I am going to fully admit that most of the below is for my own notes and recollections, as joint injections are something that are still relatively new to me, and I like having detailed notes about my vet visits outside of regular shots and coggins. There is a TL/DR section further down this page in bold, if you don’t want to read the whole post.
One of the joys of living within an hour of Churchill Downs is access to some amazing racehorse/lameness vets, and at prices that strongly undercut their NY/NJ counterparts. A few factors led to me looking for a vet to come look at May to discuss what (if any) maintenance we should be looking at:
- May had her hocks injected in October of 2016. She was showing some lameness and the vet at the time prescribed this course of action. Both hocks showed changes at the time, but I was never really certain that the improvements I saw were due to fitness or the injections.
- May’s job was fairly mild in 2017. If she jumped 6 times, I would be surprised. Between having shoes off, my wedding, our lack of jumping saddle, and zero competition goals, she was never really pushed in 2017, so I wanted an experience eye to look at her before I really started jumping or added in any heavy Dressage work.
- A couple of times, May has shown some weakness behind. She tracks up normally, but would be VERY sluggish going up hills and doing any lateral work that required her to rock back. One or twice, I swear I could feel one hip coming up a bit uneven vs. the other hip, but I could never recreate it near the mirror.
- While May is not a “high performance horse”, she is a horse that I need to stay very happy in her job. Ideally, she could continue to work and maybe even pack some kids or a timid AA around starter well into her late teens and early twenties… or do some lower level Dressage. As her owner, I think there is an ingrained responsibility to helping your horse be comfortable and happy in their work for as long as possible.
Originally, the workout was supposed to be on 17th, but due to the banamine in May’s system and the subtleness of what we were looking at, it was decided to wait a week. Good news, May’s eye got a thorough recheck and is healing even better than the vets had hoped for. Yay! Bad news, they definitively identified some lameness.
The way this vet practice works is there are two vets that come out for these types of calls, and they bring one helper to jog horses, hold horses, and basically just make it easier for the vets to do their jobs. The appointment started with the vet going over May’s entire body, utilizing acupuncture spots to see if any soreness jumped out. They also utilized hoof testers to make sure we weren’t looking at hoof pain, and they checked teeth. (May’s need to be done… not surprised, but something I am going to have to wait a few weeks to do. I had to prioritize current pain over a developing issue in this case.) They didn’t check eyes because… they had stared at her eyes a LOT lately.
Unsurprisingly, May reacted to none of their tests. Everyone kind of shrugged and acknowledged that she’s a pretty stoic girl, who would rather you stop poking her. Thank you very much! So we moved on to jogging her on hard ground. The vet explained that, if we didn’t see anything jogging on hard ground, we would move to small ground, and then to seeing her under saddle if nothing showed up. Fair enough to me.
Here’s the interesting thing. The hard ground (pretty much the only hard ground left in this part of KY… pretty much everything flooded this weekend) that we jogged on is on a slight incline. Going up the hill, May had a slight head bob and irregularity in the hind end. Heading down the hill? She looked totally sound. Huh. Ok. (Below is from before I injected her hocks the first time, you can see the lameness the most when we change directions)
We flexed the back end, first targeting hocks, although any flexions you do on the back end will stress both the hocks and the stifles. It’s not like the front end where you can clearly isolate a knee. However, the left hock showed a bit more positively than the right side. Then, we tried irritating the stifle a bit, and she looked a bit off on both sides. Then, we tried one last stifle flexion, and it really made no difference in the diagnosis. So what to do?
Again, we went back to the fact that I wasn’t really confident that the hock injections made a huge difference in 2016. The vets indicated that I had the decisions to only inject hocks and then decide on the stifles, but they were fairly confident that the stifles were also a problem and that I would just be calling them back again to do the stifles anyway. Given that I don’t take putting a horse under sedation lightly (especially not a draft cross of unknown breeding), I decided it would be best to do both sets of joints. She was testing positive both ways and showing clinical signs of issues in both joints.
May was put under fairly light sedation, again due to her assumed draft breeding. (Draft horses are often “light weights” when it comes to sedation and are more likely to have severe consequences from sedatives). She was sedated so lightly that, a few times, she picked her head up to stare at some noise she heard or some animals in the woods outside her stall. (yes, the below is the only media I got)
We decided to do the procedure in her stall since there is a step up from the aisle to her stall that would be difficult for her to navigate while drugged, her stall is large enough to allow everyone to move around comfortably, and there are lights in her stall. I acknowledged my concern with joint injections and infection, etc. I am not sure if that is why 2 people took nearly a half hour to fully clean and scrub down the area, or if that was their general procedure, but I was thankful to see it. I held May while they did the procedure, not because their weren’t enough hands, but because she is better behaved for me than strangers.
Both vets were great about explaining to me what they were doing, why, and what their opinions were on what they were seeing. We first injected the right stifle. While a good amount of fluid did come out and it was clear, it was noted that the fluid was on the thin side. A good indication that this joint would actually benefit from these injections. May continued to watch the world around her, unconcerned as a needle was shoved into that joint.
Moving on to the right hock, the vet had a difficult time getting a need. into the joint. Since this was the less positive (less lame) hock, we discussed the possibility that it was fusing. Everyone seemed to agree that it was likely and that next time we looked at injecting the hocks, it might be worth taking X-rays. (I had gotten them taken with the last set, so I knew we already had changes there.)
We moved to the other side. This stifle showed a bit more normally upon piercing the joint, but there was still some liquid. (of note, neither stifle palpated like it was full of liquid, but given the size and location of the joint, no one was really surprised.) The other hock, which flexed positive and was the one where I had felt the “offness” earlier, was clearly not as close to being fused at the other. It had a fair amount of liquid of the thin variety, and we were happy to get some relief in there as well.
TL/DR – Injecting both hocks and stifles was clearly necessary, but she was only showing the worst of her symptoms in there right stifle and left hock.
I was very happy to have decided to go with the whole round (although ask me next week if it made a difference). I do believe that doing one set would not have resolved the whole issue and that soreness in one area was likely making soreness in the other area worse.
We then rechecked the eye (easier to do under sedation), and everything looked as it should. I stayed with May for another hour – hour and a half. I wanted to make sure she came fully awake before she was fed, and I wanted to talk to the afternoon barn staff about not turning her out.
Around an hour and half after the original sedation (remember this was a very light sedation), May took a loooooonnnnnng pee and got the bright look in her eye. 30 minute later, the afternoon staff arrived to feed and turn out. May was nickering and banging against her door, asking for dinner. I watched her eat her (very very small) amount of dinner (probably unnecessary, but I am a worrier and it was only another 15 minutes anyway) and gave her one last brushing over before heading home.
When I visited her on Sunday, she was laying down, but she quickly popped up and said hello. She got a ton of cookies (and more goop shoved in her eye). I gave her Monday off too, and haven’t decided yet if I will begin her back in super light work on Tuesday, or if I will just wait until Thursday. Either way, I won’t really see results until a solid week.
All in all, happy I did this, and it gives me a bit of confidence knowing that I am helping May feel her best as we enter this competition season.