I used to get Cuna (late teens, hard-used OTTB gelding with a weak hind end) injected every 6 months and it did WONDERS for him. Seriously. He went from basically unable to use his back end to swinging and free and happy. Once I put it off a couple months because he needed $$$ joint help, but I felt like a pretty terrible human when we finally did make it in and his hocks were inflamed and uncomfortable.
I know Courage got plenty of injectable help on the track and I'm in no way opposed to that. It just means that I now own an 11 year old high mileage thoroughbred and especially in the cold winter weather, I'm starting to wonder if he'd benefit from some inter-articular relief.
So help me out. What sways you for for against injecting a horse's joint at any given time? Have you done it? Would you do it again?
I have not had to make that decision yet, but Dr. Marks in college was adamant that once you start injecting a joint, you have to continue injecting every six months forever, because there's some kind of feedback loop there where the body is like "welp, there's some cushioning here, guess I can slack off," just like the thyroid does when you're on thyroid meds.ReplyDelete
I am no vet, but she's the most scientifically educated and accomplished horsewoman I know, so I always took that as gospel and found it interesting.
This makes no sense to me, because for the most part all you are injecting is steroids to decrease inflammatory response. Sometimes you might include HA or Adequan, but not for cushioning. Both of those are also for long term anti inflammatory response.Delete
I will state that injections have been shown to only be effective up to 3 months from time of injection. That said, this time is often enough to allow a horse to build up a good enough musculature work around. And each horse's response varies.
Also, I disagree with "forever" because most often you use joint injections to help a horse with pain/discomfort while their joints fuse. Once the fusing is done, you often do not need the injection again. See: hocks and Pig's fetlocks.
I think Dr. Marks is brilliant, but I think her grasp on veterinary science was a little off here.
Every vet I've talked to about injections has told me the same thing.Delete
It depends on what you are injecting - there are multiple protocols- and why.Delete
I think it's very dependent on a number of factors, including age, history of use, intended use... etc. I injected my previous horse, and would absolutely do so again. I can't ask my horse to work through pain -- it's simply not fair.ReplyDelete
Currently I'm doing feed-through supplements for the pony (who turns 20! in a few months), with the knowledge they probably make me feel better than her. I talked to the vet about injections soon a year or so after I got her (at 17) and I'll have that conversation again with my new vet at my visit next week. We've been super lucky in that she doesn't seem to need them yet.ReplyDelete
My current feeling is that I'll inject to maintain where she's at and keep her comfortable, but won't inject with the intent of improving performance. It's a weird line drawn in the sand but I guess everyone draws their own somewhere.
I do it when my vet says to for a particular reason. For example, joint injections are what helped Simon's bad hock fuse and now his other that is starting the same process. His "bad" hock now flexes better than the good one.ReplyDelete
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whoops! didn't mean to delete my previous comment... My gelding is injected at least once a year, twice if I'm riding a lot, to treat the ringbone in his coffin joint. It helps tremendously. I can even start to tell when it's wearing off. I have talked to my vet about how long we can do this, and we plan on doing it for as long we need to and/or it seems to help him. I want to ride my horse and for him to feel comfortable, so I have no qualms about injecting.ReplyDelete
I let my vet decide, honestly. I give him the background, symptoms, and goals for the horse, and let him evaluate/x-ray/etc. I trust him completely.ReplyDelete
I had Ozzy injected twice (once in his hocks and once in his ankle) after he aggravated old injuries. It did wonders for him and he stayed sound right up until he got EPM.
I never injected JR.
Brooklyn will probably need injections in his knee sooner or later, but not yet. If he starts gimping, I'll discuss it with my vet. If my vet agrees it would be beneficial, I'll do it.
I try to hold off as long as possible because I have found that once you start, it eventually leads to injections becoming routine maintenance. It's expensive so I try to wait as long as possible before starting that cycle!
I'm pretty conservative about injecting anything into the joint of an animal (or person), as it can have career ending complications for your animal if it goes wrong. So I would say a vet would only do joint injections if your horse really really needs them. And then be prepared to get them for life... So, you're basically masking a problem and keeping your horse sound and comfortable, but you aren't solving the problem, and I think people sometimes forget that. That said, if it keeps your horse sound and comfortable and you can afford to keep doing them, great! Because the other option is probably retiring your horse... So, it's kinda the lesser evil. I know lots of people do them routinely and I don't frown upon that at all. I just don't want to have to start myself. I had joint injections on my back and they definitely helped me feel better, but never made the problem go away...ReplyDelete
I used to work for a vet that did injections all. the. time. Enough so that he was the #1 user in the state of one of the meds and the company gave him free swag all. the. time. I have seen it help horses in just about every discipline.ReplyDelete
Do any of mine get it done? No.
1) I'm not sure any of them really need it because their intermittent and mostly missing 'work load' is pretty light.
2) I'm kind of in the camp of "If they're hurting, try to find out WHY? and solve that first if you can. If the issue can't be solved without the injections, then by all means, get the horse injected. Get them some relief and keep an eye on things.
Working for the vet, you should have heard some of the reasons people gave when having their horses injected. Oh the stories people can tell.....
I fall on the conservative side of the spectrum as far as joint injections go. Knock on wood, I haven't had to inject anything as of yet. There were a couple times when I considered chatting with my vet about them, but the issue that I was concerned about ended up resolving itself and being a matter of strength/fitness/managing metabolic problems. As Dino gets older, I would not be opposed to injecting at all if he experiences soundness problems that injections could help with. But, as others have said, I am leery of sticking a needle into a joint if not absolutely necessary, and they are expensive to maintain!ReplyDelete
I have *always* thought it was dumb to inject a horse because I feel if they are too broken to be ridden comfortably naturally, why inject them for our own selfish reasons.ReplyDelete
I still think that, BUT when Yankee started to show some soreness when he was 12, I freaked, because that is still young and he was still raring to go despite hock soreness. Lo and behold, I did it despite all my wishes and he was like a new horse. He gets them once a year now, despite my hatred for them. Once he starts to show extreme pain I am going to retire him from UL jumping, until that day he goes great.
I try other options before resorting to direct injections, but I am not opposed to them--just wary of starting it if other stuff would work. If I've exhausted other therapies and injections would help, then I'll do them. Eli will most likely need his SI "joint" injected at some point, but for now chiro helps it a lot and I'd be tempted to try systemic relief first before injecting the site.ReplyDelete
I used to do Allen every six months, but he was jumping up to 3'6" and in his late teens. He was happier that way and I feel it helped keep his joints swinging through those last seasons. Fi was done once to see if it helped her jumping issue, but that turned out to be mental. I have no issue with it for a diagnosed issue that needs maintenance in a hard working horse. I do hold off as long as I can because once you start, you have to keep going. It's expensive.ReplyDelete
I'm not against them, but I have been able to help Cosmo with feed-through supplements. I noticed quite a bit of improvement once he started on those. He was just stiff before, mostly. Those and chiro work are doing it for him right now. I really do love his joint supplements, I have Thule on it as well, I have been meaning to do a review post.ReplyDelete
I've done them on every horse I've owned, when it was merited, and in every case it made a huge difference. I also use Adequan and Legend, and highly recommend those over any feed-through joint supplement. I have no shame or guilt about either - if it helps my horses be more comfortable, that's what matters.ReplyDelete
I don't have problems with injections when they're needed. I also think that it is one of the most abused treatment options out there. That being said, with Courage's racing history and age, I wouldn't see anything wrong with considering it. I have no objection when it's used for maintenance, I just don't think injecting should be used as a cure-all (which is obviously not the case with Courage).ReplyDelete
I tend to start with supplements (TC is just on MSM and Rico eventually was on Hylasport), then go to monthly adequan (and maybe legend for horse shows), then go to joint injections.ReplyDelete
Rico's injections at first were just hocks, then a year later he needed hocks again. Then about 9 months later he needed hocks and we did one coffin. Then 6 months later he needed both hocks and both coffins. That was his last injection (a bit over a year ago) since now he's semi retired on a cheaper joint supplement and no injections (IM/IV/IA).
I'm definitely not against it. Rico would have been retired at 16 without injections and that just seems so young to me when he stayed 100% sound for 3.5 more years with injections (and probably would be sound right now if I was injecting him). I think everyone has their own opinion as to how often is too often. Financially, every six months seems extreme to me, but if money was no issue, I'd probably be totally okay with it. Sure it'd be nice to never inject, but if it's between the end of a horse's career (or worse, riding through pain) and an injection here and there, I'll do the injection every time.
I don't have any problems with doing joint injections, but I definitely went through and tried to find out what was wrong before we injected Spot's coffin joint. I know a ton of people who are "inject" happy but I feel like sticking a needle into a joint is a big deal. Spot feels amazing now after her joint injection and we'll see how long it lasts. I will definitely do it again when it comes time, but I'll also keep an eye on her coffins (IE: U/S or x-ray) to see how they're doing.ReplyDelete
I also plan on starting Spot on an IM injectable like Pentosan to keep all of her other joints lubed up. Maybe it'll help her coffin injection last longer too.
I totally agree with you, but want to add that sometimes beliefs change as your horse gets older. Right now, I'm more injection happy. I don't care what's wrong, because I know it's all wear and tear. So we just stab it to make the ouch go away.Delete
Oh, I agree with you! I think I was specifically thinking about some people I know that don't know exactly what is wrong, and will just immediately jump to injections. Like this woman who injected hocks and stifles when her saddle completely did not fit. -_-Delete
I'm all about injections when needed. I think they are a better use of $ than oral always. In fact, I dong use oral and just save my money for injections into the joints. They work.ReplyDelete
That said. Find a vet who takes your horses joints seriously. You don't want a guy just stabbing away and not considering the risk of infection. Joint injections are no joke and can lead to horrifying infections. Stay on your vet to take proper precautions when breaking the skin barrier into the joint!
"dong use oral" ... Omg. I die. Autocorrect is hilarious.Delete
That one gave me a big mental pause ;)Delete
More seriously, thanks for chiming in. I definitely appreciate your perspective. :-)
This is a timely article for me... lots to think about, that's for certain.ReplyDelete
is it horribly cliche of me to say it depends on the situation? :P usually the deciding factor is safety vs money. I had a bad crash at a jump with a horse bc his hocks were bothering him. injected and was fine. later on i had a horse who used to have her hooves injected but I could maintenance it with previcox (both were older, late teens end of their career). like a nerd; cost benefit analysis.ReplyDelete
as a total aside: ive been reading your blog and this is my first time commenting and i love it. and i might accidentally buy those iridescent lorenzini stirrups (in the violet) because of you so be on the look out for a bill in the mail. i keed.
Thanks for chiming in! I still love my Lorenzinis. You definitely need some.Delete
Alex gets his Stifles injected twice per year and hocks done about once per year. Both were recommended by my vet, who I completely trust 100%, when all other avenues were exhausted. He is MUCH more comfortable and agreeable when he gets regular injections. I'm not totally surprised, because he did race and was likely injected during that time. I'll continue doing so, as long as it makes him comfortable and I can afford it :)ReplyDelete
I know joint injections can themselves wear and tear joint in humans, so I'd think its reasonable to say they should be used with caution in animals as well. I'd say its worth talking thru with a vet with Courage's age and probable level of wear at this stage. Medicine always boils down really to do the benefits outweigh the risks.ReplyDelete
I didn't inject anything on Pearl until she was... 15? and we were trying to sort out her lameness issues when they first popped up. Knowing what I know now (riding her for a few more years, plus almost a year under my belt of working at a sports med clinic) I wish I had done it WAY sooner. The first winter I had her she was so creaky in the winter it took 20 minutes of trotting to loosen up. In the brief period of time where she was sound(ish) and had her hocks lubed up and was on previcox I noticed a huge difference in her movement. Also, osphos! She hasn't had IA injections since 2013, had a regional perfusion of Tildren for her feet a little over a year ago, and then when Osphos came on the market she started getting that every six months. I was originally using it for her feet, but it has helped her neck and hocks a TON. Like she honestly moves better at coming 18 than she did 5 years ago. She also gets Pentosan and previcox which help, but I can still tell she is sore at specific joints. I'd been holding off the IA injections because she hasn't been in enough work for me to justify the expense, but she's been "sound" enough lately that I've been riding her like a regular horse the last couple months, so after next pay period I am going to have her hocks done (within the last couple rides she has had a little trouble with her left lead which is very unusual for her, but I know her right hock is worse so I'm betting that's the culprit), plus probably her neck and whatever else she wants based on flexions.ReplyDelete
When Ries was lame in 2014 I had a lameness exam done for shits and gigs and his hocks were very bad. I started him on expensive joint supps and got him injected as well. That being said he has had lameness check ups and hasn't need a new injection since the original because of the supplements and strengthenings I've done.ReplyDelete