Your horse is lame. He’s off somewhere and your vet, through flexion tests and radiographs, determines that one of his joints is irritated or potentially worse, showing signs of degeneration or arthritis. The recommended course of action is a joint injection, but is that the right thing for your horse? Are there other options? What about herbs? They helped a friend’s horse, but what about yours? Are herbs a better option for joint pain in your horse, rather than a joint injection?
Joint injections in the horse for joint related pain are extremely common. However, just because they are very common and well accepted does not mean they are the option of choice in all cases. In some instances in medicine and lameness, some therapies become the standard because there simply is nothing else to choose from for the veterinarian. There are always other options, but options may seem limited mainly because the mind is limited. Open your mind and the door for possibilities opens with it!
First, in the scenario listed above with the lame horse, realize that you, as the horse’s owner have a choice and you do not have to make a decision right there and then. If your horse is lame, with or without joint degeneration on radiograph, you do not have to inject that joint today. This option is usually best considered over time, taking a few days to weigh out pros and cons. Owners tend to jump into the decision rather hastily because of pressure from their veterinarian or the feeling that they need to do something right now. This is not true, so take the time to consider what is best for your horse.
Joint Injections in the Horse; Making the Choice
A joint injection is the process of placing a needle into the confined spaces of a joint. In most instances in the horse, this procedure is done to alleviate inflammation and pain associated with joint strain or arthritis. In other cases, the injections may be performed for other therapies, including an infected joint as an example. There are different types of medications utilized when joint injections are done for lameness reasons, but generally revolve around hyaluronic acid, a corticosteroid, and usually an antibiotic. The hyaluronic acid is intended to aid joint fluid production and thereby reduce friction in the joint. The corticosteroid is used to counter inflammation, while the antibiotic is added to help reduce the chance of infection.
There are many scenarios in which joint injections are routinely performed in the horse, some of which are warranted and some are not, at least in my opinion as a veterinarian. There are some owners that feel that joint injections should be done on a ‘preventative level’, starting often as young as a 2-year-old, targeting the hocks. Then, there are some horses that have joint flare or mild lameness within a joint, demonstrating an increased amount of joint fluid but no degenerative changes on radiograph. Then, there are those horses with obvious joint degeneration with chips, spurs, and cartilage loss (joint collapse) on radiographs along with moderate to severe degrees of lameness.
Joint injections are done fairly routinely by the veterinarian, especially if working in the sport horse industry or race track environment. Despite being routine, they should be considered far from it. A joint injection is invading a joint space, which is a sacred and sterile environment. Most injections go smoothly, but when things go wrong, they can go horribly wrong. The main two problems that can and do occur following a joint injection in the horse are needle breakage and infection, both of which can be life altering and career-ending for the horse.
Why are joint injections so popular in the horse? Simply put, because they can be very effective in the short-term and there are no other ‘medical’ options that can beat their impact on lameness. An owner can give an oral pain medication, which can help and does help many horses, but if you desire to acutely return a horse to joint soundness, there is nothing like a joint injection.
So, why wouldn’t you choose that joint injection? Yeah, I know, it sounds all good, right? Well, not in all cases. First, as mentioned above, there are risks such as needle breakage and infection. If you encounter either of those two, it could be not only a costly road but a road that leads to retirement or worse for your horse. Second, a single joint injection does not solve the issue for your horse. In most cases, the act of injecting a joint becomes a bad habit with repeat injections being required as often as every other month. It usually starts with once or twice a year, but due to the joint continuing to degenerate over time, despite the injection, the need for frequency begins to increase. It is not uncommon to have horse owners scheduling joint injections as if they were a vaccination; spring and fall kind of thing. Third, the joint is a sacred place and every time a needle is popped through that joint capsule, the capsule responds out of irritation with inflammation. This inflammatory event can result in the joint capsule becoming thicker and less flexible, making matters worse over time and harder to inject through in the future.
There are pluses and minuses to joint injections in the horse. Just because others in your barn are doing it when problems arise, does not mean you have to follow suit. Let’s look at other options.
Herbs and Joint Lameness in the Horse
My world as a veterinarian changed dramatically back in 2006. At that time, I was injecting horse’s joints almost every day. It was a job I accepted as a veterinarian, believing it was needed and warranted, but deep inside I felt it was very wrong. I went with my gut, stopped injections and started to investigate options. This was when our first research trial was conducted using herbs in horses with arthritis. The outcome of this field trial was so significant that I no longer gave my owners an option. No more joint injections and I haven’t injected one since that time.
If you look at the problem of joint lameness, most are associated with inflammation involving the joint capsule and over time, the joint cartilage and bone. This inflammatory event in the early stages results in an excess of joint fluid being produced, which is done by the body to bathe the joint and soothe discomfort. As the condition continues over time, joint fluid production begins to be decreased as the joint capsule cells become damaged and fatigued. Then, due to lower amounts of joint fluid, friction becomes an issue and inflammation spikes yet again, now impacting the joint cartilage and underlying bone. So, by the time you see degenerative changes on radiograph in your horse, you are well beyond the first stage and those degenerative changes are often permanent, leading to more discomfort and inflammation. It becomes a viscous cycle of events and why many horses are on medications every day to curb their pain or receiving joint injections month after month.
Sounds depressing, right? It is and can be for any owner, as many times those joint injections and medications just don’t seem to work anymore for your horse. So, what options do you have?
Well, many actually. You just have to open your mind and the options will simply pour out!
Seeing the process for what it is, being inflammation, this opens the door for many opportunities to intervene with herbs. Most herbs, if not all herbs, impact the process of inflammation on some level, which is how and why they are so beneficial to health when properly used. Disease and lameness, being states of ill-health in the horse, are both a result of inflammation in the body. Thus, herbs can be of tremendous benefit, some more than others. In truth, this process of inflammation is associated with the aging response in the body and for some horses, this aging or degenerative process is sped up. Interestingly enough, some herbs are well known for enhancing longevity, which is through the impact of the inflammatory and other cellular responses. Going one step further, there are some herbs that are also well known for impacting or benefitting the bone and joint regions of the body, not just through their inflammatory reducing properties, but often through other phytochemicals and minerals that are present.
The ultimate question in most horse owner’s minds is ‘can herbs produce the same effect as a joint injection for lameness in the horse?’ The answer to this is ‘yes’, at least in my opinion, but the results may not be as quick, although sometimes they can be. A joint injection will often yield improvement in a horse’s sore joint in about 2-7 days on average. An herb, when properly utilized, administered and dosed, can improve a painful condition in about 5-7 days. So, in my experience, they are pretty close when used properly.
There are other benefits however, to using herbs rather than a joint injection for the horse, which include:
- Reduction in side effects and risks
- Reduction in overall financial expenditure as compared to medications or injections over time
- Benefits the entire body versus just one or two joints
- Impacts other areas of health including immune response, digestion and circulation
For myself, the vast majority of horses that I encounter are dealing with chronic joint pain with most having repeated injections over their careers and being retired. Given this scenario, not only are the joints of those horse’s painful and stiff, but their entire body is, due to compensation. Thus, herbs are my only choice and my first choice. With the right regimen, it is very possible to improve joint function rather quickly and then alter the regimen to help rebuild and support those joints moving forward. In the end, most of these horses do quite well and become much healthier than in their previous state.
My favorite herbal formulas for joint support in the horse?
- Cur-OST EQ Pure (aids in modifying the inflammatory response)
- Cur-OST EQ Bone Support (helps to support and rebuild bone and cartilage health)
- Cur-OST EQ Topline (helps to support surrounding tissues to rebuild joint strength)
In the end, take the time needed to consider the options for your horse. Don’t just jump right into those joint injections no matter how good they sound or how many people are ‘doing it.’ Do the right thing for your horse, even if it means one injection today and beginning an herbal regimen at the same time. No harm in that approach at all.
Author: Tom Schell, D.V.M, CVCH, CHN