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  1. #1
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    Default Preserving young joints - Pentosan or Adequan?

    I participated in a Hilda Gurney clinic in January and I was excited to hear Hilda say that, in her experience, certain joint products REALLY work to prevent arthritis. She said that it used to be that top dressage horses became creaky and had issues with one-sidedness by the time they reached the upper levels. She said she uses Adequan and Cosequin for prevention and she feels that she no longer has to deal with these stiffness issues when her horses get to Grand Prix.

    I really like Pentosan. Do you know if it can also be given like Adequan to prevent premature aging of the joints?



  2. #2
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    I think I may start my 7 yr old on it. I just started the loading dose on my 17 yr old.

    My vet said it would help over all on both horses. I haven't decided only due to cost at this point. I may start my younger one on it later in the summer when finances will be looking better.

    So far so good on my older guy though!!!



  3. #3
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    And Hilda is a cartilage biologist? A vet or MD? I know, she is a biochemist?

    I am sorry, but what she is saying is proven quite wrong in the research. Nothing can prevent or mitigate arthritis. Some things can ameliorate the condition, however. NO study has EVER shown that one can "preserve young joints." Joint degradation will begin regardless.

    Working in the orthopaedics, I have seen plenty of seminars, classes etc. and spoken with many researchers, doctors, vets and scientists who are looking for cures to arthritis and none have claimed what Hilda is claiming.

    Pentosan is a superoxide dismutase that scrubs radical oxygen.
    Adequan is PSGAG. It is a "decoy" molecule that gets incorporated into the aggrecan in the joint.

    On a older horse these can provide relief (ameliorate) but NONE on a younger horse can PREVENT degeneration.



  4. #4
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    Nothing can prevent or mitigate arthritis.
    www.svhanoverians.com

    "Simple: Breeding,Training, Riding". Wolfram Wittig.



  5. #5
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    I know some good reiners do inject these drugs into their hard ridden young futurity prospects, in a "can't hurt" way of thinking.

    Reed, since you understand the exact mechanisms of Pentosan vs Adaquan, can you expand on the differences in their interaction with joints? I am struggling with this choice on a horse with moderate, but wide ranging arthritis after multiple crashing injury wrecks.

    For hocks, I believe that there is something that can prevent arthritis from advancing beyond the first tiny radiographic indications. If you believe, as I firmly do, that hocks with straighter comformation can undergo a alot of torquing and twisting (from contraction of the Cunean Tendon wrapping around the hock joint and down to the vestigal toe, now the splint bone), then relieving this twisting pressure on the joint surfaces, at the first sign of joint pathology, will result in hocks that remain sound and powerful. Read the old archived discussion here - page 2 first: http://www.chronofhorse.com/forum/sh...ad.php?t=29839


    (Reed, I always listen to your insights, and asked a lot of questions following your discussion input of stem cells not having much effect to repair cartilege in joints due to no blood supply there. I did go ahead and have stem cells/PRP injected into my mare's arthritic stifle joint (from an old injury, not conformational stress) after 5 years of lameness, and within 4 months she went sound, and has remained sound for a year now, with 4" of increased stride length on that leg. I think understanding the role of the PRP here helped me make the $$$ decision to do this. )
    Comprehensive Equestrian Site Planning and Facility Design
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  6. #6
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    Quote Originally Posted by Plumcreek View Post

    Reed, since you understand the exact mechanisms of Pentosan vs Adaquan, can you expand on the differences in their interaction with joints? I am struggling with this choice on a horse with moderate, but wide ranging arthritis after multiple crashing injury wrecks.
    Yes, please! I have been struggling with the research on the why's and what's of Pentosan vs Adequan.
    Kanoe Godby
    www.dyrkgodby.com
    See, I was raised by wolves and am really behind the 8-ball on diplomatic issue resolution.



  7. #7
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    Quote Originally Posted by RAyers View Post
    Pentosan is a superoxide dismutase that scrubs radical oxygen.
    Adequan is PSGAG. It is a "decoy" molecule that gets incorporated into the aggrecan in the joint.
    Think you might be confusing pentosan with something else? It's not a superoxide dismutase (SOD)...it's a is heparin-like, semi-synthetic polysaccharide-ester. It's derived from beechwood hemicellulose I believe.



  8. #8
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    I am a firm believer that Adequan and Cosequin are magic. I purchased one of my horses as a green 4 year old and put him on daily Cosequin and Adequan every two months. I evented him for 8 years(Novice and Training), fox hunted for 2 years, and rode about 6 days a week. He did a substantial amount of work. I recently sold him and the buyer had a vet check done. The vet said he had the joints of a 4 year old still(he is 12).

    Now, this is just my experience with it. I don't have any science to back it up. But all of my horses are on Adequan and Cosequin. I do notice a significant decrease in stiffness in the older horses as well as the young ones. To my mind, I consider it money well spent.



  9. #9
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    Omega 3 is also thought to play a roll in preserving joints, at least that's what was reported at Texas A & M and IIRC Mc Ilwraight commented along those lines in one of his articles too.

    http://www.ker.com/library/PopularPr...s-08-03-31.pdf (bottom left pg2)



  10. #10
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    I believe Reed to be correct.

    I attended a short talk by a vet. this last weekend on suppliments. In the main, the suppliments sold in the U.S. (and most escpecially those sold "over the counter") can make two claims that are scientifically proven:

    1. Their sale makes the company richer.

    2. Their purchase makes the buyer poorer.

    All other claims are scientifically bogus.

    Cosequin and Adequan were discussed speficially.

    Medications taken orally must pass through the walls of the gut. Long chain molecules do not do this well. Cosequin ASU (and straight Cosequin) have been demonstrated in double blind clinical studies to provide some relief for horses with joint dysfunction. The precise mechanism is unknown, because the active ingredients are long chain molecules. There is a clearly defineable clinical benefit to Cosequin, but no clear explanation of why this benefit exists.

    Adequan is an injectable medication and, as such, avoids the problems of gut absorbsion. It also has a strong clinical track record of easing joint dysfunction and discomfort. I've personally used it on my mare with demonstrated success.

    I'm not at all familiar with Pentosan.

    Arthritis is an inflamation of the joint. It is common in athletes and old people. It develops in frequently used joints, like knees and elbows, and in less mobile joints like spines. Seems to me that the best recipe for long term joint care in horses would be an intelligent mixture of nutrition, conditioning, equitation skill, tack selection/use, and husbandry.

    G.
    Mangalarga Marchador: Uma Raça, Uma Paixão



  11. #11
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    Jul. 28, 2004
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    Rayers - Was excited to see you weighed in on the topic, but then disappointed too.

    Indeed Hilda Gurney is not a researcher but we don't have access to a scientific study of the long term benefits of joint supplements/injections over the lifetime of a prospect who ultimately becomes a grand prix horse. I was just impressed by the results in her personal exerience (which she just reiterated in this months Dressage Today).

    If I understand you correctly, you are saying that if two identical horses live in two parallel universes with the only variable that one gets cosequin every day and bi-annual loading doses of Adequan starting at age four, while the other gets no such "support," that on their birthday at age 13 the two horses will have the exact same radiographs, same stiffness and same soundness issues (if any). Is that correct?

    I have imagined that these joint supplements/injections help the way adding oil to an engine helps. If the engine already has enough oil, extra oil doesn't help, but if the engine is low on oil, extra oil helps by acting as a lubricant which reduces friction, which thus reduces wear and tear on the engine. If you start adding oil after the engine has been running dry, you are not going to fix the damage that's been done. If you add oil before its needed, you may waste some oil, but it will be there the day its needed, and the damage will be prevented.

    Is this whimsical thinking?

    Also on a different angle, I read in this month's Dressage Connection where the DVM Eleanor Kellon mentions there a few studies which have demonstrated that certain joint supplements do have "protective" effects on cartilage.

    Thanks everyone for your input!



  12. #12
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    Quote Originally Posted by RAyers View Post
    And Hilda is a cartilage biologist? A vet or MD? I know, she is a biochemist?

    I am sorry, but what she is saying is proven quite wrong in the research. Nothing can prevent or mitigate arthritis. Some things can ameliorate the condition, however. NO study has EVER shown that one can "preserve young joints." Joint degradation will begin regardless.

    Working in the orthopaedics, I have seen plenty of seminars, classes etc. and spoken with many researchers, doctors, vets and scientists who are looking for cures to arthritis and none have claimed what Hilda is claiming.

    Pentosan is a superoxide dismutase that scrubs radical oxygen.
    Adequan is PSGAG. It is a "decoy" molecule that gets incorporated into the aggrecan in the joint.

    On a older horse these can provide relief (ameliorate) but NONE on a younger horse can PREVENT degeneration.
    AMEN! The ONLY things that will "preserve young joints," or indeed any, are proper conditioning via long, slow distance over a period of years, and a judiciously progressive program that takes conformation and behavior into account and includes proper warm-up and cool-down as well as sufficient turnout.

    There is no pill, potion, supplement or injection that is a substitute for PROPER TRAINING.



  13. #13
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    Well let's hope the salamander will be able to help us find that magic potion SOON :
    http://www.thehorse.com/ViewArticle.aspx?ID=20057

    "Interestingly, however, joint cartilage in young foals appears to have greater capacity for repairs. Early in life the tissue is growing rapidly and structurally remodeling in response to the biomechanical forces of movement.
    Unfortunately, when these processes are complete, any enhanced repair potential is lost," he said. Therefore, research studies focused on synovial joint and development and maturation can help identify new therapeutic strategies for cartilage repair.
    Any ideas at what age they are referring to, I take it yearlings .



  14. #14
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    mentions there a few studies which have demonstrated that certain joint supplements do have "protective" effects on cartilage.
    there are. There are also some studies showing that certain joint supplements and treatments actually do seem to induce cartilage to repair itself.

    No one has yet done the "real" required study, that of giving the supplement to many horses vs. a group without them, and following them for 25 years, because that would require following them for 25 years.

    Since the only downside to giving these things is cost, I'd certainly go ahead and give them, in case they work, if I could afford it.

    arthritis seems to be a complex issue- a predisposition to developing arthritis appears to be inherited separately from poor conformation, so don't breed the mare who gets creaky at a young age. Also of course poor conformation predisposes to injury to the joint= arthritis, and of course injury to the joint= arthritis.


    From the proposed mechanisms of action, and available studies, I would think Pentosan in particular would provide a protective effect against the development of arthritis.

    Pentosan info:

    Semin Arthritis Rheum. 1999 Feb;28(4):211-67.

    The pathobiology of osteoarthritis and the rationale for the use of pentosan polysulfate for its treatment.

    Ghosh P.


    Source

    Department of Surgery, University of Sydney, The Institute of Bone and Joint Research, Royal North Shore Hospital of Sydney, St Leonards, NSW, Australia. pghosh@mail.usid.edu.au


    Abstract

    OBJECTIVES:

    Structure-modifying osteoarthritis (OA) drugs (SMOADs) may be defined as agents that reverse, retard, or stabilize the underlying pathology of OA, thereby providing symptomatic relief in the long-term. The objective of this review was to evaluate the literature on sodium pentosan polysulfate (NaPPS) and calcium pentosan polysulfate (CaPPS), with respect to the pathobiology of OA to ascertain whether these agents should be classified as SMOADs.

    METHODS:

    Published studies on NaPPS and CaPPS were selected on the basis of their relevance to the known pathobiology of OA, which also was reviewed.

    RESULTS:

    Both NaPPS and CaPPS exhibit a wide range of pharmacological activities. Of significance was the ability of these agents to support chondrocyte anabolic activities and attenuate catabolic events responsible for loss of components of the cartilage extracellular matrix in OA joints. Although some of the anti-catabolic activities may be mediated through direct enzyme inhibition, NaPPS and CaPPS also have been shown to enter chondrocytes and bind to promoter proteins and alter gene expression of matrix metalloproteinases and possibly other mediators. In rat models of arthritis, NaPPS and CaPPS reduced joint swelling and inflammatory mediator levels in pouch fluids. Moreover, synoviocyte biosynthesis of high-molecular-weight hyaluronan, which is diminished in OA, was normalized when these cells were incubated with NaPPS and CaPPS or after intraarticular injection of NaPPS into arthritic joints. In rabbit, canine, and ovine models of OA, NaPPS and CaPPS preserved cartilage integrity, proteoglycan synthesis, and reduced matrix metalloproteinase activity. NaPPS and CaPPS stimulated the release of tissue plasminogen activator (t-PA), superoxide dismutase, and lipases from vascular endothelium while concomitantly decreasing plasma levels of the endogenous plasminogen activator inhibitor PAI-1. The net thrombolytic and lipolytic effects exhibited by NaPPS and CaPPS may serve to improve blood flow through subchondral capillaries of OA joints and improve bone cell nutrition. In geriatric OA dogs, NaPPS and CaPPS reduced symptoms, as well as normalized their thrombolytic status, threshold for platelet activation, and plasma triglyceride levels. These hematologic parameters were shown to be abnormal in OA animals before drug treatment. Similar outcomes were observed in OA patients when CaPPS or NaPPS were given orally or parenterally in both open and double-blind trials.

    CONCLUSIONS:

    The data presented in this review support the contention that NaPPS and CaPPS should be classified as SMOADs. However, additional long-term clinical studies employing methods of assessing joint structural changes will be needed to confirm this view.



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