Talk to me about hock fusion

[lilgreypinto]

I’ve searched the forum for information, but most of the threads I found were at least a few years old, and I wanted to see if any of you had more recent experiences.

I’ve had this horse for almost four years. As best we can tell he’s about 9. He’s never been lame, but can be stiff (which generally gets better after warm-up). Lately he has looked a bit odd in his left hind at the trot during warm-up, so we had the vet out today.

The hind flexions tested positive on both sides. He was much worse after the right hind flexion. The vet then X-rayed both hocks. The right hock is fused in the lower joints. The vet said that the left hock is trying to fuse. There is a narrowing of joint space in the tarsometatarsal joint, as well as rough edges on the joint.

The vet said at this point injections may only last for weeks instead of months. He thought the fusion process had been going on for years and likely started before we bought him. He was going to consult with surgeon in his practice and then send us a more detailed outline of the options. Basically, the vet suggested that we could look at alcohol fusion or surgical fusion so that if successful he could stay in work.

Alternatively, we could look at Pro Stride or Pentosan to make him more comfortable as a pleasure horse.

Here’s some more background:

He was bought as a project with an unknown history before about 6 weeks prior to purchase. He is cow hocked, but the thought was it wasn’t severe enough to be a problem for our intended use. As the price was so low, we didn’t get X-rays done.

He’s always been a little short-strided, but he’s only about 15hh.

We’ve been doing lower level jumpers (a couple of B shows each year at 2’6" - 2’9") as well as a little training level dressage.

I’d really like to get any information and/or advice about what questions I should be asking to make the best decision for the horse.

[BoyleHeightsKid]

I’ve heard good things about ethyl alcohol injections to help the fusion process along.

http://www.thehorse.com/articles/266…tive-aaep-2010

http://eldersequineclinic.com/veteri…ck-fusion.html

[Abbie.S]

My mare had ongoing hock fusions for years. I had to put her down in December of 2016 due to the fusions beginning in the tibiotarsal joint, the most highly mobile of the four hock joints. At that point 3/4 joints were affected in her left leg and 4/4 were affected in her right.

In theory, once the horse is fused there is no more pain. If you horse is still testing quite poorly in the right hock, his radiographs may look like he’s finished but there is likely still some degenerative processes going on at a level that cannot be detected with x-raying.

Surgical fusion is not something I would recommend - it’s incredibly expensive and even after it’s done, all you’ve accomplished is helped the body along for the fusions to occur. They go in and scrape away the cartilage, making the joint bone on bone which will force the body to create boney scar tissue and fuse the joint. You still have a horse that isn’t fully fused after surgery and there still will be a waiting period for the body to catch up. It is incredibly painful for the horse and you’re looking at minimum of a year for recovery.

I did a round of regular joint injections with a steroid. My mare got maybe a week or two of feeling “better”, and that’s about it. I use the term “better” loosely - she moved more evenly but was still not truly sound. My experience would lead me to not recommend this - A) the results tend to be short term, and B) you’re working against the fusion process by injecting a steroid, which reduces inflammation, into a space where there is active inflammatory processes occurring. The inflammatory processes are what are causing the fusion to happen, so you’re essentially disrupting that to make the horse more comfortable in the short term.

I had good luck with Previcox given daily to keep her more comfortable, but it got to a point where ethically I didn’t want to continue riding a horse who needed daily pain management just to stay sort of sound, and she also got so bad mentally that it was not worth trying anymore.

Unfortunately, it tends to be a very individual thing. Some horses fuse and then do fine with lower level activities. Some will have continued attempts to fuse up to the day they die but never get there. How much you want to interfere and try and speed up the process will depend on how deep your wallet is and how much discomfort you’re willing to subject your horse to for any given procedure.

[BoyleHeightsKid]

A friend had the surgical fusion done on her QH gelding… It did not do much for him.

[kiwichick]

Agree with Abby
In my experience once fused there is no more pain, so if its worse on the apparently fused joint, then its not done, and you have all this to go through again with the other side.
Its a common-ish problem, and even injections still seem to make the processs lengthy, plus there is the added ‘guarding’ issue, they may still remember pain even once its not.
It seems to be a very individual thing with recovery, right through from good, to not at all.
If it were my competition horse Id have a go at making him sound with injections, as the long term liklihood of him just coming sound one day could be years off, or never.

Ive seen people spend a significant amount of money on this and it doesnt always work out either.

[lilgreypinto]

Thanks everyone for your responses. I really appreciate it. I’ll be talking to the vet tomorrow about how to proceed.

[luvmyhackney]

I’ve had really good success with changing the shoeing job in the back and to help take some pressure off the heels and playing with the breakover with a rolled toe or squared toe shoe. We would use a bar shoe extended in the back and sometimes a wedge when needed with a floated heel. A good farrier can be the difference between comfortable and not comfortable.

I wouldn’t bother with the surgical fusion, its never worked that well for horses that I know have had it done.

[theresak]

My vet and I had a very brief conversation about fusion and alcohol fusion as I’d heard it somewhere but didn’t know what it was. He prefers to avoid alcohol fusion. Researches/vets have found there is still motion in the joints after alcohol fusion when they’ve dissected cadavers - the bones aren’t truly fused together and crumble apart. So you’re really just injecting something that makes the joint really painful but doesn’t actually solve the problem. His recommendation if you are past the point of regular steroid injections in the lower joints is to force gentle motion (so regular turnout and light work) and pain management as needed. Good, consistent motion of the joints will speed up the fusing process rather than having the horse stand around all day.

I may be missing some details as this was a short conversation a few years ago.

[beau159]

While I don’t have personal experience with surgical options for fusing, I don’t know that I would recommend it because I just haven’t heard that much success with it.

My horse Red has the “upper” of the lower joint fused on his right hock, and the left hock is currently in the fusion process. I inject his hocks when he needs it. When you get into advanced fusion, sometimes the injections don’t relieve the pain 100%. This was the case for his right hock (when it was still actively fusing). So I kept him on Previcox during that time.

My vet told me that OSPHOS can actually help the hocks fuse, so I am going to try that for my gelding this spring. So that might be something you want to consider too.

Regardless, I would keep your horse in work. To my understanding, keeping them in work continues to trigger the body to continue fusing that joint. Yes, hypothetically, when the joints is done fusing, they should not be in pain anymore. Just do what you have to do to manage his pain during the process.

I don’t know that pentosan or adequan is necessarily help for hock fusion. The way I understand it, they are more for lubrication of the motion joints – not the immobiles ones involved in “normal” fusion.

[sportyspicepony]

Reviving this old thread… OP, did you end up doing the fusion? I’d love to learn more about what you ended up doing! @lilgreypinto

[jcc813]

Wow I literally just posted a new topic asking a similar question!

Trying to decide if I should have vet medically intervene to help my horse’s hocks fuse or just keep managing the pain in hopes that the hocks will fuse on their own.

[sportyspicepony]

omg wow ME TOO! hahahaha going to check yours