Why do we inject joints?
We routinely perform joint injections to decrease pain or discomfort associated with osteoarthritis (“arthritis” or “OA”). Horses develop inflammation of joints during exercise, and this can lead to lameness and later in life this can develop into osteoarthritis. Alternatively, horses develop arthritis due to trauma or fragmentation within the joint and this produces the same kind of inflammation. Both of these kinds of pain require correction which may not be completely resolved with other forms of treatment e.g. Legend, Adequan, NSAIDs (Bute, Banamine, Equioxx).
What do we inject?
This is partly covered in a separate post (Why Use PRP or Prostride vs Steroids for your Horses Joint Injection?), but joint products include steroids, PRP, IRAP, Prostride, Polyacrylamide Gels, Hyaluronic acid and many others.
The product we use (PRP, Prostride, steroids) will depend on several factors including:
- Co-morbidities e.g. metabolic disease
- Previous treatments
- How many times we have used those previous treatments
- How long they last
- Drug withdrawal times
- Type of injury.
This is a long list of things to consider but we carefully balance each of these to optimize the outcome.
What should I watch for?
There are several very important things to watch for after any injection into your horse and this includes: pain, heat, swelling or lameness. If any of theses develop you should call us right away. We can determine the best course of action in these situations.
Do I need to do anything?
Immediately after the injection it is important to keep your horse quiet. For some joint injections we may place a light bandage, and this can be removed within on hour although it is ok to leave it until the next day. For the first 3 days after the injection, we recommend no ridden work. After this initial 3 days then you can resume light riding until 1 week.
How long will the drugs take to work?
Most horses show improvement in their lameness within 1-2 weeks. There is one big exception to this which is the polyacrylamide gels. These take significantly longer to work (up to a month) since their main mode of action is to increase the flexibility of the joint capsule. If you and your horse have a significant event or a quicker onset of response is needed then we may recommend another product e.g. PRP, Prostride or steroids.
Why do we recommend a short rest?
In our practice we recommend this injection/rest/rehab protocol for nearly all cases. We prefer that horses don’t go right back into exercise, and this is especially important for neck and back injections. Oftentimes multiple needles are used and this can create some slight bruising which benefits from a few days off. We also use many biologic medications, which can have a mild inflammatory response after the biologic is activated in the body. Having the horse in a controlled rehab program lets us intervene if any adverse response occurs.