Podcast Episode 29: Should you ever do joint injections?

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Have you ever wondered if joint injections are good for your horse?

If they are good, when do you do them?

If they’re not good, what options are available?

All this and more on today’s Horse Mysteries Now podcast.

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Summary by AI:

Dr. Renee Tucker discusses the pros and cons of joint injections for horses. She highlights the risks involved, such as potential bacterial contamination and the negative effects of steroids on joint health. Tucker suggests minimizing the frequency of joint injections and emphasizes the importance of addressing the underlying causes of joint issues rather than solely relying on injections for treatment. Additionally, she recommends exploring alternative options, such as herbal supplements and proper hoof care, to promote joint health and reduce the need for injections.


Renee (00:01)
Hello, friends. Dr. Renee Tucker here. Hey, we had one of our listeners request a podcast about joint injections, so here we go. Okay.

Renee (00:10)
Should you do them? Ideally, no. I think we all know that, right? Giving a joint injection has let me just talk about the negative parts first, okay? First of all, it’s sticking a needle in joint.

Renee (00:26)
In the ideal world, we would fully clip the joint and do a ten minute scrub, a surgical scrub for ten minutes to make sure there was absolutely no bacteria that would accidentally be taken into the joint when the needle pierces the skin and goes into the joint. We don’t do that for horses. We clean it. We clean it pretty good, but nobody wants to have their hair clipped off of their horse to show that it got joint injections, so we don’t do that. Now, that means that we’re not getting 100% certainty that there’s no bacteria that’s going to come into the joint.

Renee (01:11)
Now, is that a big deal? It’s not the worst thing in the world to have a little bacteria in your joint. You know why? Because we have an immune system, okay? So the immune system will be like, oh, I see a couple of bacteria, I will run into the joint and get them, which is perfect.

Renee (01:30)
But you know what happens when that happens? It’s inflammation happens. With that, the joint swells up a little bit, and then people get worried. And so what happened? The veterinarians thought, well, we don’t want this swelling here.

Renee (01:46)
Let’s add some steroids to our mixture of joint injections. The steroid stops the immune system and stops inflammation. So typically that is why you want horses to rest, because you don’t want to exacerbate what’s going on in the joint, potentially, because you can’t tell if it’s really swollen or not. Now, some people might say that’s crazy. No, sorry about your luck.

Renee (02:17)
You got an old lady here. No, just kidding. I’m not that old, really. I remember when joint injections did not have steroids in them. They didn’t.

Renee (02:26)
At the very beginning, they didn’t. They had a little antibiotic, okay? And then you had to rest the horse in a stall for at least five days, if not ten in a stall. We don’t do that so much anymore because I put steroids in it. Now, steroids is the bad part of this.

Renee (02:44)
Steroids do two things. One, they depress the immune system, like I mentioned, and then they also start eating away at the cartilage in the joint. The cartilage lines the ends of the bones, keeps them from rubbing together, and steroids erodes that over time. Now, the body is constantly trying to fix things. So it will work on that cartilage, it will try to fix that cartilage.

Renee (03:18)
Generally speaking, we say if you can do joint injections at least six months apart, that should be enough time for the body to heal up that cartilage. I don’t believe to my knowledge, there are any studies that show whether or not that works. But that is the current theory. I don’t think that works 100% of the time. But certainly trying to spread out joint injections as much as possible if you have to give them is a good idea.

Renee (03:52)
One last thing about steroids is steroids take a fairly long time to get out of the system, and steroids in horses can cause laminitis or founder. Now, how much, how many, depends on the horse. And you may have seen some studies that show scientists, veterinarians are thinking horses that founder. A lot of them have been subclinically foundering for a couple of years. So subclinically means below clinical signs.

Renee (04:30)
Sub means below. So that means there are no signs, but they’re still foundering. Kind of like that iceberg. There’s so much of it under the surface that you don’t know about. That’s sort of what happens with subclinical founder.

Renee (04:44)
You don’t know what’s happening, but it’s there. And then boom. It seems like out of the blue, the horse has laminitis, and no one knows what happened because nothing changed. Well, in fact, he’s had joint injections every three months for five years, and people now wonder why he’s foundering. Okay, the positives on joint injections is it adds the joint fluid that should be in the joint, and it lubricates it in that manner.

Renee (05:14)
Now, when a joint does not have the correct joint fluid and you lubricate it, it feels fantastic. Okay, that’s a good thing. However, I would still avoid it because why? The body should be putting in its own lubricant. It’s supposed to make joint fluid.

Renee (05:38)
If it’s not, or if it’s not making enough, we want to find out why. As on many of my examples, let’s just say the hawks, it seems that they need to have a joint injection into the hawks. But actually, one hawk is almost always worse than the other one. Almost always you will find one that has more dryness, so there’s less fluid that comes out when you put the needle in. And or you will have one that has less viscosity.

Renee (06:09)
So the joint fluid should be a little bit thick, kind of if you’re familiar with car oil, it’s supposed to have viscosity. It should be thick. It shouldn’t be literally watery. All right? It has substances in it that make it a good thick lubricant still liquid.

Renee (06:29)
Okay, it’s not solid, right? But anyways, you can tell a difference in viscosity when you do the joint injections and see how the fluid is almost always one hawk will be worse than the other. So to me, that says there is some misalignment. Now, it could be in the pelvis. So one hip, if you will, is higher than the other side, which means one hawk is loaded more than the other one.

Renee (06:57)
It doesn’t necessarily have to be a body misalignment. It could be the feet. Maybe one hoof is at a different angle than the other one in the same manner that’s going to change the pressures and the load on the joints. Okay? So it’s sort of helpful to know the joint fluid isn’t great, but the point is, again, the body should be fixing this.

Renee (07:22)
So what we need to do instead is help the body find the problem and help fix the problem, fix the cause of the joint fluid issue. Okay? I know that may probably make sense, but you might be thinking, yeah, but for what I do with my horse, my vet says I should just inject all the time. Well, there are people who do some extreme sports, let’s say, with horses, and at a very young age, and it does seem that these horses literally cannot keep up with production of the joint fluid. And that may be true.

Renee (08:06)
And if they can’t keep up with production, it does seem fair to help them out with some joint injections as long as you realize that if the horse cannot keep up with joint fluid production, whatever you’re doing is too much for the horse. And if you or the trainer or whatever, I know sometimes that’s just your thing, but it’s not good for the horse. But that’s your choice. And then if horse is going to get run down and broken, then you’re going to do joint injections to keep them going, and they’ll be dead broke when they’re five. I think many of us have either had horses or seen horses where this has happened.

Renee (08:53)
They’re five years old and they’re done because people broke them. And that’s not right. I 100% do not agree with it, though I do understand that if you’re willing to break your horse down and you want to keep them going longer, then yeah, then you might as well give them joint injections to be fair to the horse. It’s the least you could do. That was kind of a sad tangent, but it happens.

Renee (09:16)
I’ve seen it in jumping barns where it’s just what they do. I’ve heard it from the vets, I’ve heard it from the owners, where people say, oh, yeah, this is a good jumper for your daughter. It’s about eight, nine years old, so it’s got good experience. Now what we do to maintain jumpers is because jumping is not normal. So we just inject their hawks and their coffin joints on a regular basis.

Renee (09:40)
People are like, oh, yeah, okay.

Renee (09:44)
And mostly I’m mad at the veterinarians at this point because, come on, really? We just maintain them by giving them joint injections. They’re not good for the horse. Guys, come on, there’s better things we can do, all right, than just automatically put them on joint injections, all right? You may notice from my tone, I’m not thrilled with joint injections.

Renee (10:11)
I certainly understand if you need to do them as minimally as possible. Okay. Sometimes you got to do it to figure out what’s going on. To keep the horse out of pain. Cool.

Renee (10:25)
So let’s try to avoid them whenever possible because overall they’re not good for the horse. Now what else can you do? There are several herbal choices that you can do that helps with joint supplements and then helps with inflammation and that kind of thing. I’m not going to talk about a list right here because every country is different. So you’d want to look up supplements for joints in your country?

Renee (10:55)
Okay. Because oftentimes if I say something for here then everybody from Australia emails me and says, well what about Australia? And I’m sorry, I don’t know every country’s products but there are things that exist for that. Primarily we want to keep the horses aligned because that keeps the load on the horse’s joints where it should be. All right?

Renee (11:18)
Then the other thing, and I know everyone’s going to get in an uproar, is that ideally your horse should be barefoot. Like, oh my God, how is he going to do it without shoes? Listen, shoes only lift the horse up off the ground and they stop the normal expansion and contraction of the hoof. And when the hoof is able to expand and contract and in that manner the frog touches the ground. When it does that and the frog is concussion relief.

Renee (11:53)
It’s like having these nice comfortable Nike shoes on your feet. But let’s say you had nice comfortable Nike shoes and then you put a layer of steel on the bottom, it just negates the nice comfy shoes. Instead you’re clang, clang, clanging around on the steel. I understand not every horse can go barefoot at the moment. Some are extremely flat footed and they really can’t.

Renee (12:20)
I get that. And that’s probably a topic for another podcast. But if at all possible we need to be going to barefoot and correct barefooting. I know you’re like, well how am I going to know that? And there are luckily some really good videos from a place online, they’re from England called Hoofing.

Renee (12:43)
Marvelous. So they have free seminar videos. You just sign up for them and it really shows how the hoof is supposed to work. And if the hoof is working right, then we don’t have that concussion, all right? So that we’ve eliminated a lot of the concussion and too much force on the feet.

Renee (13:02)
So that takes out all of our coffin joint injections if the foot can work and then if we keep the horse aligned then the load will be even on the joints and then a lot of our other joint injections will be eliminated. Listen, this is the plan, okay? Try to your horse barefoot and aligned and you’ll be good to go. All right? Hopefully that answered a little bit.

Renee (13:26)
Anyways, on what to do about joint injections, the summary is avoid them whenever possible. All right, talk to you later.

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