Hock Injections: Oy Vey!

I watched my friend’s lesson today. She has a lovely thoroughbred gelding who she has owned since practically forever. He will be 19 next year, and she wants to be proactive in regards to his maintenance and encroaching arthritis. Right now he is in work and is sound. He is starting to show signs of stiffness when he warms up, but it is in the middle of winter and his turnout time has been cut back to only half a day. Recently he started being late to switch his lead behind when going from left to right, which led his owner to believe he was stiff mostly in his right hind leg. An accurate diagnosis, I believe, although there is no heat or swelling. We agreed that it is most likely arthritis starting to set in. After all, this horse raced for three years and was shown extensively in the hunters.

She was also concerned because he had been “extra” lazy but he sure booked it when her instructor gave her a set of spurs, so I’ll chalk that up to being a bum and not pain related. In the hour long lesson he really moved and did tons of trot work, canter work, and at least half a dozen lead changes across the long diagonal. The lesson finished up with him jumping through a grid that ended in a 2’6” oxer which he did about 8 – 10 times without refusing or knocking a rail. Like I said, the guy is sound.

But my friend really wants to stay on top of his maintenance because she is a wonderful horse mama and asked her instructor (who is also the barn owner) what she could do. The instructor’s first response?

Hock Injections.

The instructor went on to say how she found it unbelievable this horse was going as well as he was going at the old age of 18 without having any work done (yeah, it almost sounded like she was saying he needed plastic surgery and yeah, I snickered a little bit). She said hock injections were leaps and bounds ahead of where they had been ten years ago, and that every horse should get them as they age. This brought up a few questions in my mind:

1) At what age is a horse considered old? I don’t find 18 to be that old for a horse. There are 18 year old horses out on the Grand Prix circuit right now. Heck, look at Brentina, who didn’t retire until the age of 19.

2) When did hock injections become “regular maintenance”? When I went to school at Delaware Valley College, ONE out of the forty school horses there was getting its hocks injected. Now granted, it is because the owner who was leasing it to the program was paying the fee, but still…

3) How often do you have to get injections done? How much are they? Once you start, do you have to keep up with them? Can you do them yourself?

4) What the heck do hock injections DO?

Three years ago I had the vet out take a look at Darwin, who has hocks the size of softballs. He was six at the time. The vet immediately recommended hock injections. As I was poor, and my horse was only six, I said no. But as I watched my friend’s lesson and heard her instructor’s suggestions, I realized I don’t know any more about hock injections now than I did back then. So I decided to do a little research. This is what I found out (in a very simplified nutshell).

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[Please Note: Every single website and book I read had contradicting information, from what causes arthritis in the joints to if and when hock injections should be used. After wading through it all I come up with my best interpretation, but the following is not meant to replace any vet’s advice.]

The hock is basically made up of three joints (there are technically four, but for the purpose of this post I’m going to pretend there are really just three): upper, middle, and lower. Between those parts is cartilage. When the horse ages, or through repeated stress (jumping, for example) that cartilage begins to thin, allowing bone to rub on bone. This most commonly occurs in the middle and lower joints first. As you can imagine, this doesn’t feel too good for the horse.

When the cartilage begins to thin, the lower joints naturally want to fuse together. If the LOWER joints fuse, the horse will be able to move pain free. If the UPPER joints fuse the horse will most likely have to be retired from anything other than occasional trail rides and pasture status. However, when a horse begins to show symptoms of stiffness in their hocks it is mostly likely from pain in the lower joints.

Joint injections help with the pain and inflammation during the fusion process. There are a whole bunch of different joint “cocktails” that your vet can choose from. The two most common ingredients are hyaluronic acid (which occurs naturally in the joints and is present in cartilage) and a corticosteroid, which is a powerful anti-inflammatory.

“Medication of joints with the appropriate corticosteroid, at the appropriate dose, in combination with HA, will give excellent pain relief, reduction of inflammation and still be supportive of long-term joint health.” – Dr. Currid.

There is no proof that preventative hock injections (IE injecting the hocks before lameness occurs) does anything to help the horse and some vets believe injecting a healthy joint can actually cause premature degeneration of the cartilage.

How often you need to get the hocks injected varies greatly. Some horses are done twice a year, some as often as every three months. You and your vet will also need to determine WHAT joints need to be injected, depending on where the horse is getting sore (upper or lower). Often there is a “loading period” when you are first starting joint injections, followed by a scheduled maintenance dose.

Many horse owners have had great success with getting their horse’s joints injected. However, there can be side effects, including joint contamination. Make sure you discuss ALL the possible negatives with your vet before getting your horse injected.

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My personal conclusion: If your horse is sound, do not inject their hocks. If they begin to show soreness in their hind end and you suspect their hocks, get a lameness evaluation and x-rays done before you begin injecting willy nilly. If you have an older horse, a low dose of bute to help with the pain and inflammation may be a heck of a lot easier (and less expensive) to give until the joints fuse. Don’t expect hock injections to work miracles. They are intended to help your horse with their pain and inflammation during the natural fusing/degeneration process of their joints, not cure them.

So what do you think? Hock injections yay or nay? Do you get your horse injected? Will you when they get older? Do you know anyone who does?



http://drtanis.com/2011/06/03/hock-injections-101/
http://www.ctrdvm.com/html/jointinjections.html
http://www.oceanstateequine.com/news/checkoutdrcurridsarticleonhockinjectionsinequinejournal.html