Hocks
Confetti turned 20 this year. It has always felt like a matter of time until joint support of some kind became necessary. Not if, but when.
In 2012, I had her checked out, mostly for peace of mind. She looked fine. Not perfect – she did show slight lameness after flexion – but nothing concerning. The vet did not seem to think it made sense to treat aggressively. He certainly would have if I felt differently, but I agreed. She was moving fine and it was a very slight reaction. I started her on Cosequin ASU somewhat inconsistently and continued working her 4x/week with no extended time off.
I can’t remember when I started her on vitamin E, but between Mel and Dr. Garlinghouse I was convinced that was a worthwhile thing to add. She’s been on that for at least a year now, probably two. Flax has been on the menu since sometime in 2015, grinding it since early 2016. I quit re-ordering the Cosequin in early 2016 and increased the amount of flax instead.
In early 2016, a whole lot of things changed for me at once. A minor move, a lot of migraines, shorter days combined with really terrible California weather.. one of my best riding buddies was sidelined for her own reasons for some time.. and poor Fetti got significantly less work this winter/spring than she has in the past six years.
This summer I’ve noted a reluctance to balance back over her hindquarters, lack of desire to go cantering up her favorite canter/gallop hills, occasional back-soreness, resistance to putting her hind hooves up on the stand for trimming, and a tendency to throw herself up steps rather than push. She’s also ‘dropped’ her hind feet, just an occasional misstep, but for a horse that is historically 110% surefooted that has been disconcerting. And – if I’m really thinking about it – it feels like she takes more time to warm up into work, rather than being almost-immediately ready to go.
I reiterated all this for the very patient vet while he took a look at the pony. Heart sounded OK. He noted windpuffs at her fetlocks, but flexed and poked around there with zero reaction. Unsurprising: this has been noted on her endurance vet cards on and off for several years at the start and finish of rides.
We made our way over to the round pen. I encouraged Fetti into a decidedly unenthusiastic trot. She lamented not being allowed to roll. Two changes of direction later, the vet came in and listened to her heart again. No heart murmurs, good! Arthritis likely in both hocks, left more than right. OK then. That explains why I wasn’t feeling marked unevenness at the trot, if she’s moving short behind with both legs.
Fetti had a really strong season last year and then several months of doing very little. That was not a good choice and probably contributed to the arthritis showing up this spring/summer. Lesson learned. I need to make better choices next year. Ideally she will remain in fairly consistent work with the possible exception of the rainy season.
Options for arthritis vary: feed-through OTC supplements (Cosequin), NSAIDs (bute, Equioxx, Previcox), injectable joint supplements (Adequan, Legend, Pentosan), or joint injections into the joints themselves. As the vet discussed options with me and refreshed my memory on a few of them, he kept complimenting Fetti’s ability to stand still. Good mare! I’d just tossed the lead rope up on her neck when we brought her in to the middle, so she decided to nearly fall asleep. He was quite impressed. Apparently that’s not what he sees from most horses?!
The research into feed-through supplements is that most of them aren’t great. Cosequin is one of the only ones I’ve seen good scientific support for. Even that isn’t particularly amazing. It’s (roughly) $150/tub or $50/month. It is not AERC-legal, so I’ve always pulled her off it a week or so in advance of any rides we go to.
I do think I would be OK putting her on Equioxx/Previcox to keep her comfortable as a casual trail horse. These options are also not AERC-legal. I’m not thrilled at the thought of putting her on bute to keep her in competitive work, but again I might consider that if it were my only viable option to keep her comfortable for non-competitive low-key trails.
So: injectable supplements vs joint injections. Joint injections are more expensive (and though I didn’t ask, would likely be best done at a clinic, requiring a trailer ride). From my very vague memory, I think you only get so many injections before they’re no longer effective due to limited joint space and fusing. Fetti is just now showing symptoms. It seemed prudent to try the lower-tier/lower-cost option first before going to the really big guns.
Which then led to its own discussion. Adequan vs Legend vs Pentosan. Legend is IV. We ruled that out. The vet’s recommended loading dose for Adequan was once every 4 days for.. at least several shots, I don’t remember how many. We ruled that out. Fetti is still standing rock-solid at this point, and the vet is getting a kick out of listening to C and I discuss whether this poor pony will allow us to inject things and how miserable any of us will be. Pentosan’s loading dose is once weekly for 4 weeks, then once monthly. That sounded doable.
The vet did the first injection. Fetti, to her credit, managed to spin less than half a circle around me. We have a few very tolerant friends, but I am still not looking forward to doing the next injection myself. It’s back into serious conditioning mode for the pony and I, especially as the vet noted that she may have to work through some of the lingering stiffness/pain on the hills (or rather, I may have to force it because she may not want to do so and it would be in her best interest). Hopefully within a few weeks we’ll know if this is going to make a difference. Fingers crossed.
Pentosan has made a big difference for Tristan. It took about 3 weeks into the loading dose to notice. I like that you can do it more often and that it’s relatively inexpensive – Tris is on every 3 weeks right now.
Yay! Fingers crossed. I hadn’t even discussed doing it more frequently (or even considered that) – thank you!
I hope the Pentosan works for you guys. FYI: the hock injections can be done in the field and do not require trailering anywhere if you need to go that route.
Good to know. I still might have concerns about appropriate cleanliness/sterilization at the barn, but I’m glad the option is there, and I hope we don’t need it.
20 is pretty good before needing first hock maintenance. I had Carlos’ hocks done at our barn by our very knowledgeable vet most horses I know do not require going to a clinic. They are very and quickly effective and not all horses need multiple injections a year.
Yes! I’ll have to edit and correct and rephrase some of this – by ‘multiple injections’ I meant over time, not per year.
We don’t have anything resembling a sterile/clean area at our barn so I worry about the dust and dirt, but I’m glad the option is there if it comes to that.