Equioxx vs. Injections

I recently moved to a new barn about an hour from my old place, so this also required getting a new trainer. Our first lesson together, I was lunging my nearly 22 year old, greenbroke AQHA on a line when she asked me to bring him to canter, and I effectively had to chase him in order for him to pick it up. I explained that the canter is something we’ve struggled with since I first got him more than a year ago, but we hadn’t touched on it much before because we still have a lot of foundation work to establish just at the walk/trot. She said that he might have arthritis in his hocks, which I’d be inclined to agree with since there’s a constant clicking coming from one of them that he’ll “work out of” at the trot, and he’s been prone to unexplained back soreness before. Then she suggested that I try joint injections, and when I countered with “I think I’d like to try something like Equioxx first,” she said Equioxx would cost me more in the long run.

I know with humans, steroidal injections are one of the last things you reach for when treating arthritis unless it’s pretty severe, and I was kind of approaching it the same way with my horse. I have an incredibly limited experience with arthritis in horses though, can someone who might know more explain why the injections would be better than an NSAID like Equioxx?

Side note: I’ve also wondered before if the canter issue was just related to him not knowing the cues, but he’s smart, and we’ve established the cues now and he still resists. I don’t think this is a tack or behavior problem, as I’ve had the tack examined and he never acts out unless I ask him to do something he physically can’t do yet. I have made an appointment with the vet, but they’re inundated and it won’t be for several weeks, so in the meanwhile I was hoping to hear some thoughts from others.

My senior gelding has been on Equioxx since 2016–been a game changer for him. Gave him a whole pill (57 mg) for the first year, then started cutting back a bit to see what the least amount of drug would be effective for him. He now gets a full pill M-W-F, and a half pill the other 4 days of the week, and a 60 ct bottle lasts 3 months, so pretty inexpensive in my opinion for how well it works for him. I may try giving him 1/2 pill a day once we’re out of winter weather patterns and see how he does. He’s never had a stomach issue or any liver/kidney issues on it. My vet prefers this route over joint injections as there is no risk for joint infection

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I’ve had several aged horses on Equioxx since it first came out about 2007. It’s worked miracles for them. No side effects at all. I’d certainly give Equioxx a try first before resorting to injections.

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Our 21yo gelding with persistent and somewhat mysterious pain in his front feet has done really well on Equioxx for about a year. It’s $85 for a month and a half or so of pills. He used to be head-bobbing lame at the trot. He is now happily ridden lightly at a walk and he quite soundly thunders around in turnout like Wild Stallion of the Sierras, though in reality he’s just Retired Gelding of the Pasture.

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Without seeing the horse, it is hard to say if joint injections are necessary. However, it would not bother me if a trainer suggest joint injections.

The way I think of them is that joint injections are most of the time are more effective in relieving more the pain and inflammation and equinox is more for maintenance.

Depending on what the vet says, I think either approach is fine. If you are uncomfortable with the injections, try equinox first. If more relief is needed, you could then do injections.

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I have my old guy (19 y/o) on Equioxx, I think it helps him considerably. I also give him Pentosan once a month. He has a lot of arthritis - neck, SI, hock, stifle. He’s been on Equioxx daily for about 7-8 months, Pentosan for about a year. He also responds extremely well to chiropractic adjustments, maybe that’s an option for you. But eventually I will have to inject a few joints. He would probably do well if I did it now, but he is certainly comfortable and going strong as is so I will wait.

I think it’s very case by case whether joint injections or daily NSAIDs are more cost effective. Some horses get their joints injected and there’s no difference. Some need such a small dose of Equioxx that a bottle lasts a long time. I would start with the Equioxx and see how he responds. Talk to your vet and go from there.

For starters you need to be getting medical advice from a vet not a trainer. If it really is the hocks then getting them injected is much preferred over a daily NSAID. Injections are definitely not a last resort with horses.

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Thank you all for your input and for sharing your experiences! I really appreciate it.

I have found that routine chiropractic work helps him keep loose and and more flexible, so we’ll continue to do that with whatever route we take. Just have to wait for the vet now… :slight_smile:

Also, you can use previcox off-label for Equioxx. Cheaper and you use 1/4 the dog dose for the horse dose.

That said, I have had a difficult horse for two years, did a bunch of treatments (prostride, osphos, bursa injection) without much improvement. Finally gave up and tried Equioxx. OMG, he has become such a sweetheart. I cannot believe that little daily “advil” has made such a change in his attitude.

My vet recommends the full dose be 6 of 7 days, as she says the theraputic dose builds up. And she also suggests decreasing it to the lowest effective dose.

I am shocked your vet still will prescribe Previcox off-label since Equioxx is available in pill form. Good for you that you can get it that way.

As an FYI, it is now illegal for a vet to prescribe Previcox for a horse, since there is now a tab form for horses. I’m not calling drug police, just be aware if you ask a vet to do this, you are technically asking them to risk their license.

For the OP , yes, talk to your vet. All things have risks. I have used both injections & Equioxx. If I knew a horse had hock arthritis & I was asking him to work, I would use injections. They are targeted & when done correctly, very safe. For pasture/retiree management, I might lean more towards Equioxx or, as I use for my mostly retired guy, devil’s claw.

While Equioxx has a low incidence of side effects, it does still have a small impact on compounds that regulate stomach coating, maintain cartilage, etc. Much less than Bute, of course. Everything has tradeoffs, so just keep in mind & discuss options with your vet as to what would be the best fit for horse.

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Sharing my experience so you have it as a data point. My mare was on Equioxx last summer for a few months as she was recovering from a case of acute laminitis. She did great on it. We took her off it when it seemed like she didn’t need it any longer and she did great for a couple of months. Then we ended up putting her back on it (reason not important here) and it KILLED her stomach (and she was on a gastric support supplement already). My nice, quiet mare turned into a spooky mess. We took her off it, treated her stomach, and she’s back to normal. I will think long and hard before putting her back on it in the future and if I do, it will be with a stronger stomach support regime.

This. Treatment without a diagnosis makes no sense. It can be a complete waste of money and time.

While joint injections are not a last resort, there is always risk of infection.

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Try 4 oz of aloe vera juice w/2 tsp of slippery elm bark powder mixed in–forms a snot-like liquid that coats the stomach. I just dump it on top of his beep/alfalfa pellet mix. Has worked great for my ulcer prone gelding who’s been on Equioxx for 4 years. No tummy troubles at all. The above combo costs about $10-$11 a month just doing it with his evening bucket A gallon of av juice lasts a month, a 1 lb bag of slippery elm bark powder lasts 7 months).

Thanks for the tip!

My vet doesn’t. I use Equioxx, but the barn manager has dogs and her dog vet is willing to prescribe, and several use it for their horses.

Although the active ingredient in both is the same, I am not sure of the inert ingredients and whether they make a difference, so since I was trying it out, I thought I would stick with name brand first!

Usually I would suggest injections before equioxx because long term NSAIDS can cause issues, but at 22 I might suggest going to equioxx first as he probably has arthritis in more than one place. You can buy a 30 day supply and by the end of 30 days know if its arthritis causing the issue or training.

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You recommending drugs makes even less sense than the trainer recommending drugs. At least she has seen the horse.

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I don’t see how @StormyDay ‘s post was much different than yours? The OP came on here asking for insight on hock injections vs Equioxx for an older horse, and mentioned that they’ll be speaking with the vet. Trainer pointed out the hocks, but it would be fairly likely that a 22yo in work may have degeneration in more than one joint.
It’s perfectly reasonable for the OP to take all of this information, observe the horse critically, and pass along both their thoughts and trainers thoughts to the vet.

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I said ask the vet. None of us have the slightest idea what if anything is wrong with the horse.