My 19-yr old OTTB had SI injections. Didn’t help much. He had quite a bit of wear and tear from the track so when that didn’t help, I just did light hacks with him for a couple of years, which he enjoyed, then retired him to Virginia.
FWIW, my vet did not suggest stall rest after the injections. Just as well a this was a horse that went nuts when stalled and had lived out 24/7 since I got him at age 6. And yes, we trailered home as they prefer to inject at the clinic.
My horse is usually quiet but when I had him on “pen” rest before he did start to get rowdy. So we will see. I’m confident we can get at least 3 or 4 stays of full confinement but we will see if we can safely last the full 7 
I’m remembering now that when my other horse got his SI done, that he must have been on stall rest for at least a few days and then he he kicked the metal pipe in his run and fractured his splint bone. So he was on stall rest for quite some time after that… But he did feel great once he was actually back into work lol. We will never fully know if it was the rest or the injection though! But to my knowledge he never needed it done again…
Your comment got me thinking. My horse was mildly sore behind in his stifles and very mildly sore in his back and SI. I was surprised because a month ago my other vet got no results at all on flexions.
But I did have a lesson the day before (with 10 minutes of warmup with the equiband ) and about an hour after he had a farrier appointment. Then the next day we had to haul to the vet about 17 minutes away.
I’m glad that we inject the SI as I think it needed to be done but looking back I’m glad we didn’t elect to do anything else… Because I don’t know how true of a picture we were really getting given the situation. The vet did tell me that in about a month she would be willing to give Estrone a try if his stifles still seem sticky . Although my hope would be that the SI injection will kind of unlock things and help EVERYTHING feel good. Everybody that sees him keeps commenting on how good his muscle and is looking and how we are obviously on the right track. I just want him to be as close to 100% as I can get him.
Of course my vet was really happy with his feet and said it was like a 180 in his comfort level foot wise. I only have to laugh because my farrier is trying to weed out coming as far south anymore so eventually I’ll be farrier shopping 
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Apparently not! From what he said, the SI injection wouldn’t really do anything for a couple weeks anyway. None of the vets near me do the SI injection in the field since it is ultrasound guided (I assume field ultrasound equipment exists and they just don’t have it?)
I honestly feel better about having it done in the clinic in the special injection room and 30 mins of scrubbing down the horse over a drain vs our “perfectly fine but very dusty” dirt aisle in the barn (no wash rack either).
My horse also had several areas of muscle injected with sarapin simultaneous to his SI injection and starting the next day, his whole haunch was jiggly and loose like it had never been before, so the 1 hour trailer ride didn’t impact the effectiveness of those injections as far as I can tell.
Yes this vet wanted it to be done in a more sterile environment and they also put him in a stock just for extra security (He was sedated but this was just to make it even easier.)
I cant find any vet around here who will do it on the farm. I have to go to bigger hospital vets to have the SI injected.
Yup, my vet practice is outfitted with ultrasound equipment that can be used out in the field. They will do just about any injection including neck injections out in the field. But every practice is different, and also has different thresholds for risk to their equipment/vet staff.
My vet’s comment was so casual, but it was one of those remarks that has lived rent free in my head ever since. I will definitely note that last spring I brought a horse to a 3-day that was 2 hours away and I trucked in each day. He was spent by the end. He is a Thoroughbred and even then, had no gas the last leg of the XC which is very unlike him. I felt sorry I put him through that, lesson learned!
Well mine was not gassed enough from his 2 hours of trailer riding on his clinic day to not complain loudly and dramatically about being stuck inside while his friends were out 
I do feel like he used to be totally depleted after a show weekend an hour away (we stay overnight at shows) but the last couple years I think he’s gotten used to it enough that he doesn’t come home drained. Funny because he was definitely working less hard at training level dressage than third.
I know our regular vets do ultrasounds for suspensories and such in the field. Is it a different machine for the SI? Bigger? Otherwise I’m not entirely sure why they’re only done in the clinic when hock/stifle injections are regularly done in the field.
Same. I’m not sure the rationale. Maybe the depth/strength of ultrasound needed is not one they have for ambulatory visits? I know she has one for tendons, etc. she uses on site.
The one vet that told me he wouldn’t do it has a full hospital setup and he said it just wasn’t something he handles.
Moreso the needle - it is huge and very long.
Yeah my understanding is it’s about the needle. I know the vet that did my horse definitely took her time doing the ultrasound and seemed pretty meticulous about where she was going to be injecting.
My horse feels good and soft when I palpate him. 
mmmm yes, it was a large needle. There were also 4 vet techs fluttering around doing things and my field vet never travels with such an entourage 
Glad he’s jiggly! It really did take 2.5 weeks to feel the difference from the injection under saddle in our case. Ten days in, he was still protesting left lead canter by bucking a bit and it still felt like his left hind was trying to be somewhere else. It took a lot of effort from me to hold him together in canter. A week later and we were uphill, floating through left lead canter, and all his legs felt squarely under him without any effort from me to organize his body.
tldr; give it 3 weeks before deciding if it worked or not
It’s a HUGE needle. I felt much more comfortable doing it a clinic where everything was immaculate and the vets had what they needed.
My vet is fully mobile and does the SI injection in the barn with an ultrasound. My horse is also quiet in the crossties and in general, and loves the vet 
He’s a lightweight with sedation too (we usually start at a half dose of what is normal, otherwise he’s nearly falling over). I’m not sure if he’d refer less quiet horses to a clinic but I know I’m not the only client who has them done in the field.
The one time I had an SI injection done on on a horse, we did the same. I was working on the horse’s rehab with a vet that had a mobile practice (the vet at the equine hospital had failed to diagnose the original injury on two occasions). So I had reservations about it, but also it would have been awkward to ask the hospital vets to do it after the mobile vet recommended it. I don’t remember the details on stall rest afterward. I think it may have been like three days in, and no forced exercise for a week.
For posterity, the SI issues seemed to be secondary to a long layup for a fractured P1 and DDFT injury. Mare was just struggling with under saddle work after being out of work and having no turnout for almost 18 months. The injection seemed to get her over that hump and back to better function, and she did not need another injection in the three years I owned her. Coincidentally, this mare DID have a hunter’s bump, so there likely was some sort of injury to the area that possibly was aggravated by the lack of work for an extended period.
Yesterday he was a bit sore in his left hindquarter, more right behind the SI. But he did obviously roll or lay on that side as he was covered in mud.
So far he’s handing being locked in well, mentally anyways. Hopefully he starts to feel better and better in a few days.
I really don’t remember how it went with my other horse when his SI was injected. I know we did an in barn and like I said he ended up kicking a pole and fracturing a splint bone. So he was on stall rest for a long while. I remember if he was sore or not. But it sounds like it’s normal since the needle goes so deep 
Having had SI injections myself, I can tell you that it’s a lot of extra fluid going into a space that wasn’t designed for that, so it might take a couple of days for it to not be sore. Keeping him quiet will help the meds to end up where they are meant to be and give the inflammation a chance to settle down and heal.
I’ve got lots of experience with SI injections. For the more sensitive horses, 5-7 days with no weight on their back. They will be too muscle sore in the area. But we did paddock turnout starting the next day. No other work for at least 3 days. In hand work could start thereafter. After 5-7 days, light ridden work. Back to normal work at 2 weeks. These are the more chronic SI problem cases.
For my guy with the acute injury that needed several rounds of Pro Stride, the initial injections were done by a vet that had a lot of experience with racehorses and eventers. So, he worked more in a way that minimized time off. He also didn’t expand the Pro Stride with anything, so while the needles were still huge, nothing was being diffused into the muscle. With steroids, you might have sarapin or something like that and a bunch of saline. I also know one vet who will dilute the Pro Stride with a bunch of the PPP byproduct and inject the joint then put a good bit into the muscle on the way out.
Anyway, with the smaller ProStride injections, one vet will say same as any other joint, about 3 days off, then light work, then back to normal work after a week. Eventing vet said horse could tack walk or light hack right away, but I did give a couple of days off with normal turnout. I will say he was much less sore and could follow this protocol pretty easily compared to the approach of also injecting the muscle.
With the KS and everything else, OP, I think 7 days in the stall is excessive if you have access to fairly quiet turnout. But he might be too grumpy/sore for riding for at least that long. And with Depo Medrol, it’s going to take a couple of weeks for full effect anyway, so take your time getting back to ridden work. Some hand walks, turnout, and light in hand work should be fine after a couple days.
Usually with injections they want stall rest for 24 hours so that the hole made by the needle into the joint heals and to limit infection. It’s also ideal if they don’t tear around in the paddocks following the stall rest. But I’ve only ever heard of 7 days stall rest w arthramid.
SI injections also vary whether they are really just going around the area or a more invasive injection into joint space (hope I got that right). I’ve only had experience w the former. I did have one horse get quite sore from it but he was fine w some rest and banamine. I think I gave him SMZs as a precaution as I was worried about infection.
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