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Stifle Injections: Which joint?

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  • Stifle Injections: Which joint?

    Hi guys.

    I'm looking in to injecting my 16yr old Dutch gelding's stifles. I bought him last January and keep in close contact with his previous owner. He had been showing I1 dressage when I bought him but has been doing mainly first level stuff with me.

    In the six years that the last owner had him, his stifles were injected twice and the horse "felt like a different horse" after. The owner had them injected at the vet's "let's see what happens" suggestion- no sign of injury, etc.

    Now that I am starting to ride a bit more collection, forward, and lateral movements (and horse's year of being more on the forhand, not lateral, maybe a little crooked), I am thinking about trying the injections. Although I am still working on perfecting my ques for the movements, the horse feels quite stiff, etc. As I recall, he didn't feel like this when I trialled him. I realize it's normal to be less stiff when doing these movements regularly....

    Anyways, the vet that I have doesn't seem to be extremely "performance" minded, and while I'm glad to have a vet who doesn't treat my animal like a machine who should be injected and "quick fixed" at the drop of a hat, it's been a little difficult talking to them about getting the stifles done.

    I mentioned them to vet and got "well, we need to do diagnostics - ultasounds, xrays......there are several joints within the stifle and we need to make sure we inject the right [most beneficial] one".
    I got the previous vet records to see which joints they did and they say "injected stifle joints" and that's it! So.... is there a most common/go-to stifle joint most vets inject first?

    The previous owner is a trusted friend, upper level rider, and knows the horse. While I am a little cautious, I am happy to follow her suggestion of skipping diagnostics...

    And finally, while on the subject, his poll was also injected once (no signs/symptoms), apparently made an extreme difference both under saddle and in the paddock. I hadn't heard of this - any thoughts?

    Thanks so much!

  • #2
    Whilst your veterinarian may not be as "performance minded" as you might wish, I consider his desire to establish the origin of any stifle issues prior to performing an invasive treatment laudable.
    "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

    ...just settin' on the Group W bench.


    • #3
      Honestly, I would do the diagnostics. At the very least radiograph the joints first. I would really want to know WHY the horse is better after injections. I don't think stifles do very well with multiple injections either. Is the horse on Adequan?


      • #4
        The thing with injections is you run the risk of further damaging the joint the more injections you do. As much as it's a pain in the a$$ to do radiographs or other diagnostics, it's important to know why and where the stiffness is originating before treating. Could you call up the previous vet and actually ask why he decided to inject, and where? And what exactly he noticed in the horse that triggered the idea of injecting vs a supplement like Adequan or similar?
        Sometimes I wonder about vets that jump right to injecting in cases like yours, where it sounds as if there may not be such a need. I am projecting here, I realize, but it might be in your best interests to find out if there's more to the story than just an experiment.


        • #5
          I probably would not be inclined to let a non-performance vet, who probably doesn't do a large number of injections, inject my horse. There's also a difference between a horse that needs injecting to be sound, and one that needs injecting to perform at its best. It doesn't sound like your vet is going to be able to distinguish the second case.


          • #6
            My vet injects in two places for the stifles.
            I love cats, I love every single cat....
            So anyway I am a cat lover
            And I love to run.


            • Original Poster

              Thanks for your opinions. I think I will look at other practices, as CBoylen suggested, for a vet who is more experienced with the procedure. They will probably be the best at answering my question regarding the most common joint within the stifle to inject.


              • #8
                Originally posted by GimmeQs View Post
                I think I will look ...for a vet who is more experienced with the procedure. They will probably be the best at answering my question regarding the most common joint within the stifle to inject.
                While I think that seeking an experienced practitioner to perform joint injections is an excellent idea, I hardly think you're likely to locate one who is merely going to tell you which joint is most commonly injected and then simply perform the task without determining *if* it's indicated.

                Hell,I could tell you the answer to that question.
                But it's largely irrelevant.
                "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

                ...just settin' on the Group W bench.


                • #9
                  I wonder if you might consider Adequan, which is injected IM, and see if that might help him out? I am all for avoiding needles in joints whenever possible.


                  • #10
                    Realize this is an old post, but for informational purposes:

                    Vet injected my guy's medial femorotibial joint with 2.5 cc betamesthasone and 2 cc Hyvisc, and the lateral femorotibial joint with 1cc betamesthasone. This was for Stifle ocd. It worked well. He will have it done again in spring and when it fails to work, I'll try irap or tildren. Vet is well known sports med vet so I trust him over the average farm vet that I use for teeth and general stuff. Kenalog is also good instead of betamethasone. Both are chrondroprotective steroids.