"Hock Havoc" in our April 2007 print issue addressed the use of hock injections and other treatments for managing an equine athlete's lower hock-joint health, including osteoarthritic conditions. In addition to shoeing, turnout and training-routine changes, surgical fusion and supplementation can be factors in maintaining hock health and minimizing potential performance problems, as can injections of hyaluronic acid and polysulfated glycosaminoglycans.
Teresa Garofalo, VMD, a rider and horse breeder in West Chester, Pennsylvania, and fellow University of Pennsylvania graduate Jose Garcia-Lopez, VMD, offered their expert advice in the print feature. Here, Garofalo describes the hock-injection procedure.
When your horse is scheduled for hock injections, have a clean, dry area with ample space for the veterinarian to work safely. A sterile environment lessens your horse's risk for infection during and after the procedure, Garofalo advises. Have a skilled horse handler hold your horse to prevent unnecessary moves while the veterinarian works.
Garofalo explains the steps your veterinarian will take during joint injections. "The veterinarian ties up the horse's tail, sedates the horse and scrubs two areas on each hock, one on the inside and one on the outside, where the injections will be made. Scrub chlorhexidine or povidone-iodine is applied for about seven minutes, followed by alcohol to remove the soap residue.
"Once the injection sites are sterilely prepped, the doctor dons sterile gloves and prepares the medications and needles in a sterile manner," she continues. "A twitch is usually applied right before the injections to keep the horse safe, so that he doesn't move when the needle goes into the joint, and also to keep the veterinarian safe should the horse become agitated.
"Usually the process of injecting the hocks goes quite quickly compared to the prep time," Garofalo comments. "The veterinarian feels for anatomical landmarks with the injecting needle. Once the veterinarian is sure that the needle is in the joint, he attaches the syringe with the medication and injects it. The tarsometatarsal joint is generally easier to get to; the joint space for the distal intertarsal joint is much smaller and can be more of a challenge especially if the horse has significant arthritis."
In the days following hock injections, monitoring your horse's condition and managing his environment is important to his continued good health. Clean living quarters help minimize his risk of infection as does taking his temperature twice daily and checking for any heat, swelling or discomfort. After resting for four to 10 days, his movement should change within one to three weeks.