How do joint injections wear off?

[TheOrangeOne]

Sorry- cross posted from off course, where I put it accidentally.

Hi- as some of you know, I have a retiree gelding. Throughout the course of trying to get him sound, we have injected a lot of joints, but I have never really seen something wear off. What kind of pattern should I be looking for? Will it wear off over a span of weeks or days? His knees, for example, I can tell are no longer treated because they creak and are very swollen. The pastern I am having a harder time with, because while it is swollen, it always has been. He is chewing right around where we know the joint hurts, and pointing a bit, and I am trying to decide if the injection has worn off, and this is as lame as he's getting, or if he is lame despite the injection and I am going to be in trouble once it wears off, or maybe it is just starting to wear off... Anyways, any experience with how the effects of a corticosteroid in the joint behaves at the end of the time would be appreciated. This particular joint got depo-medrol.

Also, I know some people do injections every 6 months or every year. His knees seemed to last 10-11 weeks, which is what I assume I will be looking at with the pastern. Are the 6 month horses benefiting more from the HA than the steroid? I can not find any evidence the steroid works for that long.

[TheOrangeOne]

bump

[Fharoah]

When your horse shows you he is in pain then the injection has probablly worn off. Sometimes an injection can just settle things down and horse can stay comfortable for an extended period of time. I know one with ringbone first steriod HA injection didn't work, a month later a different steriod and HA the horse stayed sound for 2 years before becoming sore again. The pastern can be a very unforgiving joint I know I just had my gelding pastern fused after two years of chronic pastern lameness. We had used extended rest and rehabillition for his collateral ligament of the pastern joint injury IRAP, steroid HA, legend adequan, balanced shoeing, recovery EQ HA but I could not get him 100% when he developed ringbone. You may want to consider IRAP one injection into the knee and pastern may help alot. For general arthritis a loading dose of adeqaun really helped my boy, perhaps with equioxx. If he is lame now you may want to redue the blocks to rule out heel pain for the pointing.

[mjrtango93]

Joint injections really are a case by case basis. Typically speaking older horses, and those with more damage don't tend to go as long between injections as a horse with less damage. If the horse is showing pain again it is most likely wearing off. It shouldn't be an all in 1 day type of deal so if he was fine yesterday and bad today, chances are thats a new injury. Joint injections would gradually wear off over a couple week period. We typically do either Adequan or Legend on our guys, tends to last a little longer. Also the skill of your vet in administering the injection will be a deciding factor on how long they work. If the vet gets a really good stick, then it should last longer then if it was questionable.

[TheOrangeOne]

Thanks. I'll keep an eye on him for the next couple weeks. If this is as bad as it gets, then that's better than I had anticipated, but it makes sense that it wears off over the course of a couple weeks.

[ToN Farm]

Joint injections would gradually wear off over a couple week period.:confused: What is the source of that information? I've never heard of anyone getting IA injections more frequently than twice a year. If they only lasted two weeks, who would bother even getting them?

[EqTrainer]

It's not that they "wear off".

The idea is that you arrest inflammation in the joint. Ideally the injection does a good enough job of this, that inflammation does not reoccur for while. Perhaps, never. The usual, however, is 6 to 12 months.

It's not like 10cc of banamine, that has pain relieving qualities and is an antispasmodic and antiinflammatory. That wears off after 12 hours or so.

Hope that helps.

[mjrtango93]

:confused: What is the source of that information? I've never heard of anyone getting IA injections more frequently than twice a year. If they only lasted two weeks, who would bother even getting them?

Sorry didn't mean the injection would only last a couple weeks (ugh that would be expensive), I meant that you see the gradual decline of effectiveness over a couple week period. Say the injections "works" for 4 months. On that last day they aren't suddenly terrible, they just start getting worse over a period of time. Make sense?

[TheOrangeOne]

That makes a lot of sense, also. I had just assumed that the steroid remained in the joint for a certain amount of time (doesn't the HA?), but that explains the differences in how long you can see the effect.

ToN, what she meant was that the effects of the joint injection will wear off over a period of a couple weeks, not a couple weeks later.

[Trees4U]

Maybe has to do with the condition of the cartiledge and /or synovial fluid. When cartiledge breaks down theres not much cushion left. And if the production of synovial fluid decreases, or the fluid is not thick, that wears out cartiledge & joints rub against each other -eventually its bone on bone
So it depends on how much cart is there and the fluid condition as to if your injections last 2 months or a year

This is my opinion based on numerous visits, arthroscopic surgery, injections, etc at Cornell many yrs ago