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  Discussion on Hock injections and medications
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New Member:
Calvin

Posted on Tuesday, Dec 24, 2002 - 3:13 am:

Do you know what medication MP5 or MAP5 or MPS refers to? Mucopolysaccharide or methylpred? I can't make out the writing on the vet's report.

We are struggling to understand the apparent confusion or controversy or difference of opinion among owners, trainers and veterinarians related to injecting the hocks with steroids or the new non-steroid (HA)medications. We have been told that the lower hocks can be injected with steroids at more frequent intervals (even 3-4 times/yr) without concern for cartilage damage because these joints have a small range of motion, mostly act as a cushion, and will eventually fuse together anyway and not cause the horse any further discomfort. The process of fusion can be long and sometimes painful, so the idea is to keep the horse comfortable during the process. I've heard of people trying to encourage fusion with drugs, or even surgery or sound waves, to hurry the process along. Our former trainer recommended all the hunters and jumpers in her barn have their hocks "maintained" with injections, with or without clinical signs of discomfort or lameness, to prevent training issues arising from possible unrecognised discomfort of overworked joints. Hocks are injected at the first sign of discomfort or behavioral changes such as lead swapping or kicking out, anywhere from one to four times a year. Stifles are treated the same way. Our vet uses a combination of HA, Depo and whatever the MPS is - our horses are 5, 8 and 16 years old.
The 16 year old needs the least amount of maintenance. Shouldn't his hocks have fused by now? Why would he need these "joints" injected then?

I would really appreciate any light you can shed on this subject. I can see it will be a long learning curve! There seem to be strong differences of opinion among professionals about this, and they seem uneasy when questioned - perhaps because there is a lot of grey area and uncertainty here?

Thanks a lot!
Moderator:
DrO

Posted on Tuesday, Dec 24, 2002 - 7:30 am:

Hello Patricia,
They should be uncomfortable about injecting healthy (defined here as non-lame) joints with anything. There is NO evidence such a procedure is beneficial and a lot of reasons to believe it COULD be detrimental:
  • To start with, the effects of steroids, which are so beneficial in an inflammed joint, might be detrimental to the healthy joint. We know they slow down the normal metabolism, reducing the joints ability to deal with exercise. This is particularly true with the "Depo" form of prednisolone.
  • Secondly the injections could result in a infected joint. This can happen under the most careful of circumstances.
  • Thirdly, noninfectious acute arthritis has been documented with the use of both corticosteroids and hyaluronic acid (HA).
  • There is a fourthly, fifthly, etc... but these are the main reasons

There may be IA regimen for healthy joints found in the future that prolongs athletic ability, but we sure do not know what it is now and the above regimen almost assuredly is NOT it.

I am uncertain what the MPS is, I suspect it stands for MucoPolySaccaride. But this is confusing term. HA is a MPS, PSAG is a MPS, chonDrOitins are a MPS, many nasal discharges are a MPS. It can be pretty meaningless without some understanding of what type and its origin. I would interested in eityer a name brand or a ingredient including concentration. MAP-5 is a generic hyaluronic acid on fairly low concentration, so a larger volume needs to be used as apposed to say, Legend.

To get a better understanding of the situation you need to begin with a better understanding of arthrtis. Study Equine Diseases » Lameness » Diseases of Joints » Arthritis and DJD: An Overview. This article will lead you to other articles including those on the medications you ask about. Lastly to better understand arthritis in the hock check out the Equine Diseases » Lameness » Diseases of the Upper Rear Limb » Overview of Diseases of the Hock (Tarsus). It has a section that deals with arthritis in particular.
DrO
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