Steroid injections and advice please

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Supanova

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I know that this should probably be in Vets but i only tend to lurk in competition riders!

To cut a very long story short........my 9 year old mare was recently diagnosed with 1/10th lameness in both hind legs. (This was after 6 months of "underperformance" where she would stop at showjumps occassionally but then jump very well on other days. I had a lameness work up back in the summer with my old vet who "couldn't see anything wrong", but i still wasn't happy so had a lameness work up done with a new vet in January). She has been nerve blocked on both legs and x-rayed etc in summary:
- left hind she has high ringbone
- right hind - it was the fetlock causing the pain but x-rays and scans showed nothing.

Therefore, in early Feb she had her right hind injected with steroids and two weeks later her left hind was also injected. After the right hind was done she immediately felt much better than she had done. After her left hind was done she felt amazing. Previously we'd really struggled with flying changes from left to right and after the steroid in the left she could do them.

Anyway she jumped very well for a couple of weeks (although there was 1 rather naughty stop totally out of the blue) and felt like a different horse, but then after about 4 weeks i began to feel that she wasn't quite right again and sure enough when the vet examined her she was lame in the left hind again (the right is still fine). The vet was initially very optimistic about keeping my mare sound, but given that the steroid in the left has not worked for very long, the prognosis for keeping her sound enough to keep her jumping is pretty poor. We are now trying her with Catrophen (she has had 2 of 4 injections) and she is due to have a 2nd steroid tomorrow, however i am not very hopeful. However, my trainer was telling me that in her experience it is the 2nd steriod injection that has more impact. However, this is contrary to what the vet says!

I was just wondering if anyone had any experience of steroid injections working better the 2nd time or any other thoughts on where to go from here?
 
Mine have had joint injections for various matters- they normally last 1 yr to 6 months before they need doing again.


Have had a few thoughts-
Is it Feb this year they were done?- i'd expect them to last longer than that preferably!- have the hocks been checked out at all?

What is the exact problem with the left hind? if there is a prob with say the left hind, then the right hind ends up over compensating- for example one of my horses had a prob with his hind fetlock- nerve blocks confirmed it was def the fetlock (subchondral bone cyst/cartilage damage)- but it took 8 x ray plates and detailed investigation from my Vet to show the nature of the problem!- he had Adequan which works really well!

My other horse has mild spavin and is injected routinely at a minimum of 6 months up to a year, he has depo medrone which is a long acting steroid- did your horse have a short or long acting cortisone?

IME when mine have had cortisone injected the first joint injections work exactly the same as say a second set. If it'sa degenerative prob then you will eventually get to the point where they won't work.

If it were my horse i'd have a good chat with the vet and get to the bottom of the problem so you know exactly what the problem is before you treat with the Steroid or injections.

Wishing you good luck!
 
K27 thanks for your reply. Sorry my post is a bit rambling but we had got to the bottom of the problem before the injections. The left hind problem is ringbone i.e. arthiritis in the pastern. The x-rays show a bony change. We concluded that the right hind was compensating therefore was becoming inflamed. The steroid injection in the right has worked and she is still sound on this leg. It is the left leg where the steroid has only lasted 4 weeks - it was Feb of this year unfortunately.

The hocks haven't been checked because nerve blocks of the pastern show a definite improvement in her movement and she looks 100% sound and moves extremely well when the pain is taken out of the pastern.
 
My horse has spavins in both hocks and was medicated with cortisone in May 2009 and again in April 2010. Vet thinks that he will need to be medicated every 10 to 12 months ATM, though may need them more often as gets older. He is due to be done again in a couple of weeks, so he's basically going about 11 months between injections. My vet says he is happy to medicate hocks reasonably regularly, though isn't comfortable doing it more often than every 6 because of long term damage to the joint and because the cumulative effect can cause laminitis. He told me he would medicate for high articular ringbone once or twice maximum but because that joint is so mobile, the steroid can cause more problems than it solves in the long run.

So I know I have understood.. you had the LH injected to deal with the ringbone, yes? Talk to your vet about IRAP for that - my vet tells me it is like giving a steroid injection but without the potentially nasty side effects so is better than cortisone for treatment of ringbone symptoms. You could also try Adequan, which my horse has now had 3 courses of and I think is fantastic stuff.

My experience of steroid injections was a huge improvement in my horse after the first set. His way of going changed completely, much more power behind, no stiffness. There wasn't a big change after the second set but I guess because he had the next lot as soon as I noticed him becoming a little bit stiff, so we were starting from a better position second time around (does that make sense?).
 
Chestnut cob - your understanding is correct. She had the LH injected for the ringbone. The vet has mentioned IRAP to me as another option, however she said it is less effective when there is already a bony change? Also, apparently it is going out of favour as the results aren't that good, however i guess anything is worth a shot!

It does make sense that you feel less of a difference the second time! My mare still feels much better than she did prior to the steroids, its just that she's also not quite sound either!
 
Supanova said:
K27 thanks for your reply. Sorry my post is a bit rambling but we had got to the bottom of the problem before the injections. The left hind problem is ringbone i.e. arthiritis in the pastern. The x-rays show a bony change. We concluded that the right hind was compensating therefore was becoming inflamed. The steroid injection in the right has worked and she is still sound on this leg. It is the left leg where the steroid has only lasted 4 weeks - it was Feb of this year unfortunately.

The hocks haven't been checked because nerve blocks of the pastern show a definite improvement in her movement and she looks 100% sound and moves extremely well when the pain is taken out of the pastern.
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Sorry I hadn't read all of your post properly!- being monday morning! - hope you get it sorted- as Chestnut Cob has said Adequan is brilliant stuff as a joint injection-also have you tried any joint supplements or "alternative" things as well- with my horse that had the bone cyst he has his back on track boots put on after work and they really do seem to help him and keep him comfortable!- and i can also recommend sore no more liniment as well! I've also had him put in lightweight shoes and he is shod really long and wide to support his leg.

I hope you can get it sorted and wishing you lots of luck- do keep us posted!
 
She is on the joint supplement Synequin, but i have not heard of Adequan. How does that work? I have got some magnetic boots so i will start putting them on every night.

I had wondered about taking her hind shoes off and seeing if that might help at all or do you think i'm grasping at straws?!
 
Supanova said:
She is on the joint supplement Synequin, but i have not heard of Adequan. How does that work? I have got some magnetic boots so i will start putting them on every night.

I had wondered about taking her hind shoes off and seeing if that might help at all or do you think i'm grasping at straws?!
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Adequan can be injected as a joint injection (can also be injected in to muscle)- with the joint injections, i believe it lubricates the joint and makes them more comfortable- it was amazing stuff in getting my horse sound again, he came back better than he was before he went lame!- i do remember my vet saying that it works differently from a Cortisone.

Heres some info.... http://www.luitpoldanimalhealth.com/Adequan_ia.html

- may be see what your Farrier/Vet suggests re shoeing/shoes on/off- I'm a "shoes on" kind of person so probably not the best person to advise you really!...

Also there is Tildren which can be good for bone probs, although sometimes they need more than one go of the stuff!- my boy has had that in the past for another issue and it worked at first and then needed another go, at which point we opted for joint medication.
 
Thanks K27. I'll def speak to my vet about Adequan tomorrow and see what she thinks. We have talked about Tildren but she doesn't think its appropriate due to the type of bone formation my mare has (??not quite sure why as it got a bit technical!)
 
Supanova said:
Thanks K27. I'll def speak to my vet about Adequan tomorrow and see what she thinks. We have talked about Tildren but she doesn't think its appropriate due to the type of bone formation my mare has (??not quite sure why as it got a bit technical!)
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No worries- good luck!
 
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