Stifle Injections?

[MysticOakRanch]

My mare is struggling with some of the hard work now - very collected canter work, and flying changes. She’s sound, healthy, etc. Has been in solid work for several years with no lameness or illness issues, but we seem to have hit a roadblock in the work. Lower level work was super easy, 2nd level was relatively easy. She has minor hock arthritis, and annual hock injections and Pentosan ever 2 or 3 weeks.

Trainer suggested we inject her stifles - her vet does this regularly. My vet says she doesn’t recommend stifle injections without doing diagnostics because the stifle, unlike the hock, is a much more mobile joint. So, we are going to do some diagnostics this coming week, including updated xrays (mare hasn’t had xrays for 6 years now, since she was a 4 year old starting work). But I thought I’d do a bit of research too - find out who has done stifle injections, and what the results were… And who has decided against these injections. Thanks in advance!

[Simkie]

I’ve used IRAP in the stifle when a MCL (I think that’s what it was) strain didn’t resolve with rest. It worked beautifully and the horse didn’t have any further issues.

Highly recommend ultrasounding the joint in your workup. There’s so much soft tissue in there, and treating that can be a little different than treating bony stuff.

Good luck!!!

[x-halt-salute]

@MysticOakRanch

My mare is struggling with some of the hard work now - very collected canter work, and flying changes. She’s sound, healthy, etc. Has been in solid work for several years with no lameness or illness issues, but we seem to have hit a roadblock in the work. Lower level work was super easy, 2nd level was relatively easy. She has minor hock arthritis, and annual hock injections and Pentosan ever 2 or 3 weeks.

Trainer suggested we inject her stifles - her vet does this regularly. My vet says she doesn’t recommend stifle injections without doing diagnostics because the stifle, unlike the hock, is a much more mobile joint. So, we are going to do some diagnostics this coming week, including updated xrays (mare hasn’t had xrays for 6 years now, since she was a 4 year old starting work). But I thought I’d do a bit of research too - find out who has done stifle injections, and what the results were… And who has decided against these injections. Thanks in advance!

Last year my horse had much the same symptoms as you describe, starting to feel a little uncomfortable in canter half pass and flying changes, and just not having the same willingness to really step under with the hind leg. We did a lot of diagnostics and found minor arthritic changes in the stifles, one more obvious than the other. Hocks looked so normal on x-ray (or rather abnormally good, given that she’s a teenager) that we were really confident about the stifle being the source of her issues. Steroid and HA injections in the stifle joints, plus a regimen for strengthening the stifle ligaments and hind end generally got her moving better than she ever had before.

The deck has been stacked against us in other ways since then, but as she has gotten back into more serious work again after an unrelated, unforeseen issue we reinjected just the one stifle that was the worse of the two, and she’s starting to feel like a million bucks again.

[SonnysMom]

Have you considered weekly Estrone injections instead? My horse’s stifle xrays came up fine. He flexed fine but wasn’t really sound either. He had effusion on both stifles. We started him on estrone injections. It took maybe 3 weeks to see a difference but I think it helps.

[MidlifeCrisis]

My horse had a stifle injection done recently. I thought his problem was in the hocks and he was due for hock injections so we went to UC Davis to see our regular lameness vet. Lo and behold, he flexed positive to the rear pastern and the stifle on the same side. Ultrasound showed an inflammed sesamoid ligament and inflammation in the stifle joint along with a small meniscal tear that may have been there a long time. After 4 weeks of tack walk to let things subside, his stifle was injected with ProStride. UC Davis appears to be moving away from steroid injections and into biologicals if the owner is willing to pay. I paid $500 for the ProStride and $250 for the ultrasound guided injection. And all the other miscellaneous drug fees. Then many weeks of 5 minutes of trot and a recheck. He felt great until STUPIDLY, I WAS AN IDIOT and turned him out 2 days before his recheck and he stood in the middle of the turnout and bucked non stop. The recheck ultrasound showed 3 new small tears in the middle patellar ligament so back to rehab. Then the fire and again we’re back to square one. But that won’t be your scenario.
Get diagnostics. Don’t start injecting on a hunch. And yes, ProStride made a big big improvement until I f’d it all up.
P.S. I’ve heard but don’t know if true that there are a limited number of injections that a stifle can handle before the cartilage deteriorates. Maybe because it’s a mobile joint unlike the hock? Also, I remember reading somewhere but can’t remember where that there is a high incidence of missing the stifle joint during the injection.

[MysticOakRanch]

@MidlifeCrisis

Get diagnostics. Don’t start injecting on a hunch. And yes, ProStride made a big big improvement until I f’d it all up.
P.S. I’ve heard but don’t know if true that there are a limited number of injections that a stifle can handle before the cartilage deteriorates. Maybe because it’s a mobile joint unlike the hock? Also, I remember reading somewhere but can’t remember where that there is a high incidence of missing the stifle joint during the injection.

That is what I was wondering! One vet says “inject and see if it improves”, the other vet (who honestly, I have more faith in) says NO, stifles are not like hocks, joint is too mobile, diagnostics first. I have an appointment for Friday for diagnostics… But wanted to see what people’s experiences have been.

BTW, there is no effusion - if there was, I would have dived straight into diagnostics! No lameness either. She’s just struggling with certain aspects of the work, and I"m trying to figure out if there is something we can do to help her along, or should I just give up and accept she’s maxed out where she is…

Thanks, and I will ask about Prostride and Estrone.

[MidlifeCrisis]

Also to add, after the small tears in the patellar ligament, he was subtlely lame. I couldn’t see it and I’ve gotten pretty good after all my trips to Davis:lol: But I could feel the reluctance to rock back and weight the hind end.

[Manni01]

@MysticOakRanch

That is what I was wondering! One vet says “inject and see if it improves”, the other vet (who honestly, I have more faith in) says NO, stifles are not like hocks, joint is too mobile, diagnostics first. I have an appointment for Friday for diagnostics… But wanted to see what people’s experiences have been.

BTW, there is no effusion - if there was, I would have dived straight into diagnostics! No lameness either. She’s just struggling with certain aspects of the work, and I"m trying to figure out if there is something we can do to help her along, or should I just give up and accept she’s maxed out where she is…

Thanks, and I will ask about Prostride and Estrone.

It sounds that you are at a challenging moment of your Dressage journey with your horse…

Just a tiny little recommendation… (you can ignore it if you dont like it…)

Maybe its a training issue and not a health issue. I am sure you and your trainer are extremly experienced and know exactly what you are doing but I am at a similar point of training right now and I know exactly what I needed to change and how much I needed to reintroduce some basic things in order to get to this point.

As you know I dont believe in injections in order to improve performance if diagnostics doesnt find anything wrong… Its cheaper to simply adjust the training and its much healthier for the horse…

[CanteringCarrot]

I would not inject without diagnostics and a solid reason. I know there are some people in the “but it doesn’t hurt to try and see what happens” camp, but I need a sound reason.

I have a 6 year old they has weaker stifles that I’ve been working on. We could inject, but it’s really a last resort to me. Keeping him fit and shod behind has helped.

Some horses do reach their limit, but some also require more fitness than others. The same 6 year old mentioned above requires a lot of conditioning to do his job. It just takes more to keep him strong and in shape. It could be his “type” but I really have to work him and stay on top of it. I don’t know if it’s a baroque horse thing or what.

I know you said she has been in solid work, but is she truly strong enough?

Conformation can also be a factor and just way of going. Some horses just naturally rock back and Excell at collected work.

I absolutely agree with looking into health and physical issues first, but if that’s ruled out, take a closer look at your conditioning and how strong the horse really is. For some it takes more than we may think.