Podcast Episode 27: Do joints really fuse, and would Osphos help?

Fused hocks, Hocks, Podcast2 Comments

You may have seen my polite email from last week about fusing hocks. If not, that article is posted here.

But wait, there’s more!

This week I have a not-so-polite podcast talking about this same issue.

Discover: *why bone remodeling is like paving asphalt

*How our idea of “fusing” joints is incorrect

I try to keep these podcasts short and to-the-point, as I know we’re all busy. This one is about ten minutes. You can listen now on Horse Mysteries Solved.

Links Mentioned:
posted here.

Summary by AI:

Dr. Renee Tucker discusses the inappropriate use of Osphos for a horse with a fusing hawk, expressing frustration with the veterinary practice. She clarifies that a fusing hawk doesn’t actually mean the bones are fused but rather there’s additional bone growth on the exterior of the joint. Tucker criticizes the use of Osphos, which blocks osteoclasts, hindering bone regeneration. She argues that promoting bone fusion without addressing underlying issues like ligament laxity, muscle asymmetry, or pelvic misalignment is misguided. Tucker urges veterinarians to explore alternative approaches and emphasizes the importance of understanding the body’s reasons for certain conditions. She encourages listeners to advocate for more thoughtful veterinary practices and welcomes comments on the matter.

Renee (00:01)
Hi, friend. Dr. Renee Tucker here. Hey, listen, you know, I usually sit in my car and because supposedly it’s a better sound. Who can say?

Renee (00:09)
And I picture you sitting with me, and we’re just chatting, and so since you’re my dear friend, you don’t mind if I vent. Is that right? Because I’m gonna okay, listen, here’s what happened. An acquaintance of mine I’m sorry, by the way, this show is about fusing hawks and Osphos, all right? So what happened was an acquaintance of mine had some swelling, small swelling on the horse’s hawk.

Renee (00:36)
Like finger size? Half a finger size? A little tiny bit. All right? For about a week.

Renee (00:42)
Horse wasn’t lame, but he called the vet out, who did an X ray, who then said, ah, the joint is fusing, and gave a shot of Osphos. Now, for the purposes of this podcast, Osphos is very similar to Tildren, okay? It kind of has the same mechanism of action. Why don’t I, before I forget, go ahead and say that they pulled children off the market for humans, and the number one reason is because people reported chronic pain from children. They pulled it off the human market and they threw it at the horses.

Renee (01:25)
Don’t even get me started. But it’s too late. I’m already okay, okay, let me talk about why this doesn’t even make sense to give Osphos for a fusing hog. All right, first of all, what’s a fusing hog? When I first heard this and I was in vet school, I think, or shortly afterwards, I got the impression that that meant all the bones or at least two of the bones, two of the layers of bones, because there’s four joints, technically, in the hawk, okay?

Renee (01:59)
But so some of the bones were literally fused or, like, welded together like they’d never move. That was my impression. So I thought that made sense. All right, if the body’s going to fuse it together, well, let’s just wait till that’s done and all will be well. Turns out it doesn’t happen like that.

Renee (02:19)
It turns out that fusing just means that it doesn’t look like there’s any joint space on the X ray. So what that means is that the horse’s body is just putting extra bone on the external or outside of the joint. So, for example, if you just lay your hands on your own knee or ankle, any joint, right? You just lay your hands there and kind of hold on tight. Well, that would be what one would see on the X ray, where the hands are blocking the joint, but they’re not really restricting it so much, right?

Renee (02:58)
Because if you put your hands tight across your ankle, you can still move your ankle. It’s going to have a little bit less, I don’t know, side to side movement, little less sway, little less give, but it can still move. Okay, so when we do a necropsy on a horse on these horses, that have supposed fused joints. What we see is this external bone makes it look fused on the outside of the joint, but on the inside, it’s not fused at all. It’s still a perfectly normal joint.

Renee (03:35)
Now, maybe a little bit small, might have some rough spots, but 80% of the time, there’s nothing happening abnormally on the inside of the hawk. It’s just on the exterior. Just like if you laid your hands on the exterior of a joint just like that. I’m serious. This whole thing is ridiculous.

Renee (03:56)
Okay, I know some of you have had some experience with fusing joints. I’ve heard lots and lots of stories and worked with horses with this before. There are times when if you give the horse time to fuse the hawk, that the horse does become more sound. I’ve seen people just put their horse out to pasture for a year, and the horse is more sound. And I’ve seen people ride their horse kind of more roughly, but they use butte, so the horse isn’t feeling it for about a year.

Renee (04:31)
And in both those cases, I’ve seen where the X rays do look again externally, like they’re fused, and the horse is more sound. And there’s been way more times where people have tried to do that. I’ve known someone tried to do that for ten years. Not kidding. It was ten years.

Renee (04:53)
She says it never happened. She’s freaking hilarious. But it didn’t happen. And there’s a lot of stories of that as well. Now, you can use other drugs to try to make this happen, but I particularly want to talk about Osphos.

Renee (05:09)
Okay, listen, here’s a little story of how the body works with bone, all right? They are osteoblasts, that’s with a B, and there’s osteoclass with a C. Osteo means bone, right? So what happens is the osteoclass clear the older layers of bone, maybe the ones that need to be repaired, and the osteoblasts build the new bone on top of it. This is really similar to if you’re rebuilding a street or a highway, you don’t just pile more asphalt on top of it.

Renee (05:52)
You actually have to clear the old away just an inch or whatever, and then you lay down the new asphalt. So this is exactly what the body does. You got the osteoclast clear, and then the osteoblasts come behind them and build. So you tell me, why would you want to give Osphos? Because here’s the mechanism of action of Osphos.

Renee (06:19)
Osphos and tiltren block the osteoclass, right? So because the class cannot clear with Osphos or tiltron, then the body cannot build. It won’t just build over bone that needs to be removed, right? Think if you kept doing that to Ohio, you just kept piling more and more asphalt on there over time, it’d be, like, 10ft tall. So the body cannot just add more bone.

Renee (06:54)
It has to clear the old stuff before it puts in the new. And the body’s constantly doing this bone is constantly being regenerated. So everything is all of our cells are constantly being renewed. So if you wanted to help something fuse, theoretically you would want more bone. Right.

Renee (07:21)
But the body will not put down more bone unless it can clear the old layer. It just won’t. So it’s not going to work to theoretically fuse the horse at all. I would like veterinarians to start using their brain. Can I just say that look at the package insert.

Renee (07:45)
I’ve had it. This is no good. This asphas stuff stays in the system a minimum of four months. It’s affecting every bone in the body. There’s warning labels in the package insert for fractures.

Renee (08:03)
Well, that would make sense, right? You screwed up the whole body’s mechanism of fixing the bone. And veterinarians are just giving this willy nilly, oh, it’s got a swelling. Let’s give some Osphos. What the heck is going on?

Renee (08:21)
I hope you’re appreciating my ranting, because there’s always a way to fix stuff, people. There really, really is. If you have enough time. Okay, you can’t fix everything on a 35 year old horse, I get that. But the key is to find out why is the horse doing it?

Renee (08:41)
So in this example, why would the horse be adding extra bone? Well, horses usually add extra bone on the external parts of the outside of any joint, including the hawks, for stability and or support. So all that means is there’s many different reasons why the Hawk would have asymmetrical forces on it. So the Hawk and most of the joints in the legs, the major weight is from the body of the horse on those legs straight down to the ground. Right.

Renee (09:25)
The pressure on all the joints should be really straight vertical down for the most part. Okay? Now, if there’s lots of different reasons, so here’s a couple. If there’s, for whatever reason, lax or loose ligaments decreased or asymmetrical muscle, the hoof trim has the wrong angle or crooked angle, there’s sacral iliac issues or there’s pelvic misalignments. That’s just to name a few possibilities.

Renee (10:00)
Any of those things can cause the pressure along the Hawk joint, instead of being straight vertical to become a little bit crooked or shear or too much pressure on the inside versus the outside, or vice versa. All right? It’s just going to be asymmetrical pressure that shouldn’t be there. And so that causes instability in the joint because there’s too much pressure on one side than the other. So the body’s like, uhoh, we need some help here, let’s put in more bone.

Renee (10:36)
That’s all. So they add more bone to the outside of the joint to help it hold on. It’s a helpful thing for the horse. That’s why sometimes if you just wait another year, the body has enough time to add in some extra BORM and it looks fused again. It’s not really.

Renee (10:56)
Most of the time, internally, there’s no fusion. It just looks like it externally on the X ray, and I appreciate that. If the horses sound, that’s cool. And if you’re at the end of the rope and you want to try this, I appreciate that. Okay.

Renee (11:17)
Sorry, everyone. Here, you get me in the car. Okay. I just want the vets to stop saying a veterinarian. I am at the end of my rope.

Renee (11:28)
So there’s no other answer than fuse the Hawks? Can they not just say, I am at the end of what I know to do other than try to fuse the hawks? There may be some other answers out there. Here’s my list of alternative practitioners that I know of that maybe could have some ideas where’s that come on, people. Let’s start doing it.

Renee (11:50)
It would be so awesome.

Renee (11:53)
Okay. Sorry. This was really ranting. It just obviously happened a few days ago that I heard about this, and it just shocked me because it so doesn’t make any sense. All right, one more thing on what vets typically offer for fusing hawks.

Renee (12:16)
Also that doesn’t make any sense is to give joint fluid, right? So if, theoretically, you’re trying to fuse a joint and you’ve been taught that fusing means internally, right, the whole thing is going to just weld itself together. Why would you give more joint fluid? That would prevent the fusing. Okay, so that doesn’t make sense.

Renee (12:42)
Now, there’s nothing wrong with trying some joint fluid, and that can be oral products, intramuscular or intravenous injections or direct joint injections. It’s okay to try these things. Sometimes you’re stuck in a spot where you need to try this to see either diagnostically what’s going on or what might work for the horse. So if you’re trying to fuse a joint, theoretically, and you give joint injections and the horse gets better, that’s wonderful. But that’s telling you the joint is not trying to fuse.

Renee (13:26)
It’s trying to move. So when you gave more joint fluid stuff, the horse was happy about it. It’s like, oh, yes, I do need more joint fluid stuff because I want to move this joint. I hope that made sense. You might have to relisten to that one.

Renee (13:46)
The idea that I’d really like to get across, as always, is there’s always a reason that the body is doing stuff. You want to find that reason and fix that. And the second thing I want to get across is if you could share this with your veterinarians, please come back to the light side. Come away from the dark side and just rethink, because we’re all really smart and we’re all trying to do the best thing, and sometimes we just get stuck in this. Oh, I have a shot that might work, and let’s stop that.

Renee (14:26)
All right, thank you all for listening. I’d love to see your comments, and I appreciate you guys. I’ll talk to you later. Bye.

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2 Comments on “Podcast Episode 27: Do joints really fuse, and would Osphos help?”

  1. Hello! My question is, are joint injections a good idea? In other words, do they benefit the horse to add in hyloronic acid or not. Some vets say yes, others ‘no’.

    1. Hi Shannon,

      Thanks for your question. Because this is not a simple yes or no answer, I have two options for you.

      One is another podcast: https://wheredoesmyhorsehurt.com/podcast-episode-11-joint-supplements-if-when-and-how/
      And an article: https://wheredoesmyhorsehurt.com/horse-problems-database/front-end/joint-supplements/

      While these are about oral supplements, it is a similar idea. I’ll work on a joint injection article or podcast soon.

      Renee Tucker, DVM

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