Fusing hocks, what helps?

[SugarCubes]

Forgive me for not being more educated in this area, first time I’ve dealt with this! I have a 14 year old hunter who has been getting yearly hock injections the past couple of years. We x-rayed him again a couple of months ago before injecting him and his hocks are fusing, some joints are almost totally fused, some aren’t all the way there. My vet injected with something different than she has in the past due to the fusing (can’t remember what, sorry!) and recommended we do monthly Legend injections until they are completely fused.

My horse is very stoic and rarely shows when he hurts, but his tell is when he is late with his changes. The legend helped right after the injections, but hasn’t made as much of a difference lately and I was wondering what other alternatives I should discuss with my vet. Any recommendations? Previcox maybe?

Aside from Legend, he is on Smartcombo from SmartPak, which has a joint support supplement in it, and he wears Back on Track hock boots a few times a week.

I hate him hurting, and wish this fusing process would hurry up! Would love your advice and success stories!

[NancyM]

Well the old skool treatment always was a bit of bute, and light work/hacking, and wait. The painkiller keeps him comfortable, and relieves the possibilities of cascade effect problems due to changes in carriage due to the pain, and the light work keeps the fusing going until complete. But it sounds like you are getting lots of veterinary input into this already, and you just need to be patient. The fusing is a “natural” process, and usually will result in adequate soundness once complete. Good luck!

[SugarCubes]

Well that sounds easy enough! It seems like some days they bother him more than others, normal? I can definitely give him a little bute, and I’ve cut him down to lessons 2x/week instead of 4 so he can have light hacks on his non-lesson days, which seems to be helping too.

[flyracing]

Talk to your lameness vet about alcohol fusing the hocks. The injection deadens the nerves in the joint capsule and cartilage, immediately providing pain relief. It also quickens the process. Time off is the same as for regular hock injections.

[Abbie.S]

[QUOTE=flyracing;8254625]
Talk to your lameness vet about alcohol fusing the hocks. The injection deadens the nerves in the joint capsule and cartilage, immediately providing pain relief. It also quickens the process. Time off is the same as for regular hock injections.[/QUOTE]

This is a pretty extreme option, and one that is horrendously painful for the horse for a time before the chemicals do their job. Not usually a first go-to.

OP, I don’t have time to write extensively now, but I’m going through this myself with a young horse and it is not fun, but I’ve become very well versed in it. I will write more in depth later, but please be aware that there is no treatment for fusions, only medical interventions that can potentially help.

[flyracing]

[QUOTE=Abbie.S;8254676]
This is a pretty extreme option, and one that is horrendously painful for the horse for a time before the chemicals do their job. Not usually a first go-to.

OP, I don’t have time to write extensively now, but I’m going through this myself with a young horse and it is not fun, but I’ve become very well versed in it. I will write more in depth later, but please be aware that there is no treatment for fusions, only medical interventions that can potentially help.[/QUOTE]

You are confusing monoiodoacetic acid fusion and ethyl alcohol fusion. Very big difference! Monoiodoacetic acid fusion is often extremely painful and in my opinion, not an ethical option with other current therapies available. The pain relief from ethyl acohol is practically instant; they walk away from the injection sound.

[SugarCubes]

[QUOTE=flyracing;8254793]
You are confusing monoiodoacetic acid fusion and ethyl alcohol fusion. Very big difference! Monoiodoacetic acid fusion is often extremely painful and in my opinion, not an ethical option with other current therapies available. The pain relief from ethyl acohol is practically instant; they walk away from the injection sound.[/QUOTE]

I’m interested in learning more about this! In your experience, was the cost similar to normal joint injections? Like I said, he rarely looks off, but will be short behind and will be late with his changes. He also back sore in his lumbar/SI area which I’m sure is from him compensating for his sore hocks. Is this treatment usually only recommended for extreme cases where the horse is noticeably lame or something worth discussing with my vet?

[flyracing]

The cost depends on the vet’s preferred method of performing the procedure-standing vs down. If it’s done standing, which is common, it may be similarly priced with the addition of contrast dye and a couple of radiographs. This is because, we have to ensure the lower hocks don’t communicate with the upper joints. Following the contrast study, alcohol is injected through the same needle that injected the contrast or flushed through the joint(s) with a two needles (depending on the vet’s method). Similarly to hock injection, the horse goes home after the sedation wears off and has a couple of days off (although, I know a couple of vets who let them go back to work the next day). Some horses need a second alcohol injection 6-12 months later. I’ve not seen or heard of one needing a 3rd injection yet.

I would talk to your vet about if your horse is a good candidate. Typically horses that are candidates no longer respond to joint injections and other first line therapies, block successfully to the TMT and/or DIT (lower hock) joints, and have changes on the hock radiographs like sclerosis and osteophytes.