Joint injections puzzle me. I've seen them administered to aging sport horses whose hock joints don't function as fluidly as they once did. I've heard trainers order them for show horses who perform chronically "late" lead changes. And I've even seen a veterinarian prescribe them for a young horse with a head-scratching lameness just to "see what it would do."

Done properly, joint injections can be very effective for prolonging horse's athletic careers.

Photo: Courtesy Dr. Harry Werner

But how do we know when a horse really needs an injection? The easy and obvious answer, says sport horse specialist Mark Revenaugh, DVM, lead treating veterinarian for the United States event team and owner of Equine Performance in Oregon, is that the horse is lame, a nerve block to numb the joint pinpoints the problem, and a decision is made as to whether an injection is the best course of treatment. However, he's observed that joint injections are standard nowadays in otherwise sound, competing horses simply because "if done properly it can be very effective (for protecting joints)."

I, too, have found that it's now commonplace to show up at the barn and find a horse cross-tied and sedated, with a veterinarian intern scrubbing away at a stifle or hock with that familiar rust-colored Betadine antiseptic solution. A practitioner then puts a gloved finger on the precise point of the joint she's injecting, depresses the plunger, and hands a several-hundred-dollar invoice to the trainer or horse owner. In the hunter/jumper world, it's almost more difficult to find a horse that hasn't received this intra-articular treatment than one that has.

As Dr. Revenaugh explained it to me, if you have inflammation in a joint, enzymes in the joint fluid are degrading the cartilage. "It's like driving your car with old motor oil and not enough of it," he said. "If you liken it to that, then you're a fool not to do what you can to keep the joint fluid good. If the horse has an inflammatory process going on in the joint and does not have a screaming injury, generally speaking, treating the joint is going to promote longevity for the horse's career."

So yes, injecting show horses' joints to protect and maintain them can have beneficial effects. Good news for me, as almost all my horses have "been injected"--some of them multiple times a year--at certain points throughout their careers. This not to say, however, that this treatment is a quick fix or without consequences. It's further complicated by the fact that veterinarians have an increasing number of medications to choose from.

"The downside is that a lot of horse people have become overly reliant (on joint injections) rather than just looking at their programs," Dr. Revenaugh says. "Are they riding the horse too much or jumping him too high? This is where it gets complicated."

He likens the sport horse industry's joint injection trends to a swinging pendulum: "Initially you would only treat a joint if there was a dire need for it," he explains. "Then the pendulum swung and you could treat horses that weren't in dire need for it. In my opinion, the industry went too far--it was treating everything all the time. I think the pendulum is kind of swinging back now and people are trying to be a bit more accurate about what really needs to be done and when."

So, moral of the story, joint injections are still an intricate and highly individualized therapy. I'm sure my trainer and veterinarian will recommend my mare have her hocks injected while we have some downtime this winter, just as they did last winter, and I'll pay that extra money to help keep her performing at her best.

How frequently do you inject your horse's joints, if at all, and what are your thoughts on the matter?