Hock injections: in-clinic vs. in-barn

[lmlacross]

My horse is telling me that hock injections are in order again (she had her first last summer, and is looking a little tight in her lower back, confirmed by chiro/vet). Her first were done at the large animal vet school at a major midwestern university. We’re too far away for that to be practical this go-around, so my options are: trailer to local clinic (which is highly regarded) or have them done in-barn by a reputable field service vet.

With the understanding that lower hock injections are considerably more expensive in clinic than at home (even before considering paying for the trailer trip), is there really any reason why I wouldn’t want a qualified, experienced vet to do these injections in the field (assuming proper prepping of the area, etc.)? How many of you do? I would imagine that there are parts of the country in which trailering to a major research hospital or clinic isn’t a possibility, so doing them in the field is a necessity.

Bonus points for those who know the Chicago area and its vets. Feel free to PM with recommendations.

[Rescuer]

Everyone I know gets hock injections done in their own barns. I’ve even seen ultrasound guided SI joint injections done in barn. I personally don’t see the need to go to a major clinic. They are fairly routine and the most important aspect to preventing infection is how well the vet scrubs the injection site and that their instruments are kept clean.

[joiedevie99]

All you need is a qualified vet that does lots of them and a safe area. You don’t want to do them outside where wind could blow dirt onto the sterilized injection site.

We don’t ship to the clinic for any joint injections anymore - neck, back, SI, etc. are all done on-site - unless they’re being done in connection with some diagnostics that we have to ship for - like MRI or bone can.

[findeight]

Long as the vet is experienced and has the proper equipment in the truck? Most procedures that can be done standing are done at the barn…assuming a clean, hard surface, well lit treatment area is available. Wash rack, groom/farrier area are fine and what usually gets used.

[Senszuri]

Just throwing a recommendation out there for Merritt and Associates; they are in the Chicago area. I have been very happy with them - I chose to trailer in simply because it was cheaper to haul in than pay the $75 call fee based on my location. I have my own truck and trailer, so the cost of fuel was much lower than $75.

[222orchids]

We do them in barn but since you mentioned summer, we never do them in hot, humid weather (which is 8 months of the year, here). Cool, dry conditions lessen the risk of infection.

[EqJumper]

My horse’s hocks are always done at my barn and it was never even considered to do them elsewhere. Our vet is amazing and I trust him completely, which helps.

[jvanrens]

I’ve never thought of hauling a horse to a clinic for hocks or any other joint injection. We have racehorses and all of them are done in barn. most of the vets we use don’t even have a clinic we could haul in to and have never had an issue.

[SonnysMom]

Only hock infection I had was the horse taken to the clinic. I think it was the vet- not enough prep and his follow-up protocol was totally different that vets I used later. Make sure the vet is good with hock injections and does a lot of them.

[sportyspicepony]

Sorry to revive this old topic, but I have a variation of this exact same question right now.

My vet recommended that I inject my horse’s hocks and SI. We did x ray the hocks and found significant arthritic changes, the SI is just super sore so I think she reco’ed it just to help break the pain cycle bc it might be just caused by her hock issues.

However she said that she personally doesn’t do SI injections in the barn, and only does them in the clinic ‘in stocks’ (not sure what this means tbh). She said another vet from the same clinic WILL do them in the barn so she was like, if you don’t want to or can’t haul in to the clinic, you could easily just book the appointment with him and he’ll do the injection here at the barn for you.

Should I be concerned about injecting the SI in the barn? I don’t think it will be too hard to find a ride to the clinic if needed, but I’m just wondering why one vet is willing to do them in barn and one isn’t, like is it riskier to do it in-barn? I can also just ask her these questions but I got the feeling she was trying to be political about it when she was giving me that option so idk.

I have never had a horse get injections before but i HAVE read ten million horror stories about them on COTH in the past 24 hours so any insight is appreciated

[Renn_aissance]

@sportyspicepony

Should I be concerned about injecting the SI in the barn? I don’t think it will be too hard to find a ride to the clinic if needed, but I’m just wondering why one vet is willing to do them in barn and one isn’t, like is it riskier to do it in-barn?

In stocks means the horse will be standing in a narrow straight stall. The horse won’t be able to move sideways, so it’s less likely that it could fight sedation and move enough to affect the placement of the needle.

Our farm vet does them in the barn aisle for most horses but if you have one who’s inclined to be fractious or an expensive date, it might be safer to do this in a clinic setting to have better odds at keeping them still.

[vxf111]

I’ve done both and there was no appreciable difference in the procedure in clinic vs. in barn. There are many things I prefer to do in the clinic but hocks aren’t one.

[TheHunterKid90]

Injecting or performing procedures in the stocks is to male it safer for humans and horses.
Stocks are what mares are put in to be ultrasound, flushing embryos and breeding. They provide a safe environment where risk of injury is significant decreased. There’s a door similar to a Dutch door at the front which keeps the horse from moving forward and the handler is protected by the door and there’s also a solid door at the rear that’s about 8” taller than the hocks.
The rule of thumb your vet has of only injecting SI in stocks is probably like how some vets don’t x ray without tranq. Their policy designed to keep everyone and the horse safe.
If you trust the other vet in the practice and your vet recommends him, go for it if you have a setup that allows it to be done as cleanly as possible.

[sportyspicepony]

Got it, thank you both!!!

@Renn_aissance

In stocks means the horse will be standing in a narrow straight stall. The horse won’t be able to move sideways, so it’s less likely that it could fight sedation and move enough to affect the placement of the needle.

Our farm vet does them in the barn aisle for most horses but if you have one who’s inclined to be fractious or an expensive date, it might be safer to do this in a clinic setting to have better odds at keeping them still.

@TheHunterKid90

The rule of thumb your vet has of only injecting SI in stocks is probably like how some vets don’t x ray without tranq. Their policy designed to keep everyone and the horse safe.
If you trust the other vet in the practice and your vet recommends him, go for it if you have a setup that allows it to be done as cleanly as possible.

Sooo here’s one more question… someone else told me that they use an ultrasound machine to inject the SI, but is that always what everyone does or just like an extra precaution? I got the estimate from the office this afternoon and the SI injection line item was only $250 which seems cheap to me… so I just was wondering if there was ultrasound guidance included in that or if that would cost extra and it’s not something they typically do.

I guess this kinda did warrant its own thread

[TheHunterKid90]

Some vets use ultrasound to inject every joint and they still miss the joint……my vet never uses one and I’ve never not noticed improvement in my horses.
I would assume perhaps another 35-50 dollars if your vet is hawing ultrasound for guidance.

[Renn_aissance]

Ask your vet to see what was included in that. I’ve never had cause to do this injection, but I definitely wouldn’t want to have it done without US guidance. Deep into the body and the needle goes in proximity to the spine.

[sportyspicepony]

Thanks y’all, v helpful info!! I’m compiling my list of follow up questions for the vet

[No1]

SI injections are not actually into a joint. They are into the soft tissue under the wing of the ilium. Some vets prefer to do SI injections in stocks due to the proximity of the sciatic nerve and the possibility of hitting it when doing SI injections. That actually isn’t very common. Most vets do SIs ultrasound guided to make sure they are in the correct vicinity.

If the vet who does SIs in the field does it with the ultrasound, I would personally chose that vet. IME, the vets who are nervous enough about it to need stocks are the vets who haven’t done very many. Personally, I would prefer the vet who has the most experience.

[sportyspicepony]

Oooh good point. Yah I am gonna try to ask around my barn to see who has the tea on which vet is the most experienced with injections, hopefully I can get some intel on that.

[SolarFlare]

@Renn_aissance

I’ve never had cause to do this injection, but I definitely wouldn’t want to have it done without US guidance. Deep into the body and the needle goes in proximity to the spine.

Mine’s been done, both in clinic and in the barn. Both times were ultrasound-guided, and I wouldn’t want the vet to attempt without the US. The first time they actually had a hard time finding the right spot - if they hadn’t been using US, there’s no way they would have ended up injecting the right location. Then my vet was more familiar with where his target was the next time and we did it in the barn (with US).