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  1. #1
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    Question Adequan and Legend-as preventative??

    First of all, I already did a search on this, and couldn't really find anything that relates to my situation...

    I'm half-leasing a big ol' (17.3ish) WB gelding who is 12 years old. He has spent the last year doing about a ride a week, and previously did H/J and Dressage. Since I've been leasing him, I've decided I'd like to try him at some lower level events (think the 2' special ), nothing big or demanding...

    His owner decided to have the vet out to do a soundness exam to make sure everything is kosher, and that he's not in any pain. All his flexion tests were good, he shows no sign of pain and is ready to go.

    The vet did, however, suggest he go on Adequan and Legend. Is this common for a horse with no soundness/stiffness issues? Is it commonly used as a preventative? I have absolutely no knowledge on this stuff...

    I'm happy to do whatever I need for the horse, as per my contract (and because I like to think I'm a good person ), but I want to make sure that I'm not being asked to pay for a fairly costly expense if it's not truly needed.

    I would have asked the vet questions, but I wasn't told about the exam until after it happened, and was presented with a bill but that is neither here, nor there...

    I'd appreciate the collective wisdom of you COTHers... TIA!



  2. #2
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    Default

    I believe that is the ultimate goal of the makers of adequan/legend, and I know my horse's surgeon would encourage me to do it if I had the cash, but most of us don't have that kind of money. So I think the norm is to only do the regular injections when you have clinical/radiographical evidence of joint changes/osteoarthritis.



  3. #3
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    Default

    If it ain't broke, don't fix it.

    I have all mine on MSM as a preventative, but it's also a super cheap supplement that is basically just an anti-inflammatory.

    Is he stiff when starting work or anything? I would say no, it's not common for a vet to recommend Adequan/Legend for a horse that doesn't seem to need it. Makes me wonder why he would even recommend such an agressive/expensive treatment when the horse is totally comfortable and sound



  4. #4
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    Well, they certainly won't hurt when used judiciously, though you will never know if, in 10 years, the horse is still sound, it was because of or despite these things LOL

    I see no reason to use BOTH though. If you were just adamant about using one, then I'd probably do the loading dose 1-2 times a year.
    ______________________________
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  5. #5
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    Default

    Thanks, guys.

    That's kinda the overall thought running through my head, but like I said, I know nothing about this.

    How about hock injections as preventative instead? Is that at all feasible? Even biannual hock injections would be cheaper than the Adequan and Legend.

    Hmmm...



  6. #6
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    Feasible? Sure. But same thing I said about the Adequan/Legend

    How much do your hock injections cost? My vet is about $500 for both hocks, upper and lower. That's more than a single loading dose of Adequan by about 2/3.
    ______________________________
    The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET



  7. #7
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    Default

    Ahhh... good point, JB!

    I believe the vet a good friend uses (who does a lot of a sports medicine type clientele) charges about $250 per injection. So, yes, the same as yours.

    The GOOD news is that the BO where we board is a vet, and can get us the Adequan and Legend at cost...and can do the injections... I love her... so the cost might actually not be that bad.

    I'm still just trying to figure it all out, as I didn't know about the vet appointment (seperate vet from BO)...and I know it's one of those things they go ahead and suggest to just about everyone...just wasn't sure if it is a neccessity or a luxury at this point.



  8. #8
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    Default Here is an email that I got from farmvet a couple weeks ago.

    Adequan and Legend are both drugs which are used to treat joint disease in the equine athlete. The question often arises asking which drug do I use when and how do I use it.

    Similarities
    Both drugs are given systemically and are used to treat joint problems. Both drugs are commercially available, have had extensive testing, are proven to be effective in doing what they claim to do, and are approved by the FDA with wide margins of safety.

    Differences
    Legend is pure hyaluronic acid and is given intravenously. Once in the horse’s system, it finds its way to the synovial membrane of every joint in the horse. It has been shown to stimulate the production of normal joint fluid and has an anti-inflammatory effect on the joints by helping to prevent mediators of inflammation from entering the joint. Legend is proven to stop acute inflammation of the synovial membrane (synovitis) before it damages the articular cartilage and becomes chronic osteoarthritis (degenerative joint disease). IV administration helps a quick onset of action resulting in rapid decrease in inflammation.

    Adequan is polysulfated glycosaminoglycan which is chemically similar to the glycosaminoglycans in the normal articular cartilage matrix. It is recommended that one 500 mg dose of Adequan be given intramuscularly every 4 days for a total of 7 treatments (the “1/4/7 Plan”) over 28 days. In the articular cartilage in the joints of the horse, Adequan works to diminish or reverse the pathological processes of traumatic or degenerative joint disease. In other words, it can reverse and heal the early stages of osteoarthritis and help to manage the later stages.

    My horse has some arthritic changes in one of his stifles, so he gets regular stifle injections and I've asked both vets that I work with which they prefer. Both have stated Adequan (over Legend). So my horse gets injections & Adequan.
    "I'm holding out for the $100,000 Crossrail Classic in 2012." --mem
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  9. #9
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    Default

    As the above poster mentioned, adequan is given IM, so you can give it yourself.



  10. #10
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    I love that they use the phrase "reverse ... the early stages of oseoarthritis" ... it's possible that is taking mild liberties with the English language since I don't think we have ANYTHING human or equine that reverses the oseoarthritis cycle. But slowing down or possibly halting the cycle (safer to stick with slowing down, I think) is a very good thing (as is adequan.. and legend).

    The way I look at it is horses have not long had riding careers (or even life expectancies) that went into their teens as compared to the evolutionary history of the species. They weren't necessarily designed to go on into their late teens as performance horses, chances were they were on their way to being something else's dinner. So now we are in th place where we have found ways (diet, wormers, etc.) to prolong their life expectancy, but that doesn't mean their bodies have fully adapted. Arthritis is just a fact of aging for most of us. And the fact that he is healthy and sound today doesn't mean the process isn't going on inside his body right now, it just means you can't feel the effects of it. Hint: when you can feel the effects, it's because there already IS damage. I guess I think if you are in the position to afford adequan, then it's probably a good idea, certainly a better idea than all the other unproven oral supps out there.
    Definition of "Horse": a 4 legged mammal looking for an inconvenient place and expensive way to die. Any day they choose not to execute the Master Plan is just more time to perfect it. Be Very Afraid.



  11. #11
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    Quote Originally Posted by eventerdiva View Post
    How about hock injections as preventative instead? Is that at all feasible? Even biannual hock injections would be cheaper than the Adequan and Legend.
    Absolutely NOT, IMO. IA injections usually include steroids which actually DEGRADE articular cartilage in the joint. That's the double edged sword of IA injections; temporary relief from pain & inflammation, but more damage in the long run.
    I suppose you could inject just HA alone, but I wouldn't risk infection for that!!



  12. #12
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    Quote Originally Posted by DMK View Post
    I love that they use the phrase "reverse ... the early stages of oseoarthritis" ... it's possible that is taking mild liberties with the English language since I don't think we have ANYTHING human or equine that reverses the oseoarthritis cycle. But slowing down or possibly halting the cycle (safer to stick with slowing down, I think) is a very good thing (as is adequan.. and legend).
    As someone who does research in OA, those statements make me mad. If it's true, I want in on that because they're for sure guaranteed the Nobel Prize in medicine!!!!



  13. #13
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    Quote Originally Posted by morganpony86 View Post
    Absolutely NOT, IMO. IA injections usually include steroids which actually DEGRADE articular cartilage in the joint. That's the double edged sword of IA injections; temporary relief from pain & inflammation, but more damage in the long run.
    I suppose you could inject just HA alone, but I wouldn't risk infection for that!!
    If you were to do an injection on a healthy hock, you wouldn't use steroids. You'd use HA.

    In either case, an antibiotic should be injected as well.

    Obviously that doesn't eliminate all risk of infection, but if everything is done correctly, it's not that high of a risk.

    However, no, *I* wouldn't do it as prevention.
    ______________________________
    The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET



  14. #14
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    Quote Originally Posted by morganpony86 View Post
    Absolutely NOT, IMO. IA injections usually include steroids which actually DEGRADE articular cartilage in the joint.
    I got my horse injected for the first time last night. The vet that did it is an equine lameness specialist – a young guy, fairly recent grad – and he said that the above statement used to be true (the steroids can cause damage), but that these days, they have newer drugs and they are actually chondroprotective (strictly talking about this in the context of steroid joint injections – not other condroprotective modalities like adequan etc). I didn’t ask the name of the steroid he used in my horse’s hocks – but this makes sense to me that they would have developed/tested various steroids and come up with one that both helps in the short term and maybe in the long term (or at least wasn’t destructive).

    Because of this lack of destruction (I am assuming) - I know a number of people that are doing preventative injections now. But I don’t know what data this is based on either – that these newer steroids aren’t destructive. Just curious if anyone else knew?

    Sometimes things can get stuck as “the truth” (IE – Steroids injected into joint help in short term, but cause long term damage) - when that actually might not be the case any more due to advancements in the field?



  15. #15
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    I think the truth is somewhere in the middle, of the 3 steroids that are commonly used in joint injections the longer acting one (maybe depo-medrol?) is more likely to cause damage to the joint, but in all cases, it involves a LOT of joint injections - but the damages/risks do not appear to be the same level as in humans. Now that is an issue if you are out there pre-race injecting a 3 year old, with a life time of injections ahead of him, yeah, you probably aren't doing him any favors (for more reasons than just injecting) ... but a horse in his teens getting injected once a year? Chances are the anti-inflammatory effect of the steroid will do more good by allowing the HA to be more effective, or so some of the latest research suggests...
    Definition of "Horse": a 4 legged mammal looking for an inconvenient place and expensive way to die. Any day they choose not to execute the Master Plan is just more time to perfect it. Be Very Afraid.



  16. #16
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    Question for everyone in regards to injections...I'm thinking about "adopting" a 16 yr 17.1 gelding - he was out of work until around May for 18 months prior. His owners started him back up slowly, 5, 10, 15 minute sessions and since he was stiff they injected him all around and have him on Adequan. He's a huge guy and extremely lazy about engaging his hind end - prefers to hang on you for support rather than actually work.

    So my question is, were the injections necessary? He was stiff but not unsound when they restarted him and he never had injections before this point. Would hill and dressage work have helped with the stiffness or were injections inevitable?

    TIA



  17. #17
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    Absolutely no way for any of us to know if those injections were necessary.

    At 16 years, even if he hadn't been in work, it is likely he had bony changes - it's just a process of aging for most horses. His size likely increased the odds of having changes.

    Whether those changes were the cause of being stiff, or whether "stiff" was simply due to a horse not having been worked in 18 months, muscles were not used to being used, etc, we can't tell.

    "Stiff" is subjective, and doesn't really tell the picture. If it stilted his movement, he was unsound, technically, just not head/hip-bobbing lame. He may have only needed a few good massage sessions and been brought into work more slowly, with some hand walking/etc. Who knows
    ______________________________
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  18. #18
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    agreed, there is simply not enough information to make a remotely informed guess. Could be he was already getting injections and it was perfectly reasonable to get him injected as he ramped back into work regardless of how he felt. And as JB said "stiff" is too variable a term to know how he was truly going.

    But for most show barns, getting a horse injected under those circumstances would be more the norm than not injecting, so from that perspective, I wouldn't worry about it.
    Definition of "Horse": a 4 legged mammal looking for an inconvenient place and expensive way to die. Any day they choose not to execute the Master Plan is just more time to perfect it. Be Very Afraid.



  19. #19
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    If he has no soundness issues, or stiffness problems - do not treat for something that's not there.

    Like someone else said - If it's not broke, don't fix it.

    I use it on my mildly arthritic (from jumping at too young of an age) horse, but she is sound without it. It just helps when she flares up, and keeps her arthritis non-existent.



  20. #20
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    Default Over Used

    I think that injections should not be used as a preventative. Its kinda like the complete over perscribing of aderol in children right now. There are alot of things you can do that are preventative in your horse....I dont think injections are one of them.



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