Hock Fusion Advice

[Florida]

Hi all,

Interested in hearing your experiences with fusing hocks.

My older draft cross (late teens) has been having soundness issues, on and off for months. Several vet visits and lots of imaging have narrowed the issue to one hock. We did hock injections (HA & steroid) and started Adequan which seemed to help for a few weeks. However, we are now back to being sore. The hock is trying to fuse and vet has recommended we try to help it along.

Options for now are shockwave, another round of hock injections, and/or ethyl alcohol injections.

Would love to hear your experiences. Has anyone had particular success with any of these options? Would you recommend or not recommend any of them and why?

Thank you!

[atr]

Which particular area of the hock? Upper or lower?

[Florida]

Lower hock. Thanks!

[Bonnie2]

In the old days we put them on bute and worked them up hills. With today’s wonderful therapies, ‘fusing’ hocks causing significant problems are rare. If your vet is not an equine lameness specialist (and that doesn’t mean they’re not a good vet!) I would get a second opinion. If they are very experienced with lameness, I would inject again possibly with a different medication. Maintaining him on NSAIDs for a while will help if his gut tolerates them well. Injecting with alcohol sounds like something that would have been done 50 years ago when there were no good meds. I would never permit that to be done to my horse. Hope you find something that helps!

[endlessclimb]

I’ll tell you what I’d never do, and that’s surgical arthrodesis.

My advice is to pick a plan and jump. Once the hocks get to a certain point, you can’t get into them anymore so your options become extremely limited.

[atr]

The alcohol fusion is actually quite interesting. I had a thread many years ago about using it as an experimental procedure for my elderly QH with low ringbone. It was a last ditch attempt at getting him comfortable enough to be a pasture pet as opposed to euthanized. It worked remarkably well and caused minimal discomfort during the fusion process.

You can’t use it in the upper hock joints as it flows downwards too easily. Which was why I asked. But lower hock joints, it wouldn’t be out of the question for me at all if I’d exhausted all other joint injection/pain relieving protocols. I’d just like to make sure that the person administering knew what they were doing.

[stargzng386]

I had a very young QH’s hock chemically fused as a last ditch effort before euthanasia at a big vet hospital. Everything else had been tried and he was so lame it looked more like a broken pelvis. It worked enough to make him happily pasture sound but not rideable so he’ll spend his entire life retired. If your goal is riding I would not go with this option. If your goal is retirement I might consider it as a last resort. Before doing it I’d get a full second opinion by a lameness specialist.

[PoochPaddock]

My now 14 year old hunter had surgical arthrodesis and is now sound. While it was a LONG journey to soundness (2 years), there is a light at the end of the tunnel. We started with an old school surgeon who went in with the drill method to drill out the remaining cartilage in his arthritic hock in October of 2021 then gave him 6 months of 24/7 turnout to promote the fusion and heal. I then sent him to rehab when he seemed to be just barely grade 1 lame after the 6 months. That proved to be a mistake and a few months into the rehab (aquatread + walker therapy), he was more lame than when he started that therapy and the joint then became unstable. The next procedure (November 2022) was to install a plate and screws to hold that lower hock joint stable (new surgeon, more state of the art facility). He had the requisite time off then we started him on rehab type tack rides. Still very lame…

We suspected a possible screw impingement so the surgeon did a Tibial Nerve Block (after blocking a few other parts of the same leg without a sound jog) and he jogged sound finally, indicating the plate or screws were the problem. The CT scan showed the hock was completely fused so we removed the hardware (September of 2023). 30 days of stall rest and 2 weeks of all night turnout later, voila. SOUND horse.

If I had to do it all over again, knowing what I know now, I would have gone straight for the drilling of cartilage PLUS the hardware from the get go. That likely would have cut out an entire year of the arduous process to get him to where he is today but the point is, HE IS SOUND.

Would I do this on an older horse that had many miles under his belt? Probably not. But mine was 11 with low mileage when this started. He is ammy friendly, fairly fancy and had lots of miles left in him so I had to give it a go. 6 1/2 months after hardware removal, he showed at Pin Oak in the 2’6" hunters and got good ribbons in large classes. (without even an equioxx needed to keep him comfortable)

To the OP, there is light at the end of the tunnel. Do your research and find a reputable surgeon that has done many of these types of surgeries if surgical arthrodesis is on your radar screen. Not a snowball’s chance in hell I would try the chemical arthrodesis on any animal I hoped to use for sport in the future.

PM me if you like.