Hock inj vs adequan

[IndysMom]

I usually have the hocks injected in the spring before show season starts. He is always checked first and only done if he shows signs on flexion test or if I sense a problem such as dropping out of the canter.

However, this year he had an episode of lymphangitis a week after his hock injections. The vet says it was not related but now I’m spooked. I am considering adequan next year instead. What experience does anyone have? I think inj are the gold standard? I want him to be comfortable-esp since he’ll be 15 but I don’t want another episode like this spring!

[CindyCRNA]

I do both every 6 months so I am no help. I certainly don’t do it the most cost effective way.

[TheHunterKid90]

I would rather put my money into the exact location the problem is…whether that be knees, hocks, stifles etc. Mine are injected as needed, I do not use any form of adequan, pentosan, legend etc and no joint supplements.

[Guilherme]

We’ve done both. Injections are the most effective, the most expensive, the one with the highest risk of complications, and with injections you have a “window of diminishing returns.” Each injection will be slightly less long lasting than the one that went before. This is all per the UTN Large Animal Clinic. They also recommend the injections be done in the clinic setting vice the field or a barn. That reduces the risk of contamination of the injection site.

Adequan is cheaper, not as effective, requires a series of injections which must be in the proper sequence for maximum effect, does not have a "window of diminishing returns, and carries a very low risk of complication when done IAW label directions and the usual recommended practices for injections.

Either can be appropriate but selection may depend on the needs of the individual horse and owner.

G.

[retiredhorse]

Agreed with above that Adequan (and/or legend) is less invasive than joint injection and less effective. We usually tried that first, before going to joint injections. I feel like adequan/legend might help push back when they need the next joint injection (like 9 months instead of 6, maybe), but probably won’t be able to forgo it altogether and maintain horse’s level of work & comfort/soundness. And you probably won’t feel as big of a difference in the horse’s way of going on adequan vs few days after joint injection, but possibly the only thing that would hurt to try it is your wallet.

Not that I’m a vet or anything, but I think the lymphangitis and joint injections are unrelated too. Haven’t had a horse respond badly to joint injections, but from what I’ve heard, when a joint does get infected, it’s career or life threatening, and possibly more immediate (like noticeable after a day, not a week after). (Or maybe I only heard about those because they ended up career or life threatening, and not about smaller issues with joint injections.)

[mvp]

@TheHunterKid90

I would rather put my money into the exact location the problem is…whether that be knees, hocks, stifles etc. Mine are injected as needed, I do not use any form of adequan, pentosan, legend etc and no joint supplements.

Kinda off topic, but how do you/your vets feel about putting steroids into high motion joints? Or do you use HA? Do you all ever think of using Adequan instead of doing another round of injections for a high motion joint?

For the OP: If you are talking about injecting the lower joints of the hock vs. Adequan, I’d do the intra-articular injections. I don’t think those are related to the lymphangitis, but certainly ask your vet! And if he/she thinks there is a connection will you kindly come back and explain that physiology to us? Lots of us like hock injections; no one wants lymphangitis.

[OneTwoMany]

I’m not a vet, but I would submit that a statement that each injection will be less effective than the prior injection is a bit of an over-generalization. With a horse that has arthritis and a workload that isn’t changing ,that supposition makes sense since arthritis is progressive. However, if a horse presents with joint inflammation (no arthritis present) and the joint is injected to calm down the inflammation to prevent disease I’m not convinced it is completely accurate to say any subsequent injection will be less effective.

I will be the first to agree that there are many, many situations wherein injections are undertaken to address joints that are diseased. In these cases, the disease will progress and, if the workload/management remains unaltered, each subsequent injection is likely to provide a shorter period of relief. The science overwhelmingly supports that view. These are chronic cases.

However, if a joint injection is undertaken with the intent to reduce inflammation before any arthritis or bony changes have begun, it seems dubious to assume that any subsequent injections will have a reduced window of efficacy. Instead, it will depend on the cause of the inflammation, the health of the joint and the management program.

I only bring this up because, one can often read on this BB wherein posters are advised to “run for the hills” if a horse is injected before XX years of age, while no consideration is given to other diagnostics such as radiographs. The reality is, performance horses are athletes. If they are performing at top levels, they may benefit from joint injections to keep inflammation (and disease) at bay.

Sorry OP for hijacking your post a bit.

[Lord_Helpus]

Hopefully, I did the best of both ---- Not wanting to commit to injecting a foreign substance into 3 joint capsules, I painted the inside of the hock 2x/day for 10 days with a mixture of cortizone and DSMO to see if he became sounder with local treatment.

It did make a real difference; he became 95% sound Before the painting, he was about 60% sound. So, next Tuesday the vet will inject his LH hock. He claims there are 4 joints in the hock, but have always been told there are 3. I will see how many he injects.

Interestingly, he had become very worried about having that leg/hock touched or lifted, and shoeing that leg became difficult (as did flexion tests).

But after 7 days of painting his hock, virtually all that went away. I learned a lot. If a horse gets worried/snatches his hock away, think pain.

Since Petey was not in hard work, I thought it was just his reconditioning work. I should have called the vet in several months before I did.

[TheHunterKid90]

@mvp

Kinda off topic, but how do you/your vets feel about putting steroids into high motion joints? Or do you use HA? Do you all ever think of using Adequan instead of doing another round of injections for a high motion joint?

For the OP: If you are talking about injecting the lower joints of the hock vs. Adequan, I’d do the intra-articular injections. I don’t think those are related to the lymphangitis, but certainly ask your vet! And if he/she thinks there is a connection will you kindly come back and explain that physiology to us? Lots of us like hock injections; no one wants lymphangitis.

I’m a big advocate of HA and that is mainly what we inject with. I don’t like pumping my horses full of steroids but I let my vet make the call on an individual basis.

As far as care between injections, we really don’t over inject and our horses don’t get to the point of being lame before we help them out…all the show horses are seen by the vet and looked over monthly. I do some topical stuff like painting up knee and check ligaments to draw some blood there, I seem to inject them half as much now. I’ll throw some blue lotion and dmso to stifle cords and there’s some different things we do if a horse gets sore in its shoulder bursa. Basically there is no cookie cutter method, each horse is treated differently. I have horses in my barn that have never been injected and others that have been more than I find ideal.
I have played around with weekly injections of pentosan, glucosamine etc and never been wowed by the results. I also don’t put my money into feed through supplements. Who knows if it really gets to where the horse needs it.
just my 2 cents