to a couple of years ago.

 

[Highmileagecob]

No experience personally, but I am aware of a livery colleague years ago who went down this route on her vet's recommendation. After two years of regular injections, there was no noticeable improvement. Owner moved away and changed yards, and the new farrier said no wonder he's lame, he's got bad thrush in both hinds. this was treated and made a huge difference. Just make sure the treatment is justified and not given 'because that's what we always do.'

 

[Michen]

Why would you inject without at least nerve blocks to make sure it is the hocks. It could be anything. Jabbing a joint with steroid without good reason seems madness to me.

Could be stifles, could be soft tissue, could be suspensories...and box rest for arthiritic hocks again is odd.

 

[poiuytrewq]

I would nerve block them first for sure. There is a risk of laminitis apart from anything else, other than that it’s just best to know what your treating.
I’ve had several done over the years. One was really successful and he just needed doing again after 2 years.
The other didn’t last very long at all.

 

[Melody Grey]

Why would you inject without at least nerve blocks to make sure it is the hocks. It could be anything. Jabbing a joint with steroid without good reason seems madness to me.

Could be stifles, could be soft tissue, could be suspensories...and box rest for arthiritic hocks again is odd.

I second this- randomly jabbing something can be a thing, but only in my experience if it’s something that’s been previously investigated and medicated and you’re confident it’s the same again, or where there is no budget for investigation/ much older horse where it’s an educated guess type of approach.

At 12/13 the horse has plenty of working life left so I’d want to get it right.

 

[Birker2020]

I went down the steroid route with Bailey to start with but then switched to Tildren which was meant to be the best treatment at the time. She had three lots of Tildren but we didn't see much benefit.

In the end I plumped for chemical arthrodesis which the vets seemed very enthusiastic about at the time - injecting 97% proof alcohol into the joint after contrast x-ray guidance. Was at the time around £700 for both hocks.

This proved really effective and we never looked back. I think from distant memory it was in about 2011 when she was around 14 and she went back into full work after a few weeks including jumping competitively until aged 19.

I think there are better option on the market now.

 

[Nudibranch]

I've never heard of anyone injecting without blocks.

Mine was done as a 6yo, and as you can probably guess in a horse that young, it wasn't much use. He did have a number of issues, which often go hand in hand when there are hock problems.

In an older horse where there was a reasonably clear diagnosis I would give it a go.

 

[poiuytrewq]

So I have injected twice without blocking.
Once we knew, previous owners had disclosed he had had a previous diagnosis of arthritis and that they had injected.
The second time we blocked to the hock and injected, horse was then lame the other side so we just jabbed that one aswell. Neither did anything in the long run

 

[Birker2020]

I've never heard of anyone injecting without blocks.

Mine was done as a 6yo, and as you can probably guess in a horse that young, it wasn't much use. He did have a number of issues, which often go hand in hand when there are hock problems.

In an older horse where there was a reasonably clear diagnosis I would give it a go.

I honestly can't remember that far back but I would have thought if there is arthritis showing (as there was on the inside of Bailey's hocks) and a lameness workup is carried out they don't need to do nerve blocks. Its a given.

I suppose its like saying "you've sprained your ankle" if you tell your doctor you've gone over on it and it hurts. You don't need nerve blocks to reach that diagnosis.

Poor example but you get my drift.....

 

[Polos]

Vet has come to that conclusion based on medical history of horse (we have had this problem before but box rest and bute solved it). I’m presuming nerve blocks we’re done yesterday to reach that conclusion as vet was there a while.
Again I’ve only had a very quick conversation over text but having a proper conversation tomorrow when I’m at the yard

so I’m just looking to hear people’s experiences with the hock injections.

 

[Pinkvboots]

Surely x rays should be done after nerve blocks just to confirm it is actually the hocks that need injecting.

 

[Pinkvboots]

I had 2 lots done on my mare years ago they worked for about 3 months so I never bothered again and she just had daily bute and became a light hack.

There are other alternatives now like the gel injection or cartrophen and I would rather try those than the steroid now.

 

[Pippity]

Mine's 9 and is having her third lot of steroid injections in the hocks next week. The initial injections were based on nerve blocks and x-rays, which confirmed the vet's suspicion of arthritis. They work incredibly well in the short term but, so far, have needed to be repeated every nine months or so.

I've discussed the possibility of arthramid with my vet, and she said she only really recommends that for joints that are more mobile, such as fetlocks. I haven't raised tildren but will when I see her next week. The other alternative she's mentioned is fusing the hocks, but my understanding is that, once the hocks are fused, there's nothing more you can do. If fusing doesn't work - as it doesn't in ~10% of cases - you're stuffed. While she's only nine, and the steroids are having an effect, I'm sticking with that.

My old share horse had his hocks injected with steroids every 2-3 years, so it really is extremely variable.

 

[Cowpony]

My mare is 19 and had hers done about 18 months ago. We're getting them done again next week, but I've asked for the gel this time to see if it lasts any longer. She does flat work and jumps in competition up to 80cm. She could probably do more but I don't want to push her. I've retired her from dressage.

 

[Leandy]

He has a relatively quiet life at the minute of turnout in the week and lunging and flat/pole work/walk hacks at the weekends.

Do have a proper chat with the vet and understand how they have pinpointed that this is a hock problem. I would be quite concerned that a horse doing this little work is 3/10 lame and bute made little difference. Also, if the horse is in this little work, it may be cheaper and easier just to turn out for a period (weeks/months) and see how it comes back in and assess then.

 

[Pippity]

Do have a proper chat with the vet and understand how they have pinpointed that this is a hock problem. I would be quite concerned that a horse doing this little work is 3/10 lame and bute made little difference. Also, if the horse is in this little work, it may be cheaper and easier just to turn out for a period (weeks/months) and see how it comes back in and assess then.

My arthritic horse does better when she's in heavier work (with the caveat that the heavier work is mostly hacking on a fairly forgiving surface). When we hit winter and are down to hacking maybe twice a week, maybe once a week in the school, and the added cold and damp, that's generally when she starts to come up 1-2/10 lame. If the downturn in workload is fairly recent, that may be why it's started to show now.

 

[Polos]

My arthritic horse does better when she's in heavier work (with the caveat that the heavier work is mostly hacking on a fairly forgiving surface). When we hit winter and are down to hacking maybe twice a week, maybe once a week in the school, and the added cold and damp, that's generally when she starts to come up 1-2/10 lame. If the downturn in workload is fairly recent, that may be why it's started to show now.

He was more active up until about 6 weeks ago so that could be why it’s starting to show up now.

 

[Birker2020]

I haven't raised tildren but will when I see her next week. The other alternative she's mentioned is fusing the hocks, but my understanding is that, once the hocks are fused, there's nothing more you can do. If fusing doesn't work - as it doesn't in ~10% of cases - you're stuffed. While she's only nine, and the steroids are having an effect, I'm sticking with that.

My old share horse had his hocks injected with steroids every 2-3 years, so it really is extremely variable.

Tildren was £700 a time and over the course of the insured year I had three lots, spaced equally apart with the last one just before the year ran out.

The chemical arthrodesis (fusion using ethanol) is limited and you are right in your assumption that when that is done that's it. There can be nothing else added to the joint space. Fusion or arthrodesis can be achieved by chemical destruction of the cartilage or drilling of the space to destroy the cartilage surface in the case of surgical fusion which I don't think is still carried out now.

With chemical arthrodesis there can also be complications down the line which has been found to be approx 3 years post procedure. Its been found that in 5-8% of horses mechanics mean that the concussion absorbed by the lower hock joints then go into the top hock joint due to the lower hock joints fusing. This can cause inflammation to occur.

This can be remedied by remedial shoeing and bute but this is normally long term.

On the whole if I had to relive my experience I wouldn't hesitate to use it again if nothing better was available to me.

 

[SEL]

We injected mine with x rays not nerve blocks - she is very, very sharp with her back legs and after numerous flexion tests the vets decided to go off the back of the x rays because she was kicking with intent before anyone got near touching a back leg. Steroids didn't last for long, but arthramid was great.

 

[V&F]

The chemical arthrodesis (fusion using ethanol) is limited and you are right in your assumption that when that is done that's it. There can be nothing else added to the joint space. Fusion or arthrodesis can be achieved by chemical destruction of the cartilage or drilling of the space to destroy the cartilage surface in the case of surgical fusion which I don't think is still carried out now.

.

My pony had his hock surgically fused in 2019 - i think it is still a current procedure, but doesn't seem to be very common

 

[LEC]

My pony had his hock surgically fused in 2019 - i think it is still a current procedure, but doesn't seem to be very common

It’s a tricky procedure and with so many bones in the hock you need to have certain ones impacted to do anything chemically otherwise it’s a waste of time.

 

[TheHairyOne]

My pony is 18 and about to have his second single hock injection done next week. The first has lasted 18 months. Vet didnt bother to xray and the result was immediate.

He doesnt jump anymore other than the odd log out hacking but is otherwise in full work.

 

[Tiddlypom]

If it is hock arthritis, I'd pass up on the offer of steroid injections (don't last long) and go straight for arthramid gel injections.

I've had two horses injected with gel in both hocks after previous steroid jabs had worn off, and 18 months later both are still grand.

 

[Polos]

Thankyou for everyone’s replies. I’ll be calling the vets on Monday to talk it through properly and then I can go from there

 

[Michen]

If it is hock arthritis, I'd pass up on the offer of steroid injections (don't last long) and go straight for arthramid gel injections.

I've had two horses injected with gel in both hocks after previous steroid jabs had worn off, and 18 months later both are still grand.

Out of interest TP which hock joint were yours suffering from?

 

[tiga71]

I had my 24 year old's hocks done in Dec with arthramed. Seems more comfortable, he just hacks on the Downs now, no schooling or jumping though we might pop a log out hacking. I will probably take him xc schooling this summer just for an outing and do the water, steps, banks and a few logs.

Also had 14 year old's hocks done with steroid a month ago. Just schooled him today for first time and he is definitely more comfortable.

 

[Tiddlypom]

Out of interest TP which hock joint were yours suffering from?

I am a muppet and have tidied all my old vet invoices into a 'safe' space, oops. I have of course been told which joint it is, but I've forgotten.





It's this one, though, with the yellow arrow pointing to the white area which was the site of the hock injection. This is my wonky mare in August 2020, 5 months after she did her major pelvic injury in the field in early lockdown. The day before the pics were taken her hocks had been injected with arthramid and her SI joints with steroid (gel is too viscous for the SI joint). She's done incredibly well since then, with no more joint medications needed.

 

[Ceriann]

My mare will be imaged next week - vet believes current performance and hind limb issues are likely due to arthritis in one or both hocks. She’s had a branch suspensory issue years ago which will also be scanned to rule out but vet fairly confident it’s hocks (from work up done). He’s suggested steroids purely I think due to the cost of gel. Is it that different cost wise? Would there be any benefit in trying cartrophen?! This is all assuming images are positive.

 

[BeansNsausages]

What was the outcome here OP?