I will try to keep this short, but I have a gelding that I have been taking to a very well known performance vet who treats multiple NFR horses and every couple of months he comes in from out of state to work on horses.   He told me this last time that my horse needed his SI injected, I have seen this done before and I know that to truly inject the SI joint it is an 8" needle and needs to be ultrasound guided.  Neither of which was used on my horse.  When I received the invoice the farm call was almost twice as much as it was the last two times I have hauled there (he comes to a barn that I haul my horse too) and the standard lameness exam that he has performed the last two times went up to almost $200 this last time.  The most upsetting thing was the fact that if my horse truly does need his SI joints injected, that I know the needle was not long enough to reach the SI joint and it was not ultrasound guided.  It looked like to me that it was just muscle injections.  On the invoice it states that he used betamethasone and B12 for the injections?? Has anyone ever heard of using this?  This is a very well respected vet but I was a little disappointed in the price increase and the fact that he said he was injecting his SI joints but I know now that there was no way he could have reached the actual SI without the longer needle and ultrasound guide.  Anyone have any advice on how to handle this situation? TIA !

Older track vet never needed ultrasound. Younger track vet uses it. The price increases should have been mentioned up front. I'd be looking for a new vet. 

Older track vet never needed ultrasound. Younger track vet uses it. The price increases should have been mentioned up front. I'd be looking for a new vet. 

My performance vet uses ultrasound guided injection for SI. SI's are not only deep deep, but very very close to spinal structures. I did have one mare injected with B12 throughout her hips and SI area many years ago, same vet, and he used 2" to 3" needles. With the shorter needle I would assume some little bit of meds might spread to the SI area, and the vet would not be likely to hurt anything critical. 

When I have my SI's injected (PRP, but still SI) it is ultrasound guided. 

Yes, you are right, it takes a long needle to inject the SI and it most DEFINITELY needs to be U/S guided. I have seen B12 used with dmso in acupuncture points and in KS injections, seems like it wouldn't hurt to mix it with Betamethasone (cortisone) for an SI injection. It's not going into an actual joint pouch so it should be ok.

Thank you all so much for your input.  I am going to get another opinion once I recover from this sticker price! Thanks so much !