Joint injections are a way to control inflammation and treat joint issues in horses, specifically equine athletes. Joint disease generally has inflammation (see the image below). Reducing inflammation is a goal in the treatment of joint disease. Depending on the horse and their need, they may be treated with joint injections only a few times or receive treatments on a regular basis. There are three types of joint injections, depending on where the treatment is injected. These include intra-articular, intramuscular, and intravenous injections.
Intra-articular joint injections are injected directly into the affected or injured joint. This allows for a direct treatment of the problematic joint or area, however, it does have its risks. These include joint flares and/or joint damage. Caution should be taken if these joint injections are paired with corticosteroids as there is a risk of laminitis developing. The most common areas and joints injected on an affected horse are the hocks, stifles, and knees as well as the fetlocks, pastern, and coffin joints. There are only a few intra-articular joint injections that are FDA approved for equine athletes. This includes Legend, Adequan, and Depo-Medrol.
The second type of joint injections is intravenous injections. These injections are injected directly into the largest vein in a horse’s neck, the jugular vein. This method of injection is not as common and although it does not appear to have any side effects, horses have experienced depression, lethargy, and fevers post-injection. The only FDA approved intravenous injection is Legend, which requires a prescription from a veterinarian to be purchased.
The third type of injection is intramuscular injections. This type of joint injections is most commonly utilized to treat non-infectious degenerative joint diseases and joint dysfunction. Lameness of the of the knee and hock joints fall into this category. The only FDA approved intramuscular joint injection is Adequan. This joint injection must be prescribed by a veterinarian. These joint injections have no known side effects or harmful reactions.
Joint injections are made up of many different components depending on the type of injection method, age of horses, targeted joint, etc. The first composition of joint injections is called the standard blend. The standard blend consists of some form of hyaluronic acid, steroids, and antibiotics. The ratios of these components vary by needs and application. Hyaluronic acid concentrations are varied to create long term relief of joint pain or simply a fast inflammation reduction. Antibiotics are included in the blend as a proactive preventative against joint injections, whether it is related to the injection sites or injury. Lastly, the steroid volumes depend mostly on how the horse has reacted to prior injections or if it has a known history of not taking up the joint injections well. An example of this is a horse experiencing laminitis as a side effect of joint injections.
The second type of joint injection blend is called the regenerative mixture. The regenerative mixture consists of stem cells as well as other components to improve the health of a joint rather than fix the current issue or cause of inflammation. There are three types of stem cells that are used in these regenerative mixes; platelet rich plasma (PRP), interleukin receptor antagonist protein (IRAP), and Pro-Stride. PRP can regenerate the soft tissue found within the skin and bones. These stem cells are primarily used to treat tendons and ligaments. IRAP is a natural anti-inflammatory product found in the joints of horses. This protein is produced by the horse’s blood to promote healing in injured regions of the body. Lastly, Pro-Stride is a combination of PRP and IRAP. This mixture promotes healing and reduces inflammation of injury within the body. The image below illustrates a needle inserted in the tarsometatarsal joint for arthrocentesis or joint aspiration to remove fluid from the joint.
References
- Colin, T. An Owner’s Guide to Joint Injections in Horses. Equitait Veterinary Practice.
- Epsy, B and J. Harper. Lameness & Joint Medications. AAEP.
- Hebner, Kelly. Joint Injections for Horses: How They Work & When to Use. Mad Barn
Photo Credits
- Gibbard, D. Diagnosis and Treatment of Equine Joint Disease. Community Horse Journals.
- Tatarniuk, D. So what exactly are joint injections in horses? Equine Sports Medicine and Surgery.