🦵 Vet Insight: Injecting Alcohol into Horse Hocks | 2025 Arthritis Relief & Joint Fusion Alternative 🐴

By Dr Duncan Houston, BVSc

Lower hock joint arthritis is one of the most common causes of hind limb lameness in performance horses. Whether it’s dressage, jumping, or barrel racing, repetitive stress on the lower hock joints can lead to inflammation, pain, and reduced performance. 🧠🔥

Traditionally, treatment has involved **corticosteroids**, **hyaluronic acid**, or **surgical joint fusion**. But a newer method—injecting **ethyl alcohol** directly into the joints—offers a promising, cost-effective alternative. 💉🧪

🦴 Understanding the Lower Hock Joints

The hock is made up of several joints, but only the **lower two hock joints** (distal intertarsal and tarsometatarsal) are typically involved in degenerative arthritis. These joints have **minimal motion**, so fusing them doesn't limit mobility—but can eliminate pain. 🔧🐎

Traditional Treatment Options:

• 💊 Cortisone + hyaluronic acid injections
• 🦴 Surgical joint fusion (arthrodesis)
• ⚡ Shockwave or regenerative therapies

Each of these has pros and cons—but all require monitoring, and some can be quite costly. 💰

💉 Alcohol Injection: How It Works

Injecting **70% ethyl alcohol** into the lower hock joints destroys the cartilage, triggering the joint to eventually **fuse naturally**—a process known as **ankylosis**. The goal is to eliminate pain by removing joint movement and inflammation. 🧬

Benefits of Alcohol Injection:

• ✅ Non-surgical alternative to joint fusion
• 💸 More affordable than surgery
• 📈 Long-lasting—potentially over a year of relief

In a small study presented at the **AAEP convention**, **11 horses** with proven hock arthritis were injected with 3cc of ethyl alcohol. One year later, **10 of the 11 horses remained sound**, despite the joints not being fully fused. 📊🧠

🧠 How Might It Work?

Interestingly, the joints did not fuse in many cases—but the horses were still pain-free. This has led researchers to believe that alcohol may also affect the **nerves** that supply the joint, offering pain relief by disrupting nerve conduction. 🧠🔌

In Comparison:

• 💉 Cortisone injections may only last 2–3 months
• ⚡ Alcohol injections may offer relief for **12+ months**
• 🔬 No systemic steroid side effects

However, precision is critical—there are **risks if alcohol diffuses into surrounding soft tissues**. ⚠️

⚠️ Risks & Considerations

Ethyl alcohol is **cytotoxic**—it destroys tissues. While this is beneficial in the cartilage inside the joint, it’s dangerous if the alcohol leaks outside the joint capsule. 🚨

Potential Complications:

• ❌ Leakage into upper hock joints (which **do move**) could cause damage
• 🔥 Local tissue irritation or necrosis if injected improperly
• 🧠 Nerve damage if precision is not maintained

For this reason, alcohol injections should **only be performed by experienced equine veterinarians**, using **precise anatomical knowledge and often imaging guidance**. 🎯

📊 Is Alcohol Right for Your Horse?

Ideal candidates for alcohol injection are:

• 🐴 Performance horses with chronic lower hock lameness
• 📉 Horses no longer responding to cortisone injections
• 🚫 Horses not good candidates for surgery

It’s **not suitable** for upper hock arthritis, widespread joint disease, or horses with poor conformation that affects load-bearing. 🧬🦵

📲 Ask A Vet for Joint Injection Advice

The Ask A Vet app can help you decide if alcohol injection or another therapy is best for your horse’s hock pain. You can:

• 📸 Upload X-rays or lameness videos for evaluation
• 📋 Compare cortisone, surgery, and alcohol-based options
• 📱 Chat with a licensed vet about side effects and outcomes
• 🧾 Track post-injection recovery progress

It’s your mobile guide to smarter, safer joint care. 🐴📲

✅ Alcohol Injection Takeaways

• 💉 70% ethyl alcohol injections offer non-surgical pain relief for lower hock arthritis
• 📈 Studies show up to 1 year of soundness in most treated horses
• 🧠 Likely relieves pain by destroying cartilage and possibly affecting nerve endings
• ⚠️ Must be administered carefully to avoid damage to nearby joints and tissues
• 📱 Use Ask A Vet to explore this and other long-term lameness options

📲 Final Thoughts from Dr Duncan Houston

Injecting alcohol into the lower hock joints offers new hope for horses with chronic lameness—and a practical alternative to repeat cortisone injections or surgery. But it must be done precisely and thoughtfully. Talk with your vet about whether this promising option is right for your horse. 🧠💪

Download the Ask A Vet app for expert joint care advice, injection planning, and support throughout recovery. 🐎📱