After showing with smaller barns for “decades”, assume showing in the same Rated divisions you now compete in with the BNT? Surprised you haven’t been very aware of the now widely accepted practice of joint injections in barns if all sizes including private and backyards… There is quite a bit of good research out there you should catch up on line what substances are injected, what other IM or IV joint help the horses get and how often and when they are most appropriate and what constitutes overuse.
It is excessively common for joints to be injected for maintenance despite the lack of clinical evidence supporting joint injections as preventative medicine in humans or horses. There is a substantial risk of infection every time a horse is injected as well. Whether or not the injections actually make a difference in an otherwise sound horse is also questionable. Although the placebo effect does not exist to the horse, it certainly does for the rider/trainer.
The major issue is that people are replacing training/effective riding with injections. There are many reasons why your horse could be swapping, tripping or [insert common excuse here] and, providing the horse is sound, it is probably your fault.
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OP, I think that you can/should educate yourself about joint injections (“intra-articular injections”) AND deal directly with the vet. Of course the pro can have input and will know more than you (at least initially), but there’s no reason you can’t catch up and be part of the decision-making process.
Some things to consider.
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BNTs sometimes have higher standards for soundness than do pros who work with smaller-dollar horses and horse-care budgets. In addition, they often see small differences before those are anything you might notice or anything they’d have a huge, formal lameness exam for. This is especially true if they know the horse well.
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Injecting the lower joints of the hock are not the same proposition as injecting all other joints. I might be wrong to group all other joints typically injected into one category, but the big distinction is between a “low-motion” joint, like that very narrow, brick wall-like set of joints below the main joint of the hock and joints “high motion” joints. I’d put coffin joints into the second category, BTW.
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Know what chemicals you are injecting and what they do, physiologically speaking. Usually, the stuff put into joints are some combination of a steroid (and there are different ones, each with different properties and half-lives), Hyauluronic Acid and an antibiotic included to prevent infection. The big deal is that steroids are known to thin tissues (HA is not… and it’s also quite expensive), and that’s why you want to be conservative with those high-motion joints. For low motion joints? You care less if they fuse so using steroids there and/or injecting the lower hock joints more often is a pretty good veterinary invention. No, seriously: Horses who had hock pain and fusing joints had worse quality of life and shorter careers (some of them) before intra-articular injections became common.
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Besides steroids thinning tissues over time, you really, really (really, really) don’t want to inject too many joints with steroids at once. That’s because putting too much total steroids into the horse’s blood stream is associated with founder. Your vet knows this, your pro may or may not. You might sound like a PITA asking about it if they want to inject lots of joints in one fell swoop. But every once in a while, a horse gets in trouble.
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Same for joint infection. Sterile technique for scrubbing the injection site has more to do with time spent with disinfectant on the skin that with how they scrub. And, again, this is very basic information and protocol for your vet. So I don’t consider “possible joint infection” a reason to not inject joints. But it does happen. The big deal is to have someone watch the horse afterwards, checking in on him 12 and 24 hours afterwards. A joint infection is a big deal for an athlete, so It’s important to watch the horse for any signs of heat or swelling in the joints you injected, or lameness. Big barns, of course, usually have great supervision, so this shouldn’t be something you need to harp on.
Different vets and trainers have their preferred protocols for rest and then return to work. Do what they recommend. By and large, what you have bought in a joint injection is a chemical that breaks the physiological cycle of inflammation and irritation in the joint; HA tends to help the synovium (tissue lining the joint capsule) produce healthier joint fluid.
I like hock injections very much. I haven’t done a lot of the others. If I could choose, I’d pick a horse with good conformation and pay an excellent, excellent farrier to keep his feet balanced in order to stave off injecting anything in his feet. My sense is that you can’t do those too many times, but I could be wrong. And we all need to admit to ourselves that joint injections just slow a progression of osteoarthritis. They don’t stop it or cure it, and slower riding, more turn out and fewer days spent on the road were/are still great things you can to do preserve your horse’s joints.
I hope this helps you feel a little more confident about knowing how to evaluate the treatments your vets and pros are recommending. IMO, they should be able (and willing) to explain their treatment plans to you the paying HO.
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Joint injections can be a godsend for your horse. However, there should always be a specific medical reason to inject. I would talk to the vet about exactly why your horse is being injected. I personally would never, ever inject any joint unless there was a specific medical reason to do it. It can be a wonderful tool, but should always be used with the utmost discretion.
I completely agree with an earlier poster that BNT programs really raise the bar versus smaller barns and can be a bit of an eye-brow raiser if one is not accustomed to them or doesn’t understand them. BNT have programs that are demanding on the equine athlete and BNT’s understand that addressing issues early on, is key to maintaining a horse’s comfort and usefulness. BNT’s often have high-end clients who have paid a good sum of money for their equine partners and they pay a lot for boarding, training and showing. In exchange, these clients expect the BNT to provide a program that keeps the equine athlete happy and comfortable and able to perform at the top of their game
It isn’t uncommon for the stresses of athletic competition to result in some joint inflammation. Joint inflammation can result in a reduction of range of motion, discomfort, reduced performance, etc. Left unmanaged, joint inflammation can also lead to osteoarthritis. Early onset joint inflammation does not always result in unsoundness, but that doesn’t mean it shouldn’t be managed.
Once the science of joint inflammation is comprehended, it is easy to understand joint inflammation will occur in many athletes and when it does, the sooner you manage it, the better the outcome; to include improved performance, reduced likelihood of osteoarthritis, or to slow its progression.
As for how regularly top show horses are injected and in which joints; it will really depend on the horse and the job. The older horse; the horse with a pre-existing condition; the horse with less than ideal conformation; the horse with a more demanding program; etc., are all more likely to see the stresses of their athletic job result in some joint inflammation that should be managed.
For the OP, if the number of injections your horse is receiving is stressing you out, there are many avenues to address your concerns, some listed by earlier posters, although if you are in a BNT program, often the expectation is the trainer has responsibility for, and say over your horse’s program. Many BNT’s are busy people and their programs are finely tuned from years of experience. Some trainers are very approachable when questions about their programs are raised in a respectful fashion. Perhaps it is worth considering finding a quiet time to approach your trainer and explain that you love the program, Dobbin is performing well, you are progressing toward your goals, etc. His/her program has taught you a lot in a short period of time, and one thing you are learning is that you aren’t as informed as you’d like to be about intra-articular injections. Ask the trainer if he/she can explain what guides the decision to inject. Explain you really are interested in informing/educating yourself. After the trainer responds, be prepared to follow up with any questions that you have that are specific to your horse. If you feel comfortable, as the conversation progresses, you might even suggest to your trainer that you would find it useful to have a brief conversation with the vet that performed the injections so you can better inform yourself as to what you can expect Dobbin’s program of care will look like in the future.
Before you have this conversation with your trainer, you may want to do some research on intra-articular joint injections so you have a base of knowledge on which to build. You may wish to Google “how to treat equine synovitis” (joint inflammation) and read some of the articles that pop up, putting special emphasis on those that are written by veterinarians. You’ll note that early treatment is recommended.
Here is a useful article to get you started: http://www.thehorse.com/articles/19945/synovitis
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Not to derail this thread but does anyone do blistering anymore?? I feel like joint injections have become so crazy popular in recent years, but blistering used to have that recognition a few years back.
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I haven’t seen anyone blister anything except stifles in a looong time.
Not to derail - but it was not that long ago that horses got a month or so off mid summer and got turned out. Hot weather and hard ground. Ring any bells to the oldies?? In fields, with grass. Decent sized fields I meet owners that are proud of the turnout their horses get but really??? little outside stalls? I would be a lot happier if my horse went home to real R’n’R rather than be injected to keep up with the BNT’S high standards of performance. As an owner (and I am) I would much rather my horse had time off as a part of his program. So far see a million reasons to medicate or what ever you want to call it but not much about stopping on the horse for a while. Very minor joint infection was upside of 4 thousand $$ and a month rest anyway. Yes - i know - no such thing as a minor infection but it was caught and treated very quickly because the horse was at home with me. .
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When I worked for a BNT the horses were all flexed once or twice a year, and injected as needed. Some never needed anything, and some needed multiple joints injected.
Looking back, the frequency that some of those horses needed injecting probably meant the horse actually needed a new job or at least a lighter schedule.
Now days, some big barns show at an astounding schedule. It would not shock me to see very regular injections being actually warranted, although I am not sure that is the right choice vs less time on the road.
Hmmm. I get it. Modifying the schedule to help the horse stay healthy and happy is not considered at some locations. That should always be the first thing done. But I know what it is all about for some, so let’s do any and everything to keep the horse going. Being able to show year round is certainly not a plus for horses.
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Best thing about blistering was the time off the horse got while legs healed up.
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You can’t lump all A barns tigether or assume if one does or doesn’t, that’s true of all of them. Likewise we can only speak truthfully about horses we own or have specific knowledge of. Barn gossip is not specific knowledge and unless you see an itemized vet bill you can’t assume anything about other people’s horses.
There’s horror stories out there but there’s just as many barns who manage these things appropriately. That’s up to the horse owner to educate themselves, ask questions and select a barn accordingly.
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This OP doesn’t seem legit…?
I would only inject once Adequan isn’t effective.
Remeber that adequan (and legend) work on any joint- if they have it one place, they likely have it more places (ie -neck) so I like the systemic approach, and less risky.
I bring out the big guns when I need them- same for farrier work/shoeing.
Luckily I have had good luck with this approach. I’m neurotic about saddle fit, chiro and massage- all of those every 4 months. I see a positive change after those. And good footing, and riding straight/even.
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I know a successful program in Virginia that gives their horses the month of July off. They do go on trail rides and have a couple of dressage clinics but no jumping and no showing. Their workers also enjoy the break and the chance to be at home.
Mine always got the mid winter off and a month late summer, the ones who went to WEF got March off and a month late summer before Indoors plus my barn always got turnout on the grounds if available (on or off showgrounds) and hacked out whenever possible… By off meaning no lessons or jumping, light hack only plus generous turn out in large paddock with 1 or 2 buddies. Generally no lessons or jumping for at least a week after returning from multi day shows.
Increasing number of show barns are arranging off show ground turnout at nearby farms for horses on the road or leasing nearby barn space and hauling or hacking to the showgrounds for schooling and showing, using a smaller number of show ground stalls for these needing a place to hang out waiting for classes or schooling.
That said, some owners push and can put trainers in a position of conceding to their wishes to show more extensively or having them pull out their horses and go to a trainer who will follow owners wishes and possibly diesnt give a rare hind end about horse welfare… That is a harsh reality of being a real Pro without a second source of income. Many choose to keep the client and continue doing the best they can to insure the welfare of the horse instead of seeing them go to a trainer who does not care and will pound them into the ground.
Easier to sit back and postulate then choose between making a mortgage payment or not being able to sustain your business.
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I’ll go with you on this part of the de-rail.
Look, you HOs who don’t like the joint-injection “solution” to OA and prefer time off and TO? Be prepared to pay a whole lot more in board. How else can pros buy farms close enough to the cities where you live (and earn enough to own show horses?). Land values are high in those areas and there’s just no other way to produce adequate TO for horses other than purchasing more real estate. How else can pros make their living if the horses are staying home from the horse shows?
Just being clear about this since it’s convenient to blame the “full service barn machine” when, really, part of the problem is that those programs and farms are selling only what we are willing to pay for.
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MVP makes some really good points. Horse shows are big business. I only wonder if the package as it exists now will survive…I wince at your comment" How else can pros make their living if the horses are staying home from the horse shows?" That is a real can of worms…
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And as I said earlier, if there is NO INDICATION that the horse is having a problem, then the joints do not need to be injected.
Yes, decreased performance can be a reason to inject. And obviously if the horse is uncomfortable or unsound, that’s a reason to inject.
But if the horse is going along fine – good range of motion — no discomfort – great performance – and totally sound, then I cannot fathom why you would inject just because “it’s what we do every 6 months”.
And if you are talking about injecting steroids to control that inflammation you speak of; long-term use of steroids in joints can damage the joint as well. Not to mention, there is ALWAYS a risk of infection every time you put a needle into a joint.
I’ll say it again: if there is no reason to inject the horse, I believe you shouldn’t. There’s no such thing as injecting joints every 3 months or 6 months or whatever it may, because it’s “normal maintenance”. If the horse does not need it, don’t inject them.
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What I do as a HO is “talk the talk” (as I posted) and I walk the walk. I always choose the best barn I can find in terms of good care for the horse. If I have less money to go to shows, so be it. But I try to think like the trainer, too, and I try to be a good client who spends what she can on lessons, day care at shows (if that’s what the pro wants, even though I can do it myself) and the rest. I try to be easy to coach at shows. I won’t spend the most with a trainer in terms of showing or buying new horses often, but I’ll be reliable and not a PITA client. I am committed to people who help me with my luxury sport make a living. I think it’s unsustainable if you don’t do that.
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I am totally not an expert, just the person who has paid the bills on my kids 2 Ponies & now a horse. We don’t inject unless & until there is a reason to inject. Thankfully we have had good luck. With the small, we never injected anything, even now, she gets no injections. With the large we did the hocks once a year & that is probably what we will end up doing with the current horse too. Again, not an expert, but the injections do seem to be something that once you start, you have to keep up. We are shopping for a horse at the moment & have lost interest in a couple because their injection schedule was excessive to us.
We also give our horses time off. They get to be horses & play in the fields with their buddies. We keep the show schedule to mostly 2 weekends a month, sometimes it works out to be 2 shows in a row & then 2 or even 3 weeks off, but we try for every other weekend as much as we can. There is a barn in our area where they have 0 turnout. I could never board there, our horse would hate it. We are in a big city, but have large rural areas near us, we are lucky. One of the things I hate most about the big shows is the fact that the horses are stuck in their stalls so much, but it is the way it is.
I would say be an informed owner. There is a fine line that I try really hard to not step over with the trainer because she is the professional, but there have defiantly been times when she said she wanted to do something & I questioned it. I love my kids horses, we aren’t horse people & they are members of the family to us, so i would never want them to hurt or be uncomfortable, ever!! But I also don’t think it is responsible on my part to be injecting them because it is just what you do?? That doesn’t work for me, I need to know why we are doing it.
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