Hyaluronic Acid....experiences????

[imaequiholic]

I am thinking about putting my older gelding on HA. He has some arthritis/lameness issues and I would like to put him on something that would help keep him more comfortable. I was just curious to see how well everyone thinks HA works? When did you see an improvement in your horse (2wks, 1month, etc.)? Or did you not notice an improvement? Also, where is the cheapest place to purchase it? Thanks.

[Appassionato]

Honestly, cost for cost, check out Adequan IM.

[Simkie]

Honestly, cost for cost, check out Adequan IM.
Thirded!

[RAyers]

Uh, Adequan IS NOT A SUBSTITUTE FOR HYALURONIC ACID! It is completely DIFFERENT than HA and has a different mode of action.

The appropriate use is dictated by the age and condition of the joints in questions so talk to your vet, get X-rays, and than make a choice.

Reed

[Simkie]

I took the OP to be asking about oral HA, rather than IV or IA.

If the OP is asking about non-oral forms, then yes, HA is fantastic.

If the OP is talking about oral HA, I would skip it and go with Adequan or Legend.

Reed, are there any studies that show that oral HA is effective at anything?

[Carol Ames]

Adequan produces a noticeable effect;:yes: Many of the foxhunters at JR Fieldhunters got a shot monthly; and a vet told me that many race horses continue their careers on a weekly shot; ;)There is a pharmacy in N. J. which sells a generic; I think you can get it through Piedmont equine inMarshall, Va; I've been told by someone whose horse was on monhly Adequan injections, I M/. that her horse had an even better response from Legend;:yes:

[IFG]

I would defer to Reed regarding any scientific studies, but in my horse, I think that Hyalun (oral HA) has made a huge difference. I tried Legend and had no response, but I did not do the loading dose, just a shot.

[CB/TB]

Try Corta-flx. The original formula has 40 mg of HA. Maybe try a quart of liquid, or a small sizes pellet or granules( not too small, you need a fair time trial) and see how he does. There is also a Corta-flx HA with 100 mg of HA /1 OZ. Conquer gel ( paste) has 100mg of HA. Each tube has 5 doses and Dover sells it in case lots for $11.99 each. I use the Liquid Conquer from Horse warehouse for $134.?for 64oz and 1/2 oz delivers 100 mg of HA, so that lasts me 2 months for 2 horses. It's hard to find a product that works in a lot of cases. Some will work for some horses and do nothing for others. It's hit or miss. I like to start with the least expensive and work up . The initial expense in trying products will even out once you find one that works if it's for long term use.

[c_expresso]

HA is useless orally, according to several people including my vet. HA is a rather large molecule and when administered orally, the vast majority of it cannot be absorbed through the stomach lining because the molecules of HA are too big.

Injecting HA is great, although MUCH different than adequan, as adequan has no HA in it. Adequan helps repair joints, where as HA is an actual substance found naturally in the joints and by injecting HA you are just replenishing this.

[shamrocker]

Totally agree with previous poster. Oral HA is a huge waste of money. Have your vet look at your horse. Injectable HA/cortisone will bring results. We have just done this procedure to my daughter's event horse, and he is so much more comfortable. He gets better every day. I'm glad I did it....clearly it makes the horse feel better physically, and that is our responsibility to them.

I will put the horse on IM Adequan. I think Oral joint supplements are a big waste of money, but that's my opinion. The amount of $ you will spend on Adequan can equal what some of those oral supplements cost, so when the do the math, the choice is clear.

[LookinSouth]

HA is useless orally, according to several people including my vet. HA is a rather large molecule and when administered orally, the vast majority of it cannot be absorbed through the stomach lining because the molecules of HA are too big.

Injecting HA is great, although MUCH different than adequan, as adequan has no HA in it. Adequan helps repair joints, where as HA is an actual substance found naturally in the joints and by injecting HA you are just replenishing this.
'

Ordinarily I would agree with the theory that HA is useless orally. However, I have used IV Legend with my horse. Saw no difference whatsoever. I then tried Lubrysin. The level of fluidity in his gaits and impulsion definitely improved. I saw a difference in 5 days. I also see this difference with the Uckele Hylarin-B paste.

Again, I am usually skeptical when it comes to oral joint supplements since I've tried many and rarely see a difference. But due to my firsthand experience I do feel oral HA makes a difference with SOME horses regardless of what studies say.

I would suggest trying the Hylarin-B paste by Uckele. You can order 2 tubes and it won't break the bank. (24.00ish) You should be able to tell by the end of the dosages whether or not orals are going to work for you horse. It's alot cheaper than dumping 70.00-100.00 to have the vet out for one IV shot of Legend to see if it's going to work or not IMO.

[deltawave]

For every "n" of oral products there are approximately "n+1" anecdotes saying they work very well on one horse or a handful of horses. The important thing to realize is that while this may reflect the possibility that there "is" or "may be" benefit for any given animal with any given product, what the studies say is that the benefits are small-to-minimal and unpredictable. Before investing big bucks, I personally want a little more than anecdotes. The studies are extremely disappointing for orals.

One also observes that proclamations that "product X is a miracle!" are often left dangling out there, months after the person who said it is no longer using the product because an initial benefit or improvement is no longer present. This may indicate a short period of benefit, or (more likely) may indicate the very well known fact that arthritic complaints get better and worse all by themselves. :) It is human nature to not go back and retract our glowing endorsements, even after the glow has worn off.

My very non-scientific ;) observations of these threads over time indicates that there is a definite "front loading" effect of the wonderful properties of various products, whereas if you look back a year later at similar threads, you will often find the same posters who raved about "product X" now saying they tried it and it didn't do much for them. How to account for this? How to account for the small but perceptible number of people who DO seem to think it helps over time? IMO it's all down to the relapsing/remitting nature of arthritis itself.

[Posting Trot]

In my experience (limited to my own horse plus a couple of others in the same barn, and in my dog), oral HA helped quite a bit. These experiences are of course anecdotal and don't constitute scientific proof. But it may well mean that it would be worth it for you to try the oral HA.

Again, in my limited experience, if you buy yourself a couple of tubes of Conquer gel (and initially I'd try either a gel or a liquid formula), and by the end of the loading period (with Conquer 10ml per day for two weeks) you will know whether it's helping the horse or not.

In my limited experience Adequan was not as effective.

Good luck.

[LookinSouth]

Before investing big bucks, I personally want a little more than anecdotes. The studies are extremely disappointing for orals.




Good points to consider. I always say that ANY joint supplement and even injectables are a crap shoot. What works for one may/may not work for another.
That said, I personally would rather waste my 24.00 -45.00 to try an Oral HA for a few weeks just to see if it makes a difference than bother with having to pay the vet to come out and give an IV shot of Legend that is easily going to run 100.00. But I'm on a budget and that may be just me:D Even if the cheaper Oral product only makes a difference for a few months? You are still saving money with certain products in comparison to Legend. If you have money to blow....by all means go right to Legend.

[c_expresso]

Legend is not much more than oral HA if you can give an IV shot yourself, but if you have to call the vet out, may as well try the oral HA first.

[IFG]

To counter what Deltawave said about the front loading dose, I have had my horse on the Hyalun for nearly 10 months. He was really stiff in the hind end. The Hyalun was a miracle. I am a scientist, I know that this is just one horse and that my assessment is open to bias, but I was amazed. I discontinued it for a few months while he was laid up for other reasons, then I could see a real change when I started back up. I have discontinued the Glucosamine that he was on, but I do give him MSM.

[LookinSouth]

Legend is not much more than oral HA if you can give an IV shot yourself, but if you have to call the vet out, may as well try the oral HA first.


Agreed. And some vets will. My vet however will not prescribe IV drugs for clients to administer themselves for liability reasons. IM yes, because it is much simpler than IV and the average layperson can do IM shots. To have her out for one dose of IV Legend was 125.00. Hence why in my circumstances it is far more affordable to TRY orals first.

[wlrottge]

The Horse magazine had several good articles on this subject last summer/fall. Here are links to a couple of the articles. The mag itself was better b/c it had some graphs/illustrations.

http://www.thehorse.com/ViewArticle.aspx?ID=10073&kw=oral%20joint

http://www.thehorse.com/ViewArticle.aspx?ID=9673&kw=oral%20joint

We use Adequan. You KNOW it's going where it needs to.

[LookinSouth]

To counter what Deltawave said about the front loading dose, I have had my horse on the Hyalun for nearly 10 months. He was really stiff in the hind end. The Hyalun was a miracle. I am a scientist, I know that this is just one horse and that my assessment is open to bias, but I was amazed. I discontinued it for a few months while he was laid up for other reasons, then I could see a real change when I started back up. I have discontinued the Glucosamine that he was on, but I do give him MSM.


Hmmm. And this is the Hyalun that I've seen readily available at tack stores and such? The kind in with the dropper? May be worth trying for my guy. I'd rather spend the few extra dollars and buy locally as I need it since with shipping it ends up costing the same to order online often.

[deltawave]

Legend is not much more than oral HA

That's like saying you can give IV drugs by mouth and have them work perfectly well and that is just NOT SO. Boy, it would be nice if we could just give heparin, antibiotics, and all the array of IV drugs by mouth. Unfortunately, they DON'T WORK when you do that.

[LookinSouth]

That's like saying you can give IV drugs by mouth and have them work perfectly well and that is just NOT SO. Boy, it would be nice if we could just give heparin, antibiotics, and all the array of IV drugs by mouth. Unfortunately, they DON'T WORK when you do that.


I may be wrong but I think she was talking about cost wise? :confused:

[c_expresso]

I may be wrong but I think she was talking about cost wise? :confused:

Yes I was! You can buy Legend online for about $70 a shot, which isn't much more than a good HA oral supplement. If you know how to give an IV shot, might as well give Legend a try. However if you have to pay and go through the hassle of having the vet out... not so much worth it.

[DressageGeek "Ribbon Ho"]

I think what many people forget is that as with all animals, there are huge individual differences in how you metabolize and respond to any drug.

Give me a bit of time - I'll do an updated pubmed search and see what I can come up with about oral supplements and bioavailability - unless someone else has done one recently?

[deltawave]

I just looked at the Cosequin stuff last night. I believe they reported the bioavailability for glucosamine was 5% and for their "house recipe" of chondroitin it was 22%. Lousy. And that's just what gets into the bloodstream. Never mind what makes it to the joint in a relevant, usable form. :no:

Obviously this is vastly different between species, and cannot be interpolated. Dogs have a much better ability to make use of this stuff, IIRC. Makes sense, as the chondroitin/HA/PSGAG stuff is animal based. Herbivores are not wired to make much use of animal products, ingested orally. :)

[wlrottge]

Oh yeah, since nobody else picked up on the mention of "generic" Adequan... there is NO such thing!!

[c_expresso]

Oh yeah, since nobody else picked up on the mention of "generic" Adequan... there is NO such thing!!

I use Polyglycan, reccomended by my vet. It is similar to combining Adequan and Legend, and I have seen good results with my horse.

[CC]

I am another who would just tell someone to go directly to adequan and/or legend (after a lameness eval!). And my horse is on both (well, I use chrondroprotec, not adequan. And yes, i know it is not the same)

BUT, the effects of the legend only last a week or 10 days. So, i have been supplementing with Hyla RX which is a paste HA with very good results.

And a somewhat frugal relative of mine just started her aged horse on Hyla RX also with very good results. Since she is not also doing injectables, it will be interesting to see how long the effects last.

I had zilch results with any oral glucosamine but do see a difference with MSM.

[wlrottge]

I use Polyglycan, reccomended by my vet. It is similar to combining Adequan and Legend, and I have seen good results with my horse.

Regardless, it's NOT generic Adequan. Polyglycan is HA and N-acetyl-D-glucosamine. As far as I understand is inteneded to be used topically, not injected. Legend is injectable HA (IA or IV).

Adequan is a polysulfated glycosaminoglycan (PSGAG), different compounds and completely different in the way they interact with the body.

[c_expresso]

Polyglycan is given by IV injection...

[deltawave]

How it's given in practice isn't necessarily how it was MEANT to be given. I have nothing against off-label use of drugs per se, but Polyglycan is meant (by the manufacturer) to be used as a joint lavage fluid.

[RAyers]

I use Polyglycan, reccomended by my vet. It is similar to combining Adequan and Legend, and I have seen good results with my horse.

I am not sure what your vet is saying specifically but they are wrong. As Deltawave says, Polyglycan is only approved as a joint lavage and NOT as a drug. Having been involved with off label litigation, your vet's use and his statement opens both your vet and the manufacturer to HUGE liability issues if anything goes wrong.

As for your vet being wrong, the formulation of Polyglycan is very different than Adequan and Legend and has been shown to only be effective when used IA.

Reed

[eventrider]

I have seen good results with Legend on some of my horses, but the Lubrisyn worked as well and even if you still need to do shots, it increases the length of time between them. The Lubrisyn uses a much smaller molecule and gets around the problem of the HA being too large. It is mostly absorbed in the mouth. I have seen a visible diferrence using this, where I did not using Cortaflex or Actiflex 4000. I think that no matter what research says, you need to try it and see if you can tell as difference yourself...I definitly can.

Christan

[deltawave]

The purpose of well-done research is so people don't HAVE to "see if they can tell a difference". Properly done studies do this leg-work for us. The problem is that 95%+ of the "research" done on these products is in vitro stuff dealing with molecular manipulation and trivial differences between molecules or trivial (usually) effects on tissue, not legitimate head-to-head trials of one product vs. another in a good, validated, blinded model. It's just way too expensive and cumbersome to do that, and, well--why should "company X" cough up the money for pricey, properly-done studies when people are perfectly willing to cough up THEIR money with NO studies, or "studies" done in petri dishes or in rats? :no:

[IFG]

The purpose of well-done research is so people don't HAVE to "see if they can tell a difference". Properly done studies do this leg-work for us. The problem is that 95%+ of the "research" done on these products is in vitro stuff dealing with molecular manipulation and trivial differences between molecules or trivial (usually) effects on tissue, not legitimate head-to-head trials of one product vs. another in a good, validated, blinded model. It's just way too expensive and cumbersome to do that, and, well--why should "company X" cough up the money for pricey, properly-done studies when people are perfectly willing to cough up THEIR money with NO studies, or "studies" done in petri dishes or in rats? :no:

Deltawave, I agree with you, but you need to remember that clinical trials yield an assessment by comparing groups. The results are that "on average" Rx A did or did not work compared with Rx B or Placebo. What you don't see in most clinical trials are subgroup analyses to examine what works for specific people or animals. These types of trials for "designer drugs" are the current big thing in clinical trials. That is, figuring out what works for subgroups, or even specific individuals, not for the group "on average."

I am still becoming familiar with the science of these new trial designs, but some days, I wonder if they differ that much from the case reports and anecdotes that we are discussing.

[RAyers]

I think that no matter what research says, you need to try it and see if you can tell as difference yourself...I definitly can.

Christan


And that right there is the most dangerous thought about the claims made by nutraceuticals and ointments. Many times things will make a person or horse feel better but will NOT treat the actual conditions. Thus Fluffy will be sound on a leg that continues to degrade. So a person thinks they are doing the right thing but they are simply exacerbating a problem (like giving bute or Surpass for arthritis) .

Like Deltawave said, that is what studies done on approved drugs are meant to do, porve that they treat the conditions and affect the biology, not just make the horse feel better. This is something nutraceuticals continue to fail at. Even Lubisyn continues to market thier product based on hafhazard claims connected to studies that have NOTHING to do with thier product. That is a HUGE failing in that industry and why I continue to advocate against thier claims.

For example, Lubrisyn claims that their product does not test based ona a study that examined IV administration of HA, NOT oral. While it is likely that the oral form will not test, this shows that a company such as Lubrisyn feels no compunction to actually test thier product for efficacy and safety because people will continue to buy it, even if the product claims are based on faulty evidence.

Reed

[Simkie]

One also observes that proclamations that "product X is a miracle!" are often left dangling out there, months after the person who said it is no longer using the product because an initial benefit or improvement is no longer present. This may indicate a short period of benefit, or (more likely) may indicate the very well known fact that arthritic complaints get better and worse all by themselves. :) It is human nature to not go back and retract our glowing endorsements, even after the glow has worn off.LOL! So true!

You'll find posts from me touting Corta-RX with HA and MSM and Collagen. I fed it FOREVER. It was cheap, had all the "necessary" ingredients, and I do think it helped a bit.

Now I skip that, do adequan and legend monthly (lots more expensive) but I feel that the money I've spent is backed up by actual research. I feel that I'm helping my horse a lot more by doing the rx drugs instead of the orals.

Of course, I'll still recommend the Corta-RX stuff--in fact, a friend is feeding to her young horse in a "can't hurt, might help" preventative way. But if you've actually got a soundness problem, I am a big believer in the injectables.

[findeight]

Ok...one more time. Short version.

Mare is now 19 showed as a Hunter up thru AA level Adults. PPE showed arthritic hocks needing management. That was 8 years ago.

Started on Adequan when purchased at age 11 and then over to monthly Legend IV. Marked improvement for about 5-7 days then slowly back to stiff.

Tried LubriSyn oral HA when a distributor gave me a quart for free. Checked with vet first. Mare much more flexible in hocks within 3 days and remained so until ran out of the stuff. Back to good after injection, stiff in about 2 weeks. Got more LubriSyn.

Vet took interest, took mare off the Legend and just on the oral HA. Fine. No need for the Legend. Vet now recommends and sells oral HA both the LS and Hyalauronex(pretty much the same). Tried a couple of cheaper powdered HA products-little or no improvement noted, nothing like the LS or Hyalauronex.

Mare has only had 2 hock jobs in 8 years but light work schedual and 2'6" limit on good footing now. Moving well and comfortably. been on it 3 years this month.

Fat Cat at home gets 2 ccs twice a week for bad hip. Owner takes 2 cc twice a week for age related stiffness. Good mixed with cheap moisturizer too-the latest $$$cosmetic ingredient.

Anecdotal? Yes. Miracle cure? Absolutely NOT but worth a try AFTER appropriate vet diagnosis, not in place of. If a little extra joint lubrication is what is needed, it will help. Maybe.

There is a human oral HA pill called Conquer-major investors? The vets at one of the two best known vet clinics in Lexington KY.

[deltawave]

Virtually ANYTHING is better than what we're calling "research" for nutraceuticals. In-house, Rube Goldberg-type things that are very clearly "designed" after the fact (meaning, after the data are collected, the hypothesis is declared) to show what the company intended to show. Or tiny groups of subjects where no meaningful conclusions can be drawn. Or huge gaps in what is reported. It's pitiful.

What is needed are LARGE, randomized, blinded, head-to-head trials with enough subjects, all of whom have the same malady, to make meaningful observations. Just doing VERYVERY rough numbers in my head, to demonstrate a "meaningful" difference in (for instance) degree of lameness in arthritic hocks in horses of one grade or more, you'd need AT LEAST a couple of hundred animals in each group. Think about the logistics of that for a minute. Find 200-300 horses, all with the same findings on X-ray and roughly the same degree of lameness. They can't have too many confounding issues like ankles, stifles, knees, etc. that would sludge up the data. They all need to be on similar feeding and management regimens, ideally. None receiving any other meds or products. Roughly the same age, breed, etc. would be best, and ideally the joint problem would come from the same type of injury or overuse. Where in the h*ll are all these animals going to come from?

Oh, and someone needs to pay for their upkeep, the study protocol, the products they receive, and all the data collection, measurements, etc. We are comparing two nutraceuticals in this study, MAYBE three. Shall we repeat this gargantuan undertaking for the other 198 products out there? Care to pay 10 times more for your joint products?

The very depressing reality is, that there will probably never be the kind of research done that is needed to be able to say anything compelling or convincing about these products. So we're basically left where we are right now: trial and error, pick your way through the generally spotty and often HORRIBLE research that IS out there (with all your critical thinking on HIGH ALERT) and . . . do your best to decide. :no:

[grayarabpony]

Uh, Adequan IS NOT A SUBSTITUTE FOR HYALURONIC ACID! It is completely DIFFERENT than HA and has a different mode of action.

The appropriate use is dictated by the age and condition of the joints in questions so talk to your vet, get X-rays, and than make a choice.

Reed

Reed, can you elaborate please? Which situation would be good for joint injections of Adequan and which for Hyaluronic acid?

[RAyers]

Reed, can you elaborate please? Which situation would be good for joint injections of Adequan and which for Hyaluronic acid?

Adequan is a chondroportective agent while Legend acts as an anti-inflammatory in the synovium.

That is what I meant when I said you need to discuss this with your vet. For example, if the animal shows no outward signs of arthritis Adequan works well while as the joints degrade Legend can be used to control the inflammation. Things such as X-rays (which do NOT show cartilage), a good lameness axam with an experienced vet, and open communication with the owner all go towards making the correct choice.

There are no specific conditions that I can tell you clinically. I can tell you plenty if I knew the specific biology and condition of a horse's articular cartilage. However, that is an expensive and very difficult undertaking.

I have tried many ways - including joint biopsies on horses to make the decision so I can only say you need to work with your vet.

Reed

[findeight]

We are mainly talking about Legend HA and Adequan along with oral HA as a regular maintainance substance administered either with a shot (Legend HA or Adequan) or orally (LubriSyn/Hyalauronex).

Joint injections ar actually a more involved and invasive treatment, almost minor surgery. Some form HA is sometimes part of the mix of injected fluid, Adequan is not to my knowledge.

[eventrider]

Reed,

I understand your point...to a degree. I do not believe for one second that because I can tell a difference in my horse on an oral HA, that I am putting him on something that is masking his degradation, and in turn ultimately hurting him. I HAVE consulted with my vet...and this is what was recommended...after lamness exams which showed the horse was not lame, etc. This is a good program IMO...and my vets, for keeping an event horse happy and healthy. I am not claiming that Lubrisyn is not testable (for what though...is HA illegal?), nor that it works in the body one way or another...but if I listened to all that was posted on this board, I never would have tried it and I never would have seen the benefit. SO my point is....just because the really poorly done (to your and others claims) tests do not show that these products definitly do work on all horses, I do think that in some cases they help. And you will not know unless you try them. Now if I am way off base, please correct me.

Christan

[findeight]

Oral HA is a nutraceutical duplicating something the body is supposed to produce on it's own that slows down with age. It's not a drug. It does not mask anything-if anything the lubrication may prevent further degradation.
That's the theory anyway and all are free to accept it or not.

I also never say to "shotgun" something and just try it without a good lamness work up from a qualified vet to find out exactly what is wrong. There are a great many other things that could be wrong HA will do nothing for other then lighten your wallet.

I will say I see little or no harm in trying a quart of the stuff on an older horse that is obviously stiff and has had normal age related issues confirmed by the vet. If it doesn't work within a week, it's not going to.

[LookinSouth]

Oral HA is a nutraceutical duplicating something the body is supposed to produce on it's own that slows down with age. It's not a drug. It does not mask anything-if anything the lubrication may prevent further degradation.
That's the theory anyway and all are free to accept it or not.

I also never say to "shotgun" something and just try it without a good lamness work up from a qualified vet to find out exactly what is wrong. There are a great many other things that could be wrong HA will do nothing for other then lighten your wallet.

I will say I see little or no harm in trying a quart of the stuff on an older horse that is obviously stiff and has had normal age related issues confirmed by the vet. If it doesn't work within a week, it's not going to.


Well said. I agree 100%

[deltawave]

Me, too. Especially this part makes total sense:
I see little or no harm in trying a quart of the stuff on an older horse that is obviously stiff and has had normal age related issues confirmed by the vet. If it doesn't work within a week, it's not going to.

In the grand scheme of things, at least the risk:benefit ratio for this stuff is pretty favorable. I just object to them being proclaime the Second Coming based on those two most-misused words: "studies show". :p

[findeight]

:lol: that's not me and I agree. works well if that's the problem. Doesn't do anything but prolong the horse's discomfort if it's not.

interestingly, the manufacterers of both the products I have used are, IMO, fairly low key in most of their ads and don't claim it cures the common cold;)

[RAyers]

We are mainly talking about Legend HA and Adequan along with oral HA as a regular maintainance substance administered either with a shot (Legend HA or Adequan) or orally (LubriSyn/Hyalauronex).

Joint injections ar actually a more involved and invasive treatment, almost minor surgery. Some form HA is sometimes part of the mix of injected fluid, Adequan is not to my knowledge.

A polyglycan molecule (Polyglycan is the product) used to flush the joint post surgery shows very good effect to preserve the cartilage form inflammatory degradation. There are similar products on the market, including an IA administered Adequan.

I agree if a person uses this simply as a piece of mind it is one thing but for the companies to make the claims you see in ads is just idiotic.

I understand your point...to a degree. I do not believe for one second that because I can tell a difference in my horse on an oral HA, that I am putting him on something that is masking his degradation, and in turn ultimately hurting him. I HAVE consulted with my vet...and this is what was recommended...after lamness exams which showed the horse was not lame, etc. This is a good program IMO...and my vets, for keeping an event horse happy and healthy. I am not claiming that Lubrisyn is not testable (for what though...is HA illegal?), nor that it works in the body one way or another...but if I listened to all that was posted on this board, I never would have tried it and I never would have seen the benefit. SO my point is....just because the really poorly done (to your and others claims) tests do not show that these products definitly do work on all horses, I do think that in some cases they help. And you will not know unless you try them. Now if I am way off base, please correct me.

Christan

Christian, my job is to figure out how to regenerate bone and cartilage so I spend day in and day out studying the research in these areas. I am continually amazed at the claims companies make. Of course if you read the label on your bottles of Lubrisyn, you see a DISCLAIMER about if the product works. In other words they DO NOT HAVE TO BACK UP ANY OF THIER CLAIMS. On the other hand, compaines such as Bayer and Luitpold must prove efficacy so the consumer has some confidence that when they use the product it may work.

My question to you, you say this stuff workes and Lubisyn uses your testimony in their ads, do you actually see an affect on the cartilage? Is the cartilage intact? X-rays won't tell you. A lameness exam won't tell you. Fibrocartilage looks just like hyaline cartilage on them. Is the joint fluid appropriate? Is there blood, are there excess proteins or is the viscosity thin? These are ALL things nutraceutical companies claim to help but ther is NO proof. At the same time these are things a vet can examine or test.

I had an old eventer that had blood in his joints and fibrocartilage and he was sound. I had him on Legend and Adequan, however the disease still progressed.

So, it is like buying a car, trying it, buying another car, trying it, buying another car and trying until you find one that may or may not work. Sure the car looks great but under the hood it could be junk. In the meantime you, the customer, spends lots of money and time to find out.

I am not even saying the testing was poorly done, I am saying the testing was NEVER done! If it was, the company should be able to guide you to specific data and results. What they do do is refer to other studies done for different reasons and say, "See it worked here!"

My money is that the marketing for these porducts is done by the same folks who sell low interest rate mortgages.

There is a reason that drugs that could TRUELY cure arthritis in horses and humans are killed before market. They cost too much to make and many people are willing to buy a hope and a dream for a quick fix.

Reed

[findeight]

LS does not use my testimony in any of their ads, I have no affiliation at all, fact I make no "testimony" only shared what worked with a stiff old horse on this BB...although my vet has been in the Hyalauronex magazine adds...but not with any stupid claims.

All these claims are the same as all the vitiman/supplement claims. Some may work and some won't while others may work for some but not others but you can never pin down anybody claiming they WILL work...other then those fly by night PO box based consistently name changing outfits with late night ads on the TV or in sleazy gossip mags.

Any consumer needs to do a little research and consult the appropriate medical professional whether it's worth a try or not.
Big difference is the horse-or Fat Cat-can't look at a glossy magazine backcover and think they feel better.

[deltawave]

But their owner certainly can. :)

[RAyers]

Findeight, true but it is amazing how an owner can be affected by claims when they judge how thier horse moves. Vitamins are NOT allowed to make the claims that nutraceutcals can. They have a different requirement via the FDA. The nutraceutical industry is completely unregulated. Hence the push to try to create some sort of standardization. The industry has responded by forming their own self-policing entity but we have see how that sort of thing works in the investing world.

Here is an abstract from a very recent article that elucidates what I am saying:


Vet Clin North Am Equine Pract. 2007 Aug;23(2):443-60.
An evidence-based approach to selected joint therapies in horses.
Richardson DW, Loinaz R.

There is an enormous volume of published material about most of the agents used to treat or prevent arthritis in horses. Unfortunately, most of the claims made by nearly all purveyors of arthritis medications in such media are largely unsubstantiated. In addition, the quality of the available information is highly inconsistent, making evidence-based recommendations difficult. This article concentrates on injectable polysulfated glycosaminoglycan, injectable hyaluronan, and the common oral "nutraceuticals".

A Warning from the FDA with good common sense:

While many of the products mentioned above are unlikely to do anything to benefit horses, they may be found in local feed or tack shops. These products are not removed from the market because most of FDA's limited resources must be focused on products or incidences that pose a known hazard to human or animal health. Thus, FDA does not always have the time or resources to take enforcement action against products that are more fraudulent than dangerous. This is also true of feed programs administered by State governments. Therefore, horse owners must protect themselves from fraudulent products. Horse owners should be aware of the following signs when considering purchasing feed supplements.

First, they should look for disclaimers on the label or promotional material that read: "This is not a drug," and then other statements on the label claim that the product prevents, mitigates, treats, or cures a disease. The FDA does not allow the use of disclaimers on approved products. So, if the product has such a disclaimer, it is not approved. These types of products may be indirectly unsafe to horses, if owners are trying to treat their own horses rather than seeking advice from their veterinarian.

Second, owners should look for exaggerated claims for a product or products that are too good to be true. These are products that may solve a variety of problems, make horses win at shows, improve mental attitude, etc.

Third, horse owners should look for statements on products that use scare tactics. For example, products that claim that a horse has been suffering from a deficiency for years and owners never knew it. Other products may claim that they are totally unique and unlike any other feed supplement on the market and that it contains vitamin X or a new special ingredient.

Lastly, horse owners should look carefully at the label and learn how to interpret them. All labels for feed supplements should have a statement that describes the intended use of the product, for example, a vitamin and mineral supplement. The label should also have a list of ingredients. Federal regulation requires that the ingredients be listed by the common or usual name in descending order of predominance by weight. The list of ingredients can also help owners distinguish between a poor quality supplement and a good quality one. For example, the relative availability of copper from copper oxide is very low and generally less than 10 percent when compared to the copper sulfate, which is highly available. Therefore, a poor quality supplement may list copper oxide as a source of copper.

Reed

[Janet]

Hmmm. And this is the Hyalun that I've seen readily available at tack stores and such? The kind in with the dropper? May be worth trying for my guy. I'd rather spend the few extra dollars and buy locally as I need it since with shipping it ends up costing the same to order online often.
Just a point about Hyalun that isn't clear in the instructions.
You need to administer it IN THE MOUTH, so it is absorbed through the oral mucus membranes. If you mix it with the food, it will be "digested" befeor being absorbed through the stomach lining, and much less will make it into the blood stream.

[eventrider]

I understand the fact that companies may be making claims that they cannot back up...and that frustrates me as well. But I guess I have been around horses long enough to not even pay attention to the claims of miracles made by companies...I have to see for myself. My questions is this: if you are not a researcher or a vet, how is one supposed to see if these oral sups are doing anything for their horse? If you cannot x-ray cartiledge, how can we tell? Other than anecdotal evidence?

Christan

[findeight]

True...but kitty is not 3 legged lame up the stairs while on it either and there is an obvious difference with the horse when on any of these things and when shes completely off of everything. Not in my mind or wishful thinking.

[deltawave]

how can we tell? Other than anecdotal evidence?

We cannot, until and unless somebody does the studies. So if you're a "believer", you tend to use them. If you're a "nonbeliever" you tend to NOT use them. Take a group of believers and nonbelievers and you will hear a lot of similar stories about horses' varioius ills and complaints get better, worse, or stay the same over time regardless of what is done "to" or "for" them. :)

[RAyers]

I understand the fact that companies may be making claims that they cannot back up...and that frustrates me as well. But I guess I have been around horses long enough to not even pay attention to the claims of miracles made by companies...I have to see for myself. My questions is this: if you are not a researcher or a vet, how is one supposed to see if these oral sups are doing anything for their horse? If you cannot x-ray cartiledge, how can we tell? Other than anecdotal evidence?

Christan


That is how nutraceutcal companies get away with what they do. For the consumer understanding has to come through a vet, however the vets must also be educated. Many vet simply go on what the product rep tells them because they are too busy with many other things, unless they are a specialist.

At the same time, peole who give testamonies have the ability to educate those who rely on them (their customers etc.) that the product they advocate may not work. In other words we must hold these "sponsors" to a newer, higher standard of representation of their product.

I have used various supplements over the years. At the same time I continued to be an educated consumer by learning all that I can about what the product is, how it is made and what it supposed effects are in vivo. I even have received supplements as part of sponsorship. Thus, while I may use one product, when folks ask me about it, I refuse to give a "one fix" answer. My standard response is what I said earlier, talk with your vet, learn all you can about the condition your horse has and various products on the market that can be used to treat it.

Just like buying a computer, car, house, people MUST be an educated consumer about health care. An example is there is a reason Robert Jarvik is under investigation for his Lipitor ads and if he has crossed the line as a doctor. You the consumer think, "he is a doctor so he should know." Other see him as having become a doctor who only advocates a single fix without considering specific individual cases. Thus we the consumer must educate ourselves in conjunction with our helath care practitioners.

At the moment the is no way to tell if any of these nutraceuticals work, other than observation which is valid but that does not preclude the fact that what is happening is most likely that something else is occuring instead of the supplement.

Reed

[Penthilisea]

Ok sadly I don't have a link or backup data so this IS anecdotal evidence. My former BO is a medical editor for a large pharma in the area. She edited the work on oral HA for joint in equines and there was a statistically significant result. No I don't remeber anymore details, this was 5 years ago plus, so when I started to hear about Lubrisyn 3 years ago it sort of triggered the memory. My TB is another lubrisyn sucess.

[deltawave]

There are ALL KINDS of studies on oral nutraceuticals for horses with "statistically significant" findings. Unfortunately, most of the findings are obscure, in vitro measurements with little clinical relevance to the disease process in living animals.

A good p-value is easy to flog out of even the messiest data. The trick to good research is not torturing the data into good answers, it is asking the right questions. :) :)

[Penthilisea]

I'm sorry, I agree 100% with your points on the fluidity of statistics but this particular study was on adult live animals

[LookinSouth]

Just a point about Hyalun that isn't clear in the instructions.
You need to administer it IN THE MOUTH, so it is absorbed through the oral mucus membranes. If you mix it with the food, it will be "digested" befeor being absorbed through the stomach lining, and much less will make it into the blood stream.


Thanks for the input Janet. Since the Hyalun is the little dropper I am guessing it would be easier to dispense then the cumbersome HA paste tubes. My guy is no fun when it comes to worming or trying to dispense any type of paste into his mouth but I think the little dropper would be a cinch. I just may have to try it, I can even pick it up tommorrow at the tack shop on my way home from work.

[LookinSouth]

As for oral joint supplements like Lubrysin, Hylalun and the like we can argue till the cows come home whether or not they "work". Since there are no conclusive studies to speak of one can debate their lack of efficacy to eternity and claim that they really don't work because ther is NO PROOF.
That very well may be, I am willing to bet that they don't/won't work for many horses.

However, if a horse owner feels it is worthwhile to try some of these products after consulting with their vet who really gives a rats patootie whether studies exist or not?

Particularly in the case of Hyalun and Hylarin-B which are EXTREMELY affordable, what does the horse owner have to lose in trying these products? IMO there is nothing to lose if the products have the potential to make an older, arthritic horse a little more comfortable when the costs run less than 1 dose of Legend.

Of course the horse owners that try these products and find success only have "anecdotal evidence". But who really cares? If it works for them and is effective for their horse does it really matter in the big scheme of things whether studies exist the PROVE they work?

I know the Lubrysin worked for my TBX. When I say his movement and impulsion improved significantly I'm NOT speaking just in terms of visually. I am speaking in terms of impulsion I could seriously FEEL undersaddle. This is a horse that is not lacking in the impulsion department to begin with. I have never in the 3 years I've owned him felt the level of impulsion I felt when he was on the loading dose of Lubrysin. I've tried many, many products with this horse and that was the first time I ever noticed ANY difference in him undersaddle whatsoever.
He is not lame and at 16 is in very good health. My vet suggested the HA after he had lyme disease and showed slight lack of flexion in his right hock. I did a shot of Legend and followed up with Conquer gel. No improvement.

I then tried the Lubrysin and by day 5 the improvement was very significant as I stated earlier. After spending 125.00 on Legend for this horse and seeing NO improvement quite frankly it does not matter to me one bit whether Bayer provides studies or not. Legend isn't a preventative like Adequan and doesn't work for long term. No HA product offers long term or preventative effects. The Adequan studies are more pertinent to me for that reason.

I agree with everyone that says it is the responsibility of the horse owner to do the proper research and consulting with their vet BEFORE jumping on the wagon when it comes to anecdotal evidence. The same goes for products like Adequan and Legend with conclusive studies present as well. JMHO

[deltawave]

Nobody's objecting at all to people trying things out after thoughtful discussion with vets and after considering other beneficial treatments. But those of us who are believers in the scientific method object (rather violently, in my case, LOL) to the indiscriminate BULLSH*T that is put out in advertisements for these products, often couched in pseudoscientific terminology. It's sickening, and very, very obviously effective because you can overhear people CONSTANTLY saying "this product is PROVEN" or "they studied this one" or "that one is shown to be better". Heck, I don't care if people EAT their horses or not, but I do care about scientific precision and am faced daily with "proof" ;) that there are a lot of really poorly informed, gullible people out there getting fleeced. And yes, I care because it's my job to do so. Not WRT equine joint supplements, but this same conversation goes on in parallel CONSTANTLY where I work, and I've seen people truly hurt by nutraceuticals, both physically and financially.

So, bottom line for me is and has ALWAYS been: do what you think is right, but please be precise with the spreading of tales of "scientifically proven", etc. It never hurts to apply a little scientific rigor. :yes:

[MassageLady]

DW...here you go-but something tells me this just won't be enough 'scientific evidence' for you.:winkgrin:
From the Hyalun website.
Backed by thousands of clinical trials in the fields of orthopedics and eye surgery, one of hyaluronic acid's most important functions in the body is to lubricate joints as an integral component of synovial fluid. While hyaluronic acid is in the "family" of glycosaminoglycans, it is unique in its restorative ability, and will often provide improvement, where glucosamine and chondroitin have failed to do so.

[wlrottge]

I don't think she's doubting WHAT it does... just more like the rest of us who doubt, it's efficacy produced by it's administration. i.e. it's not well absorbed when feed to the animal.

[deltawave]

Exactly. Piggybacking the widespread function and use of hyaluronic acid onto its efficacy as a joint supplement is a little silly. It's like saying the use of all those ridiculous "muscle building" supplements is based on "Nobel prize winning research". Yeeeesss, the research is in the same FIELD, but it's an entirely different universe between nitric oxide effects on the endothelium of blood vessels (that's what won the Nobel prize) and hawking a "muscle pumping" supplement. :lol: Then again, that industry (muscle supplements) may rival the horse nutraceutical industry in terms of BILLIONS spent per year. :dead: :dead: :rolleyes:

As my current signature line says . . . ;)

[RAyers]

DW...here you go-but something tells me this just won't be enough 'scientific evidence' for you.:winkgrin:
From the Hyalun website.

What you/they suggest as scientific evidence is only valid for the particular study. The sad part is a majority of those studies have NOTHING to do with what the company claims their product does, nor the fact that their product is not the same thing as was studied. It is like saying that Crosby saddles fit 1,000 horses so they should fit every horse.

For example, a low molecular weight HA has little efficacy in a joint (but is good for eye and skin tissue) while a high molecular weight has been show to have good effect in a joint. Of course the route of administration studied in the joint is direct injection NOT orally. The chemistry is the same but because the molecules are different, they have VERY DIFFERENT actions and efficacies that are applicable in specific tissues.

The fact a company attempts to equate studies in the eye to a joint product is a complete lie.

And, NO, HA had NOT been shown to be restorative in joint tissues while glucosamine has - another lie.

Reed

[vanheimrhorses]

back when i was in horses oral HA was not available and I used with good results msm, joint flex supplements, biotin, and yucca. i would try these first, yucca really does help some horses and it helped my mare who had arthritis and a bog spavin turned into nasty spavin and she went sound on that and corrective hind shoes

[grayarabpony]

Here is an abstract from a very recent article that elucidates what I am saying:


Vet Clin North Am Equine Pract. 2007 Aug;23(2):443-60.
An evidence-based approach to selected joint therapies in horses.
Richardson DW, Loinaz R.

There is an enormous volume of published material about most of the agents used to treat or prevent arthritis in horses. Unfortunately, most of the claims made by nearly all purveyors of arthritis medications in such media are largely unsubstantiated. In addition, the quality of the available information is highly inconsistent, making evidence-based recommendations difficult. This article concentrates on injectable polysulfated glycosaminoglycan, injectable hyaluronan, and the common oral "nutraceuticals".



Reed, I tried to read this article but was thwarted was the $30 price tag. What were the conclusions? That the injectables work and the orals don't?

[RAyers]

Reed, I tried to read this article but was thwarted was the $30 price tag. What were the conclusions? That the injectables work and the orals don't?

The overall conclusion of this work, "Conflicting results, flaws in experimental design, commercial sponsorship, and a lack of detailed descriptions regarding the experimental process make it unlikely that many of the publications found could be considered outstanding examples of evidenced-based medicine. Accordingly, recommendations for the use of the products considered in this review are not made from a strong base of evidence and considerably more research is necessary before a truly evidence-based prescription can be made."

This is what deltawave and I have also been saying.

The paper quoted examined 76 various studies of nutraceuticals as well as drugs both in human and equine applications.

Reed

[grayarabpony]

But this is very confusing -- on my Adequan thread you said that there were studies supporting Adequan as effective. What am I missing?

[LookinSouth]

I don't think she's doubting WHAT it does... just more like the rest of us who doubt, it's efficacy produced by it's administration. i.e. it's not well absorbed when feed to the animal.


Again, I am not going to argue the efficacy of oral administration according to science.
However, if some horse owners have tried Oral HA with good success and experienced results why is it wrong for these people to share their experiences???
Who cares if science has not proven the efficacy of the drug orally? If it works for some horses...it works for some horses. period.

I've never attempted to compare the Efficacy of Lubrysin or Hylarin B or Hyalun to IV Legend. That would just be stupid, they are administered two very different ways.

However, as I said earlier, IV Legend showed NO effects with my horse whatsoever. It was 125.00 down the drain. I then tried Lubrysin because of yes GASP "Anecdotal Evidence" and come to find out there were results in 5 days. Significant results.
Now whether or not SCIENCE has proven that Lubrysin does not have the same efficacy as IV Legend doesn't matter to me one bit if IV Legend doesn't work for my horse. This is what I have been trying to express all along.

It is just irritating when someone comes on this board to say "yeah Lubrysin/Hyalun or whatever has worked for my horse" and then the scientist naysayers jumps aboard just to argue that their experience is all hogwash because there is no SCIENTIFIC studies to PROVE they work.

There is alot SCIENCE hasn't quite figured out yet and the opinions vary greatly...for example Lyme Disease. I have always gone by clinical symptons when dealing with Lyme for this reason. Yeah the tests performed etc...are helping but they are not the end all be all and there is still a great deal of gray areas.

The bottom line is I am much more interested in what is going to produce RESULTS in my horse rather than what Science says is proven to work. There are many, many horse owners who have experienced results with Oral joint supplements. These experiences are not invalid simple because Science says it just isn't so.

[RAyers]

If you are looking for definitive answers, I don't blame you for the confusion. That is the difficulty in conducting research, being able to figure out the real data from poor quality data.

As I do not know your experience or background, please forgive what I am about to say if otherwise. The challenge of relating the research to the lay person is difficult as many people want everything wrapped up with simple cliche or definite answer. The reality in much of this work is different simply because we still do not fully understand the biology, mechanics, and function of joints yet. Thus studies that may appear to conflict each other come out.

The work on Adequan and Legend is much more extensive than any/every nutraceutical study. Through this we have a better idea of the potential efficacy and function of the drugs. However, even those works had faults, either because of author's lack of communication, the possibility of sponsor conflict of interest, or the small sample size. At the same time, we do not know the drug's exact function because the metabolic pathways are still not fully characterized. Hence, why I and other keep calling for more work by the entities that could fund it, if they wanted to. Various entities, including the nutraceutical companies, piggy-backed onto those studies saying their product functions just like those without ever conducting the full research necessary.

Even this review is flawed as it failed to include studies by Kawcek, Nixon and others in human medicine.


As for your experience, LookinSouth, I will repeat what I said before, I am not a nay sayer because your horse feels better but because these companies claim their product "fixes" joints. Yes, your horse may feel better but that does NOT mean that the arthritis has been ameliorated. These products may only act as glorified analgesics allowing the horse to fell better while the joint cartilage continues to degrade. I do not deny your experience but allude that a product such as Lubisyn mitigates arthritis without understanding of what is actually happening at the joint surface is fallacy.

Reed

[LookinSouth]

As for your experience, LookinSouth, I will repeat what I said before, I am not a nay sayer because your horse feels better but because these companies claim their product "fixes" joints.


But it is my understanding that Legend does not "FIX" joints either. It merely supplies lubrication in the joints where it is lost. Or am I wrong about that?

I do know that Adequan has been proven to repair joints. I am an avid supporter of Adequan versus OTC glucosamine Orals. I am not talking about Adequan though. I am specifically talking about Legend.

[deltawave]

Even when there ARE good studies, there is a lot of inter-observer and individual variability in response to any given agent.

I have no personal objections to ANYONE using ANYTHING on themselves or their horses. Why would I?? My point in always chiming in on these threads is to inject a little bit of critical thinking, which is BY AND LARGE (not singling out the good number of thoughtful people who are judicious about their decision-making) lacking when it comes to the use of these products. As I've said before, a little rigor and critical thinking cannot POSSIBLY hurt. There is a LOT of bogus advertising out there, slickly couched in fantastical, pseudoscientific terms. Those claims about the properties of glorified vitamins, minerals and half-baked "nutraceuticals" with no GOOD research are my personal pet peeve, and I've seen WAY too many people really negatively impacted by it. In short, it pisses me off. :D

If something works for an individual animal, that's GREAT. But we have to be really careful to not extrapolate too much, we have to be really careful to not delude ourselves that we are really "curing" or even "treating" anything with these products, and we have to be ever-vigilant about fooling ourselves. Sometimes horses (and people) JUST GET BETTER. Giving credit to a nostrum is harmless, unless you count the cost. You can afford it? Fine, so can I. But the notion of a multi-BILLION dollar industry churning along and raking in the bucks without ANY need to prove what they're doing bugs the heck out of me.

Call me Don (Dona?) Quixote. ;)

[RAyers]

But it is my understanding that Legend does not "FIX" joints either. It merely supplies lubrication in the joints where it is lost. Or am I wrong about that?

I do know that Adequan has been proven to repair joints. I am an avid supporter of Adequan versus OTC glucosamine Orals. I am not talking about Adequan though. I am specifically talking about Legend.

Legend never claims to"fix" joints, and yes you are mistaken, Legend does not supply lubrication. Legend stabilizes the synovial environment so that a better quality of fluid can be produced by the synovial membrane. Legend does NOT have a direct effect on the synovial fluid (based on both human and equine studies) other than helping the tissue that produces the fluid function better.

Thus what I continue to say, Legend and Adequan can not be substituted nor equated to/for each other. They have different functions in the joint.

Reed

[Calena]

Legend never claims to"fix" joints, and yes you are mistaken, Legend does not supply lubrication. Legend stabilizes the synovial environment so that a better quality of fluid can be produced by the synovial membrane. Legend does NOT have a direct effect on the synovial fluid (based on both human and equine studies) other than helping the tissue that produces the fluid function better.

Thus what I continue to say, Legend and Adequan can not be substituted nor equated to/for each other. They have different functions in the joint.

Reed

The problem here is that you are stating scientific facts. Very few people are interested in scientific facts; we want our horses to move better. As far as we're concerned, better movement is equivalent to healing, health and well being. The fact that we're wrong is beside the point. We're happy. It's all about the movement, not the science.

So, we buy XYZ product whose label states it works wonders on our horse. We give it to our animals and watch for an improvement in movement. Lo and behold, within the standard 5 day to 2 week loading period, we see improved movement. The product works! We have tested it, or so we say and tell all our friends.

So what really happened in that space of time? How much water did the animal drink? How much time did the animal spend walking, trotting, cantering (proven to lubricate joints)? Was the work schedule changed in any way from the time prior to administration? How much rest did the animal get? Did he/she lay down during that period and for how long? What about diet - fed exactly the same thing at the same time every day? Exercised at the same time every day? That's for starters.

Then there are external variables. What was the temp/humidity/dewpoint during that time span? Was it calm or windy weather? Was the footing the exact same, was the arena watered/raked, who else was in the arena? Did anyone else work with the horse (we all know that horses respond differently to different riders or even the same rider depending on our frame of mind)? What other horses or animals or activities were going on? What about heat cycle if it's a mare, was that taken into consideration?

Personally, I'm trying to figure out how to bottle "windy day in the pasture with low humidity and that hot Cody on the other side of the fence while her highness is in heat". Talk about movement! I know for a fact it works, I've seen it ;).

Like everyone else, I'm longing and watching for a product that's scientifically proven to work to at least stop further cartilage degeneration even if it doesn't heal.

[RAyers]

Like everyone else, I'm longing and watching for a product that's scientifically proven to work to at least stop further cartilage degeneration even if it doesn't heal.

The sad part is that the joint has NO regenerative capacity, period. Thus even if the joint "heals" it will never be the same as original. The only things I have seen "regenerate" cartilage tissues as original are genetically engineered and very specific protein compounds that would run hundreds of thousands of dollars a treatment. The one I experimented with we figured would run $2.3 million/treatment.

Stopping degradation is just as difficult. Adequan is the closest anybody has come and that is not the greatest. Given the current state of the art, to really stop, you have to start with IA injections/treatments; IM/IV injections are second in efficacy and oral is last.

Reed

[deltawave]

And yet you hear anecdotes (I think there's one on this or another recent thread) about people, even VETS, doing serial X-rays and INSISTING that a horse's "arthritis went away". :rolleyes: :no:

Calena, you forgot to also factor in the very NATURE of arthritis: it gets a little better, it gets a little worse, back and forth over time even if we leave it alone! :) And I'm with you--I'd love to bottle the trot I get out of Gwen (and I've seen Reed's horse do the same thing) in XC warmup and pull THAT trot out in the dressage ring! ;) I'd like to know how they can go buck-farting around with all four feet off the ground for an hour and a half on the first windy day of springtime and still resist tooth and nail a simple leg yield! :lol:

[LookinSouth]

Legend never claims to"fix" joints, and yes you are mistaken, Legend does not supply lubrication. Legend stabilizes the synovial environment so that a better quality of fluid can be produced by the synovial membrane. Legend does NOT have a direct effect on the synovial fluid (based on both human and equine studies) other than helping the tissue that produces the fluid function better.

Thus what I continue to say, Legend and Adequan can not be substituted nor equated to/for each other. They have different functions in the joint.

Reed


I clearly understand and always have the difference between Legend (or HA) and Adequan. You will not find me using the two interchangeably.

My questions are regarding Legend in comparison to other HA's that are administered via the mouth (like Hylalun) or in the food etc..

You said earlier that Oral HA may only show "results" in the form of an analgesic. Well if the oral HA is nothing but Sodium Hylaronate how is that possible? How is possible that feeding a horse pure HA in the paste or liquid form is suddenly an analgesic in comparison to the IV? I understand that the IV goes directly to the source. However, why is it that you stated earlier that oral HA's may be just essentially covering up issues rather than treating the issue at hand. If both Legend and Lubrysin are HA how is it that Lubrysin can be an "analgesic" and Legend cannot?

How is it possible that the results I may see from an Oral HA versus results one sees from IV Legend may just be masking the issue but if I see THE SAME EXACT results from Legend it is because the drug is actually stabilizing the synovial fluid??

[BuddyRoo]

HA has a slight anti-inflammatory effect. To quote Dr. van Wessum from his seminar on this very topic today, "On a scale of 1-10 considering anti-inflammatory and pain management effects, bute is a 7, morphine is a 9 and HA is a 1." So it MAY offer some relief in a very very mild case of synovitis--but most of the cases where it would be effective would be so slight that you'd really have to being paying attention to notice a problem in the first place.

The therapeutic effect of using HA is more to offer molecules for use in constructing the scar tissue to replace damaged cartilage. If that scar tissue forms appropriately, and the problem was lack of cartilage in an area resulting in bone on bone contact, then yes...you should in theory see some improvement in pain levels and mobility. But in and of itself, I don't think (and apparently neither do the people actively studying this stuff) that HA is going to do a lot on it's own for pain.

ETA: And further, why would anyone think that giving it orally would NOT result in the HA being metabolized long before it ever gets to a joint? The benefits of HA as I understand it require being injected IA--into the synovial fluid.

[RAyers]

I understand that the IV goes directly to the source.

I always said Legend acts as an anti-inflammatory/analgesic so I am not contradicting myself. I never said Legend cures the condition. I said Legend has multiple effects, including anti-inflammatory and analgesic, all of which help manage the condition. See my previous post where I mentioned that my old eventer was on Adequan and Legend and his joints still went to hell (we biopsied the cartilage several times to track progression of the disease). None of that has ever been shown in oral forms of HA.

Legend does not go directly to the source. Legend is taken into the blood stream and goes to all synovial joints in the body. The molecule is unmodified by metabolic activities of the digestive tract and subsequent uptake into the blood stream.

At the same time, Legend has a specific high molecular weight that has been shown to affect the joint (e.g. synovial secretion increases in all joints post injection). Oral forms have another molecular weight that may or may not work at all, given that nobody has shown that the molecule remains intact after digestion nor have they ever shown increased synovial secretion. Therefore you can not equate oral forms to Legend.

You are saying that by OBSERVATION oral HA is acting like Legend. As I asked before did you actually take synovium biopsies? Did you draw joint fluid and conduct protein analysis? What you are equating is akin to telling me that you can KNOW the difference between a diesel and gas engine simply by looking at the outside of the car. You can't.

Based on the LACK of any data, other than observation such as yourself concerning oral HA, and using Occam's Razor, the most likely explanation at this point is that they act as some sort of analgesic in the surrounding tissues. Unless you have data or understanding otherwise.


Reed

[LookinSouth]

ETA: And further, why would anyone think that giving it orally would NOT result in the HA being metabolized long before it ever gets to a joint? The benefits of HA as I understand it require being injected IA--into the synovial fluid.


Yes it does make sense that oral HA would metabolize before it gets to the joint. My point is what then is causing the horses who recieve oral HA (i.e Lubrysin etc..) to have these noticeable effects many horse owners have had with their horses?? Lubrysin contains nothing other than HA

This is my point. If some horse owners notice results with the oral that are the same as those results that horse owners notice with the injected form how can we assume the orals "don't work" simply based on the fact that NO research currently exists?

Again, there is alot that science has yet to figure out. There are ALOT of things science has yet to produce facts for.

[LookinSouth]

At the same time, Legend has a specific high molecular weight that has been shown to affect the joint (e.g. synovial secretion increases in all joints post injection). Oral forms have another molecular weight that may or may not work at all, given that nobody has shown that the molecule remains intact after digestion nor have they ever shown increased synovial secretion. Therefore you can not equate oral forms to Legend.

Okay so because science has not shown it yet it cannot be. Got it.

You are saying that by OBSERVATION oral HA is acting like Legend. As I asked before did you actually take synovium biopsies? Did you draw joint fluid and conduct protein analysis? What you are equating is akin to telling me that you can KNOW the difference between a diesel and gas engine simply by looking at the outside of the car. You can't.

I understand that. But they both essentially get the passenger from point A to point B.

Based on the LACK of any data, other than observation such as yourself concerning oral HA, and using Occam's Razor, the most likely explanation at this point is that they act as some sort of analgesic in the surrounding tissues. Unless you have data or understanding otherwise.


Reed

Okay. This is what I have been trying to figure out. Why is it these scientists are claiming Oral HA is useless or simply an "analgesic". And claim Legend is more likely to be effective when the fact of the matter the data DOESN'T exist so in reality nobody knows for sure correct??

[deltawave]

It is also entirely possible that the effects people are noticing are not due to the product itself. Arthritis pain waxes and wanes, it is a very well-described fact.

Although I wouldn't implicate the entire industry, there are also more than a handful of reports of nutraceuticals, upon analysis, containing products that are not meant to be in there. One example that's very pertinent to me is a recent smackdown from the FDA on TWO different nutraceutical companies because they found significant levels of lovastatin, an FDA-regulated, prescription drug in their "natural" cholesterol product, red yeast rice.

http://www.fda.gov/foi/warning_letters/s6456c.htm

Anecdotes, no matter how passionate and heartwarming, are not and SHOULD not be enough to make us put aside critical thinking and a healthy, natural skepticism. I for one am perfectly willing to believe there are many animals who do well on various oral products, but the existing evidence would indicate that these animals are the exception and not the rule.

[RAyers]

Okay. This is what I have been trying to figure out. Why is it these scientists are claiming Oral HA is useless or simply an "analgesic". And claim Legend is more likely to be effective when the fact of the matter the data DOESN'T exist so in reality nobody knows for sure correct??

Your logic fails when you say the "same passenger." How do you know that? How do you know where A and B are? Perhaps A is far enough, that a gas engine won't make it? I am sorry but you must get over that your idea that oral HA and Legend are the same thing. They are only similar in chemical nature, however, structure (the length of the HA chains) has more to do with efficacy than chemistry in the case of joints. Thus while both are engines, one may NOT get you from A to B no matter how much you want to believe it will.

What I am saying is that there is NO proof that the molecule ingested is the same molecule that reaches the joint, unlike with Legend. You ASSUME it is but you really don't know. Thus, the effect may be from a totally different mechanism or mode.

Yes, the data DOES exist as to what Legend can do, I have said that before. The scientists are not claiming anything WORKS by your definition. They are describing HOW it works. They make NO claims toward the fact it cures anything. When one takes in the larger body of studies, then one begins to develop a possible idea of if the HA molecule, injected in the joint or IV, may be used in joint preservation.

Reed

[grayarabpony]

If you are looking for definitive answers, I don't blame you for the confusion. That is the difficulty in conducting research, being able to figure out the real data from poor quality data.

As I do not know your experience or background, please forgive what I am about to say if otherwise. The challenge of relating the research to the lay person is difficult as many people want everything wrapped up with simple cliche or definite answer. The reality in much of this work is different simply because we still do not fully understand the biology, mechanics, and function of joints yet. Thus studies that may appear to conflict each other come out.

The work on Adequan and Legend is much more extensive than any/every nutraceutical study. Through this we have a better idea of the potential efficacy and function of the drugs. However, even those works had faults, either because of author's lack of communication, the possibility of sponsor conflict of interest, or the small sample size. At the same time, we do not know the drug's exact function because the metabolic pathways are still not fully characterized. Hence, why I and other keep calling for more work by the entities that could fund it, if they wanted to. Various entities, including the nutraceutical companies, piggy-backed onto those studies saying their product functions just like those without ever conducting the full research necessary.



Reed


I do have a scientific background, so while I may not understand the medical terms, I do understand scientific method and all of the problems that go with it. I really do appreciate your input.

So, basically, there has not been an independent study with a large enough n to show statisical signifiance to show that IM Adequan actually helps with a horse's discomfort?

My other question is, since so many horses have problems with the lower low-motion joint of the hock, does it matter if current treatments aren't stopping or curing the degradation of the cartiledge? Does that joint actually eventually fuse, and the horse's discomfort end at that point?

[grayarabpony]

bump

[grayarabpony]

bump again. Any comments?

[deltawave]

You would really have to dig into the study designs to see if Adequan had studied pain relief/measures of lameness or discomfort. No doubt there's stuff out there, maybe I'll have a look later, but if you want to do your own digging try plugging in "Adequan + equine + arthritis + lameness" or some such on pubmed.

www.pubmed.gov

[grayarabpony]

Yesterday I asked Luitpold for copies of the studies by Mcllwraith, Burba, White and Jones.

[wlrottge]

There are some studies about Adequan out there that have been published, but they are hard to find in their entirity. I think I saved the pdf's somewhere, but.... not sure where.

http://www.ivis.org/proceedings/aaep/2001/91010100180.pdf

There is a longer version of this study out there somewhere:
http://www.luitpoldanimalhealth.com/pdf/improof/Adequan%20VS%20Chondroprotec.pdf

http://www.fda.gov/cvm/FOI/1379.htm

http://www.dvmnews.com/dvm/Equine/Treating-early-osteoarthritis-Orally-administratio/ArticleStandard/Article/detail/134767?contextCategoryId=355

Even smartpak plays a little bit a skeptic
http://www.smartpakequine.com/Articles.aspx?ArticleName=jointsupplements

Colorado State Univ:
http://www.equineortho.colostate.edu/questions/tjd.htm#oral

[RAyers]

I have maybe 10 or 15 studies of Adequan/PSGAGs in joint, cartilage, skin, and corneal function, in jumans and horses however, right now I have too many other things to do. I spent a good chunk of 1996 and 2000 reading and understanding this body of work. Suffice to say, PSGAGs do not necessarily "heal" the joint surface as we would expect. They do slow down degrative processes in many tissues simply by their chemistry/presence.

Reed

[moribelle]

Your friend is correct. HA and Legends are two completely different animals.
What I find interesting, is no one mentions giving HA in the joint as an injection. It has wonderful lubricating and some anti-inflammatory effects which creates a better comfort level than any Legends anytime.

BUT, if your horse truly has an arthritic process going on, then it needs to be addressed directly, and not by treating the symptoms. Treat the cause., which is : during the process of arthritis, whether osteoarthritis, or degenerative joint disease, certain messenger substances of the immune system are released, ie: Interleukin-1 or TNF-alpha. These substances are responsible for inflammation, pain, and sensory disorders. The constant inflammation within the joint deteriorates the joint over time, ie: arthritis.

The IRAP therapy using the horse's own naturally occurring biological antagonists, especially Interleukin-1 receptor antagonist protein (IL-1Ra), can stop the inflammation and pain.

The IRAP injections treat the cause. (Interleukin-1 Receptor Antagonist Protein). It is a natural blood product that is within your horse's own blood.
If you are interested in knowing more, please respond. This is a naturally occurring medicine that comes only from your horse's blood. It is used widely thru the U.S. successfully now for 6-7years in the equine, and most recently in the last 2yrs, in the canine here in Colorado. In Germany, where this technology came from, it has been used on humans successfully for the last 12years. Are you familiar with it?

Sherry

[spoiledsweet]

I haven't read all the responses, but personally, I'm not impressed with HA products. My vet really likes Conquer. I have tried it on several horses and ... pffft. Didn't see anything. I have also used Lubrisyn on a couple of horses. Same results. I used them longterm, too. I have seen improvements with Gluco./Chon./MSM supplements.

[RAyers]

BUT, if your horse truly has an arthritic process going on, then it needs to be addressed directly, and not by treating the symptoms. Treat the cause., which is : during the process of arthritis, whether osteoarthritis, or degenerative joint disease, certain messenger substances of the immune system are released, ie: Interleukin-1 or TNF-alpha. These substances are responsible for inflammation, pain, and sensory disorders. The constant inflammation within the joint deteriorates the joint over time, ie: arthritis.

The IRAP therapy using the horse's own naturally occurring biological antagonists, especially Interleukin-1 receptor antagonist protein (IL-1Ra), can stop the inflammation and pain.

The IRAP injections treat the cause. (Interleukin-1 Receptor Antagonist Protein). It is a natural blood product that is within your horse's own blood.
If you are interested in knowing more, please respond. This is a naturally occurring medicine that comes only from your horse's blood. It is used widely thru the U.S. successfully now for 6-7years in the equine, and most recently in the last 2yrs, in the canine here in Colorado. In Germany, where this technology came from, it has been used on humans successfully for the last 12years. Are you familiar with it?

Sherry

The Il-1 pathway is only partially responsible for degradation in joints. While not turning this into a rheumatology discussion, besides TNF there is also Il-10, RANKL, Il-4 and Il-18. Each of these has been shown to have significant effect, depending on the specific cause of the joint condition. For example, Inoe et al suggested that Il-1ra must be administered daily in type II collagen induced osteoarthritis.

Zwerina et al show that while the combination Il-1ra/anti-TNF is the best for preventing cartilage degradation, it was only 80% blockage. Yes, that is better than nothing, however it indicates that the condition will continue and the the joint will degrade.

Reed

[grayarabpony]

80% blockage sounds very significant though...

[RAyers]

Yes, but excess NO (nitrous oxide) production (a product of inflammation) can render Il-1ra inactive. Thus if the animal's physiology is such that there is large amounts of NO, the 80%, while significant, still leaves the door open for further degradation as well as suggesting that even this does NOT work for ALL animals.

In other words, even IRAP, as good as it is, is NOT a cure all. And, for IRAP to be truly effective should be combined with anti-TNF as well.

Reed

[moribelle]

Yes, but excess NO (nitrous oxide) production (a product of inflammation) can render Il-1ra inactive. Thus if the animal's physiology is such that there is large amounts of NO, the 80%, while significant, still leaves the door open for further degradation as well as suggesting that even this does NOT work for ALL animals.

In other words, even IRAP, as good as it is, is NOT a cure all. And, for IRAP to be truly effective should be combined with anti-TNF as well.

Reed

Nothing is a cure all, no one has suggested it is. Nor are any of these other products. The best we can hope for is to help our equine friends as best we can, and hope to ease any suffering they may endure. But one thing is for sure, ..NOTHING repairs , or contributes to the repair of the joint cartilage (as you stated earlier that Legends does).
The person who is able to unlock that , can retire yesterday. Any claims made to that effect are ludicrous and unfounded.
If that ever happened, it would be a worldwide event. Not kept a secret by someone saying they accomplished it without having the reviews by their peers and made public.

[grayarabpony]

Why the thumbs down?

[deltawave]

Our moribelle (this is just a guess based on her posing, I mean posting, as an authority on all things IRAP and medical) works for an IRAP company, I think. :lol: Disagree with her or at your PERIL. :lol:

[moribelle]

Our moribelle (this is just a guess based on her posing, I mean posting, as an authority on all things IRAP and medical) works for an IRAP company, I think. :lol: Disagree with her or at your PERIL. :lol:

Again Deltawave, (a $25.00 handle indeed!) my suggestion to you is to spend this time to :no:educate yourself more thoroughly on the several subjects you have mentioned
as your uninformed rhetoric confuses people who are genuinely trying to learn more about different subjects. :no: I've posted in several areas, on different subjects, not just IRAP. EVERYONE has an opinion, some are just more 'informed" than others.:yes:

[deltawave]

Thank you for the advice. Uninformed, I ain't. Back when you were being civil and PT'd me on the topic I shared with you my lack of personal experience with IRAP as an equine remedy and the fact that I wasn't aware of any good equine studies (hmmm!) but I believe I told you I was fairly familiar with the topic in general.

I have even more experience with people who are bent on promoting their "pet" substance/technique/therapy/substance/beliefs come hell or high water. And those who tie a string of letters after their name to give themselves credibility just rub me the wrong way. Sorry. :)

[ButterflyIris]

I think Moribelle keeps cutting and pasting the same 'blurb' about IRAP (or whatever it's called) into these threads.
It feels like Groundhog's Day.

[petitefilly]

I'm not sure any two people can agree on Legend of Adequan. Nobody really knows exactly how the substances work, it has minimal results for each. Science is not sure of any 100% cure for arthritis. My horse did go through hock fusing, and while it was hot we used Legend, the series of four intravenous applications. The horse did seem more comfortable, but not 100% sound. I did it because I hoped for change. This is what humans do, we *HOPE* it works. Do we see results? Maybe, maybe not; rest might have been as useful. Vets let us pay for this, we let them work their magic, but I doubt seriously if any horse who was unsound became 100% back to normal work due to any drug that is suppose to lube joints. Once damage is done, damage is done. El finito!

I think my best advice is *HOPE* for the best, and do what your wallet will let you do. Remember results vary, and vary a great deal. My better advice is find a new horse, a sound one. That will work better than any darn drug 100% of the time. Guaranteed.

[grayarabpony]

So what to do with the horse with lameness problems? Send it to slaughter? :rolleyes: A lot of horses with arthritis are managed successfully.

As someone on TMP once said, sometimes posters on this board make my rolly eyes tired.

[findeight]

My better advice is find a new horse, a sound one. That will work better than any darn drug 100% of the time. Guaranteed.

Yeah...once they hit the late teens and get the "treadwear", you need to replace them.

Let me go buy a lottery ticket to do just that.

Oh...and help me find a vet that will pronounce one 100% sound on that PPE.

[moribelle]

I think Moribelle keeps cutting and pasting the same 'blurb' about IRAP (or whatever it's called) into these threads.
It feels like Groundhog's Day.

Actually butterfly, (or is it dragonfly?) the monitors of this website did that themselves. In an effort to be helpful because THEY feel it is a worthwhile subject to discuss.
Oh my, yet another poor soul that is uninformed yet cannot get over her own rhetoric long enough to learn something constructive.:no::no::no::no::no::no::no::no::no:: no::no::no::no::no::no::lol::lol::lol::lol::lol::l ol::lol::lol::lol::lol::lol::lol:

[Moderator 1]

I think there was a misunderstanding in the previous two posts. ButterflyIris commented that Moribelle appears to provide a lot of IRAP information during the course of various threads. I'm guessing Moribelle interpreted that as a reference to her two IRAP threads in this forum.

Moribelle has admitted previously to not being the handiest when it comes to computers and apparently mistakenly posted an IRAP thread in the "help" forum. We had moved it to "horse care" without realizing she had started a similar thread here. Just trying to keep things orderly, not a commentary on the relative importance of IRAP as a discussion topic. ;)

Thanks!

[lindat]

The only HA we have used was injectable. However, I have a friend that swears by it - it is costly but for her it was worth it...