Backsliding after SI injection?

[starsandsun]

I recently had my horse injected at his SI for the first time (with IRAP). As instructed by my vet, we waited 3 days to do anything, then started with light walk/trot. After a few days we added canter. By day 7, he felt the best he’s felt in years, and that continued to the next ride (2 days after) where he was asked to do a bit more. It was a 30 minute ride, mostly walk/trot, with some canter and then a few lines of half-pass. The next day (day 11) he was back to where we started.

Did I push him too quickly? It didn’t seem like I had, but it was a bit of a shock that he had felt so great, and then quickly so uncomfortable again. Is this muscle soreness from using himself in a new way? Other than a return to his previous level of discomfort and unwillingness, there is nothing else new going on. He is being treated for ulcers.

Vet is coming tomorrow for the second IRAP injection.

[Obsidian_Fire]

Might post this in the Horse Care section - more specific area of the forum for a question like this, since not everyone visits Dressage.

[Bogey2]

I have found over the years it depends on what is causing the pain/tightness in the specific horse makes a difference in how long it “lasts”. I leased a horse out many years ago to a person who was had a shitty seat but insisted on sitting trot when the horse was barely through his back. When she wouldn’t listen to me I made her drop the lease…had the S/I injected just once and began riding him correctly again.
My PSG horse was done once when he first started that level, again never needed it again, the saddle was bothering him, fixed it and off we went.
A vet once told me he would go to the Morgan shows and inject S/I DAILY for some of the saddle seat horses. I was aghast.

[DressageD1va]

Sounds like the burst of medication into the body helped in general. The S/I isn’t a closed joint so the irap will be traveling a bit. Could mean that the benefit you felt short term was as a result of the treatment temporarily calming down a different area

[Calhoun]

Like you, I am curious why the injection did not hold. Please report back. I had my horse’s SI done (I don’t think IRAP was used), there was good success and 2 years later did shockwave on the area. It took a month before I saw results from the shockwave. Two years after shockwave, I started monthly Legend injections and felt a real difference in my 16-year-old horse.

[lorilu]

COuld it be that he started using himself differently, and got a bit body sore? FIrst fo course I’d ask my vet. Then, Id give some bute and a day or two off, maybe PEMF… (for other areas of his body not SI), then start back…

[ZELLA]

Not every horse responds to injections. We’d all like to hope they work, seeing as how much money they cost. Unfortunately, life sometimes has other plans.

[starsandsun]

Thanks Lorilu. Vet is coming tomorrow for second injection, and I’ll be pestering her with questions. I intend to give him a longer time period off after this injection, and then work back more slowly and see if that helps. My concern is that the IRAP is making ‘something else’ feel better as it leaks out of the joint. I’m also going to do some diagnostics to see if there is something else going on, somewhere else.

[leheath]

I had steroids, rather than IRAP, injected into my horse’s SI. Depending on where exactly was injected, those needles were huge and it took at least 7 days before my horse was even close to comfortable being ridden just from the injections. My vet also indicated it can take at least 2 weeks for the injections to really take full effect. It could be you just had a short burst, but need more time and the follow up injections to really make a more lasting difference.

[mpsbarnmanager]

My horse has had them several times. The last time it took a good month for him to feel better. My vet said he must have had a lot of inflammation that took longer to go away. It was really hard to wait, I was upset thinking it hadn’t worked. Hes getting done again next week, but I didnt wait was long between this time.

[paw]

I think you may have gone too quickly. Why was he having problems with his SI in the first place? If he’s using his body correctly now for the first time in awhile, you’re going to need time to develop whatever muscles he’s not been using. Way too easy to get back in to old habits.

Horse’s bodies are just like ours - think about what sort of PT you would do if you got your SI joint injected to make sure that the problem didn’t recur.

[Equibrit]

About the use of IRAP; https://www.desertpinesequine.com/pdfs/IRAPFinal.pdf

[joiedevie99]

Sounds like there are a few things going on here.

Why are you treating the SI? What is the underlying injury/OA/soft tissue etc. problem? Depending on what the problem is, you proceed differently after injection. For maintenance of a chronic issue, we usually give them 3 days off, then lunge for the rest of the week. On day 8, they start back under saddle and build up to full work over the second week. For an injury, there may be some period of full rest, and then a gradual rehab program of hand walking and lunging and backing and hills, avoiding the canter for several months. IRAP isn’t going to fix whatever is wrong in there, or whatever led to the issue in the first place. It’s just going to knock down the inflammation so you can make the changes and move forward.

IRAP is also pretty different from steroids. Some horses take 3-4 weeks to respond to treatment, and a few horses feel worse before they feel better.

There may also be compensation issues. It’s a bit like whack-a-mole, but sometimes multiple things hurt and you have to find the one that came first and caused all of the others.

[starsandsun]

Thanks all for your ideas. Yes, I do think we went too quickly for him, but I did follow vet guidance. We just had second SI injection (IRAP again) and will be taking it much more slowly and see what happens.

JoieDevie99, we are treating because he’s always been sore there in response to chiro/accupuncture, and his reluctance under saddle is to step through with the right hind. And ultrasound showed some slight remodeling (I think I’m explaining it correctly). We have an exam in another 2 weeks to see how he looks under saddle to consider any other potential diagnostics. Thanks for the comment re worse before better. I can see that - also, using himself differently because he felt good might have done it as well.

You are not kidding about whack-a-mole. He’s such a good horse … will do all I can to get him comfortable.

[eponacelt]

Are you sure its the SI? My vet had suggested SI injections for my mare, which we did, and she got somewhat better (although it took a month to see full results). However, we’ve now identified that while her SI is sore, the real problem is arthritis in her T16-L1 facets. So, your horse could have a sore SI, but with an underlying problem that means the SI injection isn’t the actual fix.

[bathsheba8542]

Hi - thanks for the suggestion. We are fairly confident the SI is involved as it is slightly different right side to left. A bone scan did not show any uptake in neck or back. More diagnostics are happening this week.