Hock injections – my 2-year-old AQHA filly needs them. Are they safe? How long until the horse is sound?

Quarter Horse hockQuestion: Last year I purchased a 2-year-old quarter horse filly. She is a complete doll but when I was starting her she turned up lame. I was boarding her at a stable with someone that had 30 years + experience with Arabians. I asked that she would be fed a hay mixture with little alfalfa as she was still young and growing. Soon after I went away and was not able to see my filly for a while. I asked one of my friends to go and check on her and spend time with her. Soon after I left, my friend informed me that my filly was receiving pure alfalfa. I had her moved. When I returned I waited a while as my filly grew about so much and her butt was about 2 hands higher than her withers She evened out some and then I started her. Soon after she was stiff in her left hock. I called the vet and I was told by that she had a bone lesion (spur) in her hock, then seeking another opinion another vet told me all she needed was her hock injected and stall rest and she would recover. I am wondering was you think? I stopped working with her while waiting for a slot with the vet to open up and she was fine…. so I lunged her a little and she was fine for about a week and then her hock started to hurt again. I then contacted another vet and they came and looked at her and they too though all she needed was her hocks injected. How long do you think it will take her to recover?

Answer from April Reeves: First, I am so glad you called not one, but two vets. To all who read this, you are a ‘shining’ example of the care and attention a horse needs.

Hock injections can and do work, but there are many questions that need to be answered before anyone injects anything.

hock joint bonesFirst, let’s understand the back hock joint. It is comprised of 8 bones, and resembles our ankle. There are four joints in the hock. The upper joint has the majority of movement (high motion), with the three below having very little movement (low motion joints). There are 3 types of joints – fibrous, cartilaginous, and synovial. Fibrous bones are found in the skull and beween the shafts of some long bones. Cartilaginous joints are in the pelvis, vertebrae and growth plates, which extend a bone’s length during the growth years. Synovial joints are the most flexible and active joints. They are comprised of two bone ends that are covered by cartilage, which is smooth and lubricated, for friction-free movement. Strong ligaments help support these bones. When a horse is injured or worked too young (during the growth and development of these bones) the excess ‘friction’ breaks down the synovial fluid and the two bones ‘collide’.

If the soreness occurs in the high motion joint, it is a sign that the filly could have ongoing joint problems such as degeneration or arthritis, as these joints will endure the majority of movement the filly’s entire life. If the problem is in the lower, soft movement joints, it may be a matter of care and attention, plus injections.

One thing that comes to my mind is to look at both hocks and the horse’s movement. I have often seen horses diagnosed in the wrong areas. Often, when one leg is a bit weak (especially in young horses), they compensate by using the other leg too much, and cause damage. This is why it is important to assess your training and care. While you are treating the major problem on one side, it is the other side that activates the problem.

Your filly did have an unusual growth pattern, in that she ‘sprouted’ in the back so quickly, before the front caught up. She may have suffered some injury or stress to the hock when she was in this stage of development, which can only come out when the hock is asked to perform. This would explain the bone spur. While most spurs are not that bad, some can continue to develop with stress and activity, causing restrictions on the horse later in life (5 and older). It depends where they are located. It is almost impossible to diagnose the future of ‘osteophytes’. Some spur problems can be hereditary. A look into her background may tell a story.

Your first vet must have radiographs of the hock. You need to ask many questions regarding where and how this problem occurred.

Your second vet should see these radiographs, and be aware of the potential for using injections on a hock that may not need them.

Personally, I hope the second vet is correct. But it does mean you will be a year later when starting the filly, to ride anyway.

In response to “how long to take to recover”, I would suggest that you look at this as a one-year plan to get her active but not under stress or pressure. This is regardless of whether the filly is sound shortly after her injections. I have added more information to this question below. Your filly may appear sound shortly after injections, or it may be a longer time span; it is up to the vet and the extent of damage. Many owners have noticed complete improvement after one injection, with no recurring problems. Since you love this horse and seem to want to have her long term, it is my suggestion that you take the time, as it will pay off in the future. Her personality tells me that she is worth keeping for the long haul. Mares are wonderful – and if you get a good one when it’s young, you will have a great one when it matures.

When diagnosing hock lameness, it’s important to know 2 things: 1. Where the lameness occurs, and 2. How the lameness started (conformation or training?). if you don’t address the root cause, you will continue to have the problem.

Understanding ‘where’ is a matter of due diligence on the vet’s part, but it’s important for you to know as your mare is young, and knowing this will tell you when and how to begin her training, and how to look after her. Knowing where will also tell you if the mare will ever be reliably serviceable in the future.

Quarter horses are known for having straight back hocks. While this is a benefit for some disciplines, it is not a benefit when you start them before the age of 4.

Many young horses are slightly cow-hocked until they finish growing. Riding and sharper, tighter maneuvers can add undue stress on young joints. When a horse is asked to turn quickly, around 1000 pounds of pressure (+-) on bones and connective tissue come bearing down, causing extreme stress on hocks. Many young quarter horses not bred specifically for halter work have a ‘soft’ cow-hock. My big appendix QH’s hocks were both straight and soft cow-hocked. I waited until he was 4 just to start him.

Hoof angles can play a part in hock problems. Letting a horse go too long between trims can cause stress to joints.

Injections have benefits. They reduce inflammation, therefore reducing pain. Injections also reduce degeneration from arthritis.

Injection medications include cortisone (corticosteroids / steroid) – Trimacinolone (used widely), Methylprednisolone acetate (Depro-Medrol), a potent, long-lasting corticoseriod for lower hock joints. Another is Hyaluronic acid, found naturally occurring in the hock, which reduces inflammation and improves the quality of the synovial fluid and cartilage maintenance. You can use Methylprednisolone along with Hyaluronic acid together.

The ‘Why’ of unsoundness
It’s important, when considering injections, to ask “why” the horse became sore. Personally, I do not ride or lunge a 2 year old of any breed or size. I spend countless hours on the ground, working for other aspects, such as desensitizing and flexion, which will be invaluable when I start the horse.

I also take youngsters out for long walks to get them use to smells and different environments. I begin walking my colts from weaning time. I learned this from an amazing vet I use to have (John Gilray). Dr. Gilray checked out a weanling Arab colt I had, for small, weak ankles. He suggested I walk this colt every day on the road, to help strengthen the bones. The soft impact would help build up the calcium levels and create a larger, stronger leg, without being too much of a strain. It worked brilliantly, and I still do this with all my young horses. Consequently, I have never had one serious problem with legs on any of my horses, over the course of 35 years, and I KNOW this is because I take it slow and pay attention to the horse.

Other causes
My first thought from your question is that your filly may be lunged in too small a circle too quickly. The only circling I would be doing with a 2 year old is to lead her or allow her to play in a large roundpen (60foot minimum).

She may not be getting enough ‘moving around’ time. Young horses should not be stalled before the age of 2. They need to move and let bones develop naturally. Those bones need to feel soft impact and bones learn to grow and adjust to this. Leaving them in stalls only decreases the chance of a reliable healthy bone.

Does the timing of her unsoundness correspond with being saddled? Check the fit for pinching. Usually pinching shows up at the front, but nothing is impossible when diagnosing.

Another thing is her feed. You did explain the alfalfa problem, and I agree with you. Young horses should not be fed an alfalfa diet. It is too rich in protein (15-25%) and while it is part of the natural food chain, it’s purpose is not a singular food source, but a supplement for underweight horses or horses that work hard. It is a good complement to regular high-fibre hay (1-2 flakes/day). Alfalfa is dangerously low in fibre, and some horses have allergies to it, causing joint pain and a whole list of problems (allergies are not the same as blood sugar imbalances and metabolic disorders). I would eliminate all alfalfa from her diet to see if it has any effects.

Pros and cons for your filly: while she is young, you have caught the problem early, and you may be able to fix it so that she can have a long riding life.

I would ask more questions with your vets (especially about arthritis), and get solid answers, since the two diagnoses are worlds apart. I would keep off the horse for another year, walking her every day, and doing tons of groundwork and desensitizing.

For young horses with joint problems, you may want to add a supplement. Although there are many ‘drug’ compounds available, I prefer natural products, as the horse is closer to nature than a manufactured drug is. You may want to check out Riva’s Remedies (http://www.rivasremedies.com/) and if you want, call Marijke van de Water toll free at 1-800-405-6643. She can help you choose the best maintenance program for her. Marijke is a highly sought after clinician and nutritionist.

In my many years, I have noticed ‘patterns’ with horses and how they are kept and managed. Today, in the barns I teach at, one barn in particular has never suffered any leg injury other than the odd cut or self-inflicted ‘stupidity’. These riders are mainly hunter/jumper riders and ride religiously. The other barns are a great learning experience for me, as they are always confronting some problem.

The problem-free barn puts the horses out into pasture every day, rain or shine, all seasons. These horses run and play together, moving continually. They rarely injure each other from kicking, other than the odd scrape.

The problem barn turns their horses out from stalls to small paddocks. When the horses are brought in to work, they are used heavily for one hour, until retired back into their stalls.

This is not random. In all my years, I have begun to notice this strong pattern. While not all horses in stalls will ever suffer injury or lameness, it is an observation that does merit some attention and serves as a question to those who have injured horses in confinement.

In the wild, horses in herds need to keep up, regardless of injury, or risk the entire herd to predators. A predator will sense there is weakness in the herd. Therefore, the horse begins to heal and carry on. This is why it is so important to let horses stay active as much as possible. It is in their nature, and cannot be bred out.

I hope this information helps and gives you a more diversified background into what you are facing. Let me know how it goes and what you finally decide on.

14 responses to “Hock injections – my 2-year-old AQHA filly needs them. Are they safe? How long until the horse is sound?

  1. Cheers for the useful post – I enjoyed reading it! I always enjoy reading your blog. :)

  2. i am looking at a 16.3 hand 2 yr old appendix quarter horse gelding. his owner is a college student and cant afford him anymore so she is selling him for a reasonable price. when he was 1 a bone spur was found on his hock. his owner had him injected with hock injections and has kept up on proper shoeing and neither her or the trainer have seen any signs of the problem since. he is now 2 and is broken. he has been shown (hunter under saddle, equitation, and showmanship) and has won a good bit of money, he is ridden/worked everyday and hasnt been injected since. im wondering if he couldve grown out of this or if it is going to give me any future problems, i already have a horse with a badly injured back so i dont need another hurt horse. i plan to do hunter under saddle, equitation, showmanship, some western pleasure, and some light jumping(around age 5) he will be worked just about everyday and shown almost every weekend. PLEASE HELP!!!!!

    • Hello Riaco4, your answer is on the front page of the blog. April

      • your blog helped a lot. not only was it the first to give encouraging information it also helped me understand more. i have been looking for a horse just like the one i described for 4 years due to my other horse’s back injury and i dont want to let this deal get away but i also dont want to rush into it and be stuck with a hurt horse. he also has great bloodlines and is not to far from my home. im just looking for all the advice i can get. do you think i should buy this horse, or do you think i will have problems with him in the long run?

  3. I have an 11 year old quarter horse mare I have owned since she was 2- SHe has never been ridden hard in any discipline. She has developed some lameness issues over the past year, which originally I attributed to shoeing. I had to relocate and it took some degree of time to find a competent farrier. I see this tremendous “popping ” of her hock joints when she is turned out and than she seems to be sore- can you give me any cause for this- I have had her x-rayed and the Vet could not see anything which would create lamesness, but this “popping is very pronounced and you can tell she is uncomfortable after she trots or runs around.

    • I have a student whose horse is having the same problem right now. It was caused by incorrect angles (poor farriers), and she will have to wait out a growth period (for the new farrier I suggested). This horse’s hocks pop also, and his leg twists. I’ve not seen anything like it. The horse is not lame (yet). Again, I stress this over and over on this blog: your horse will not improve by locking it in a stall at night or keeping it in small spaces. I also think that many of the quarter horse lines have bred the feet right out of them. While they may look fine on the outside, they are too small and shallow walled to be of much use for the large bodies they carry around. I will recommend a great product: Farrier’s Formula. It’s a small pellet packed with essential nutrients that can fix the toughest of foot problems. I double up the amount suggested for 6 weeks and then use the suggested amount every day. I have a quarter horse whose lineage is one of the worst for feet, but this guy can be ridden on trails and gravel without shoes thanks to this supplement. It makes him very shiny also, without the use of oils!

      I often witness horses who change their movement to adjust to soreness in areas not suspected. I am suggesting to improve her feet, as she may be altering her movement and popping her hock to compensate for pain or discomfort somewhere in her foot. If her feet are in good condition after 6 weeks of being treated, you can almost rule them out and look elsewhere. Nerve blocking can come up with solutions to lameness also. I hope you find out where the problem is. Sounds sad to have a best friend in pain.

  4. Wow. This is one of the best articles that I have found relating to hocks. I purchased a 5 year old quarter horse that had her hocks injected, according to the breeder, as a weanling, because she “wasn’t moving well, poorly held the lope.” She says that there are no medical records pertaining to the hock injections. This makes me wonder if the vet injected without record to help her sell the horse. Not knowing anything about injections, I stupidly didn’t ask questions. My horse is now in half an acre (with slight hill), is healthy and strong, and I credit that to her ability to run free daily. I have begun slow training on the lunge line, but after reading your article and noticing that my mare does lean in strongly, I am worrying that this may be putting undue stress on these healing joints, and may try taking walks with her instead. I have decided to have my veterinarian do x-rays on location, to see whether this is an upper or lower bone problem. At this point, I am supplementing with Magesty’s Joint Supplement Treats, am consistent on farrier visits, and am taking training slowly. She has Safe Choice grain in the evening with her hay. However, come summertime, she will be in daily intensive Western training with a trainer. Is there anything else I can do to prepare her for this? She also receives a flake of alfalfa daily in addition to her hay, and I am considering changing this to another hay. Would love your advice. She is so precious to me and I wouldn’t want her to risk her health.

  5. Karina, the alfalfa is not excessive enough to make that much of a difference. Anything over a flake a day and I would say to cut back. Having said that though, if the mare had issues on alfalfa as a youngster, you may just want to stop it altogether. I’m assuming you are in the US as well. I wouldn’t touch alfalfa there unless I knew the grower. Genetically modified alfalfa is the #4 crop in the US, and it’s anyone’s guess whether it’s dangerous or deadly, since no testing was done on horses. Since GMO Bt bacteria is 4-5000 times higher than normal, and is found in every cell of GM plants, it’s my guess that it’s only a matter of time when they can prove a problem. Until then I’m not one to risk a horse on a toxic diet.

    I would be out watching the mare for the first week with the trainer. He/she should know the history of the mare as well. As for preparing her for training, as long as she is “field fit” and healthy, start her and see how she progresses. A good trainer will be conscious of her past condition and adjust.

    It takes time to recognize where lameness and problems originate, and not all of them originate in the areas that show up lame. I have worked with a brilliant body worker, Guliz Unlu, and have watched her “set” ribs back in place for back leg injuries, when vets misdiagnosed them.

    The first person to teach a horse the English language will be a Saint… But if we listen in their language, they will tell us everything.

    Let me know how it goes Karina. Hope she does well in her training!

  6. Very interesting. She just had x-rays, and the vet found a small (relatively benign) bone spur on her hock. He sees no reason why she could not train daily with supervision. Probably had cortisone injection, due to spur forming after a lameness issue that was perhaps brought on after an accident at a young age. I was definitely foolish to believe the breeder’s apparent lack of knowledge on anything but the fact that she “wasn’t moving all that great when they started training.”

  7. Karina: I’m hoping in your case that your mare moves out of the problem. Small lameness issues are more costly in both time and money than big issues. One thing I forgot to mention above: I believe in keeping horses moving (which I know you are doing). I have had several broodmares that I bought dead lame, only to come up sound within weeks to a few months after being able to move in a field with others. Movement isn’t a luxury: it’s a necessity. It heals, and movement does this by allowing a natural instinctive cycle to take place within the lame horse by being forced to keep up with the herd.

    There is so much more to healing than modern medicine has yet the experience to discover. While I am the first to call a vet, I am also the first to ask questions beyond the obvious.

    Your comment on trusting the breeder is a good reflection for others to be aware of. The quality of the questions you put forward to breeders, vets and others will be the opening of your learning curve. Ask, dig and never take no for an answer with horses. Their limits for discovery are endless.

  8. Hi April I was looking for a way to contact you relating to this article…phone, email? I have a mare who has been an ongoing project for years and its getting to the point where something needs to be decided and right now we are to hock injections, I amnot opposed to them, but I just want to make sure I am not dumping more money down the drain and maybe she needs a new endevor nor do I wan to be giving up on a great animal if its something that can be maintained easily. KP @ americanquarterhorses2000@yahoo.com
    PS…I’m getting really frustrated and really don’t have tons of money to throw around…

    • From what I know, there are several types of injections, and they should work immediately after the first. One of my students horses had one type that did not have any effect, and then another that worked right away and has never needed them again. It appears to be a “hit and miss” type of experiment. My big question is whether or not to return the horse to it’s original training schedule. Tough choice when the horse is a reiner or cutter or jumper.

      My email is april reeves 17 at gmail dot com

      Sorry for not getting back to you earlier, but I had to ask around and talk to a few vets to get more info. I don’t like getting info off the web.

    • Hi KP, not sure if or when I responded, as I did a major move this year and just now settling in to keep up the blog. You can reach me at 403 224 3893 or april reeves 17 at gmail dot com.

  9. My mare just got hock injections and still seems to be lame. It has been 10 days.

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