Adequan Time Frame - UPDATE: stifle wisdom?

Whew! Ok, much better! That’s totally reasonable in a lot of cases.

Yes, make sure IA injections are really necessary. My issue was the (mistakenly, see above) use of the loading dose every 6 weeks (not months) . If someone was going to recommend that, if the horse actually needed that much Adequan, then by all means do the IA injection

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I have tried both the loading dose (per box instructions) followed by monthly and the 2 loading doses/year and I think I see better results from just doing 2 loading doses per year spaced 6 months apart. Of course YMMV but I just don’t think I see much from the monthly shot following the loading dose.

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Good to know! When doing the loading dose, when do you notice it taking effect, in your experience? Fourth dose, fifth? Or does it take all 7 before you notice a change?

I feel like I usually start seeing benefits a couple shots into the loading dose series and then I see peak improvement for the first few months afterwards, slowly tapering down, until towards the end of the 6 months I see little effect. I space it out alternatingly with hock injections, so he gets that as a “boost” right as we hit mid-way with the loading dose… so like…

September hock injections
December Adequan loading dose
March hock injections
June Adequan loading dose

Sometimes I don’t need 2 hock injections/year. Sometimes I do. That’s just a rough idea of the timing. Last year I did Legend right around when the hocks would normally be done and I didn’t need to do that round of hock injections at all. This is an older, well-maintained but plenty of miles horse with some existing hock issues that were there since foalhood. He has always been SOUND SOUND SOUND ever since I bought him at 3 years old. He had one big injury (soft tissue, front feet) that was related to undiagnosed kissing spines (back hurt and he was overweighting the front feet trying to get relief for the back), but knock on wood the hocks have been in great shape his whole life notwithstanding the issue he came to me with.

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I just did a series and didn’t notice a difference until the 5th shot. My vet recommends doing the series twice a year (every 6 months); it’s a shot every 4 days. We do not do anything monthly. On the other horse I lease and hunt, I didn’t feel much of a difference on him until the last shot; however, in total, the difference with him wasn’t as significant as the difference on my event horse.

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JB - Thanks for the clarification. I just wanted to make sure they hadn’t changed guidance on when or when not to give joint injections. :slight_smile:

Oh man, what a wonderful story, thank you! If the Adequan makes her even close to that comfortable I’d be so grateful.

Sort of using this thread as a time capsule for myself too.

Gave her the second dose today a bit before her chiropractor came. I’ve never seen her so relaxed in the two years I’ve known her, there was drool all over the aisle floor when he was done! Tight in her hips and right shoulder. He’ll come back at the beginning of September when she’ll have been finished with the full series for two weeks to adjust her again.

Chiropractor is a vet and had nothing but good things to say about Adequan so, expectations managed but fingers crossed. Going to stick to walk/trot work with some poles mixed in for now.

Thanks to everyone so far for your experiences!

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I think your whole approach is just perfect! Body work to help resolve issues caused by the soreness, while the soreness is being addressed, while keeping her lightly moving (motion is lotion). Good luck!

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We are a week out from the last dose with clear and obvious improvement. She’s much happier to take up contact, stretching her nose down to the ground whenever I give her the reins during a break, more forward and willing. Her overall demeanor seems to have improved too. She has never been a cuddly horse, but I’ve noticed more overt affection from her and she’s less spooky/worried about her surroundings. She’s never been hard to catch but she’s started leaving her hay bag(!) to meet me at the gate when I come to get her.

We’re still mostly doing walk/trot polework with some flat canter mixed in. Her canter seems to be a sticking point - the transition seems to make her nervous, and I have to encourage her to maintain canter all the way around the ring or she’ll break whereas she’ll trot for me all day long without encouragement. Not sure if it’s the possibility of SI involvement, or the fact that she’s not as well muscled behind/over her topline as she’d need to be yet. Also possibly ulcer-y? Vet is coming back for a follow-up so I will breeze it by her.

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My 27 y.o. gelding was on Adequan in late August-September 2020. It was the loading dose: 1 shot every four days for 28 days. The manufacturer had changed the website because that’s where I found it.

He was much better. He was sound at walk/trot. Unfortunatley he wasn’t getting adequate care from the BO (she had him for 19-1/2 years). His lameness got much worse so I pulled him out of that barn in late November. We tried another round in Decemeber and it helped but not the way it had earlier.

I retired him from riding a few weeks ago after another consult with the lameness specialist. His left carpal joint was injected with a steroid and antibiotics and he was comfortable. I’ve been on him 6 times since October 2020. We thought he might get back to light riding but that isn’t going to happen. He is a “young” 27 so I have to find ground work to keep his mind in gear and his joints moving. I’m learning how to long line. He seems to like it, and we both are worn out at about the same time.

Vet was out Wednesday for two month follow-up. I was really glad to hear she was blown away by mare’s muscle development over the last two months, and in the right places. Makes me feel like I’m doing something right!

She flexed her and watched her lunge again and agrees with me she kind of plateaued despite being a month out from the last Adequan injection. Definitely better, but not quite 100%. It was always in the cards she might need hock injections on top of/as needed in conjunction with Adequan based on x-rays taken two months ago and her visible symptoms (dragging her toes, short-strided behind, difficulty getting off the forehand). So next week we take the plunge on those. I am confident she is close to being comfortable again, and am looking forward to continued rehab work with her. If nothing else it’s allowed me to get much closer to her taking it a bit slower.

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We are now two weeks out from hock injections and the change is astounding. I think the Adequan was a good thing, especially as per the vet it’ll prolong our results from the hock injections, but I’m on a much happier horse.

Quick question for the collective minds here tho as I’m inexperienced with stifle dysfunction. What’s the difference between weakness and lameness? I notice this mare tends to slip/do the classic “falling in a hole” thing once or twice a ride, mostly if I don’t have her collected perfectly or am asking her to come more around my inside leg. She doesn’t feel lame at all, though she appears a little short strided behind when I watch back some of my video, and her right lead canter is unbalanced. That has improved since hock injections. Overall she feels so much better, but the stifle slipping concerns me.

I am also waiting for a call back from the vet, but wondering - when would you be concerned about lameness vs weakness from compensation due to hock discomfort? I am more than fine with any necessary rehab program if it’s weakness, but I guess I don’t know what I should be concerned about as pain and lameness. Thanks in advance!

Lameness can be mechanical (such as scar tissue shortening some part of the stride), or due to pain.

Weakness that is unilateral can look like lameness, but not be due to pain - they may not push off as much with one hind leg, so the stride isn’t even.

Stifle on the same side as the injected hock?

This sounds like a compensation issue from the hock, maybe the stifle is a little sore, so she doesn’t use it as much, which has made it weaker. Asking her to really engage prevents the slipping

I would keep work to walking and trotting for a while, so the hock and stifle aren’t taking full weight in the canter. I’d treat her like a UFP/locking stifle horse, and work on fitness from that angle.

@JB She had bilateral hock injections in both lower joints for “mild” arthritis diagnosed via x-ray. Arthritis was slightly worse on the left hock, stifle slip seems slightly worse on the right hind tho it’s also somewhat bilateral.

Her hindquarters are visibly less muscled than the rest of her, though over the last few months I’ve gotten them to draw even with each other and start filling out overall. Now my goal is to help her get more supple while continuing to build muscle in the right places. I can absolutely believe she is just weak there from trying to stay off her hocks but want to do right by her and rule out any further sources of pain. Thanks for your input as always!

This makes sense, as a sore LH can lead to over-compensation in the RH and make the stifle (or hock) sore, and then the LH stifle/muscles get weaker due to less use.

Not necessarily. Depo Medrol is a very effective steroid, but it can damage the joint over time. So, other steroids (e.g., triamcinolone) are often used in high motion joints that are not known to have a detrimental effect over time. Some vets will reach for Depo Medrol anyway for things like hocks, and so it’s good to know what your vet is using where and why and how often. And of course you can also use a biologic for your IA injection which should not damage the joint at all and could potentially have some healing effects (unless you have an adverse reaction or infection which can occur with any invasive procedure).

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Quick update. Vet is coming this Friday as I noticed some swelling over the left stifle starting last week, when I palpate it is warm and feels like fluid. Doesn’t seem to be bothering her any more or less than the intermittent catchy quality to her gait I’ve noticed, but I’d much prefer to see what’s going on in there now and do whatever needs doing. Bit worried it’s going to be something untreatable, but I do tend to think the sky is falling!

Vet filling in for my usual one who is on maternity leave spent a lot of time with me yesterday. Performed flexions again, watched her lunge, checked her back, and performed ultrasound on both stifles. In her opinion and on ultrasound images, the lump is thickening tissue, possibly scar tissue from an incident last year where my lease mare got her leg caught in a fence. She saw no signs of OA, or any soft tissue injury. She did mention the muscle and skin over the stifle appeared “loose” and less developed.

So the plan is still, as suggested by my usual vet and posters here, physical rehab to strengthen thr muscle over that stifle. She said if I don’t see some improvement in a month or two we can consider Estrone to help her use herself and muscle properly.

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