Coffin Joints and Hocks: Sometimes Quick Success

It seems like Standardbred trainers and Veterinarians have played a large role in teaching me some lameness issues, directly and indirectly. I suppose part of it is the trainer is generally sitting right behind the horse. He is up close to a lameness issue. The standardbred also trains on a pretty hard surface which provides for more chronic traumatic jarring type soreness as opposed to the many acute lameness issues thoroughbreds can have.

Some thirty years or more ago one of my biggest mentors, Dr. Teigland, learned of hock lameness, I think, form a very well respected standardbred veterinarian, Dr. Steele. At the time (I was a veterinary technician) we didn’t know how to inject the hock joints and the standard of treatment was “cutting the jacks” or cutting a small tendon that runs on the medial side of the hock. For some reason this greatly enhanced the way a “hocky” horse travelled. The “hocky”  horse tends to travel with the leg moving inward, commonly hitting the other hind leg in the process. The horse can have an elevated “hiking” appearance from behind; and, since most hock lameness’s are bilateral, if you flex one for a minute or two, accentuating the lameness  (flex your knee for a minute or two and see the effect), and jog the horse off, the horse can actually demonstrate a usual 1-2 degree of lameness, usually nothing too dramatic.

Of course, since that time we have learned how to inject the joints of the hock, although there can be spirited discussion as to which joints need to be injected. There are basically three joints to the hock:  the upper joint, which is seldom a lameness issue, but lends itself to becoming a candidate for getting an OCD lesion, and the bottom two which lend themselves to getting jarred or sore. Scientific papers have suggested the two communicate sometimes; my clinical experience has blocked lamenesses to each joint independent of the other; so I inject both lower joints. The beauty of hock lameness is that most of the time injecting the hocks can give a prolonged relief. There are exceptions: sometimes the joint has severe degeneration and on occasion I have had to literally, chemically fuse the lower joints. When injecting I tend to stay away from Depo-Medrol as it is very granular and multiple injections tend to degrade the very small narrow joint.

Not that many years ago, while working at early days of Adena Springs, I met a rather talented and notorious veterinarian, Dr. Allday. Dr. Allday was brought up around standardbreds. He introduced me to coffin joint lamenesses. Doing a lot of my training at Calder, with the underlying Tartan cushion back then, I had little experience with foot problems. On more conventional tracks feet lameness showed up. Horses tend to  have a shuffly short gait up front, maybe holding their heads out in front of them. The feet themselves tend to  be normal. The clincher to diagnosis is flexion of the coffin joint. Horses will go dramatically off. The beauty of it is injecting the coffin joints would alleviate the soreness for a exceptionally long time. In fact, in my experience many horses I have not had to be reinject. There is the occasional non responsive horse and these need to be radiographed. Most have a pastern coffin joint partial luxation due to apparent foot angle issue. These horses need corrective trimming to realign the pastern with the coffin bone.

June 1, 2017

H.O. Ferguson, DVM