|
|
 Money Eating Baggage Owner
Posts: 9586
   
Location: Phoenix | What cocktail do you guys have your vets inject joints with?
As default my vet is offering HA. I know steroids are not ideal in the joint....what else is there? |
|
| |
|
The Advice Guru
Posts: 6419
 
| HA is the best, it is synthetic joint fluid.
There are different grades of HA, legend is a low grade, hylartil 4 or 5 is higher grade, but it costs 150-200 per injection, it lasts longer.
I won't inject depo, beta, into any joint, trimisclione (sp) there are some studies that have shown cartilage improvement after injections.
The only other alternative is adequan, which has success given IA but the largest risk factor was the infection rate was about 50 percent, I think the latest studies are showing infection rate of 30 percent. My vet won't do this unless the horse is all out of options due to the infection rate. |
|
| |
|
 Straight Shooter
Posts: 5725
Location: SW North Dakota | IMO it depends on the joint... i don't mind a steroid in the lower hock joints and the vet combines it with HA and an antibiotic. |
|
| |
|
 Expert
Posts: 5293
| ND3canAddict - 2016-12-08 8:41 AM
IMO it depends on the joint... i don't mind a steroid in the lower hock joints and the vet combines it with HA and an antibiotic.
Sometimes you HAVE to have a steroid... There is inflammation in the joint and thats the only way to get it out. My vet uses a combo of HA/Steroid ( Long acting) and Antibiotic in high motion joints. Low motion joints like Hocks are Steroid only. I WANT them to FUSE. HA prolongs the process/Pain. |
|
| |
|
Straight Shooter
Posts: 5725
Location: SW North Dakota | FLITASTIC - 2016-12-08 10:00 AM ND3canAddict - 2016-12-08 8:41 AM IMO it depends on the joint... i don't mind a steroid in the lower hock joints and the vet combines it with HA and an antibiotic. Sometimes you HAVE to have a steroid... There is inflammation in the joint and thats the only way to get it out. My vet uses a combo of HA/Steroid ( Long acting ) and Antibiotic in high motion joints. Low motion joints like Hocks are Steroid only. I WANT them to FUSE. HA prolongs the process/Pain.
I had a gelding that had chronically sore hocks- injections of any sort would only help for about 2 days. After 4 years of farting around with him, we finally did the alcohol fusion as a last ditch. Within hours he seemed better, and in a few days there was no doubt he was better. Although the research says this is an usual reponse time, as most get SUPER sore afterward, our horse had almost instant relief. It's been 3 years since we treated him and he's 100% sound! |
|
| |
|
 Coyote Country Queen
Posts: 5666
| I just had hocks injected with Legend, Triamcinolone, and Depo Medrol. I honestly haven't done research, I'm just trusting my vet to treat my horses with the best/appropriate medications. He is a well-respected vet at a well-respected clinic, so I feel like he has the knowledge to do this. And I guarantee that if I asked he would explain exactly why he is doing what he is. (He answered several random questions for me at my appointment!) |
|
| |
|
Expert
Posts: 1509
Location: TN | I do a steroid and antibiotic only in low motion joints.... HA comes right out right quick. you want HA give legend or a generic HA 48- 5hours out before a run.
Edited by tnmagnolia 2016-12-08 12:54 PM
|
|
| |
|
 You get what you give
Posts: 13030
Location: Texas |
Typically you get some type of steroid, plus or minus HA, plus or minus an antibiotic.
Depending on the type of joint, number of joints, job of the horse, and age of the horse, the steroid choice may change. With older horses we may choose to not use HA and just put steroids in.
Edited by casualdust07 2016-12-08 1:06 PM
|
|
| |
|
You get what you give
Posts: 13030
Location: Texas | There was a paper that came out a year or so ago that suggested combining HA with steroids actually decreases the efficacy of the steroid, so I've seen several vets using less HA in joints especially in older horses who really need the steroid for pain relief. |
|
| |
|
 BHW Resident Surgeon
Posts: 25352
Location: Bastrop, Texas | Betamethasone, dexamethasone, and Triamcinolone are all steroids.
They vary in terms of their anti inflammatory potency. The main advantage of Triamcinolone is that it is less soluble than the others, so it stays in the joint longer than the others, which are more readily absorbed into the systemic circulation, eventually.
 (image.jpg)
Attachments
----------------
 image.jpg (46KB - 195 downloads)
|
|
| |
|
 It Goes On
Posts: 2262
Location: Muskogee, OK | In my opinion Hyalauronic acid is a must have in all high motion joint injections- I personally include HA in most of my lower motion joint injections as well but I think you could get away without in those instances if you had to. It is very rare for me to inject any joint with just HA and no steroid- you just don't get the significant anti-inflammatory effect without utilizing some sort of corticosteroid in your injection, and the whole point of most joint injections is to reduce inflammation and promote a healthy joint environment.
All steroids are not made equal, some are not so cartilage friendly and others have actually been shown to have chondroprotective (pro-cartilage) effects. By and far the three most common steroids to be injected into a joint are Depo-medrol, Triamcinolone and Betamethasone. All veterinarians have their own preferences and below is a simplified outline of my protocols.
Standard hock injections (DIT/TMT= lower 2 hock joints): Legend, Depo and Triamcinolone.
Higher motion joints (coffin joints, stifles, fetlocks, etc): A higher molecular weight HA such as Hyvisc and either triamcinolone or betamethasone depending on the horse's history and circumstances.
Keep in mind the higher the molecular weight the more expensive the HA product will be. One of the main benefits of a higher molecular weight product is the ability to stay within the joint capsule better.
|
|
| |
|
 Expert
Posts: 1612
Location: Cocoa, Florida | My mare is 8 and I give her a adequan/glucosamine injection in the butt monthly, she has shown no signs of lameness or soreness, no swelling etc. I started her late 6/7 year old year, ran pretty hard this year so when do I start injevting? I had a 4 year old that already needed it she was race bred top and bottom, this mare is cow bred/foundation and old school running, I feel like she will hold up better in the long run.
So do I just wait until she shows signs of soreness? I don't like jumping on the injection band wagon unless absolutely necessary. |
|
| |
|
Elite Veteran
Posts: 618
| RnRJack - 2016-12-08 6:32 PM
My mare is 8 and I give her a adequan/glucosamine injection in the butt monthly, she has shown no signs of lameness or soreness, no swelling etc. I started her late 6/7 year old year, ran pretty hard this year so when do I start injevting? I had a 4 year old that already needed it she was race bred top and bottom, this mare is cow bred/foundation and old school running, I feel like she will hold up better in the long run.
So do I just wait until she shows signs of soreness? I don't like jumping on the injection band wagon unless absolutely necessary.
Generally speakingi wait for my horses to "tell me" something is wrong before I inject but you need to be paying attention for the subtle cues.
Taking them for yearly checks otherwise is a good rule of thumb.
I have a 5 yr old that was riding correctly, not lame we aren't going fast, he's not finished, but just felt off in his right hand turns particularly on the backside of turn. I took him in and he was sore in his left front fetlock. Xrays showed a tiny cyst. Treatment included injection, Pentosan monthly(I did load dose) my vet also reccommended cosequin ASU however I mix my own supplements. He feels 110%
Recheck in 60 days. Most vets don't tell you that the meds can only stay in the joint about that long. X Ray in 4-6 months. Right now we are managing issue and as long as this protocol works we'll continue. We used Vetalog(sp) for injection.
Took my 10 yr old in as well for just an overall check up. Upon flexion he was a little sore in right stifle, xray was clean but we injected and started him on Pentosan as well. Check in 6 months.
It's important to know WHY your injecting as well as what your injecting with. So many people I know just inject without xrays and have no clue what's really going on.
I love how good my horses are feeling on the Pentosan.
Edited by iloveequine40 2016-12-08 8:02 PM
|
|
| |
|
 Mature beyond Years
Posts: 10780
Location: North of the 49th Parallel | HA and Triamcinolone |
|
| |
Folks on-line