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Case Study 4: Joint Injections

Our vet Claire has been working with a client who has performance horses, and in particular, over the last couple of months, with a 14 year old mare. This mare is in high intensity work, who started the season competing well, but as the ground got harder, she went on to develop tail swishing and agitation when asked to go forward, followed by a hind limb lameness. This mare has also struggled for a while with thin soles affecting both front feet which led to a stiff gait on hard surfaces which resolves on soft surfaces. This ongoing forelimb issue has been helped tremendously by her farrier placing equithane pads and raising the heel on both front feet.

After a lameness work up which included diagnostic analgesia (nerve blocks) and radiography it was revealed that there was osteoarthritis affecting both hocks. Radiographs of the front feet were taken to assist the farrier with foot balance. Foot radiographs also revealed osteoarthritis affecting the coffin joints.

It was decided to medicate the tarsometatarsal joints of the hocks and the coffin joints with corticosteroids. Two sets of injections were undertaken, one in our new examination room and the other at the client’s yard. Medicating any joint in the horse carries a very small risk of inducing laminitis, therefore a period of 5 weeks was left between medicating the hocks and the coffin joints to further reduce the risk of laminitis. In this period, the farrier re-shod the front feet with heel extensions and reduced the break over angle by setting the shoe further back, the farrier also placed lateral extensions on the hind feet.

It has been several weeks since the coffin joints were medicated and the results are very pleasing. The mare is much more forward going with no lameness or tail swishing, and she is comfortable walking on hard surfaces. A combination of joint medication and farriery has really helped this mare; hopefully she will back to full competing fitness soon!

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