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Dr. Taus
Dr. Taus, Veterinarian
Category: Veterinary
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Experience:  Veterinarian with experience in equine and small animal medicine.
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2 year old gelding in training for cutting. Just switched

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2 year old gelding in training for cutting. Just switched trainers, when he arrived at new trainers had difficulty going to the left this was new. Vet asscoiated with this trainer brought in and assessed gelding. Injected SI joints anterior and posterior BL using aseptic technique and US for needle placement, also did hocks. Horse tranqed for procedure, used a combination of NexHA, and triamcinoloe injected interarticularly. As far as I know nothing used prior to this to alleviate obvious pain. Concerns about steroid use and the NexHA any information on the use of these drugs for same would be appreciated. Sire is Neat Little Cat, and Dam is Hewlett Me do it a daughter of Docsonita and grandaughter of Sonita's Last.
Hi there,
The drugs you described and the injection sites are pretty standard procedure for treating pain and inflammation in performance horses, especially if the vet felt swelling/joint effusion in the hocks or the horse responded negatively to handling the area over the SI joints. Hock trouble is super common in young cutting and reining horses that have to sit down and turn sharply.

The triamcinolone is a good choice of steroid as long as it's used in appropriate doses because it's a little faster acting than other options and it is a little more protective of the cartilage within the joint. There's some concern that steroids may encourage thinning of this cartilage; however, triamcinolone has been shown not to, and it's often necessary to use steroids in joint injections to get the inflammation down and get good results.

The HA is harmless at worst and replaces the thick, slimy, lubricating part of joint fluid that tends to get diluted out when extra joint fluid is produced in an inflamed joint. It helps protect cartilage.

I find that when there are issues developing with performance, joint injections can help get your horse back to moving comfortably without the GI side effects we can get with Bute and Banamine. They are also more effective because they take place right at the source of the problem. To keep him on the right track, you might consider Adequan or Legend on a regular basis while he's in training. This avoids the risks of infection associated with joint infections, doesn't require sedation, and can improve performance in some horses.

I would also caution you that since this is such a young horse, you may see problems ahead if the saddle/rider is too heavy for him (more than 20% of his body weight, a pretty light amount in a 2 yo) or if he has OCDs or anything associated with his long bones still growing. If this is recurrent, I'd advise x-rays to rule out OCDs. My personal opinion is that starting these horses so young contributes to the need to chronically manage joint pain early in their careers, but it has become necessary to make them competitive. Just my two cents.

I hope this is helpful. If so, please rate me positively, and don't hesitate to let me know how I can help further.

Customer: replied 3 years ago.

Thank you for your response. I did however get my ages mixed up, this gelding turned 3 this year. Had been working very well but then when going to the left would not stop on his hind end but instead would stop on his front. He seem to have improved since the injections, I will pass along the information for maintenance using Adequan or Legend while he is in training. I wasn't so concerned about the HA as I was the steroid. I know it is important to use to get the inflammation down. But I always worry that it can set the horse up for more serious injury in the future. As pain does limit us and it keeps us from doing further damave

It does, but if he continues to go on his forehand due to pain, he will develop problems in his knees and front fetlocks too. It's best to get him comfortable so he can move in a normal way, but if you find that he is persistently getting sore after getting back to normal it may be time to modify his training program.

I thought 2 sounded a bit young to be in full cutting training :).
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Customer: replied 3 years ago.

I have a couple of more questions you mentioned appropriate dose, could you tell me what the appropriate dose is? Also how often is too often? How soon after treatment can he be ridden? And should he have some time off before they start up with him again?

I kind of cringe at the idea of injecting anything in a horse this young, but he is not mine, I did however halter break him and do most of the handling of him as a weanling and yearling, when he left me you could do darn near anything with him and he didn't fuss. Lead well, trailered well, groomed and washed, clipped, and was ok with having his feet done.... the whole nine yards. My best friend owns him and she is worried and is looking to me for answers. Thank-you for your replies. I appreciate anything you can tell me and I will pass along your information to her as well as the information I have gotten from reading some research papers on the this type of treatment in performance horses.

His trainer is away at a show for the next 10 days and his staff is keeping him legged up, I told her to just bring him home for those 10 days. She went up to see him and she is not happy with the way he looks. But other than gather information for her there is not much else I can do.

The sort of "magic number" for triamcinolone in horses is 18mg total body dose. As long as you don't surpass that amount, divided among all the joints injected, side effects are minimal. Most equine vets are pretty careful about this and stay well under this amount. I've worked quite a bit with performance horses and the frequency of injection varies dramatically; some do great with a single round of injections or a round of injections at the beginning of show season, while others need work every 4-6 weeks. In a horse this young and just starting out, I don't expect him to have significant osteoarthritis, so if he gets sore again before the summer is over, I'd be looking pretty carefully at his training program. It may be that he needs work to build his hindquarters and have the muscular strength to sit down and turn like he needs to without over-straining his other muscles. It may be, too, that he's learning to move in the way a cutting horse moves, which doesn't come naturally, and as he gets better and more flexible, he will do better. Turnout as much as possible helps, because it keeps those joints moving in a gentle walking motion that helps feed his cartilage when he's not working. Avoid lunging if you can-- tight circles are hard on the hocks. Sometimes, ice after exercise and keeping the toes short and the heels raised with trimming or shoes can help, too. Checking the saddle fit can help with SI issues, and sometimes, letting the chiropractor have a look at him can work wonders for horses that suddenly don't want to go to one side or the other.

Ultimately, I'd suggest following these injections through, giving him about 5-7 days of turnout, and then gradually bringing him back into training. Then, if he's not looking good, or if he looks great and then gets sore again, I'd advise your friend to talk to her trainer about his training program.
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Hi Anne,

I'm just following up on our conversation about your pet. How is everything going?

Customer: replied 3 years ago.

Hello Dr Taus. I just sent some information about the horse i asked information on, unfortunately i used the wrong window to repy, i used "asked a question" window. so you will probably get everything you need from that. If not let me know and I will resend using this page. sincerely xxxx xxxx

Unfortunately, the new question isn't popping up in my worklog. You may get an answer from somebody else, or if you want to continue here, that's fine too :).