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Capped hock is a common condition in horses and is usually only a cosmetic problem rather than a physical one. About 90% of horses with a capped hock will not have any sign of lameness no matter how large the bursa grows. It is important, however, to find out how and why your horse got capped hock in the first place. There are many ways in which a horse may get capped hock such as kicking the trailer when in transport or kicking the stalls for no reason at all. This is usually from irritation or stress, but it may just be boredom. With repeated bouts of capped hock, the effect will become permanent so it is best to discover the reason for the condition and try to find a solution.
Capped hock, or bursal enlargement (bursitis), in horses is not uncommon and can affect any age, discipline, or breed of horses. It is caused by a traumatic injury or repeatedly kicking a fence, wall, or trailer door. A capped hock is an inflamed and swollen calcaneal bursa (sac) of the ankle that can grow up to the size of a tennis ball or even larger in some cases. Even though it may look horrible, it usually does not affect the horse much and may only cause slight lameness, if at all. However, if the hock grows so large that it affects movement, the fluid may need to be drained and the fibrous tissue can be removed if necessary. If a large bursa is not treated, the hock may become permanently thickened.
Signs of a capped hock are obvious and look like a swelling above or on the horse’s hock.
You should see an equine veterinarian for diagnosis of capped hock because they are more informed about all matters to do with horses. The veterinarian will ask for your horse’s history, which is important in getting the right diagnosis. Besides a medical and vaccination history, the veterinarian will also need to know what type of work your horse does. A physical examination is needed to rule out other diagnoses such as strained ligament, fracture, infected joint, idiopathic joint fluid accumulation, thoroughpin, and infection of the bursa. A comprehensive physical examination includes behavior, height, weight, heart rate, body condition, body temperature, blood pressure, and breath sounds. A lameness examination is done next, which will include conformation, movement, flexion exam (putting pressure on the limb before movement), hoof testing, and using a joint block to numb the area before repeating the movement test.
Imaging will be done with an ultrasound to see the tissues, x-rays to see the bones, and maybe bone scans, CT scans, or MRI. Contrast radiography will be used to get a better view of the joints and tendon sheaths. The veterinarian may also want to test the fluid in the bursa for infection by taking a sample with a hypodermic needle and sending it for cytological examination. Some diagnostic tests will be done as to help rule out other illnesses, including blood and urine cultures, chemistry panel, and a complete blood count (CBC).
Treating capped hock in your horse may not be necessary unless it is causing lameness or obvious pain or it the veterinarian is worried about permanent scarring or the rupture of the bursae.
The veterinarian will drain the fluid from the area with a hypodermic needle
Elastic bandages will be applied firmly but not too tight to stop the swelling from returning.
There are several types of hydrotherapy such as cold water soaking, static spas, water treadmills, and swimming.
The veterinarian may give your horse a corticosteroid injection to relieve the swelling and non-steroidal anti-inflammatories for pain. There are some types of topical creams that can be used for inflammation as well such as diclofenac sodium liposomal cream.
If the inflammation is severe, rubber tubing will be placed in the bursa to prevent any future swelling. The tubes are there to provide a means of escape for fluid so inflammation will not return.
Your horse’s prognosis with capped hock is excellent. Even if the swelling of the bursa is permanent, it usually does not create any kind of pain or lameness. If the veterinarian suggests one or more of the above treatments, you can decide whether or not it is needed if it is just for cosmetic purposes.
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I just rescued a horse with what I believe is capped hock. The lady was VERY untruthful about a lot of things with this horse, and I believe he was abused (many reasons why). That being said, is it ever to late to treat “capped hock”? I called my vet but to be honest where I live no vets are “horse worthy” and google is our best friend. The horse is 17 and is not lame at all... but I’m a “bigger” rider and I DO NOT want to hurt him. Although I will only ride him for short periods until I get him trained enough for my daughter. He is about 15.3hh and I’m about 290lbs he does need weight which I’m working on and I will not ride him until completely filled out. But I want to know what I’m dealing with first!
March 17, 2018
Thankfully the majority of cases of capped hock do not present with any lameness and the conditions is more of a cosmetic problem than an actual medical issue. Treatment is usually case dependent but generally removal of repetitive trauma, hosing the area, pressure bandaging, corticosteroid therapy and surgical drainage are all possible options; these options should be explored with a Veterinarian regardless of their ‘horse worthiness’. Regards Dr Callum Turner DVM
March 17, 2018
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