Steroid injections into the SI Joint

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bings

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Has anyone had them ,if so what was the results short and long term ? my horse has inflammation to one side of his sacroiliac joint ,my vet is against steroid injections , saying its a short term fix he said he would refer me to another vet if thats what i wanted .Im so confused ,he wants to box rest him for months and give him sodium hyaluronate , i have researched steroid injections and it seems to give good results ,but my vet has made me feel guilty about having them .:confused:
 
Hi there bings, sorry your having such a worrying/confusing time. How was your horse diagnosed? My lad showed SI inflammation in April but the spavins that were found at the time in both hocks and were deemed more important to treat (with steroids). We did have improvement for a while followed by a rapid decline to being much worse than before. In October his pelvis was rescanned and showed significant bony changes.
A steroid injection was given with a 50/50 chance of it getting to the right area and Tildren was given to help stop the boney changes forming and to help with the spavins. There was no immediate improvement but after a couple of weeks things started to get better and (touchwood) have continued to do so. My instinct is telling me the Tildren is the reason for the improvement as steroids should have worked quicker.
The way I understand it is it's very difficult to get the steroids directly into the area required. After listening to staff saying they 'survived' putting the 10" needle in, and the fact no real improvement was seen, I wouldn't let him have it again but don't regret trying it.
 
Thanks for your reply , he had the usual lameness work up , he watched him being ridden also and he gave him an ultra sound ,he has a windgall looking fetlock ,which turns out to be an old injury ,he scanned his fetlock area also to see what was going on and found old scar tissue and fluid but no damage .i am so confused on what is the best treatment for him !!! he has been on 4 weeks box rest with 2 x bute a day .do they give Tildren as a treatment for sacroiliac problems ?
 
Funny you should mention the windgally fetlock - my lad has exactly the same on the same side as the SI issue, perhaps compensatory injury???
They give Tildren for bone diseases but reading your other thread it sounds like a soft tissue/ligament strain so would probably not be an option. With all my lads newly diagnosed arthritic activity I would be worried sick about lengthy box rest and wouldn't be happy unless we were talking about a non-weightbearing lameness, but as you were still riding yours before diagnosis I can understand your confusion. Can he not have area limited turnout out or is vet wanting complete immobility?
 
Whitehorseslave said:
Funny you should mention the windgally fetlock - my lad has exactly the same on the same side as the SI issue, perhaps compensatory injury???
They give Tildren for bone diseases but reading your other thread it sounds like a soft tissue/ligament strain so would probably not be an option. With all my lads newly diagnosed arthritic activity I would be worried sick about lengthy box rest and wouldn't be happy unless we were talking about a non-weightbearing lameness, but as you were still riding yours before diagnosis I can understand your confusion. Can he not have area limited turnout out or is vet wanting complete immobility?
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My vet said it could be caused by compensation , he said its a chicken and egg situation , he is not lame ,lame .My instructor has told me not to box rest him ,as she said he could end up with other problems , my vet wants to keep him completely immobile ,to restrict his movement to reduce the inflammation, my vet is very young and im worried if he has enough experience .
 
I think you need to raise your concerns with the Vets - maybe ask a senior vet to visit for a chat and if you think there is no compromises get a second opinion. I've known horses that have managed long term box rest but never quite recovered their full vigour but they all had serious injuries.
Good luck, your obviously wanting to do the best for your lad and hopefully the 4 weeks he's already done will have helped his recovery not hindered it.
 
SI injection has been offered as an option on my OH's horse. He had his hock medicated earlier this year but was still not moving correctly even though the hock mobility was drastically improved, horse has had physio previously for an asymetric pelvis but we are unsure if the hocks have caused the SI issue or the other way round.

My vet isn't a big fan of injecting the SI as its quite a big proceedure, he gave the horse accupuncture and lots of 'remedial' ground and ridden work a go and now have a horse that is 8/10th sound - and getting sounder as he gets stronger - and not 8/10th lame. The accupuncture can reach muscles in there that physios etc can't and have returned our lad to ridden work. If this could possibly be used as an option on your boy I'd give it a go.... Good luck!
 
It is a short term fix, but in conjunction with a careful work programme and good(!) physiotherapy, SI steroid injections can pave the way for a good rehabilitation. They helped my girl's SI problems (sadly, she had others, which have resulted in her retirement, but the SI area is fine now!). Box rest isn't great for horses physically or mentally, so unless absolutely unavoidable, I'd always be inclined to turn them away for a few months instead.
 
My horse has just had 2 steroid injections in his neck (2 weeks ago today) where the worst of his osteoarthritis is and when he goes back in another 2 weeks they are going to consider doing his SI where he has a milder "hotspot" on the bone scan he had.

He was very sore and grumpy until a couple of days ago even on 2 bute a day. He has had turn out apart from 2 days immediately after, and when I asked vet if he should be turned away she was clear for arthritis he needed to be kept moving, including riding soon - as long as it is paced slowly and carefully.

I am looking into getting an ArcEquine unit.
 
I'm currently rehabbing a 5 year old mare who damaged her SI as a 2 year old. She was never lame until she started to work a bit more after being backed - and she just couldn't come through properly. She had u/s guided steroid injections into the SI, followed by physio, light work, more physio and then more injections, more physio, and a progessive work programme. It's taken over a year - and she is now about 99% right! We think the remaining issue is more about remembered pain. SI injuries are hard work!!
 
Thanks everyone for sharing your experiences , after a long discussion with my vet ,and him explaining to me in more detail what his exact problem is ,my boy has subluxation of the sacroiliac ,he explained that his ligaments are stretched in that area ,so he needs box rest to allow everything to heal ,he is giving iv Ha injections once a week for 3 weeks and we may need to have them monthly ,in 2 weeks i can start hand walking him and backing him up .its going to take a long time but my vet feels that this would give my boy the best chance of recovery , If he shows no improvement then i might have to go for steroids injections . which i am happy to to if needed .
 
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