A sudden lack of enthusiasm towards work may be the sign of painful hocks in horses. Intense pain due to a measurable loss of cartilage and synovial fluid can lead to further joint damage, flexion loss, arthritis, and lameness. While thoroughbreds commonly present with sore and arthritic hocks the conditions can be found in all horses both young and old.
Dr. Kris Woodaman, a Tryon vet, treats equine hock problems frequently. Every step that she takes to both diagnose the actual condition of the horse and then deliver treatment can be both laborious and time consuming. Determining range of motion on a large horses sometimes requires the help of an assistant to support the horse for balance Next Woodaman must keep the horse completely still during radiographic imaging in order to obtain a clear shot. The imaging is done in a dark barn with a brightly lit computer monitor and a motionless horse. Each shot must be checked for quality before the next image is taken.
The results of these tests however provide Woodaman with a clear indication of the hock’s condition allowing a more precise treatment plan. Woodaman said that the hock is a complex joint made up of four separate compartments similar in theory to the human ankle. When the lower compartments become damaged a decision must be made as to whether hock injections are necessary. Blends of hyaluronic acid (HA), at the correct molecular weight, along with long acting steroids are injected into the lower joints. The injectable drugs balance the joints requirements for lubrication and protection. It is also believed that injecting HA actually stimulates the naturally production of synovial fluids.
Woodaman assures that prior to hock injections the horse is sedated and a sterile environment is maintained, in order to prevent post injection infection. Woodaman ties up the horse’s tale, wears sanitary gloves and washes both sides of each hock with chlorhexidine or povidone-iodine for at least seven minutes.
As with many medical treatments the preparation time may take longer than the actual injection procedure. However the process of inserting the needle is both a balancing act and an art. The drowsy horse must be oriented properly as the Woodaman uses her finger to feel the anatomical geography of the joint structure. The needle is then introduced into the joint followed by a full syringe. Woodaman said that unexpected twitches and shifts of body weight can provide for a tedious barn call.
Woodaman explains that proper use of hock injections can be the pathway to pain relief, however, the exact treatment plan for every animal is determined on a case by case basis. Questions surface when healthcare providers prescribe a more liberal treatment plan on horses suffering with end-stage arthritic conditions. Further concern arises when horse owners push to prophylactically prescribe hock injections on healthy horses not yet suffering from joint damage. Woodaman takes all of these issues into consideration and determines the appropriate approach.