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Hock injection question: Steroid only, or HA?

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  • Hock injection question: Steroid only, or HA?

    I've decided to have my daughter's 21 year old pony club mount's hocks injected this week for the first time. He's reached the point where he needs a bit of help beyond Adequan.

    I've discussed all this at length with my vet. We've decided not to do radiographs. The vet says he typically uses just a steroid in the hocks and does not use hyaluronic acid.

    I'm curious to hear others who are having hock injections done with older horses. I always had the impression that most joint injections combined a steroid with HA.

    Thanks!

  • #2
    I had my guy injected with cortizone. I would be a bit leary of having injections done without Xrays. You don't want to disrupt the hocks if you truly don't have to.

    Comment


    • #3
      There's differing opinions. One vet told me that in the lower joints, he prefers to just use steriods, since those joints don't move much and it's ok to just use steriods because any damage to the cartledge just encourages that jont to fuse faster.

      Another vet said to always use HA and steriod.

      All horses differ, but mine was just injected with just steriod and it only lasted 2 weeks! She's on Adequan now with possible reinjection (with HA and steriods) in April if she's not doing well.

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      • Original Poster

        #4
        Thanks for the input!

        Comment


        • #5
          I've never had a vet use just steroid- he either uses just HA or a mixture. The steroid quiets the inflammation in the joint, the HA provides the lubrication to make the joint work better (at least thats how the vet explained it).

          However, at 21 I'd want to make sure the lower hock joints weren't fused (or almost fused) before I injected them. Some vets think that injecting can delay the fusing process, which is not what you want.

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          • #6
            Originally posted by joiedevie99 View Post
            I've never had a vet use just steroid- he either uses just HA or a mixture. The steroid quiets the inflammation in the joint, the HA provides the lubrication to make the joint work better (at least thats how the vet explained it).
            Yea, I've never heard of steroids alone. Only HA alone, and steroids + HA.

            And I would strongly suggest radiographs, especially since it's the pony's first IA injection!

            Comment


            • #7
              I have used steroids alone in the lower hocks and was not happy with the results. Personally, I prefer a mix of steroids and HA.

              Comment

              • Original Poster

                #8
                Thank you everyone for your responses. I really appreciate it. Vet says he uses just a steroid in the hocks due to so little joint space, it being a 'low motion' joint (lower hock joints).

                After reading a bunch about steroid vs. steroid/HA in the hocks, I can see that vets do both, and can see the pros and cons to some degree.

                We're going to discuss this further and I think I'm going to go ahead and spring for full hock rads. Thank you COTHERS for all your input, as always it's so helpful.

                MTA: Helpful article on hock injections!
                Last edited by Watermark Farm; Mar. 24, 2011, 02:44 PM.

                Comment


                • #9
                  Steroids only: short term solution. Can actually result in more cartl damage in the long run. Doesn't "solve" the problem.

                  My vets use HA and steroids. (I don't do hocks, esp not on my own!) The steroid is for short term immediate anti-inflammatory effect but the HA is what actually helps the joint fluid.

                  Jsut my 2 cents.

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                  • #10
                    I've had 3 vets do hocks for me. 2 use steriods and HA, one just steriods. I've had a pretty extensive discussion with the one that doesn't use it about why she doesn't use it, and she said (after talking to many different, very well-qualified lameness vets and getting their opinions) that she doesn't think it really helps in older horses. She will use it in younger animals, but she doesn't think there is a huge change in the older ones. This is something I had not heard before, but after doing just the steriods this last time around we injected hocks, I have to say I had the same effects as in past when using the HA.

                    She also discussed the type of steriod she would use- Depo for the lower hock joints, since they are low motion, as well as triamcinolone. But in the high motion joints she injects, she just uses triamcinolone or betamethasone since these do not cause the same (or any?) damage to the cartilage. SHe also will not inject more than twice a year. So a lot of the damage you see is caused by the type of steriod you use, and how often you use it.

                    She said she would be happy to use the HA if I wanted, but thought, in her opinion, it would be a waste of money. Just another opinion to throw in there...

                    Comment


                    • #11
                      I would want HA in there. I actually prefer IRAP and adequan but that is me. Best luck!

                      Comment

                      • Original Poster

                        #12
                        Thanks all. Vet injected the lower 2 hock joints with a steroid only on Friday. The vet felt HA was unwarranted in this situation. Thanks Eventer 13 for the info, I'm going to ask what steroid he used. The horse is already moving better, not dragging his toes behind so much, and it's easier for him to lay down. Fingers crossed this was the 'right' way to go.

                        I also have this horse on Adequan and Recovery EQ with the hope that this helps support better joint function overall.

                        When the vet inserted one of the needles, some joint fluid spurted out. Vet said that happens. Is it normal? Is it a bad thing?

                        Comment


                        • #13
                          Joint fluid does usually come out unless the joint is "dry". My vet can usually tell alot by the consistentcy of the fluid in terms of how well the fluid is lubricating the joint.
                          www.shawneeacres.net

                          Comment


                          • #14
                            Just wanted to add my story. My horse just had his hocks injected with steroid only. My vet said lower joint is best for steroid only as well as the age of the horse. He said he would problably mix HA for a horse younger than 10 but since my guy is just a tad older and in pretty hard work, suggested just the steroid. He also suggested Pentason(spelling?) before any "stressful" event. We shall see.

                            Comment


                            • #15
                              I had my horse's hocks injected a few weeks ago with steroids only (depo- lower hock joints) and while the hocks ended up not being the primary cause of the hind end lameness, he does now flex negative to hock flexions so it seems like the steroids only helped.

                              Comment


                              • #16
                                Originally posted by morganpony86 View Post
                                Yea, I've never heard of steroids alone. Only HA alone, and steroids + HA.
                                LOL, that just means you aren't old enough. Just like we used to tube worm and didn't have ivermectin, there was a time before HA.

                                But yeah, HA is an obvious improvement on the old days.

                                I'd be interested and maybe a tad skeptical on the steroid only to speed fusing, if only all the research I have read says a) that steroids damaging the joint is not as true as we thought and b) of the steroids that do ultimately cause issues in the hock, it takes frequency and time - more like the monthly injections seen in some areas of the track, not the typical 1-2x year show horse routine. It also seems like anything that reduces inflammation would slow the fusing process.

                                But then again there are a LOT of things that in a way contrary to the logic a layperson could come up with, so there is that.

                                Interesting though, I've got an app't next week for a laundry list of stuff (aka bankrupt DMK day) and one of the things on the list is "are those hocks fusing on the 19 year old or will I be paying for injections as well?" Would be interesting to know if both could be on the table.
                                Your crazy is showing. You might want to tuck that back in.

                                Comment


                                • #17
                                  I just had my 14 year old OTTB's hocks done a few weeks ago. Upper, middle, and lower joints with acid and steroids, half and half we call it. After struggling a bit on the one lower joint, she told me that next time we do him, she thinks just the steroid would be the way to go, as he is almost fused hence the trouble trying to get into the particular joint. She thinks, in his case, that would be of the most benefit.

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