To inject, or not to inject? Opinions please!

[BentoBean]

So a little bit of background info… My OTTB just turned 13 this year and has one Mild and one Very Mild arthritis in his hocks. The vet said this was what she would consider a normal finding in a competitive event horse that has been campaigned regularly since he was 7, after a full racing career.

After a complete change in attitude last year he did have to have his first round of hock/stifle injections. A lot of fluid build up was present, so after 6 months we went ahead with a 2nd round of injections just to be totally sure he was comfortable!

So my question is this… what is everybody’s thoughts on injections? Is it something you do yearly, before show season, when your horse starts acting weird, or what? He is my once-in-a-lifetime horse and I really want to keep him comfy and happy for as long as I can, and with that I want to make sure I do right by him!

[vineyridge]

IMO, anytime you invade a joint with a needle you are asking for trouble in the long run. Legend and Adequan are systemic and don’t require injecting the joints. They have been my personal go to medications for aging joints.

[Blugal]

I talk to the best sport horse vet I can access, and follow their recommendations.

[bornfreenowexpensive]

@Blugal

I talk to the best sport horse vet I can access, and follow their recommendations.

Ditto. There are lots of different treatments and options. Most of my competition horses are on Legend or Adaquan (or both). But some need more support. It completely depends on the individual horse.

[kcmel]

I inject hocks in the spring and do an OsPhos injection late summer. This is the program I find works the best for my guy, and I would rather not inject twice a year. However, there are also issues with OsPhos, so you have to weigh the pros and cons. (You might also try pentosan, which seems to help many horses).

My guy has a “tell” that let’s me know when the hocks are getting uncomfortable. That’s helpful in figuring out what works best for your horse.

And yes, find the best vet that you can!

Good luck!

[CindyCRNA]

I inject every 6 months by the calendar before my guy gets uncomfortable.

[endlessclimb]

As someone who elected to wait (used a couple rounds of Adequan in the meantime), which resulted in the hocks becoming too fused to inject and not fused enough to be sound, which then resulted in bilateral surgical arthrodesis of the hocks, which never ultimately had him go sound again…

Inject.

[melula]

I inject when necessary (he lets me know when he is getting uncomfortable) and use adequan regularly. I think a huge factor in longevity is movement. Middle aged ponies have to maintain a level of fitness and movement. It’s amazing what 24/7 turn-out can do.

[alternating_alter]

My 15 yr old Trakehner gelding gets sore coffins about once a year. I inject approximately yearly. He’s also on a monthly IM dose of Pentosan, and a weekly IM shot of glucosamine. He’s retired from competing with me, but is showing my BF the ropes of eventing. I only inject when he appears to be uncomfortable.

[Princess_Sparkles]

I injected my 17 year old Trakehner for the first time this year and oh my God it was amazing. I had my horse on Adequan until we could no longer get it in Canada, then switched to Legend, as well as daily Previcox. She has hock issues and last year she injured her knee. I injected both hocks and her knee and the change was almost immediate and incredible. I don’t event, I do h/j, and have scaled back her work appropriately due to her age/injuries, but she is so much more comfortable that I regret not doing it sooner.

My vet is lovely, I trust her implicitly, and I know she likes to take a conservative approach–she isn’t one to just inject everything because you can. When we evaluated my mare this year and she said to me, “you probably can’t get away with not injecting this horse any longer” I trusted her judgement and she was 100% right. I will probably be less hesitant to inject in the future due to the excellent results that I have had. Due to the knee injury, which affects range of motion in that limb, I will inject that knee at least yearly for the rest of my mare’s life, for her comfort. Her hocks I will evaluate and do as needed. She is still on monthly Legend for the summer when we are riding more, but for SURE the targeted joint injections have done waaaaayyyy more than the Legend/Adequan ever did.

I understand that injections have risks, which is why I waited so long, but with a competent and experienced sports medicine vet, I have the opinion that the benefits outweigh the risks for my particular horse.

[beowulf]

Injections have risks, but hocks are not one I’d sit around on. Once they compromise because of pain in their hocks, it’s like watching a ball of yarn unravel - you will have bigger issues down the road. If you see behavioral issues, IME you’ve waited too long.

Good luck. I don’t inject willy-nilly, but I don’t sit on my hands about it either. If a horse needs it, it needs it, plain and simple.

We saw some tremendous improvements with hock injections on our middle-aged TBs. I generally, for a horse in competition that also raced (we have mostly only TBs) I expect I will have to do some sort of injection maintenance by the time they are 12. For non-raced horses, it might be different.

Once they are injected, I assume I will be re-doing it every year - but some can go 6 months, some can go 15 months… it really depends on the horse, their level of work, the damage in the joint, etc.

[jen-s]

@melula

I inject when necessary (he lets me know when he is getting uncomfortable) and use adequan regularly. I think a huge factor in longevity is movement. Middle aged ponies have to maintain a level of fitness and movement. It’s amazing what 24/7 turn-out can do.

I’ve had 2 close friends lose horses to infections from joint injections. I’m not afraid to inject, but I am very careful about who I will allow to do it and I watch everything they do. I’ve spent a number of years working in various sterile environments and I’m rather picky about technique.

But I also 100% agree with @melula’s comment above. I believe in turnout as much as possible. 24/7 is fab. Access to a stall in inclement weather is totally reasonable. But for my personal horses, they will be pasture board unless they just cannot cope for some reason.

[Jealoushe]

Polyglycan is another cheaper, safer alternative.

[SolarFlare]

@beowulf

Injections have risks, but hocks are not one I’d sit around on. Once they compromise because of pain in their hocks, it’s like watching a ball of yarn unravel - you will have bigger issues down the road. If you see behavioral issues, IME you’ve waited too long.

My previous horse had lower hock arthritis, and vet said we can either start with the systemic treatments (ie. Adequan, etc) first, then “save” the injections for when it’s worse, OR we could go with the “big guns” first and inject. Adequan was really tough (and expensive) to get in Canada, so we injected. Amazing difference and happy horse.

Now having a second OTTB with lower hock arthritis, we tried Previcox first (I don’t think it was out yet with horse #1). Unfortunately he gets ulcery on Previcox, so we went to injections. Again, amazing difference. I maintain him with monthly Ichon injections (similar to Adequan) per the vet, and we’ve gone from hock injections every 6 months to once a year.

I am starting to believe that getting on top of the inflammation earlier rather than later is the key (ie. start with the “big guns”). I think if you start off with the systemics, when there is a known, diagnosed issue, is allowing the deterioration to continue, possibly to the point where it is beyond where the horse can be made sound. By lubricating the joint, we can attempt to delay further cartilage degeneration and slow the progress of the arthritis.

Of course, this is combined with movement and supplemented with systemics if desired.

I agree with @beowulf as above too - leaving hocks untreated will get you in bigger trouble as the horse compensates. The entire hind end is like a cascade of problems just waiting to happen!

[Tattooed_Dressage]

Discuss the best treatment plan for your horse with your vet.
Personally I wont delay injecting hocks on any of my horses if they need it. The problems that can arise from hock-sore compensations can be very problematic and not easily rectified even when the horse is no longer experiencing discomfort in their hocks.

[runNjump86]

@beowulf

Injections have risks, but hocks are not one I’d sit around on. Once they compromise because of pain in their hocks, it’s like watching a ball of yarn unravel - you will have bigger issues down the road. If you see behavioral issues, IME you’ve waited too long.

Good luck. I don’t inject willy-nilly, but I don’t sit on my hands about it either. If a horse needs it, it needs it, plain and simple.

We saw some tremendous improvements with hock injections on our middle-aged TBs. I generally, for a horse in competition that also raced (we have mostly only TBs) I expect I will have to do some sort of injection maintenance by the time they are 12. For non-raced horses, it might be different.

Once they are injected, I assume I will be re-doing it every year - but some can go 6 months, some can go 15 months… it really depends on the horse, their level of work, the damage in the joint, etc.

This, 100%. Everything has risks, even injecting with Legend and Adequan. The ball of yarn reference is spot on. Sore hocks lead to compensating elsewhere, which can lead to a sore SI, stifles, plopping with the front feet, using the neck more than normal, etc. I owned that ball of yarn, and thankfully after we got everything lubed up over the course of several months he was happier and going better than ever. I an diligent about his care and injection schedule because I know what can happen if I don’t. It absolutely depends on the vet, the horse, and what your program is.

[staceymc]

Anything I find I need to inject at 6 month intervals, I’ve switched to ProStride instead of steroids. Slightly more expensive, but don’t have as many concerns as with steroid injections and I’ve found I get longer intervals between them. In the end is saving me money and the horse is happier and more comfortable. I am a big believer in preventive maintenance though and not chasing issues. If they need something to stay comfortable I do it. No questions.

[skipollo]

@beowulf

Injections have risks, but hocks are not one I’d sit around on. Once they compromise because of pain in their hocks, it’s like watching a ball of yarn unravel - you will have bigger issues down the road. If you see behavioral issues, IME you’ve waited too long.

Good luck. I don’t inject willy-nilly, but I don’t sit on my hands about it either. If a horse needs it, it needs it, plain and simple.

We saw some tremendous improvements with hock injections on our middle-aged TBs. I generally, for a horse in competition that also raced (we have mostly only TBs) I expect I will have to do some sort of injection maintenance by the time they are 12. For non-raced horses, it might be different.

Once they are injected, I assume I will be re-doing it every year - but some can go 6 months, some can go 15 months… it really depends on the horse, their level of work, the damage in the joint, etc.

x100000. My horse had a “winter of maintenance” this year. His behavior and performance started to really decline. Arthritic in both hocks, possibly arthritic in stifles (pain could also be from compensating for hock pain.) The pain from these joints led to issues with his SI/hip bursas because he was compensating for the hock/stifle pain. He was a wreck to jump–he was stopping OR hollowing out and chest-rushing fences.

Over the winter we had to get his chronic pain and inflammation under control. He got his stifles, hocks (lower), bursas, and SI injected (over the span of several months.) 180 degree change. Now that his pain is under control, he will just need to be on a schedule for his hocks and possibly his stifles. He had stifles done in November, hocks done in January and so far no issues/no signs he needs to get done again yet.

There’s always a risk going into a joint, but IMO if your horse needs it, then they need it. I’m kicking myself for not getting his hocks done sooner because we would’ve avoided all the other issues he’s had (particularly with his SI.)

[findeight]

@staceymc

Anything I find I need to inject at 6 month intervals, I’ve switched to ProStride instead of steroids. Slightly more expensive, but don’t have as many concerns as with steroid injections and I’ve found I get longer intervals between them. In the end is saving me money and the horse is happier and more comfortable. I am a big believer in preventive maintenance though and not chasing issues. If they need something to stay comfortable I do it. No questions.

The typical injection is HA combined with one of the newer steroids. The steroid only option fell out of favor some years back.