Joint disease: Adequan, Legend and more…

Joint disease typically starts very insidiously, and can be missed by even the most attentive owner. Some horses are more stoic than others, and a small mis-step can turn into front or hind end lameness. There are a variety of degenerative joint diseases (DJD) and in some cases can end a horse’s competitive. It is not unheard of for horses as young as 7-years old to become pasture ornaments.

There are various theories surrounding why so many horses seem to be suffering from different forms of DJD. New portable diagnostic techniques also enable more veterinarians to diagnose joint problems with more ease than ever before. While there are a variety of treatments available for horses, many types of joint disease are progressive and will only destroy the joint without attention and management.

Types of joint disease can include: Synovitis, Capsulitis, Articular cartilage and bone fragmentation or fracture, Ligamentous tearing and Osteoarthritis. Your veterinarian may use different diagnostic techniques such as flexion tests, jogging for soundness, nerve blocks, radiographs, ultrasound, arthroscopy or MRI.  There is little benefit at guessing when it comes to joint disease, as the “wait and see” game could go on for years. Have you vet perform a thorough exam from the beginning to avoid heartache and unecessary pain for your horse.

Common oral supplements to treat joint disease may contain any of the following: glucosamine, sodium chondroitin sulfate, MSM, cetyl myristoleate, hydrolyzed collagen/gelatin, hyaluronic acid and chondroitin sulfate. Herbs for pain and inflammation can include Devil’s Claw, Yucca, Boswellia, Bromelain and shark cartilage.  Be prepared to try a few supplements before settling on one for your horse. While manufacturers may make impressive claims, studies show that oral supplements in horses is not entirely supported by the scientific community due to lack of conclusive data that proves they work. Many riders, owners and veterinarians may have annectodal stories of certain products that worked for their horses, however be cautioned they may not work on all horses.

A more rigorous approach to joint care may include products such as Adequan or Legend. There are many products that are generic forms of both of these products, and while you may save on cost your horse may not get the full benefit of these drugs. There are also other drugs that are not marketed for joint disease however owners choose to use them off-label. Using drugs off-label can be dangerous to your horse and include horrific side effects, contraindications you may not be aware about with common drugs and other complications. If your veterinarian advises you to use a product that is off-label, a second opinion might be valuable to prevent serious health problems with your horse.

Taking care of your horse's joints will keep him comfortable and competing!

Adequan™ is an intra-muscular (IM) joint treatment/supplement for horses. It can also be administered through intra-articular (IA) injection. It is a polysulfated glycosaminoglycan and is a common option for certain types of joint disease. The recommended treatment schedule is one injection every 4 days for 7 treatments (approximately one month). While this is the optimal treatment schedule, many horses will feel the benefits of this drug if used every week, every other week or once a month depending on the severity of the damage.

Legend™ is hyaluronate sodium that is administered through intra-vascular (IV) or IA injection. The manufacturer recomments 1 treatment per week for 3 weeks.  As with any invasive injection such as IA, extreme caution must be exercised to prevent infection in the joint. After the injection, your vet may advise you to keep your horse in a clean stall for 24-48 hours to prevent infection and allow the joint to recover. Your horse can resume his regular exercise and turnout schedule after that.

Intra-articular corticosteroids and glucocorticoids are a common but controversial method of addressing joint disease in horses. While they have been proven to reduce inflammation and pain, the long-term effects of regularly injecting a horse have also indicated possible increased deterioration of the joint. Injecting with corticosteroids should be done only on the advice of a veterinarian who has experience with joint disease and whether it is the best option for your horse. Common corticosteroids and glucocorticoids include: Depo-Medrol, Celestone and Vetalog.

There are other options for joint treatments that are not pharmacautical-based including shockwave treatments, magnetic therapy, Interleukin-1 Receptor Antagonist Protein (IRAP), Platelet-rich plasma (PRP) and stem cell treatment. New studies are also investigating the uses of select types of collagen and showing positive results. Talk to your veterinarian about what options will work best for your horse.

Many owners choose to use a combination of therapies (such as Adequan, magnetic therapy and then corticosteroids at the beginning of the show season) to get the best results in the least invasive way. Many recreational riders do not need the full effects of corticosteroids however may find that a glucosamine supplement and some MSM keeps their horse happy and working all year around. Armed with your veterinarian’s advice and some common sense, your horse can plan for a long and happy career!