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Another hock injection question

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  • Another hock injection question

    Hi there,

    I'm new to this whole hock injection process and have some curiosity questions.

    I have a 20 year old mare who was out of consistent work for a while, and since last summer when she was brought back into regular work by a lessor, has developed some soreness in one hock. When I purchased her at age 9, she was acknowledged to have a tiny OCD lesion in that hock. Since she never showed any issues working on it, I didn't bother having surgery and stuck with oral cosequin and periodically HA as a preventative measure. She hasn't been on that recently.

    Since then, the mare was kicked in the hock and developed a small cap (more due to scar tissue from getting sliced across the point of the hock than anything) but again was sound after that all healed up and showed for a few years after that with no issues.

    After several months of not seeing her and going down to visit this weekend, she is definitely sore in that hock. She was a bit stiff on the longe, and when I rode her to the right at the canter she was extremely tight and "stilty" and my sister (who was watching) said she wasn't bending that hock at all. It seems obvious the time has come to do some injections on it.

    Here is my question- where do you start? Do you start with injecting all over, or just the lower portion of the joint? Do you do both hocks even though the other one seems fine? Despite knowing exactly what the deal is, would you x-ray anyway?

    She's been adjusted by a chiro who said she should be "good to go" as far as chiro work goes, so we have definitely narrowed things down to this particular joint. The vet looked at her during her spring visit last week and said she doesn't have any other obvious issues, muscling looks even, etc. Plus given her history it seems a no-brainer.

    However I would love some feedback from others with more experience on this and how you normally start on this process in such a situation.

    Thanks!

  • #2
    Originally posted by Spectrum View Post
    Here is my question- where do you start? Do you start with injecting all over, or just the lower portion of the joint? Do you do both hocks even though the other one seems fine? Despite knowing exactly what the deal is, would you x-ray anyway?
    In this case, I'd start with flexions and a radiograph, because you're dealing with two potential issues here: arthritis in the lower joints or an OCD in the high movement upper joint. Those two scenarios are treated differently and treating one if the problem is the other will not provide relief.

    There are 7 bones in the hock, right? There's one high movement joint that's responsible for nearly all of the flex in the hock (I assume this is where the OCD lesion is?) Obviously you want to maintain as much cartilage health in this joint as possible, so treating it would involve injecting HA, or IRAP or perhaps Adequan into the joint. Surpass might also help.

    But if the problem is arthritis in the lower joint of the hock, that's different, because you WANT that joint to fuse. It has very little movement and the horse is only painful during the fusing process. So you use Depo-Medrol, which will knock back the pain significantly and also aid in degrading that cartilage, to encourage the joint to fuse. You can also inject other things that will seriously speed up the fusion of the joint, like alcohol (although you would need to do a contrast study to ensure that the lower joint doesn't communicate with the upper joint, as alcohol leaking into that upper joint would be a Very Bad thing.)

    So, long story short: even though you know the issue is the hock, you need further diagnostics to figure out exactly *where* in the hock the problem is, as treatment varies depending on the exact problem.

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    • #3
      Shoot some x-rays of both hocks so you know what you are dealing with.

      Comment


      • #4
        Definitely get an xray of it to check the status of the OCD lesion.

        If you decide to inject, do both hocks.

        Comment


        • #5
          Lameness exam and x-rays. You never know what's really going on until you can see inside! Once you get x-rays, then you can choose your options. Injectable joint support like Pentosan, Legend, Adequan to keep the horse happy while getting back in shape, or injecting the joint(s) right away, or doing some combination of both.
          "On the back of a horse I felt whole, complete, connected to that vital place in the center of me...and the chaos within me found balance."

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