medicating the joints - the pro's and con's please

S

sarahhowen

Well-Known Member
Joined
25 August 2007
Messages
64
Visit site
Hi guys,

So my pony is due to have his Coffin joint medicated next Friday due to having collateral ligament damage and I have heard some horror stories about possible side effects, what are your experiences with having this done, both negatives and positives please!

Thanks in advance :)
 
Frank has had his done twice Jan then 7 weeks later, with steroid and HA (diagnosis of DJD although there maybe some ligament contingent too!)

No side effects, and did improve lameness although did not result in complete soundness.

Did discuss lami concerns with the vet given his type (welsh) although no history but we decided that risk was small as only medicating one joint and the time of year.
 
I had a horse with bone spavin who had his hock joint medicated and sorry to say I had a bad experience and wouldn't put any horse through it again.

Despite the vet being meticulous when scrubbing up, the horse got a joint infection 2 weeks after treatment. He spent 9 days in hospital on a drip and we were lucky not too loose him.

Weirdly he came sound, and has stayed sound 5yrs on, but couldn't say if it was down to the injections or not.

The other downside is that he suffered mild lami the following summer, so we had to be very careful with grass intake during the rest of the time we owned him.

Hope you have a better outcome!
 
Last edited:
The key to success is establishing the cause of the problem and curing that. Medication will halt the damage done by reducing the inflammation present, but if a persistent imbalance, continues aggravate the original condition then the prognosis isnt great.
 
sidney out of interest were antibs given at the same time? Mine has had a penicillin shot each time.

we have done both of our injections at home rather than in practice (mostly because being a microbiologist I am pretty au fait with sterile techniques and in my younger days spent far too much time doing work experience at vets!).

Good to hear that your boy did come through that though.
 
We had medication done at Rossdales. Os is a 17.2 shire x...very long in the body and could never be described as fat. We thought that the risk of him getting lami was very remote. Wrong..... within a week he had it. He did become sound enough to hunt again...not sure if I would do it again.
 
yes he was given a course of anti bi's - just bad luck, but has put me off the whole process...

He was injected at the vets.
 
Had no problem with any joint injections carried out on my horse. But there was a horse owner on the forum a few months ago who asked your very question. She was asking if it was safe to have the horses joint injected (from recollection I think it was its hock joint) at the yard or would it be safer in a hospital environment and I and a number of other people said no problem, its fine to do it at the yard, we all had our horses done at the yard and its perfectly safe. And then she posted to say her horse had got a terrible infection in its hock as a result of the injection (somehow baceria had entered the injection site). So really not 100% sure it is as safe as it can be, but my vet has never come across this in all the years he's been practising but of course there are always exceptions to the rule like this poor girls horse. Her horse had to go to horspital in the end but it was fine after a few days.

Of course the other danger with injections is the risk of laminitis so you have to keep the horse on box rest for 48 hours afterwards but to be honest the benefits of the injections far outweigh the risks in my opinion. There are always going to be exceptions to the rule with any procedure but it will really help your horse.

If you are worried about the sterile implications ask if you can take the horse to the vets and have the injection done there. You will save yourself call out on your bill too!
 
Last edited by a moderator:
thanks sidney, I was just curious as to whether that was standard practice or not, I would assume it was.

There will always be a risk with most treatments that are used but it is, as always a case of weighing those up. If the horse is lame without it and it is resolved, particularly with arthritis type issues which are not going to get better by themselves I think the advantages out weigh the risks (when the only other alternative is retirement etc)

OP if it is collateral ligament damage I would query whether injecting is just to speed up the process that would occur naturally given time? I don't know much about the ligament side of things.
 
Thanks guys I will have a chat to the vet about the concerns you have raised! To be honest I have never had ajoint injected so this is all new to me! Keep conning with the pro's, con's and experiences please - the more info I have the better and more relevant questions I can ask the vet!
 
my welsh x cob had his stifle injected 3 wks ago as he does dressage and was getting more and more unlevel behind and struggling with his school work. i was told to keep an eye on him for first 48hrs especially but he could go on short time turn out . 2 wks off and then walking. Bang on 1 wk he went down with laminitis . caught it early and have treated it aggressively . He is looking much more comfy now and has had his meds halfed. Mon is having x rays and weds pads fitted in shoes . so fingers xxxxx. Not a pleasant experience,but he would have only got worse without the original treatment.
 
There are definitely risks, both from the actual injection and from some of the various medications that might be injected, so it is definitely worth a serious discussion with your vet. BUT, despite the stories here, there are literally thousands of horses having joint injections and in most cases it's straightforward and in many cases helpful.

Injecting joints seems to be a bit of a "dirty little secret" in the UK but, trust me, it is very, very common in competition horses. I would say one of the big risk factors though is who is doing the injections and perhaps this is why so many people seem to have horror stories here. You need a vet who is experienced with the procedure, which is quite a tricky thing to find if you can't ask people who they use and can't ask your vet how many he does regularly. I have to say, I would be leery of having them done by any vet who is not an equine performance horse specialist because I don't see how such a practitioner could be doing enough of them to be really, really good at them. I do appreciate though, that it's not always an option.

It also depends a lot on what is being injected. Again, despite evidence on this board, steroids are not the only option and I'm surprised how often they seem to be the first port of call. Again, worth a discussion.
 
Last edited:
Tarrsteps - many of the drugs used in the states in joint injections are not available here. Also, my experiences from the states were that steroids formed the basis of the vast majority if not all joint meds. It certainly is a treatment done very very frequently. However, I actually disagree to some extent with the "who" is treating being the problem. Apart from knowing what type of steroid to use in what joint/ injury and what combinations of meds can be used - the vet rarely affects the outcome. The difficulty with steroid is that the chondroprotective variant ( therefore the only one you want in a non OA joint) is the one linked with arthritis. There are of course some non intra articular drugs worth trying when using a steroid is a concern - however nowhere near as many alternatives as in the states.
 
Very interesting, thank you. I'll confess the bulk of my experience here is with a vet who spends a lot of time in the US and treats horses belonging to an American here, so not representative!

I'm not actually a fan of joint injections here at the level they are now done in North America and in high level competition on general. As you say, there is a diminishing return and many people are too quick to start down a dead end path. But I will say the bulk of common opinion here seems to be that joint injections won't help in most cases and that they will actually lessen the horse's useful life. This just hasn't been my experience - whether I agree with the process or not I've seen and looked after a fair number of horses that have been regularly injected for years after an initial diagnosis and remained sound and useful so long as they stayed in the program. In many cases the regime can be custom tailored to allow the optimal period between treatments using very subtle signs, so there is no question it's best to have the longest possible interval but going too long in between isn't ideal, either.

Sorry that sounds like I'm arguing! Totally not, I'm just intrigued. More horses here seem to have procedures, more where I'm from seem to have meds. Obviously many factors in play.

My comment on the practitioner is also - very unscientifically - the result of observation. I've seen vets who seemed to have a very good touch for the job, quick, clean and accurate, and others who seemed to struggle a bit more with placement and also seemed more likely to have complications. But I freely admit my sample isn't large enough.

I guess my only salient point was these threads do usually seem to end up suggesting that joint injections are often a disaster and ineffective/short term at best and this simply hasn't been my experience, even with owners and vets who inject if the horse looks at them funny. :(
 
Thanks everyone for taking the time to reply, my understanding is that the primary purpose of medicating this joint is to reduce the inflammation from the injury to the collateral ligament and reduce the inflammation to the bruised pedal bone, so I am thinking that this is a one off and won't be a regular thing.

Tarrsteps can you elabourate on why injecting the joint leads to a diminishing return to work? My main adverse side effects that I was concerned about was a.) Increased risk to a bout of laminitis and b.) Infection in the joint - does medicating the joint have more long term side effects?
 
tarrsteps meant that basically the more times you inject the less of an effect/benefit you will get each time. :).
 
Our WB has the same problem and had his coffin joints injected in december and then repeated last month as he was tracking up slightly short on the left rein,but not lame.He has gel pads on both front feet as the ground is becoming harder and the horses are spending increasing amounts of time in the paddock.I am keeping my fingers crossed but still not sure about the longer term efficacy of the treatment.Time will tell.
 
sarahhowen said:
Thanks everyone for taking the time to reply, my understanding is that the primary purpose of medicating this joint is to reduce the inflammation from the injury to the collateral ligament and reduce the inflammation to the bruised pedal bone, so I am thinking that this is a one off and won't be a regular thing.

Tarrsteps can you elabourate on why injecting the joint leads to a diminishing return to work? My main adverse side effects that I was concerned about was a.) Increased risk to a bout of laminitis and b.) Infection in the joint - does medicating the joint have more long term side effects?
Click to expand...

My personal experience is from the the injecting of hocks; my understanding is that the more you inject into the joint capsule the more scar tissue you create which makes further injections more difficult. Also, as it is a dejenerative condition that we are dealing with the more it progresses, the more the calcification complicates/hinders the injection process.

My horse is a 22 year old ex 4* eventer/hunter that has worked hard all his life....he is currently having his hocks injected on a six monthly basis but still managed a full-on hunting season 2011/12.

My horse has never been susceptible to lammi but I keep him on the lean side deliberately and after an injection put him in the starvation paddock.

Infection of the joint is down to hygiene and luck!
 
Last edited:
Agree Tarrsteps. I think a lot Of the reason they don't get repeated/ once off ia injections here is much to do with money/ insurance and the purpose the horse is kept for. It is much cheaper to keep a horse here than in the us therefore we have a different demographic of owner. Most have less available cash to undertake repeated "maintenance" procedures at roughly £150-£200 each time ( without radiographs). If insured they tend to inject once and if the presenting complaint recurred during the insured period - go for any corrective surgery available before insurance runs out. Not necessarily the best plan. Also many of those with riding club or low level competition horses that develop arthritis and the like here choose to retire or adjust the work level of their horse. The ready availability Nd popularity of bute as a long term drug is alto a factor( the FDA are not exactly fans of bute- much like the EU).
 
My 13 year old fell pony Had his right fore coffin joint injected with steroids at my vets clinic in august after being lame with varying intensity for four months. He'd been injured in the field and then radiographed, referred to leahurst and mri'd.*He had subchondral bone cysts in the pedal and pastern bones. The ones in the pedal bone are in close proximity to the collateral ligament but now damage to the soft tissues showed up.*

*He*was given antibiotics at the same time and the area on his fetlock was made sterile first then dressed for the first 48 hours to be on the safe side because as my vet put it, it's at the ****** end ;-) he was box rested for a week then started being walked out again.

*I was made well aware of the risks of the steroids regarding laminitis as he is a very good doer! He was not overweight or laminitic prior to the steroids because I'm a miser and he was in quite heavy work so was lean and fit. *No infections or other side effects thankfully and we are fine turned out and are just introducing ridden work again! Believe me each ride is a bonus because the days after he injured himself it was very likely my only option was to pts but I had to try for him, I owed him at least finding out if he had some hope.*

Another option was to surgically go in through the base of his foot, scrape out any cystic material in the pedal bone and pack the holes left with steroids. I personally thought the prognosis of that op was so poor it was not worth putting him through it when it was very likely to get infected so opted for more conservative treatment.*
 
You must log in or register to reply here.
Top