I don’t know about the rest of you, but I have found it quite interesting that those turning in their Decade Team interviews recently have nearly all answered this question: Do you give any kind of joint products? with a yes, and then followed by a description. Many are using a feed through product with a large number using Adequan IM. I also answered yes and covered what I use on Chief in our interview.
Most of us that choose to use injectible joint products do so as a way to prevent joint damage and to help our horse’s stay sound and to extend their longevity. I want my horse’s to retire and still be able to move around without being uncomfortable. To this end, we seek the fountain of youth for our horses.
I thought I’d go over the differences in the three main injectible joint products that are on the market and most used by endurance riders: 1) Adequan; 2) Legend; and 3) Pentosan. Each works a bit differently, and each horse may respond differently. All of these products require a prescription from a veterinarian. It is always a good idea to discuss using these products with your vet anyway. I tried listing information that most will want to know in order get started.
If you are interested in using a joint product on your horse – do your research, ask questions. Find out why some riders prefer a certain product over another. Start with determining WHY you think your horse needs a joint product. Is your horse aging or showing signs of arthritis or joint stiffness? What do you hope to accomplish by using a joint product?
Personally, I have been most impressed with Pentosan and feel that I am getting the most bang for the buck with it (see video at bottom). I am using it as a preventative and not to treat any known problems. Others may have a horse that responds better to one of the other products. I have not used feed through type joint products as there have been a lot of questions raised about their efficacy. Some riders say they can tell a difference when they stop using a feed through joint product.
If you are having to pay a vet to give each dose of an IV or IM joint injection, then the cost can certainly add up and might make the feed through products worth consideration. Prices listed are from an average found on-line. Costs can vary depending upon your source, and quantity purchased.
Adequan IM
Cost Per Dose: $43.00 to $65.00 average, depending upon quantity purchased.
Method Given: Intra muscularly via syringe.
Suggested Loading Dose: 5 ml every 4 days for 7 treatments. Some vets recommend doubling that initial loading dose; or doing a loading dose each season prior to the start of competition.
Suggested Maintenance Dose: 5 ml every 2 to 4 weeks.
Important Take Away Point: The dose of Adequan you give today helps you best eight weeks from now. This is because Adequan works to heal damaged cartilage. The process of healing damaged cartilage takes time, at least eight weeks for a significant defect. Click here for more info.
Adequan I.M. helps relieve pain and decrease inflammation. Additionally, it restores synovial lubrication, helping the horse produce healthy synovial fluid to prevent the breakdown of healthy joint tissue. It also does something other treatments don’t: It stops the cycle of degeneration by inhibiting cartilage damage and collapse. Since it is given intramuscularly, the idea is that the treatment travels into injured joints and stimulates production of new cartilage, while relieving non-infective degenerative joint disease symptoms.
This is from the manufacturer of Adequan: FDA-approved Adequan® i.m. (POLYSULFATED GLYCOSAMINOGLYCAN) offers the complete disease-modifying osteoarthritis treatment that begins working two hours after the first injection. It combines the benefits of the other types of products, plus it is the only product that stops the joint disease cycle, blocks destructive enzymes, stimulates cartilage repair and reverses traumatic joint dysfunction. Adequan i.m. is a potent enzyme inhibitor that travels to traumatized knee or hock joints. The FDA-approved treatment of one dose every four days for seven treatments provides maximum benefit. Independent and public research has proven that administering Adequan i.m. as recommended results in substantial clinical improvement.
Legend IV
Cost Per Dose: $70.00 to $85.00 average depending upon quantity purchased.
Method Given: Intravenously via syringe.
Suggested Loading Dose: None suggested.
Suggested Maintenance Dose: 4 ml as needed.
Important Take Away Point: Legend will last only 2 to 7 days, then it is gone. There is no long term benefit from Legend. Click here for more.
Legend is Hyaluronic Acid. Hyaluronic Acid (HA) is the major component of normal joint fluid. When it is placed within a specific joint it acts as a lubricant and a mild anti-inflammatory for that joint only. When it is given in a vein, it goes to all the joint capsules in the body. It does not go into any of the joints themselves, but merely attaches to anti-inflammatory receptors on the blood vessel side of the joint capsule. Here it is an even stronger anti-inflammatory than when placed within a joint! As it does not enter the joints, there is no lubrication effect when given intravenously(IV). Remember too, it is only an anti-inflammatory for joint related issues. It will not work for tendon, ligament or muscle problems like bute or banamine might.
The duration of its anti-inflammatory effect when given IV is anywhere from 2 to 7 days maximum. Because it works well for these short periods and is a naturally occurring substance Legend is considered “bute for joints that does not test.” In other words, it can be used during AERC or FEI sanctioned competitions without fear of having a positive drug test. As it is also quite natural there is essentially no limitation on the amount that can be administered. Give the first dose 48 hours prior to competition in order to give it time to work.
Forty-six horses with lameness in either the carpal or fetlock joints were treated intravenously or intra-articularly with Legend Injectable Solution in a well-controlled clinical study conducted at four locations. One, two or three injections were given based on clinical improvement. Overall clinical improvement was judged as excellent or good in 90% of the cases treated intravenously and 96% of those treated intra-articularly with Legend Injectable Solution.
A Colorado State University study demonstrated an LV. administration of Legend® (hyaluronate sodium):
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Significantly decreased inflammation associated with joint disease in the horse.
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Decreased inflammatory mediators within the joint.
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Decreased the degree of lameness in horses with arthritis (joint inflammation).
Pentosan
Cost Per Dose: $31.25 from Equine Health Resources.
Method Given: Intra muscularly via syringe.
Suggested Loading Dose: 6 ml every 5 days for four doses.
Suggested Maintenance Dose: 5 or 6 ml every 2 to 4 weeks (similar to Adequan)
Important Take Away Point: Rather than simply masking pain, Pentosan (PPS) directly stimulates joint healing and repair.
Pentosan is a concentrated anti-inflammatory and stimulant of cartilage synthesis, repair and protection. It actively reverses the effects of osteoarthritis in the joints via a series of actions, including:
(a) Stimulating Chondrocyte Metabolism – resulting in increased production of proteoglycans and healthy cartilage matrix. PPS stimulates synovial fibroblasts to produce increased amounts of high molecular weight hyaluronic acid which results in an increased production of normally viscous joint fluid. Improving the fluid volume and consistency results in more effective joint lubrication and stabilisation, which limits further cartilage damage.(b) Anti-inflammatory Activity – PPS has an inhibitory action on all mediators of the arachidonic acid cascade. PPS also inhibits the lysosomal catabolic enzymes hyaluronidase, histamine, cathepsin B, and polymorphonuclear elastase. PPS exerts a specific inhibitory effect on mediators implicated in the degradation of cartilage matrix components, preserving the cartilage and preventing the release of the highly inflammatory mediators, thus relieving pain and inflammation.
(c) Fibrinolysis and Lipolysis – PPS is strongly fibrinolytic, stimulating the release of plasminogen activator, and promoting the dissolution of thrombi and fibrin deposits in synovial tissues and subchondral blood vessels. PPS also mobilises lipids and cholesterol in synovial and subchondral blood vessels, which have been implicated in the pathogenesis of osteoarthritis in older animals. These effects combine to increase the prefusion to the joint, which stimulates cartilage healing and repair.
Pentosan is a sophisticated approach to the long term management of osteoarthritis in horses, and is equally effective by both intramuscular and intra-articular injection. Unlike traditional treatments, the unique effects of Pentosan promote healing and the restoration of a healthy joint, in addition to having a safe anti-inflammatory effect.
Here is a video about Pentosan:
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