I am so discouraged right now. After $$$ of money in cortisone (only) hock injections, vet calls, xrays, my 8yo KWPN mare is STILL not staying sound. I feel like I am throwing megabucks at a problem that is just not going away :no:. My mare is not happy and I am NOT enjoying myself either.
I am just not sure what to do next. The whole point of this was to get my girl to fuse the lower hock joint so ergo, no more pain. But in the meantime, she’s not comfortable and I’ve sunk almost $2K into this thing. She has had just the cortisone injections and I’ve started to feed her Omegas by using Finishing Touch, which helps. She gets 10,000 mgs of straight MSM a day. I’ve used some bute here and there and some Voltaren (not at the same time). After 5 months she has not fused-yet, and the injections do not last. Where the heck do I go from here? I know I need to call the vet again. But should I be calling for a second opinion? I am so upset and disappointed.
I need some COTH experiences here, this is a relatively new problem, and the mare’s xrays were perfect when I bought her. I am not looking for diagnosis, I know what the issue is.
First, let me say my sympathies! Lameness is frustrating. Have you used Adequan, legend, or pentosan? How long ago was the cortisone injection? Sometimes they need to be done more than once to really work. A friend of mine has a horse that they are waiting for his hock to fuse. She has done IRAP on it. It makes him more sound but it also caused the joint to “open back up” and make fusing take longer. Personally, I would get a second opinion from another lameness vet. What does your vet say?
I have had incredibly good results with IRAP. Never looked back.
Where in Canada are you located?
I am in SW Ontario.
Vet is still hoping for fusion. Last injection he said it was much harder to get the needle in there. We have done 3 injections to date of cortisone only. I get about 4 wks (or less) out of it. I am now trying to stretch the next one out until the end of this month, as that would make it 2.5-3 months away from the last injection. I did 3 cortisone injections, one January, one Feb and one March per his recommendation. As I said he is trying to fuse it.
I have not tried any other injectables yet because he said not to, didn’t want to lubricate the joint too much, want it to fuse.
Fusing is painful, but the end will come. The horse may need to just be turned out and not ridden for a few months while you let the process run its course.
I second IRAP and Adequan. Both kept my 20-something gelding happy for years. And his hocks were about as bad as they can get.
Alcohol arthrodesis may be an excellent choice. It kills the nerve endings in those joints immediately causing pain relief that day. Costs are slightly more than regular injection (they also inject contrast to confirm placement and check for unexpected synovial communication to the PIT (next joint up) or the tarsal tendon sheath). Otherwise it’s a pretty straight forward procedure and recovery. Some require a second after 6 months treatments to complete the fusion. No down time.
There are horses who need steroid into that joint for YEARS before they fuse, or need maintenance for the rest of their lives and never completely fuse. You’ve gone five months.
Fusion takes time. And sometimes never happens. Hock injections are very, very rarely a one time deal that magically make the horse better forever.
Does the horse block sound at that joint? If not, I’d be looking at further diagnostics, because if she’s not sound when you make that joint pain free, she’s not going to be sound with fusion. If she blocks sound, perhaps the alcohol fusion process is more up your alley.
Best of luck.
There are horses who need steroid into that joint for YEARS before they fuse, or need maintenance for the rest of their lives and never completely fuse. You’ve gone five months.
Fusion takes time. And sometimes never happens. Hock injections are very, very rarely a one time deal that magically make the horse better forever. Injecting every 4 weeks is pretty odd–not something I’ve ever heard of before? My vets have always moved on to other modalities if the horse doesn’t stay sound for several months and consider steroid injections a failure in that case.
Does the horse block sound at that joint? If not, I’d be looking at further diagnostics, because if she’s not sound when you make that joint pain free, she’s not going to be sound with fusion. If she blocks sound, perhaps the alcohol fusion process is more up your alley.
Best of luck.
Simkie makes excellent points.
I’m also going to throw out my personal almost oops on a horse of my own that I “knew” what was going on because he had sclerosis and joint space narrowing and blocked to the the lowest hock joint (TMT). He was also looked at by 2 excellent surgeons in different states with confirmation of the problem. After the most recent hock injections lasted for 10 day and 3 rides, I decided it was time and I scheduled him to come with me to work for alcohol arthrodesis on a day we were supposed to be slow. This was going to be Friday. On Wednesday, it just wasn’t sitting right with me. Both lower joints would fuse (except for 10% of horses that don’t communicate between the two lower joints), but one joint was beautiful on radiograph. And I hated the idea of destroying a healthy joint as collateral damage. I scheduled him for an MRI on Friday morning of his hocks and suspensories (because distal hock blocks often block the proximal suspensory at the same time). Then we could fuse him that day after confirming those two joints were the problem. Well guess what. I was wrong. Yes, his hock joints were working on fusing, but they weren’t making him lame. His lameness was proximal suspensory desmitis and a subchondral bone cyst that would have never responded to fusing. We treated his actual problem and he was sound after 3 months and went back to yearly hock injections as needed.
So, just a reminder that blocks aren’t perfect and we always need to keep an open mind. I’m not saying you should do an mri as that would probably be overkill (I got lucky, I found a cyst that required specific treatment and identified the thick suspensory). But, the point is, horses always humble us and when treatment isn’t responding as expected, reconsider the problem. Treatment is only as good as the diagnosis (and it sounds like you have great vets, so this more of me rambling for anyone that it may help :))
horses always humble us and when treatment isn’t responding as expected, reconsider the problem. Treatment is only as good as the diagnosis
I love this statement.
Are you sure it is the hocks? SI and saddle fit issues can cause over use of hocks making them sore.
Have you tried a Chiropractor or Osteopath?
I had my horse hocks surgical fused (lazer) it took about eight months to return and he came back a better mover than before ( dressage)
Done at the vet school in Pullman ( WA)
If you’re in SW Ontario, I HIGHLY recommend McKee Pownall.
