Post Temporomandibular Joint (TMJ) Injections

We would like to make several recommendations pursuant to the treatment your horse just received for temporomandibular joint inflammation/ pain. A combination of both short- and long-acting steroid as well as a synthetic hyaluronan were individually infused into the dorsal (upper) and ventral (lower) pouches of both temporomandibular joints (on either side of the head). The location of the left TMJ is highlighted in the image above. An analgesic (pain killer) was administered along with the sedative to reduce discomfort during the procedure, and 3 grams phenylbutazone were administered intravenously to reduce discomfort over the next 12-24 hours. No more medication for discomfort is required.

Please do not bathe your horse for 24 hours following the procedure. Although the inject portals seal very quickly, we request that they not come in contact with water for at least 24 hours, as this may increase the chance for contamination.

Resume exercise gradually. The presence of medication in your horse’s joints can result in mild discomfort that can last for several days. Therefore, we suggest giving your horse some time off prior to resuming normal exercise. This will allow time for the medication to take effect.

• We recommend not exercising the horse on the day of treatment as well as the 1 day following treatment (i.e. a total of two days). Turnout is permitted on the day following treatment (i.e. the first day post-injection), but is discouraged on the day of treatment.(1)

• You may resume light work (i.e.walking and trotting on a loose rein) during the following 2 days (i.e. day 2 and 3 post-injection).

• Normal exercise may resume on the fourth post-injection day.(2)

(1) If it is raining outside, we do not recommend turnout during the first 24 hours post-injection, as the water may contaminate the injection sites.
(2) If secondary problems (such as head tossing or rearing) are severe, we may recommend more time off prior to resuming exercise.

 

Monitor the injection site(s) for increased swelling, heat, pain, or any other abnormality(ies). Please call IMMEDIATELY if any questions or concerns arise: OFFICE: 678-867-2577; DR. GRISEL'S CELL: 706-658-4713.

Monitor performance: determine 1) the DEGREE and 2) the DURATION of improvement.

Your horse’s response to the injections will play a large part in helping us develop a future performance maintenance regimen. The effect of the medication typically maximizes in 2 weeks post-injection, so wait 2-4 weeks to assess the initial response.

We will call you an average of once weekly to check on progress.

To learn more about TEMPOROMANDIBULAR JOINT DISEASE (TMJ) in the horse please click HERE.