| HorseAdvice.com » Diseases of Horses » Lameness » Joint, Bone, Ligament Diseases » Arthrodesis and Joint Fusion for Arthritis » |
| Discussion on Big Hock | |
| Author | Message |
| Member: Suzeb |
Posted on Saturday, Sep 25, 2004 - 9:02 pm: Hello Dr.O and All,Was out today taking photos of My Good Boy and believe me, he thinks everything should be in view  . However, I managed to get a photo of his right hock. We have a known "Bone Spavin" happening here and would appreciate any comments or advice. Both hocks have been IA injected with a cocktail of antibiotic, steroid and Hyaluronic Acid. Last injection was November of 2003. This man gets controlled excercise, slow warmups and cooldowns, no jumping or tight circles, mostly on straight ground but can go up and down small hills. Looking forward to responses  . Susan B. 
|
| Moderator: DrO |
|
| Member: Sunny66 |
|
| Member: Suzeb |
Posted on Monday, Sep 27, 2004 - 4:45 pm: Dr.O,I guess the specific question would be, how long does one use hock injections as part of the maintenance program? This is a 15 year old quarter horse gelding whom I have had for 5 years. I don't remember any specific injury that may have precluded this big hock setting him up for arthritis in this region. Perhaps he was worked too soon as a youngster or made to grow up too fast or just plain worked too hard, I don't know  . My gelding has been IA injected in both hocks 4 times in the last 2½ years. It is very difficult to penetrate this big one. My goals are to keep him riding sound, but he won't be asked to do anything athletic or enduring. I will go through your article again to maybe pick up something that I have missed. Thanks Aileen, I think this looks worse than it feels, at least he hardly responds, if at all, to a flexion test...go figure. Although....when the farrier does his back feet, he gets a little sensitive about having that leg hoisted. Will keep on keeping on with this one. Susan B. |
| Member: Sunny66 |
Posted on Monday, Sep 27, 2004 - 5:29 pm: Well, that's good he doesn't hurt too much.I think Fran said something on another thread about horses bringing us peace and driving us crazy at the same time - they sure are good at it
|
| Moderator: DrO |
|
| Member: Suzeb |
Posted on Wednesday, Sep 29, 2004 - 11:39 am: Dr.O,You have been making me do homework  . In reading the article Arthritis and DJD: An Overview, the closest answer came from these paragraphs regarding Intrarticular Medications. }Intrarticular Medications For horses whose lameness that has not responded to more conservative treatment, inarticular injections are still the therapy of choice and corticosteroids are the most effective treatment. With the exception of Adequan, concerns over frequent post injection infections are misplaced. Any injection can result in infection but the procedure is safe with approved medications and careful technique. Adequan has been shown to represent an increased risk of infection when injected directly in the joint and is not recommended routinely for anything but IM therapy. Other concerns over the use of steroids are also misplaced. Though corticosteroids can be abused, if used judiciously they certainly go a long way to allowing the horse to work pain free and probably slows down the progress of arthritis. Hyaluronic acid, alone, may be helpful when injected directly in the joint. Decreased inflammation and improved joint fluid quality have been documented in experiments. Sometimes this is enough when combined with rest and NSAIDs to return a mild to moderately lame horse to work, but frequently not in the markedly lame horse. Intrarticular therapy with hyaluronic acid or corticosteroids should be contemplated. There are many horses that cannot continue working without this treatment. Frequently, half the labeled dose is effective at returning the horse to use for six months to two years. At reduced dosages and managed exercise many horses remain usable for years after treatment is given. The most effective treatment for acute exacerbations of DJD is intrarticular corticosteroid. It is also one of the most controversial. Back in the 60's it was noted that many of the joints that were repeatedly injected developed advanced stages of DJD faster than those not injected. Research has shown that following an injection of corticosteroid there is a decrease in joint fluid production and probably a slow down in cartilage replacement but the clinical implications are harder to pin down. It has been noted that the increase rate of DJD in those early cases resulted from very frequent use of larger doses than are currently recommended and the horses were worked immediately following it's use. It has also been noted that there is no way of knowing what the rate of breakdown would have been without use of the drug. The measurable deleterious effects are transient so it is advisable to pasture rest the horse following injection for three to four weeks. It also seems that some deleterious effects can be lessened with concurrent use of intrarticular hyaluronic acid. Recent work suggests that the corticosteroid triamcinolone acetonide, a potent medium duration drug and may not have any of the down sides that some steroids have. In very young horses betametasome, a short acting steroid, may be indicated. That said some lameness specialist feel they get a better response with the long acting steroid metylprednisolone acetate. Occasionally you get a transient noninfectious inflammatory flare with steroid use in the joint. Phenylbutazone is helpful to control these as quickly as possible. It was alarming to note that the horse should be rested 3 to 4 weeks following an injection. Does this apply to all types of IA injections in the hock or just the steroid ones? I am hoping for natural arthrodesis as surgery and long term rest would present some other management problems. Perhaps the joint injections are contraindicated for this? Hope you can help. Susan B. |
| Moderator: DrO |
|
