Hock Injections - both hocks?

[kaispen]

I’m sure this has been discussed, but why do vets recommend injecting both hocks if only one hock needs it? I suspect different reasons as to why my 10yr old warmblood has ‘problems’ with her right hock, none of which have anything to do with her left hock. I have only injected her hocks(both hocks) once and only the right side was dry and needed it done. The left was good. Why should I do the left one then?

I am trying her on Cosequin, but still want to know (incase it doesn’t ‘work’ for her) if anyone else does one joint? I’ve never known a human to inject a good joint!

[SonnysMom]

My lameness vet only recommends injecting the hock joint that actually flexes unsound. We only did did one hock the last time. His reasoning is the same that a doctor would only inject the bad knee not both just because.

I think the thought for many vets is that if the horse has arthritis he likely has it in both hocks except in the few cases of a specific injury to only one hock.

[SolarFlare]

Have both hocks been x-rayed (to see if they’re both arthritic) or was the first injection done based on vet’s opinion? I’ve once had only one hock injected to see if we could get good results, but ended up having to do the other anyway. Once the worse one felt better, the other was more obviously off. Then again, mine does have minor arthritis in both lower joints, but one side definitely flexed worse.

[kaispen]

SonnysMom, I do think there is some mild arthritis in the left since she wasn’t perfect on her left flexion(1out of 5). However, the joint fluid was still good so I wondered if it was necessary. The right one flexes 3 out of 5 and has a lot of inflammation and was dry when she was first injected a year and a half ago.

SolarFlare, I have yet to x-ray the joints. The injections were originally done when I was not present and I was told the results of the flexion. The vet injected based on those results. I believe that the left hock flexed perfect at that time but was told that both are always done. Now more recently the left hock flexed 1 out of 5.

I think at this point I will just request having the right one done and see if the left one becomes more noticeable. I would rather that then get aggressive with a joint that doesn’t NEED it yet.

Anyone have positive results with Cosequin?

[SolarFlare]

I would suggest then getting xrays of both hocks done before injecting this time, so that your vet can see exactly what’s going on in each one. Also, you’ll then have a baseline to compare to later on rather than just fluid quantity/quality. Mine actually will have excess fluid at times when he’s injected, so I don’t think whether or not the joint is dry can be used to determine whether treatment is necessary.

[beau159]

@kaispen

why do vets recommend injecting both hocks if only one hock needs it?

I have yet to x-ray the joints.

The injections were originally done when I was not present and I was told the results of the flexion. The vet injected based on those results.

Personally, I don’t understand why vets will inject a hock without x-raying it first.

IMO, an x-ray is a very cheap diagnostic that can tell you a lot. We would have never known my gelding was fusing (at the time) in his right hock if I had not opted to do x-rays. He flexed FINE. Yet he had very very advanced changes. Vet was surprised. There were mild changes on the left hock as well. We injected both and I had a whole new horse and the problem he was having went away.

If there is changes/lameness in one hock, chances are, there’s a problem worth treating in the other one. Of course, there are always exceptions, but usually there is something that can benefit, especially if you are looking to do performance with your horse.

But I also don’t go around injecting hocks unless the horse NEEDS it, based on a problem they may be having with their performance.

[joiedevie99]

Yes - x-ray before you inject. The other thing to keep in mind is that horses will compensate. You don’t want the horse over-using the bad one after the injection because the other one is mildly sore.

[SonnysMom]

@beau159

Personally, I don’t understand why vets will inject a hock without x-raying it first.

IMO, an x-ray is a very cheap diagnostic that can tell you a lot. We would have never known my gelding was fusing (at the time) in his right hock if I had not opted to do x-rays. He flexed FINE. Yet he had very very advanced changes. Vet was surprised. There were mild changes on the left hock as well. We injected both and I had a whole new horse and the problem he was having went away.

If there is changes/lameness in one hock, chances are, there’s a problem worth treating in the other one. Of course, there are always exceptions, but usually there is something that can benefit, especially if you are looking to do performance with your horse.

But I also don’t go around injecting hocks unless the horse NEEDS it, based on a problem they may be having with their performance.

I had an original set of xrays done for Finnegan before hock injections. I did not see the need to get xrays every single time and neither did my vets.

[beau159]

@SonnysMom

I had an original set of xrays done for Finnegan before hock injections. I did not see the need to get xrays every single time and neither did my vets.

I too don’t think it needs to be done every single time (but if you are getting the hocks injected frequently, you should be somewhat watching the x-rays closely too), but sounds like OP has never had the hocks x-rayed. And that’s what I personally don’t like: Vet is (possibly) seeing horse for the very first time. Horse has never had rads. But vet injects.

I don’t like “blindly” injecting into joints. JMO

[kaispen]

Beau159 I asked about whether my mare needed Xrays first but I only spoke to the barn manager. I was told she was overdue for injections since she was 8 and most show horses get them at 6 or 7. I didn’t like that answer but figured the vet would do the ‘right’ thing. In the end she was injected with no xrays done and it definately bothered me. I like thorough answers!

I agree with everyone who posted though, getting xrays is the next step. Thanks

[jawa]

Prior to having my horse’s hocks injected, I had a full work up done. Going on soft surface, hard surface, circles, lunging, flexions and X-rays. Prior to the X-rays the vet was seeing unsoundness with only one hock. Once the X-rays were done, he noted that the sounder led actually had more arthritic changes than the unsound one. Both hocks were injected. He was 6 at the time. He is now 11 and hasn’t had to have his hocks injected again. Consistent work, correct trimming/shoeing and correct saddle fit have helped to keep the injections to a minimum.

[beau159]

@kaispen

I asked about whether my mare needed Xrays first but I only spoke to the barn manager. I was told she was overdue for injections since she was 8 and most show horses get them at 6 or 7. I didn’t like that answer but figured the vet would do the ‘right’ thing. In the end she was injected with no xrays done and it definately bothered me. I like thorough answers!

So barn manager told you “she needs injections because she is 8 years old”? Between you and me, I would NEVER ask this BM for advice on the care of my horse again. Period.

Hock injections should NEVER be done as “routine maintenance” or strictly because of age, IMO. Every time you stick a needle into a joint, there are risks. Every time you shove medicine where it doesn’t normally belong, there are risks. Why on earth would your BM advise to “treat” a horse that didn’t have a problem? I don’t understand the mentality of injecting joints like what your BM told you.

Of course, if the horse has a problem and needs the injections, yes, the benefits outweigh those risks and injections should be done to help the horse. And that’s a different scenario.

@kaispen

I do think there is some mild arthritis in the left since she wasn’t perfect on her left flexion(1out of 5). However, the joint fluid was still good so I wondered if it was necessary. The right one flexes 3 out of 5 and has a lot of inflammation and was dry when she was first injected a year and a half ago.

OP, you said the horse flexed a little bit “off” but… ARE YOU HAVING ANY PROBLEMS WITH HER?
What disipline / events do you do with her?
Is there any problem with her performance?

Take the flexions with a grain of salt and look at the whole picture. Consider how the horse is performing. Consider what the flexions told the vet. Consider what the x-rays look like.

If the whole picture indicates that she should have her hock(s) injected, then by all means, do it!

However, if the whole picture does NOT indicate it … then do not.

An example of the flexions:

1. Red flexed fine on his hock that was around 75% fused and causing us great problems with his performance (barrel racing). X-rays showed the advanced fusion. Injections made him a whole new horse! Amazing. (although still had to supplement with previcox b/c the injections just didn’t quite 100% take care of the fusion pain)
2. Shotgun flexed a little bit off on his hock flexions. X-rays maybe showed beginning signs of fusion but slight. He was 7 last year at the time of the exam. I was not having any problems with his performance and we did not inject. I just did not see the need. Finished out the season with his best times and no issues.

[kaispen]

So barn manager told you “she needs injections because she is 8 years old”? Between you and me, I would NEVER ask this BM for advice on the care of my horse again. Period.

Hock injections should NEVER be done as “routine maintenance” or strictly because of age, IMO. Every time you stick a needle into a joint, there are risks. Every time you shove medicine where it doesn’t normally belong, there are risks. Why on earth would your BM advise to “treat” a horse that didn’t have a problem? I don’t understand the mentality of injecting joints like what your BM told you.

Of course, if the horse has a problem and needs the injections, yes, the benefits outweigh those risks and injections should be done to help the horse. And that’s a different scenario.

OP, you said the horse flexed a little bit “off” but… ARE YOU HAVING ANY PROBLEMS WITH HER?
What disipline / events do you do with her?
Is there any problem with her performance?

Take the flexions with a grain of salt and look at the whole picture. Consider how the horse is performing. Consider what the flexions told the vet. Consider what the x-rays look like.

If the whole picture indicates that she should have her hock(s) injected, then by all means, do it!

However, if the whole picture does NOT indicate it … then do not.

[/QUOTE]

I completely agree with you beau159! I googled hock injections when the BM told me she would need them and I understood from what I read that you do not inject for maintenance or before you exhaust all other methods of joint repair. It definately sounded like a ‘worst case scenario’ and shouldn’t be suggested so off-handedly. That raised a red flag for me. However, I knew her right hock was not doing well and we were in the middle of show season (hunters) so I let them do what the vet determined was best. I do believe she needed her right hock injected (it WAS dry afterall) and the results were great. She had inflammation in that joint for a while and was increasingly getting worse. Then she started to ‘stick’ off the ground at fences, miss her right change and generally perform poorly. But like you said, does a 1 out of 5 on flexion for her left mean she needed an injection? My gut, and what I know of this mare, tells me ‘no’. There were no indications that the left hock was sore or inflamed so I thought it was extreme for a good joint to get the same treatment. I likely could have started her on a different maintenance program to help both down the road. Too bad I didn’t have the knowledge at the time to ask these questions but I figure after one injection I can still try other things first. I am at a different farm now and managing her on my own.

Since the summer I have noticed a slow change in her soundness. The right hock has gotten more inflamed and she leans on that left rein to the point my fingers are numb. Ive tried her on IM shots (for four months, suggested to me by the same vet after I asked for a less invasive approach) which I can’t say helped with enough certainty to continue, I also had her on previcox for a few weeks but there was no change in the amount of swelling around the joint or her soundness (she likely needs more help than just previcox alone). Now I am trying her on Cosequin.

I do think I will need to inject that right hock again but I will be doing xrays before any more injections!