Last Updated on March 15, 2022 by Allison Price
Did you know that there is a wide range of costs for hock injections from different vets? Have you ever wondered why? There are many different types of “hock injections”. It is important to know which joints and what substance are being injected into your horse’s hocks. Prices for hock injections can vary depending on the medication being injected and the number of joints being injected.
Although the “hock joint” is made up of many different spaces, the horse’s “hock joint” actually has a number of smaller ones. However, for injection purposes, most vets refer them to the lower, middle, and upper hock joints.
The upper hock joint is responsible for the majority of the motion in the hock joint. When the hock bends it happens because this joint is responsible. Although it is rare for show horses to experience primary issues with their upper hocks, it does happen. Young horses who are just beginning to work can have OCD at the upper hock joint. This is often manifested as a swelling of the hock. OCD should be checked for surgical removal. Upper hock joint injections are also possible to reduce swelling and keep horses comfortable.
The lower and middle hock joints are the most commonly injected in show horses. Two very low motion joint spaces are the lower and middle hock joints. They are made up of many tarsal bones (hock) that are stacked on top of each other like blocks. They are surrounded by synovial joint capsule and cartilage. Although they are technically considered joint spaces, they are only a small part of the overall motion of the hock joint. They are therefore low motion joints. They are basically just enough joint fluid and cartilage to allow them to slide over each other as the horse places its foot on the ground.
Horses in work place a lot of strain on their lower and middle hock joints. The genetics of horses (including their breed and conformation), as well as the stresses and forces we place on them when we ask them to rock back on each side, turn and slide over each other’s tarsal bones.
Cartilage provides cushioning between bones. Pain is usually caused by bone grinding and thinning of cartilage in the lower and mid-joint spaces. Radiographs can also show bone spurs around the edges of bones. This is the start of the fusion process at the lower and middle hip joints.
Injections of the lower and mid-joint spaces are often used to relieve the pain caused by degeneration. It is often a good idea to try to promote the fusion process at the lower and middle joint spaces. They don’t slide and they don’t hurt anymore.
You can use different medicines for joint injections. A combination of a HA product (hyaluronic-both alubricant-and anti-inflammatory) may be used to treat a young horse suffering from hock pain. This could include triamcinalone (kenalog), which is more cartilage-preserving than other steroid options.
We may only use methyprednisolone if a horse is already showing signs that the fusion process is beginning. Because it does not have pain killing properties, Depo can be a great choice for these joints. It is also thought to accelerate the cartilage degrading process and speed up the fusion process. Different veterinarians will have different preferences depending on the horse’s age and the extent of radiographic changes in their hock. Typically, steroids +/- hyaluronic acids are injected into the hock joint. However, there are other options such as intra-articular adequan and IRAP.
Horses that have not been helped by steroid injections for some time or are only being helped for a brief period of time may be able to benefit from ethyl alcohol injections in the fusion of lower and middle hip joints. This procedure is relatively new and should be performed after appropriate contrast dye studies and xrays of the lower and/or mid-hock joints have been done. These studies will prove that the joint spaces do not connect to the upper (high movement) joint. A small number of horses may have communicating joint spaces. While injecting a little steroid into the upper joint is fine, it can be dangerous and could lead to the death of the horse.
Ethyl alcohol has two functions. Ethyl alcohol has two properties. It can be used to reduce pain and can increase comfort for horses. This procedure is becoming more popular and being performed or referred to by more veterinarians.
Discuss with your veterinarian all options for injecting hocks to your horse.