How long for hock injections to take effect? Or what else could this be?

[FineAlready]

I know I’ve seen other threads on this, but can’t find them. I’ve had my horse’s hocks injected before, and he usually shows almost complete improvement within a week.

That said, this time he was actually 2/5 lame on his right hind at the time we decided to inject. Suspensories etc. all palpated normally, although it would be hard to tell about a high hind suspensory on palpation. Hoof testers elicited no pain. There was a LOT of watery fluid in the right hock when the needle went in for the injections.

I brought him back into very light walk and a little trot work on the third day after injections. He was fresh and felt quite sound. The next day, he felt okay, less fresh and not quite as sound as he had felt the prior day. Now we are at day 7, and he looks and feels just as bad as he did before injections when he starts out, but he works out of the lameness within about 7 minutes after picking up the trot (he had been largely working out of the lameness prior to injections also). It’s much worse with the lame leg (RH) to the outside of a circle, which makes me want to puke because it makes me think suspensory.

Since he truly does look really good after about 7 minutes of warming up, I’m somewhat wondering if the injections still haven’t done their job yet. Or I’m wondering if he is stifle sore from me letting the hocks go too long. Finally, as mentioned above, I have a horrible sick worry that this could actually be a hind suspensory injury.

For what it is worth, he’s 10 years old and does have visible changes in his hocks on x-ray, although I did not get a new set of x-rays this time. He has a small spur on the left hock, and narrowing joint space on the right hock.

Anyone want to chime in? Those of you with horses that have had hind suspensory injuries - did your horses work out of the lameness so that they looked completely sound (which is pretty much what he does each day)? Same question about stifle problems - could he be working out of it into soundness if he’s stifle sore?

Ugh. I just don’t need this additional worry right now. Too much other stuff going on in my life. He will see a vet after Christmas if this has not resolved by then.

[Bluey]

I too would think there may be more going on there, but give the injecting a bit longer to work first, especially since it is not an emergency and we have the holidays to go thru.

It sounds like you were a bit further into the lame cycle when you injected this time, so as you say, that too could be part of this, he needs more time to see how much that may help.

[joiedevie99]

While I suspect you have gotten all the benefit that you will out of the hock injections, I too would give him another week of rest/tack walking since he was quite a bit lamer when you injected this time. That said, I’d probably be penciling in a date with the vet for next week, and happily canceling if something changes.

[FineAlready]

Part of me actually thinks it could be an abscess. The mud has just been awful, and he has had abscesses in the right hind hoof on several prior occasions. Sometimes they didn’t respond to hoof testers, either, so I do think it is possible. I did soak and wrap the hoof in animalintex for two days about a week ago (before the hock injections) and got no drainage…I’m wondering if I should have kept at it.

I think maybe I’ll resume that again tonight. I looked back at some video of him from the last bad RH abscess he had, and the lameness is quite similar, including random lame/short steps at the walk when first starting out. He also typically does work out of hoof abscess lameness to a large degree.

Yes, I’ll console myself with the possibility that this is an abscess and not something more nefarious.

[Victorious]

FA-I’m no vet. But here’s what I do know. I hop on the treadmill and go for about 5 minutes before I actually feel loose and even. I’m not unsound at first but rather tight. If your guy warms up to even, I’d say keep going. The hind suspensory I dealt with in the past would not come out lame and warm up sound, or vice versa. He was lame all the time( before diagnosis and rehab). I don’t think that sounds like your guy at all.
Years ago, in the 80’s, my trainer always told me to ignore the first 5 minutes of a cold weather ride. She said it was arthritis and it took a while to warm up. That mare never had the benefit of injections or supplement and she stayed super sound(with 5 minutes of warmup) well into her late teens! Hope this helps a little!Good luck!

[Manni01]

not an expert on injections, but I would be scared of infections… Each injection is also a risk, and if there is swelling I would closely monitor it…

[FineAlready]

Thanks guys…I’m leaning more and more toward stifle soreness from waiting too long on hocks. It helps to know that your hind suspensory horse didn’t warm out of his lameness, Victorious. This horse had a front suspensory injury about 6 years ago and he did warm out of it to a degree…until he did not.

I soaked and wrapped the hoof tonight just for the heck of it. But I think his problem is higher up. He kind of objects to having his leg on that side held up for too long right now, and sort of sticks it out to the side. It’s tough with him because he’s also a suspected EPSM horse…so…it could also be related to that, but doesn’t seem like it.

Ah, horses, you make me insane.

[FineAlready]

Oh, and it’s not a joint infection from the injections. I’m familiar with those. He’s got no heat or swelling anywhere and he’s not the kind of lame you see with a septic joint.

[Gumby80]

The horse I knew with high hind suspensory issues initially started out stiff, then mostly worked out of it. We injected the hocks, which led to a small improvement for a week or so, which apparently can happen if there’s high suspensory trouble.

Eventually she started out not just stiff, but slightly lame. At that point, we ultrasounded rear suspensories, and found the damage. There was some calcification, which suggested it might have been a chronic problem for a while.

My impression is that hock injections take only a short amount of time to work. If after a week he’s not feeling much better, it sounds like his problem is elsewhere.

[workin_onit]

We find that it takes 30 days for the injections to be fully effective. We also inject adequan IM every two weeks. I had my horse done on December 4 and while it initially helped, I’m now really seeing a difference. I would have an ultrasound done just to rule out the suspensory issue.

[FineAlready]

Yep, he will get an ultrasound if this doesn’t resolve by Christmas. Interestingly, I had both hind suspensories ultrasounded last year because of a mystery lameness and they were both clean. The recommendation at that time was to inject his hocks, which I did, and it resolved the problem.

Gah. Hate this. Also, I think high hind suspensory injuries don’t always show up except for on MRI…?

It would be super nice if this would just resolve itself. That would be a good Christmas present!

[betsyk]

When mine had a high hind suspensory, we thought it was a stifle but it didnt get better, with work or in general, so we had it ultra sounded. He got the winter off and we had him back in pretty close to full work in June, after the initial injury the week before Christmas.

My experience with hock injections, and the vet’s advice, is to give them two weeks to ramp the workload back up to normal. At the end of two weeks you should see whatever improvement you’re going to see, according to our vet and confirmed by my experience. If he’s warming back up to normal in 7 minutes, that’s pretty good.

[SolarFlare]

Mine is similar in that he’s got small spurs in both hocks. He was last injected in the summer, but with the colder weather he is definitely stiffer. He also works out of it.

I have had the vet out just to be sure (also keeping in mind this is after rehabbing all year, and he’s been blocked toe to stifle and had two vets go over him with a fine-tooth comb, bone scan, x-rays, etc), and in this case it is just hock arthritis.

What I’ve started doing with very positive results is “sweating” the hock before riding. When I first get to the barn, I spray alcohol on the hock (his is lower joint, and the left is the one that is stiff). I rub it in, then wrap with a layer of Saran wrap, then a polo over top. I leave that on while I get my tack ready, brush him, tack up, etc and remove just before getting on. It has made a world of difference with him just getting that hock warm before we start. It takes about 15 minutes off of our warmup time, and he is no longer taking the funky stepped-in-a-hole step on occasion during warm up.

I’ve also found that warming up, after about 10 minutes of walk (timed), I trot and only think about going forward and large. No circles, etc right away. I have a nice, forward trot on loose contact for a couple laps each direction. If he’s feeling a little more stiff that day, we’ll then canter a lap or two each direction early on. He always feels much looser after a canter. Then we’ll begin more work, with contact and figures.

It’s worth a try at least if you are going to continue riding him - at least you can see if it helps or not.

Oops - I just realized I have no idea where you live and whether or not you’re cold-weather-affected! Try it though if you are somewhere chilly.

[TWH_Girl]

Well that’s just a bummer, especially this time of year. I’d have to agree it’s not hocks though or he would’ve improved by now.

As it is, I’ll be blistering horse’s stifles for his Christmas present. Maybe we should plan a day to visit Dr Langer and commiserate while we’re there

Sure hope he improves! I know how stressful this stuff is.

Try not to worry to much, and have a Merry Christmas!

[FineAlready]

Thanks, TWH Girl! Yes, party at the vet clinic.

[IPEsq]

I’d wait 2 weeks. I’ve had to do 2 rounds of hock injections on a horse once who I had sent off to be sold and he came back to me 3/5 on a hock. This horse had shown in 3 rings from 3’6-4’ for the year prior and been the soundest horse I ever had. Anyway, the joint fluid was pretty bad when we went in for the first injections. Got to maybe 1.5-2/5 after a week or so. Did Adequan and Legend and then injected again after a couple weeks. He was fine after that and went on to show for several months with me and finally got sold.

I don’t know if that is a common thing, but we had no reason to suspect other structures. IME, hocks will be one where they can warm out of it. Stifles not so much. I don’t have experience with hind suspensory injuries except for assisting with a rehab that went well, so can’t comment on that.

[mroades]

There is also a technique for scanning the high hind suspensories that helps too. Often you wont see them until you do this…have the hoof almost parallel to the ground with the ankle flexed. The way it was explained to me it that up high you wont see any disruptions in the fibers while they are standing on it, but you can see them if they are not putting pressure on it. Its worth doing if you go so far as to do a scan.

[FineAlready]

So, I got on him this morning and walked for 15 minutes. Then trotted a couple laps each way. He was reluctant to pick up the trot and really felt braced/backed off. I hopped off and stuck him on the lunge to look at him. He actually looked pretty sound, but DID NOT want to trot. He would resist, then rear, then trot (seemingly soundly), then slam on the brakes, then EXPLODE into a bucking, running, frantic mess if I encouraged him to keep trotting.

So.

I have no idea what is up, but definitely something. He’s definitely not a quiet horse generally, and he does sometimes do the “I can’t go forward, unless I rear and bounce around first” thing on the lunge when he’s fresh. But this just seemed like something hurts. And I’m inclined to believe that’s the case, since he didn’t look right at all yesterday starting out on the lunge.

Ugh.

[retrofit]

Ultrasound won’t always show a suspensory issue either if it’s high enough. But your vet can block the hind suspensory. It’s a quick & easy test.

[IPEsq]

I may have missed it, but does his back palpate sore?