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Opinions on Injecting Joints

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Last activity 2015-04-07 8:42 AM
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Zanadoo88
Reg. Sep 2010
Posted 2015-04-05 5:22 PM
Subject: Opinions on Injecting Joints



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I was curious about the pros and cons of injecting joints with HA and steroids. What are your experiences with it? Does it have any long term consequences involved? Will horses deteriorate faster? Etc..??? Thanks :)
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svincent
Reg. Feb 2012
Posted 2015-04-05 5:26 PM
Subject: RE: Opinions on Injecting Joints


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There's a TON of info on here. I'd do a search. Also, it is pretty case specific what/when/where to inject - I'd just talk to your vet. What makes you think your horse needs injections? Where? Has he had scans done? What does your vet say?
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cheryl makofka
Reg. Jan 2011
Posted 2015-04-05 5:31 PM
Subject: RE: Opinions on Injecting Joints


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Trimethisclione is the only steroid that has the studies showing a benefit

Depo medrol and betamethasone have studies showing long term cartilage damage, these will actually errode or eat away at the remaining cartilage

Depo has been showen to prevent healing for month after injection due to the metabolites left behind

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Zanadoo88
Reg. Sep 2010
Posted 2015-04-05 5:39 PM
Subject: RE: Opinions on Injecting Joints



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svincent - 2015-04-05 5:26 PM

There's a TON of info on here. I'd do a search. Also, it is pretty case specific what/when/where to inject - I'd just talk to your vet. What makes you think your horse needs injections? Where? Has he had scans done? What does your vet say?

The reason why I'm asking is that my vet had thought that my horse was a candidate for surgery on her stifle and hock as I think he said she had OCD. He said she had lesions in both hocks and on the right stifle. He had a surgeon review the x-rays and the surgeon said he didn't think her lesions were bad enough to warrant surgery at this time. She is only five years old and I just want her to be comfortable and have the most longevity possible. My vet said he would like to inject her with HA and a steroid to make her more comfortable but he was not specific on what he would be using.
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cheryl makofka
Reg. Jan 2011
Posted 2015-04-05 6:39 PM
Subject: RE: Opinions on Injecting Joints


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Zanadoo88 - 2015-04-05 5:39 PM

svincent - 2015-04-05 5:26 PM

There's a TON of info on here. I'd do a search. Also, it is pretty case specific what/when/where to inject - I'd just talk to your vet. What makes you think your horse needs injections? Where? Has he had scans done? What does your vet say?

The reason why I'm asking is that my vet had thought that my horse was a candidate for surgery on her stifle and hock as I think he said she had OCD. He said she had lesions in both hocks and on the right stifle. He had a surgeon review the x-rays and the surgeon said he didn't think her lesions were bad enough to warrant surgery at this time. She is only five years old and I just want her to be comfortable and have the most longevity possible. My vet said he would like to inject her with HA and a steroid to make her more comfortable but he was not specific on what he would be using.

Depo is very cheap and this is why vets like using it as they make more money (IMO)

I don't allow any vet to inject anything into my horse without telling me and myself knowing all the potential side effects/adverse reactions

This goes from sedatives all the way to what they are injecting into joints

I have found the vet drug books do not give sufficient info

The equine pharmacology text books give more detail, I have bought mine off of amazon
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Zanadoo88
Reg. Sep 2010
Posted 2015-04-05 11:49 PM
Subject: RE: Opinions on Injecting Joints



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Ok well I just have general questions I guess. Like on average how often do you have to inject? My mare is not considered lame just stiff and her lesions are very slight. If I didn't go the injection route is there anything I can do to make her more comfortable? Does conditioning do anything? Etc..


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SKM
Reg. Dec 2003
Posted 2015-04-06 5:34 AM
Subject: RE: Opinions on Injecting Joints



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 OCD lesions happen when the soft ends don't change over to bone properly in babies. You basically have pockets of cartilage in what should be bone. They don't fix themselves. Injecting might help the pain, but you won't be fixing the underlaying cause of that pain. Injections typically last 6-12 months.
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kwanatha
Reg. Dec 2003
Posted 2015-04-06 8:41 AM
Subject: RE: Opinions on Injecting Joints


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mine was not lame either and his lesion was very small. my surgeon had the opposite advice. He warned me that if I inject I risk a fragment from that weak spot breaking loose and causing damage to the joint;. we did surgery. good thing there was a very tiny fragment and it did cause a very minor amount of damage.my surgeon congratulated me for making that call as he gets disappointed when his clients wait until there is too much damage for him to go in repair and risks having an unsuccessful outcome.
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Zebra racer
Reg. Feb 2015
Posted 2015-04-06 10:11 AM
Subject: RE: Opinions on Injecting Joints



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Is she a performing horse now or just a prospect? I would try injection rather than surgery as a start.
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dianeguinn
Reg. Oct 2003
Posted 2015-04-06 10:21 AM
Subject: RE: Opinions on Injecting Joints



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Zanadoo88 - 2015-04-05 11:49 PM

Ok well I just have general questions I guess. Like on average how often do you have to inject? My mare is not considered lame just stiff and her lesions are very slight. If I didn't go the injection route is there anything I can do to make her more comfortable? Does conditioning do anything? Etc..



Honestly, having dealt with this, you're better off to just go ahead and have the lesions arthroscopically removed. As long as they are there, the horse will have pain. The injections just take away the pain for awhile and they will eventually eat up the cartilage long term, so especially in the stifle, I would do the surgery to remove the lesion if you are going to continue to barrel race on this horse. Depending on where the lesion is in the hock, you might be ok to go ahead and inject if the lesion is in the bottom joint. If it's in the upper joint, I would just recommend you go ahead and have surgery to remove that one, too. Yes, you can keep her serviceably sound for awhile with injections, but she will eventually be a broodmare or pasture pet if you don't remove the lesions. They don't go away or heal. :(
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dianeguinn
Reg. Oct 2003
Posted 2015-04-06 10:22 AM
Subject: RE: Opinions on Injecting Joints



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kwanatha - 2015-04-06 8:41 AM

mine was not lame either and his lesion was very small. my surgeon had the opposite advice. He warned me that if I inject I risk a fragment from that weak spot breaking loose and causing damage to the joint;. we did surgery. good thing there was a very tiny fragment and it did cause a very minor amount of damage.my surgeon congratulated me for making that call as he gets disappointed when his clients wait until there is too much damage for him to go in repair and risks having an unsuccessful outcome.

I think you and I were posting at the same time. Bad idea to inject and not remove IMO.
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barrelracr131
Reg. Aug 2011
Posted 2015-04-06 10:25 AM
Subject: RE: Opinions on Injecting Joints


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dianeguinn - 2015-04-06 10:21 AM
Zanadoo88 - 2015-04-05 11:49 PM Ok well I just have general questions I guess. Like on average how often do you have to inject? My mare is not considered lame just stiff and her lesions are very slight. If I didn't go the injection route is there anything I can do to make her more comfortable? Does conditioning do anything? Etc..
Honestly, having dealt with this, you're better off to just go ahead and have the lesions arthroscopically removed. As long as they are there, the horse will have pain. The injections just take away the pain for awhile and they will eventually eat up the cartilage long term, so especially in the stifle, I would do the surgery to remove the lesion if you are going to continue to barrel race on this horse. Depending on where the lesion is in the hock, you might be ok to go ahead and inject if the lesion is in the bottom joint. If it's in the upper joint, I would just recommend you go ahead and have surgery to remove that one, too. Yes, you can keep her serviceably sound for awhile with injections, but she will eventually be a broodmare or pasture pet if you don't remove the lesions. They don't go away or heal. :(

 Agree

I get lower hocks injected, but high motion joints are another story. If they think the surgery would take care of the issue, and has a low risk, I'd get be lesions removed. 
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hammer_time
Reg. Jul 2007
Posted 2015-04-06 10:30 AM
Subject: RE: Opinions on Injecting Joints



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 I inject the lower hock where my guy shows signs of arthritis per X-rays (he's 16).  If he's that young and shows damage, you're probably better off doing the surgery and eliminating any future damage because he's so young.  If it were a horse like mine (older) Id probably inject to keep him comfortable. 
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SKM
Reg. Dec 2003
Posted 2015-04-06 10:46 AM
Subject: RE: Opinions on Injecting Joints



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dianeguinn - 2015-04-06 9:22 AM

kwanatha - 2015-04-06 8:41 AM

mine was not lame either and his lesion was very small. my surgeon had the opposite advice. He warned me that if I inject I risk a fragment from that weak spot breaking loose and causing damage to the joint;. we did surgery. good thing there was a very tiny fragment and it did cause a very minor amount of damage.my surgeon congratulated me for making that call as he gets disappointed when his clients wait until there is too much damage for him to go in repair and risks having an unsuccessful outcome.

I think you and I were posting at the same time. Bad idea to inject and not remove IMO.

I agree too and I'm honestly wondering what sort of surgeon says to just inject and leave an OCD alone. JMHO but that is setting the horse up to fail.
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grinandbareit
Reg. Jan 2007
Posted 2015-04-06 5:56 PM
Subject: RE: Opinions on Injecting Joints



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I bought a DTF mare several years back... she had an OCD lesion on her right hock... she showed no lameness but I opted to do surgery anyway. I ran her for a few years and then sold her, she did very well on the pro circuit and even won a round in Ft Worth. It was a good decision to do the surgery and she never had a problem after that.

Good luck.

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casualdust07
Reg. Mar 2005
Posted 2015-04-06 6:03 PM
Subject: RE: Opinions on Injecting Joints



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I would remove the lesions. what happens is, healthy cartilage gets defects in them when they are foals.. either from genetics, nutrition(over or under), lack of exercise (usually a big combination of all of it).. the bad cartilage forms the cysts and then you can get flaps of good cartilage over that defective cartilage... then, if it ends up vascularizing, you will get mineralization and bony like tissue where cartilage is supposed to be.

I had a mare with an OCD lesion that had a big mineralized chip in there. We removed it arthroscopically. There's no way injections would have touched that long term.
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Zanadoo88
Reg. Sep 2010
Posted 2015-04-06 6:11 PM
Subject: RE: Opinions on Injecting Joints



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casualdust07 - 2015-04-06 6:03 PM

I would remove the lesions. what happens is, healthy cartilage gets defects in them when they are foals.. either from genetics, nutrition(over or under), lack of exercise (usually a big combination of all of it).. the bad cartilage forms the cysts and then you can get flaps of good cartilage over that defective cartilage... then, if it ends up vascularizing, you will get mineralization and bony like tissue where cartilage is supposed to be.

I had a mare with an OCD lesion that had a big mineralized chip in there. We removed it arthroscopically. There's no way injections would have touched that long term.

So what do I do when the surgeon says he doesn't think it is necessary? If anything shouldn't he know what should and shouldn't be done??
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kwanatha
Reg. Dec 2003
Posted 2015-04-06 6:19 PM
Subject: RE: Opinions on Injecting Joints


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Zanadoo88 - 2015-04-06 4:11 PM
casualdust07 - 2015-04-06 6:03 PM I would remove the lesions. what happens is, healthy cartilage gets defects in them when they are foals.. either from genetics, nutrition(over or under), lack of exercise (usually a big combination of all of it).. the bad cartilage forms the cysts and then you can get flaps of good cartilage over that defective cartilage... then, if it ends up vascularizing, you will get mineralization and bony like tissue where cartilage is supposed to be. I had a mare with an OCD lesion that had a big mineralized chip in there. We removed it arthroscopically. There's no way injections would have touched that long term.
So what do I do when the surgeon says he doesn't think it is necessary? If anything shouldn't he know what should and shouldn't be done??

find a new surgeon
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iloveequine40
Reg. Oct 2013
Posted 2015-04-06 6:25 PM
Subject: RE: Opinions on Injecting Joints


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Get a 2nd opinion if you're not comfortable with th is surgeon
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Zanadoo88
Reg. Sep 2010
Posted 2015-04-06 6:35 PM
Subject: RE: Opinions on Injecting Joints



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Ok so my vet suggested the surgery then had the x-rays reviewed by the hospital's surgeon and he said he didn't feel the lesions warranted surgery at this time. So my vet went on to say he would like to at least inject her to make her more comfortable. I am located in the Pacific northwest and the surgeon that reviewed the x-rays was Dr. Schneider if anyone is familiar with him. He was also a teaching vet at the Washington State University College of Veterinary Medicine. I get where you guys are coming from but I also kind of feel like he knows what he is talking about??
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