Are there any new(er) studies out regarding care/management of joints in horses?
What are best (better) long-term options other than injections? How long can joints be managed via injections before permanently damaged from the steroids used?
When you have a younger horse who has developed changes in a joint (for example hocks) can the damage be “halted” (not reversed, just stopped) if the offending activity is removed or lessened?
I know for humans, exercise (strength training, if done correctly), weight management, and anti-inflammatory diet choices, can contribute to better joint health but will not reverse damage already done.
I can’t find any newer-ish research especially in regards to glucosamine & chondroitin, I do feel liquid HA in high enough doses does help.
Some people swear by Adequan, is the research behind it solid enough to justify the price tag?
Combine injections, say once a year, with Adequan/Pentosan/other for “maintenance”?
I would like to not have a washed-up useless horse by the age of 15, so I am researching and considering my options very, very carefully.
The studies I have seen are fairly consistent in concluding that certain corticosteroids actually improve the cartilage, although this is dose dependent.
Here is a fairly recent review:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622344/
[INDENT]Corticosteroids have a time- and dose-dependent effect on articular cartilage, with beneficial effects occurring at low doses and durations and detrimental effects at high doses and durations. Clinically, beneficial effects are supported for IA administration, but the lowest efficacious dose should be used.[/INDENT]
It’s not uncommon for OA to appear in younger horses. Mine was found to have mild lumbar and hock changes at age five, while rehabbing from a suspensory branch injury. In my opinion, the best approach is to get them comfortable, do whatever you can to keep them comfortable and keep them fit. My horse so far has had a few IA injections (back twice, stifles twice, hocks once) and regular Adequan, plus assorted oral supplements (not sure how much they help but I do think the HA makes a difference). And he gets NSAIDs as needed. Don’t even get me started on the shoeing, but suffice it to say that if you are OCD and have a willing farrier, the right shoeing can make or break the horse.
Is the price tag justified? It depends on your budget, your tolerance for regular vet checks, and your goals. My horse is in full work and has steadily grown stronger and advanced since the suspensory injury (schooling 2nd level dressage and working on 3rd level movements). It’s been expensive, but I’m okay with that because he is so talented, and is such a pleasure to ride, and I am able to afford the extras and special attention he demands.
Steroid damage is not as much of a factor as it was 20 years or so ago, modern product is just not the same so that’s not really a consideration.
Whatever you do, at some point, age plus wear and tear will win the battle. Usually mid to late teens when they are bone on bone and fused joints lose range of motion and the needle won’t even go in. I had great luck with the $$ oral HA gels…until they no longer worked. Never had any luck with powders or granules.
Try to get as informed as you can with current protocols and products, beware of fancy ads and gushing endorsements light on specific details.
@LarkspurCO Thank you for your response. That helps, if nothing else mentally. And I am definitely OCD about this; I’ve been thru too much with other horses to not be, and I think an ounce of prevention will prevent a whole host of playing catch-up later down the line.
Get them fit and keep them fit. Oh yes I know this very well.
@findeight and yet I have a 23 y/o who’s hocks are pretty much fine. Go figure. He’s had stifle injections, had hock injections in the past (didn’t work, because it was actually a stifle issue).
Regular quality work is what kept him going & relatively sound, other injuries are what retired him.
I guess I will be less afraid of the injections but I will be questioning my vets thoroughly.
My vets are very skeptical of the oral HA. The absorption of HA when taken orally is way too low to be effective.
The intra-articular injection “cocktail” is crucial in ensuring that the healthy cartilage is not destroyed. Correct me if I’m wrong, but I believe for younger horses, triamcinolone and hyaluronic acid are most effective at promoting healthy cartilage, while vets often use a high ratio of Depo to triamcinolone or HA to speed up joint fusion in older horses with evidence of existing effusion.
I think it’s maybe good to specify what “changes” you are talking about.
Are you talking about lack of cartilage?
Or fusing joints?
Or bone spurs in the joint?
Or soft tissue inflammation?
Etc. Etc.
There can be many different reasons that a horse has “joint pain”. And thus different ways one might want to manage it.
And when you say “joint injections”, that can mean other things too.
For example, I am going to try IRAP injections in my horse’s front feet this year, instead of the typical steroid cocktail, to see if he responds better. So there are other things you can inject too.
What proof is there that an ACTIVITY caused the hock changes? (in our hypothetical example)
How do we know the horse wasn’t predisposed to have changes anyway?
I’ll use my horse Red as an example. I purchased him when he was 6 years old. He was essentially green broke and ridden very lightly when I bought him. I started riding him on a regular basis. When I started asking “more” of him a year later, we discovered he had a very advanced fusing right hock. Both of my vets I use (one is a regional specialist) believe he probably had hock changes at birth, for how advanced he was by age 7. So in his case, there was no such ACTIVITY that caused his hock changes. It thankfully fully fused by age 9 and doesn’t seem to bother him anymore.
Just like anything, I think Adequan is an option but not all horses respond to it. I do have my horses on it, as good maintenance. I don’t know how much it is actually helping, but it makes me feel better, so it’s worth the money to me.
Red’s other hock is fusing now, so I’m actually going to try Osphos this year and see if that seems to help him (along with Adequan).
I too don’t like to go around injecting joints if I don’t have to. But I also believe that if the horse NEEDS them to stay comfortable in their job, then they need them. I won’t hesitate to inject if they need them.
I think there are lots of things that can help the injections … but nothing that replaces how well they relieve pain (in a lot of cases).
I give my horses Cosequin and Chia seeds daily.
Did the injections and all for a year on same horses when they were much younger to no effect. Their chiropractor wants them on adequan now but I’m not ready to go that route again.
I know lots of people who have had success with IRAP or ProStride injections. They are still going into the joint, but are made from blood pulled from your horse and are supposed to last longer than steroid injections and be less damaging. In my area ProStride is about $600 CND per joint, and IRAP is more and you have to do a series of injections with IRAP. ProStride has the IRAP protein and PRP and you only have to do one injection.
These are questions you need to ask your vet. Most well kept 15 yr old horses are not washed up or useless. Mine included.
Yes, there are “studies” all the time. I’ve sort of given up knowing what to believe from any given “study”.
Better long term options: Other than steroid/HA injections- IRAP, PRP, Pro-Stride, daily Equioxx, turnout, light to moderate exercise, a good oral supplement, Pentosan, Legend, and/or Adequan. The answers really have not changed very much.
You would have to try Adequan or Pentosan to judge if they are worth the price tag. For me, they are not and I stopped using them on my older horse.
Can’t recall any research at all in using injections as a preventative. Important to understand exactly why you are injecting and being sure there is a good case for using whatever you inject. Sticking them just in case in the belief it will prevent future damage will help your vets wallet more then your horse. BTW, was my vets who got me on tne $$ oral HA gels to replace the $$$$ monthly Legend IA injections. Neither worked at about age 18.
Gotta be careful not to compare horses just by age. Total miles, type of use, environmental factors and conformation related stresses on joints are far more influential on joint degradation then chronological age anyway and often that age is a guesstimate with no foaling date. Horse that’s been in a regular jumping or Reining program for a decade or more doesn’t compare to a horse 10 years older that has had a lighter, more casual career with no Jumping or repetitive pattern work.
Depends on the horse and their soecific situation…not to mention owners budget.
I’m in Canada, so Legend is what I have been using on my WB Gelding for the last two years. He’s 18 now and schools most of the PSG work regularly along with quite a bit of trail riding and hill work etc. I hesitated starting it, as like mentioned above the research doesn’t lead you to jump right in, but I figured it was worth a try and if I didn’t see results I’d stop it.
He wasn’t unsound prior to starting it, but some days there was more edema and stiffness in his body. He did the recommended loading dose, and then the monthly injections and I very quickly noticed a few things - less edema, a very forward happy horse, and one that was willing to give through parts of his body he wouldn’t have previously offered without really having to work into it so for him I see the results and value for him. I haven’t had to do anything else for him at this point. All horses respond differently and I don’t think you really know until you try it.
Okay so I need to clarify my questions a bit. Horse in question is an OTTB, age 7. Been off the track 2 years. Ran on county fair tracks, so not great.
PPE’d fairly clean - no chips anywhere - but xrays show mild/moderate changes in the hocks. Also has a fused lower lumbar spine (a bit of roached back) but no KS.
She drags her left hind. Now, chiro had an interesting point in that her hips were uneven, so is the toe dragging higher up, or lower? She seems to bend each hock equally, but I’m not a vet.
Somebody somewhere did a lot of the “round penning” with her. Which on top of being on the track, puts a crap ton of stress on their back ends.
As I condition this mare, I note certain oddities here n there, such as the toe dragging, and she can get really tired (and thus crabby) really fast when working on 20m circles for any length of time. I spend as much time doing straight lines as I do circles and I also work over poles frequently, and we do a lot of work at the walk. We are not cantering yet. She also occasionally seems to “trip” over herself behind, like she isn’t able to get one hind out of the way of the other quickly enough. She is not neurologic.
Since I have been down this road before - I previously had a young horse with marked changes by age 4 in the hocks - I am carefully considering my options since I want this mare to be a long term partner.
I am sure we all know performance horses who are done by age 10, crippled for life or some other such thing. I do not want that to happen if I can avoid it. I don’t compete, so that does take some stress off the table. I do ride in the hills tho, and a horse with bad hocks/stifles/SI will have trouble with that.
I just want to be informed and make good decisions for my horse.
Is mare shod behind? If not you might want to try it and play with the break over, especially with toe dragging. A shoe set a little farther back will do wonders so will adding a wedge behind to take some pressure off the hocks.
If she is shod, play around with different shoeing options and angles to find something that might help.
@luvmyhackney No, she is not shod behind. There hasn’t been a compelling reason to do it yet, and not knowing for sure, I didn’t want to take the chance of added stress.
