So sorry to hear about your horse Peggy 
Sounds like you did all you could and made the right decision ultimately.
Osphos is one of those things that really helps some horses, and seems to do nothing with others.
As the directions say, we do 3 5ml injections rather than putting 15 ml in one place.
As with Tildren (although less so) it carries a risk of colic, so have some banamine on hand just in case your horse gets crampy.
For the same reason, we always give it in the morning so someone will be around the horse for a few hours afterwards.
Mixing NSAIDs and Tildren/Osphos within a 48hr period can cause kidney failure. Most of the time, colic symptoms resolve with hand walking, so youād want to try that before giving banamine. In the trials, some horses with severe colic symptoms were given banamine and were ok.
My horse originally started getting Osphos for navicular (and tildren before that, but that was a regional limb perfusion so would not have done anything for her neck) and I feel that it has helped her be looser through her neck/back/hind end. She does have some probable neck arthritis going on (have not done rads; just based on how she moves/palpates). She is coming 19. Iāve seen it used in a lot of horses through the vet clinic I work at, and it is often used for neck/SI pain rather than going straight to steroid injections. We have not had any issues with horses getting colicky but we do recommend you watch them for an hour after just to be on the safe side. Check the expiration date on your bottle when you receive it, but it does not need to be refrigerated, just keep it from extreme temps like you would any medication.
Thanks all! I had talked to my vet (whoās also my friend and a fellow boarder which is nice!) 
Weāre going to give the osphos when both of us plan to be at the barn for a while so we can keep an eye on her. And weāre taking her off the Equioxx now so that when the osphos order comes in, sheās good to go with no NSAIDs in her system. We have also already drawn blood to check her kidney levels which all came back good. We wanted to make sure she didnāt have any pre-existing kidney conditions.
Did neck injections on 22 + yr old horse who was also neurological. They helped quite a bit. Was able to ride lightly for close to 2 yrs. before he was noticeably NQR. Did not do a second round because of other issues, but have been told they donāt work as well, and sometimes not at all.
I would give your horse some time to assess the results of the neck before next steps.
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Thanks 2tempe. Thankfully my mare is not showing any neuro signs at this point. She passes any of the neuro ātestsā they do (leg crossing, tail pulling, etc) But itās something I will definitely be watching for.
We did Osphos on my big guy 2 weeks ago. Just got him back from the hospital from acute renal failure. Full disclosure - the vet gave him banamine after for minor cramping. Presumably it was the combination of Osphos + banamine that did it. The vet who gave the shots hadnāt used Osphos or Tildren prior to my guy, and did quite a bit of research beforehand. Seems like maybe she missed the āword on the streetā suggestions to not mix NSAIDS plus Osphos because there are no specific warnings against the combination in the literature or package insert (though there are lots of warnings published about Tildren + NSAIDS). The company said that yes, this is something theyāve seen and heard of, but they have zero data on it because they havenāt collected data from those who have had it happen.
So I guess I can be the cautionary tale that the āword on the streetā about never combining NSAIDS + Osphos is absolutely the truth.
My vet said heās put one horse into renal failure with Osphos alone (without any NSAIDs), so it can happen even without the combo, but I think the combo does increase the risks of that with Osphos as well as Tildren.
Itās definitely a concernā¦my vet has done osphos multiple times without issue, but she is definitely going to be cautious and stick around to monitor her just in case of course. And we already checked her kidneys to make sure she doesnāt have a pre-existing condition. My vet said that the only horses she has heard about going into renal failure, they discovered afterwards that they all had kidney issues the owner wasnāt aware of. Not saying they HAVE to have a condition for it to happen, but itās certainly a huge precursor.
I tried Osphos on my horse with neck arthritis and kissing spines. He had already had his neck injected, which helped briefly. Unfortunately I did not see an improvement with the Osphos. I did the three separate injections (rather than one huge dose) and he was off NSAIDs for over a week before the injections. He had no reaction to the Osphos.
My vet really likes it though and it was not expensive compared to the other treatments so it is definitely worth a try. Hope it helps your horse!
OP -I was not so clear on my post - if youāve just done the neck injections, Iād wait a few weeks to see how much they help overall comfort level. If you do Osphos before you know that, you canāt so easily tell what works and what doesnāt. Good luck.
I believe vets are seeing more success with Osphos as opposed to Tildren. So I would definitely lean towards Osphos if you were going to go that route. Shockwave is also a super helpful therapy and could be used in combination with osphos if you wanted to get really aggressive about your treatment.
I have my mare who has some arthritis in her SI on pentosan and I see a noticeable difference when I give that to her as well. Adequan may be another great option for you as well.
If you care to read a novel Iāve got an older thread about my horseās issues. 
My horse also has arthritic changes in the neck, C4/5-6/7, discovered via bone scan Feb. 2015. Heās also had chronic lameness issues on the RF due to poor foot conformation, a sore neck, and sore hocks.
What has finally worked for him was a combination of treatments. First neck injections were Feb 2015, coffin joints were around the same time. Hocks flexed positive May 2016, so we injected hocks with steroids and coffins with IRAP. We did one round of Osphos last year around the same time because it was covered by insurance. He felt like a new horse. The last time his neck was injected was October 2015 and itās just now to the point where we are talking about doing it again. He has been getting routine chiropractic care, which has helped tremendously. We were able to get by without more injections from May 2016 until last week. There was no fluid that came out of his hocks and what little fluid came out of the coffins was good color and not overly watery, so we are ahead of the soreness (our goal).
So, I would try it, but I think it works best when used in conjunction with other treatments.
UPDATE: We did the osphos yesterday and she didnāt have any reactions to the injections whatsoever which was a relief Now we wait I guess, since I know the osphos will take a while to show results with. For those of you who noticed a difference in your horse with the osphos, how long before you began to see its effects? I would imagine itās got to take a little while considering the action of the drug, basically helping to allow the body to heal itself (well to a degree of course, I know a lot of the damage is already done and not reversible of course.)
My vet uses it on her own (very arthritic) horse and says that he is at his best 4 weeks post injection. My mare was acting brighter and happier at 4 weeks, but it took the full 6 weeks for her to really be moving significantly better. She continues to look better as the residual back soreness from compensating for sore hocks dissipates with gentle, correct work.
I spent the first week post injection (so no Previcox) hand walking and body working my horse to give her body some time to reset, which I think was helpful.
I think it took 3-4 weeks before I saw an improvement with my guy. He had his hocks injected last spring and he was starting to feel a bit uncomfortable again in the fall (itās very obvious with himāthe last couple of strides before a jump feel really funky as he doesnāt want to rock back). I didnāt want to inject again so we tried the OsPhos.
Iāve been very happy with the results. He still feels really good. I am hoping we can get by with the OsPhos and not have to inject any more.
Good luck OP!
Well Iāll update you all with her progress! So far, weāve done shock wave on her back, hock injections, neck injections, Equioxx (until recently so we could do the OsPhos) and now the OsPhos. Going to be bringing her back into work sloooowly focusing on forward and long and low for a while before I start asking her for any sort of collected work. And by collected, I mean the type of collection required for like Training level dressage (so not much) 
I would be pleased as punch just to get her back as my BN Eventer or Training level dressage pony honestly!
My mare was diagnosed with cervical arthritis in C6. I honestly donāt know if the arthritis is really causing her any issues or not. It seemed like the sports vet was grasping at straws honestly. He did a whole workup on her and that was the only thing he found, though it didnāt look very severe from the xrays. They did a joint injection into the cervical spine with ultrasound to guide the needle. I saw no difference from that.
About a year later I did an Osphos injection as several people I know have had good luck with it. My mare did do better after the injection within 4-5 weeks. My vet does the 3 injections (two on each side of the neck and one on the butt) instead of one injection site.
The only things Iāve seen make a difference for my mare so far have been Osphos, lots of bending exercises under saddle and a specific massage therapist.
TequilaMockingbird,
Are you good with reading radiographs, or did your sports vet tell you that it didnāt look very severe? Just curious because my vet made it sound like my mareās was pretty severe, and he pointed out a little grey circle on there that he said was a bone cyst (lesion). It was really hard for me to see some of what he was pointing out, which made me wonderā¦but Iām not a vet so I mean, Iām sure he can see a LOT more than my untrained eye can. But it definitely leaves me wondering how she could have such severe arthritis and still perform at anywhere near the level she has for me. Unless sheās just extremely stoicā¦
