4 Year Old w/ Mild Arthritis (DJD) in Hock

[ytr45]

Our 4 year old QH gelding was diagnosed yesterday with mild degenerative joint disease in the hock. What prompted us having the vet out was the fact that he was starting out his flatwork with a slight (between grade 1 and grade 2) lameness that he would work out of after a few minutes. The vet is recommending a treatment program of previcox, adequan and hind shoes. We got this horse back in January after he passed a prepurchase exam with flying colors.

Since I don't know very much about DJD, except what I'm reading on the internet, I'm trying to put together a list of follow-up questions for the vet. My husband and I plan on scheduling a consultation with the vet so we can get a better understanding of "What does this diagnosis really mean for us and this horse."

The vet had to leave right after the xrays so I am in the dark about what this means in terms of what the horse can and cannot do, or should and should not do, or never ever do. All the vet said was no small circles for 2 months, but continue trail riding.

For those of you who have dealt with DJD in a young horse, what questions do I need to ask the vet at our followup consultation? And since the horse is insured, what procedures, treatments, etc should we do before the hock gets excluded at policy renewal time ?????

I'm feeling pretty bummed about all of this. This horse is my husband's fun recreational horse, including very lower level flatwork/dressage and jumping (he just started doing cross-rails and my husband loved it).

Some of my own questions are:
What is the difference between DJD and regular osteoarthritis and wear-and-tear that a lot of young QH's have due to being worked hard as a two year old?
Does this situation warrant getting a second opinion (I can get the digital xrays). ?
Will it get worse, aka do these young horses w/ DJD end up being completely unsound?
Will jumping x-rails be out of the question after the initial treatment w/ previcox and adequan?
How much will hind shoes really help a joint problem?
etc, etc, etc :-)

[LMH]

Sadly, I have 2 experiences with this-two babies I raised-same mom different dads.

In both it progressed very rapidly and included more than the hocks. One had arthur in both hocks, fetlock and the spine.

The other has both hocks and spine (maybe other areas as well).

Each were retired at very young ages.

I wish I had a better experience to share.

I personally don't see the benefit of hind shoes if the horse has healthy feet...others will disagree.

[Dressage.For.Life.]

Check out the supplement OCD Pellets (http://www.ocdpellets.com/). It's commonly used on racehorses, young horses with DJD, and horses with injury. I just started my 9 year old ex-racer who was recently diagnosed with a bone spavin on it today. Someone on here had an extra bucket and offered it to me :)

Just read the success stories / testimonials - seems like a great product - I hope it helps my guy!

[ytr45]

Thanks LMH & Dressage.for.Life - please let us know how the ocd pellets work. I didn't see anything on the ocd webpage about arthritis. At first glance it looks to be "souped-up" corta-flx. ?

[Plumcreek]

ytr45, I PM'd you.

For others, refer to this reference thread: http://www.chronicleforums.com/Forum/showthread.php?t=29839

[Fharoah]

Steroid HA injections can work really well
monthly legend injections can make the joint injections last longer
IRAP is my favorite as a powerful natural antiflammatory
adequan loading dose twice weekly for a month, if you see a significent
improvement back down slowly and find which maitnance dose works for you.
sometimes shockwave theropy can be effective
tildren can be effective on arthritis
If the horse becomes chronically lame and doesn't respond to conventional theropies then chemical or surgical fusion can produce soundness.

[mrsbradbury]

Plum Creek, the reference thread is quite useful/ However, from my understanding the cunean tenectomy i sbeneficial in the horses who still have some cartilidge to work with, or that the actual cunean tendon is causing the twisting and grinding of the hock bones.

We just had a young horse ddx with DJD, and after looking at his xrays, releasing the cunean tendon is not going to offer him relief.

[monstrpony]

It depends on which joint in the hock is showing arthritis.

Monstr was dx'd with hock DJD at a young age, as well. He was put on supplements (this was long ago, before the plethora of joint supps we have today, so it's irrelevant which ones I used; tried several, and my experience since is that you have to try a few to see what works on your individual). In the long run, his problems were totally different than the hock fusing, but I can say that with the joint supps, the hock issue never really slowed him down.

My QH gelding, who I bought as a 7 year old, was also dx'd with hock DJD. His joint fluid was rusty looking and the space was difficult to even get a needle into. It was decided that he was too far gone (in the fusing process) to inject or supplement, and was put on a low dose of bute as maintenance, along with sympathetic work to encourage the fusing to finish (he stayed on the bute for about 18 months; there are other strategies in use today to accelerate the fusing process, if indeed fusing is the issue). I backed off on the amount of engagement I was asking of him, but otherwise I can't say it ever slowed him down, either. He had days when he had a bit of a flat tire behind, but taking it easy on those days kept him from being really uncomfortable. Today, at 16, he's very serviceably sound, as he has been since about two years after the hock dx. I do not jump my horses, I do some dressage work and trail riding.

Neither horse was ever shod behind (nor was that recommended). The QH doesn't have brilliant hock action, never has, but ... he's a QH. He does drag his toes a bit, but ... now, he's an older QH.

Recognize that hock fusing is a process of nature, who recognizes that the horse no longer needs that hock joint and wants to get rid of it. So, it is not necessarily terrifying to see this process happen in a young horse, and if the fusing is all that's going on (clearly not the case in LMH's horses, alas) it's a short term (year or two?) bother and should not be career-ending (unless your goal is the Olympics or such).

You might also consider a product called Duralactin. It's a milk protein derivative that moderates inflammation and seemed to be helpful to my QH while he was going thru this.

Good luck!

[Dressage.For.Life.]

I started a blog when my horse was diagnosed with the bone spavin to keep friends updated on him- http://notquiteaspretty.wordpress.com/ Yes, corta-flx is mentioned in a few places (online, the bucket, etc.).

I've sent my horses x-rays to Rood & Riddle so will see what they say. Have done a lot of research and modern CT (cunean tendon) surgery is something that may be a possibility (regular vet thought there was to much room for error as he thinks some of the pain is coming from elsewhere in the hock). Then there's newer ethanol injections which I brought up when sending the x-rays. We tried Legend IA once and it did nothing. The chiropractor was out once, and will be out a second time in the next week or so. He's being ridden very lightly 1x a week with Bute before riding and liniment + DMSO. He's out all the time which keeps him moving.

[Plumcreek]

Plum Creek, the reference thread is quite useful/ However, from my understanding the cunean tenectomy is beneficial in the horses who still have some cartilidge to work with, or that the actual cunean tendon is causing the twisting and grinding of the hock bones.

We just had a young horse ddx with DJD, and after looking at his xrays, releasing the cunean tendon is not going to offer him relief.


Not sure I understand your post.

The more joint space, fluid, cartlidge a horse has when djd is discovered, the greater the chance of total long term soundness after a CT. That is why my vet puts forth such a high percentage of long term soundness success; she suggests doing a CT right away vs waiting until injections no longer work. But, a horse with no space, fluid, or cartlidge will still get immediate inflamation/pain relief and fuse much faster after a CT, so it helpe either way.

The way the cunean tendon lays over the hock is an unfortunate result of hind leg evolution, and the CT itself is a relic that is not needed, and now causes trouble. The cunean tendon IS causing the hock joint to twist upon itself, moreso in straignt/post legged horses. The CT surgery stops the twisting and grinding and two things happen: Inflamation and pain subsides, and the joint is less moblile and can fuse much faster. The side benefit is much less strain on backs - for that reason alone some owners around here do this surgery on horses with back arthritis.

<<<<"We just had a young horse ddx with DJD, and after looking at his xrays, releasing the cunean tendon is not going to offer him relief.">>> Just curious, what is the thinking behind this conclusion?

Since that reference thread was posted, I am more a fan of this surgery as a hock djd/pain preventative than ever. 4 horses I own have had a CT. The last two were done before any lameness issues presented (for which I got really flamed in the original thread) - (on routine X-rays, one showed increasing joint narrowing and the other the beginnings of djd), and they have remained sound, with great impulsion from their hocks for around 6 years now, with no joint supplements. It is just nice to know I do not have to worry about their hocks.

[mrsbradbury]

Not sure I understand your post.

The more joint space, fluid, cartlidge a horse has when djd is discovered, the greater the chance of total long term soundness after a CT. That is why my vet puts forth such a high percentage of long term soundness success; she suggests doing a CT right away vs waiting until injections no longer work. But, a horse with no space, fluid, or cartlidge will still get immediate inflamation/pain relief and fuse much faster after a CT, so it helpe either way.

The way the cunean tendon lays over the hock is an unfortunate result of hind leg evolution, and the CT itself is a relic that is not needed, and now causes trouble. The cunean tendon IS causing the hock joint to twist upon itself, moreso in straignt/post legged horses. The CT surgery stops the twisting and grinding and two things happen: Inflamation and pain subsides, and the joint is less moblile and can fuse much faster. The side benefit is much less strain on backs - for that reason alone some owners around here do this surgery on horses with back arthritis.

<<<<"We just had a young horse ddx with DJD, and after looking at his xrays, releasing the cunean tendon is not going to offer him relief.">>> Just curious, what is the thinking behind this conclusion?

Since that reference thread was posted, I am more a fan of this surgery as a hock djd/pain preventative than ever. 4 horses I own have had a CT. The last two were done before any lameness issues presented (for which I got really flamed in the original thread) - (on routine X-rays, one showed increasing joint narrowing and the other the beginnings of djd), and they have remained sound, with great impulsion from their hocks for around 6 years now, with no joint supplements. It is just nice to know I do not have to worry about their hocks.

I have read the thread, and find it very fascinating, and am a proponent of the procedure. I discussed it with our vets for a particlular horse. Clearly, I must have misunderstood soemthing in my reading. As whenI asked the vet about the options for our current case, it was not presented as an option. I did not by any means try to nay-say the surgery. I was questioning relevency.

[Guilherme]

If you've got this problem in a four year old you're looking at very large vet bills for very many years and a very high probability of a poor outcome. Nothing in life is certain beyond death (and maybe taxes) but this does not sound like a horse that is going to be able to do any appreciable work. As difficult as it sounds, maybe it's time to "cut your losses" and look for a new mount.

G.

[Plumcreek]

If you've got this problem in a four year old you're looking at very large vet bills for very many years and a very high probability of a poor outcome. Nothing in life is certain beyond death (and maybe taxes) but this does not sound like a horse that is going to be able to do any appreciable work. As difficult as it sounds, maybe it's time to "cut your losses" and look for a new mount.
G.

Not at all. My first horse to do a CT on, 12 years ago, was a 4 year old. His hocks had significant arthritis, so much so that the the Big Deal vet clinic here featured his case in their weekly group conference re how he could be that bad at 4 years of age and with no previous hard work. He was off on circles and reluctant to jump. The CT made him sound for the remaining 6 years I owned him, and I did not supplement or inject anything. His jumping thrust and willingness to jump improved 1000%, and I showed him OF for many years at 2'6" - 3'. He passed his PPE hind flexions 100% when I sold him. I called out the CT surgery, when asked about any surgeries, and the PPE vets just nodded.

I would not be wasting my time posting all this if I did not believe correctly done early CTs are an incredibly overlooked solution for many horses.

mrsbradbury: CTs are almost never presented as an option in 99% of US vet clinics and all Universities. That is the reason for these threads. This is so hard for me to understand. We individual owners are one thing, but if I were a trainer responsible for ensuring my clients' horses stayed sound and jumped better or got higher dressage scores than their competition, or could save their rider's life by powering over a CC jump? You betcha any horse in my barn with radiographic hock changes (and my vet's agreement) would have a CT done.

[Fharoah]

I have a friend who is a recently retired unniversity professor. He had allot of experience and is very wise. When my gelding developed ringbone I asked his opinion. He said write a list of all the possible treatments list them from the least expensive to the most expensive. Start your list if something works keep using it until no longer works and then move on. So if you were using adequan do a loading dose twice a week for a month, if you notice a significant improvement try once a week for a month, then twice a month until the find the lowest effective dose and keep using it. If adequan is no longer achieveing soundness the increase frequency of the dose if you are no longer getting the results move down your list.

My list was along the lines of:
balanced shoeing
recovery EQ HA (loading dose)
equioxx
adequan 2 weekly for a month
legend loading dose is once a week for a month
steroid HA
IRAP 3 injections once every two weeks for 3 injections
tildren
shockwave
fusion

I tried steroid HA, IRAP, legend and adeqaun, and recovery EQ HA and wide webbed shoes with rolled toes, most helped but he wassn't sound so I had pastern arthrodesis surgery. I will no in about 10 months if effective.

[Donkey]

As others have mentioned it makes a big difference depending on what hock joint is affected.

Depending on your choice of treatment and the response to treatment your horse may not be limited at all. I like to try the least evasive and go from there depending on success.

For example, you inject IV Legend your horse becomes sound - there would be no reason to limit your horse's activities as you described.

If IV Legend didn't work and you do IA injections of some sort, and the horse becomes sound, then you might decide to keep it to crossrails or flat work only. etc. etc.

I don't think mild arthritis is a show stopper at 4, it just means you're going to have to manage the horse carefully and thoughtfully to make sure you get the best out of him while not affecting his future quality of life.

Also keep in mind excercise is often the best treatment for arthritis.

Ask your vet - with your planned activities would there be any difference in his future quality of life if you instead let him become a pasture potatoe... In the case of mild arthritis I would expect the answer to be that riding and excercise will only improve his current and future quality of life (as long as he warms out of his stiffness and is not lame when working).

Also consider how your horse is being kept - more turnout is best for arthritis.

I would also only try one thing at a time - so you can observe if it has made a difference before adding something else.

[ytr45]

Someone mentioned a specialized shoe that is beneficial for hock arthritis, called the dr. watson shoe . ? Has anyone heard of this?