Page 114 - 2021 Barrel Stallion Register

EQUINE HEALTH
Many horses continue to perform at a high level of activity with a joint chip. Whether that chip causes problems may depend on if it ever gets caught in the joint.
do extreme exercise with immature joints. “We see hock problems later in the dressage horses, barrel horses, etc., when the hocks are already broken down from the exertion they did 10 years earlier,” he says.
“When I see a hock problem in a fairly young horse, I look at symmetry of the hock, making sure there isn’t joint distention on one side com- pared to the other. If there is asymmetrical dis- tention, this may mean there’s potential to find OCD fragments, joint chips, etc., so we have
to check to see if that’s an issue. I think there is some debate as to whether these joint chips truly cause problems as the horses get older. Many horses continue to perform at a high level of ac- tivity with a joint chip,” says Cassells. Whether that chip causes problems may depend on if it ever gets caught in the joint. If it is embedded in the joint capsule and not floating around in the joint, it may not be an issue.
“I think the bigger problem is what that chip represents. If it’s due to a defect in the cartilage, this may be more of an issue than the chip itself. With those horses I usually try medical management first, if they are having a problem. The medical management usually
involves injection of the joint with regenerative therapies. I try to avoid corticosteroids in these horses because the cartilage is already impaired. I think the regenerative therapies such as Pro- Stride, IRAP, stem cells, etc., are superior to corticosteroids in these joints, to try to reduce any cartilage damage or at least keep it from getting worse,” Cassells explains.
“I am a big believer in some of the supple- mental systemic treatments like Adequan or Pentosan. Anything we can do proactively that will reduce the likelihood of a problem due to joint inflammation will be helpful. Cosequin is a feed-through product that works very well, as does Platinum Performance CJ, for joint health. There are a number of products that people use, including Legend and polyglycan.” The veterinarian can give advice on what
to use. It may depend on the situation and whether the owner is comfortable giving shots or whether the horse will or won’t eat medica- tion in the grain. What works on one horse may not necessarily work on the next.
“For me, if the horse does not have a lame- ness issue, then I try to manage it with systemic joint supplementation. If the horse starts devel- oping lameness issues, then surgery becomes higher on my list of things to do, and medical management with regenerative therapies versus corticosteroids,” says Cassells.
If there is a questionable area on a hock that’s noted on radiographs, he suggests taking subsequent radiographs over time, such as every 6 months to a year. “This can show us any pro- gression of the condition, or lack of progression of a disease condition. If it is maintaining well, and the horse is performing well, then maybe nothing else needs to be changed.”
Peters says synovitis and bone trauma can lead to arthritis in the lower joints. “This can progress and become serious if not taken care of early on. Usually we will use injections in those joints (steroids, hyaluronic acid, IRAP, stem cells, platelet rich plasma, amnionic fluid isolates, etc.) in an effort to reduce inflamma- tion and curb development of arthritis. We’ll also back off on exercise and training for a while. If there is bone soreness and trauma— perhaps some micro-fractures associated with the bone bruising—this may take four to six months before the horse can go back to work, and racehorse people don’t like to miss that
much time in training/racing.” This is time and money lost.
“If the joint has synovitis, many of those horses will respond favorably if we change their routine a little, backing off on the level of work, and treating the joints themselves with injec- tions. Those horses may only lose two to four weeks of work and then can get right back to it,” says Peters.
Several of these problems may show up with similar signs but may need a completely differ- ent course of treatment and a different length of time off, in terms of how they respond.
“Another thing that’s interesting about the hock is that there is sometimes some involve- ment with the proximal suspensory ligament. There may be some pain-causing damage to that ligament where it originates at the back
of the hock. This may actually be the primary problem that leads to secondary hock problems. We find this on MRIs more than with any other type of diagnostic tool,” Peters says.
“These horses won’t be performing well; they will have a soft-tissue problem related to the origin of the suspensory ligament, either
at the back of the cannon bone (just below the hock) or even into the plantar ligament—since some of those fibers attach up into the plantar ligament at the back of the hock,” he explains.
“That whole area functions as one unit. There may be general hock soreness that includes a soft tissue component. The high suspensory area may need to be addressed or explored to make sure we are taking care of all the problems that are causing the soreness,” says Peters.
There are also some unusual aspects that are sometimes encountered with hock joint soreness. “There may be collateral ligament injuries. These are interesting because the hock has two sets of collateral ligaments. One set is under tension during flexion and the other set is under tension during extension of the hock joint. Occasionally we see ligament damage in one or the other set, depending on what kind of trauma occurred. Collateral ligament injury can certainly occur but is not quite as common.”
Depending on where the injury is located— which bone and surface within the hock—the horse might need arthroscopic surgery. “There might be interference with joint articulation,” says Rudolphi. Some cases are more involved
Some hock problems may be due to conformation, and how straight or angled the hind leg is, and which stresses are put on the hock joint.
112 SPEEDHORSE