Adequan Time Frame - UPDATE: stifle wisdom?

[hybriseris]

My lease mare had a full lameness workup a little over a week ago. She is a low mileage 17 year old who was starting to feel short-strided behind and not as enthusiastic about our occasional jumping as she was when I started leasing her two years ago. Conclusion by the vet after palpating, flexions, watching me lunge and then ride her, and several x-rays of both hocks, is mild OA in right hock causing an abnormal movement pattern that may have stressed the SI as well. She discussed lots of options with us, but recommended starting with Adequan, continuing the bodywork I already have done on her, and a rehab program to strengthen her hindquarters up and support her joints. If you look at her now she’s beautifully muscled for her age with a teeny booty that doesn’t seem to be developing with the rest of her yet. Specific joint injections would be a next step if Adequan doesn’t seem to be the answer for her, but the thinking was as it seems like it may be mild in several areas it may be a better first option.

If you’ve read any of my other threads I am a nervous nelly and would like to have some idea of when I might feel an improvement in her comfort. I gave her her first dose today but am curious about other’s experiences. Third dose? Fifth? Didn’t notice much change until the entire series was done? Hoping with some other’s experienced input I might be more relaxed about taking her gradual improvement in stride. Thanks!

[EmilyM]

How are you doing the Adequan. I’ve had various recommendations from different vets:
4 shots one week apart then monthly thereafter
7 shots one week apart done. Wait 3 months, repeat
Every 4 days for (I forget how many) and then monthly

I do method 1. And i honestly don’t know how ling it takes. I do preventative. Personally I find results w legend that I can feel. Similar protocol. I use both.

Hope that helps some

[hybriseris]

One injection every four days for seven injections. I know there is lots of debate about whether a once a month injection is useful after that but for now, vet is recommending doing the injection series every six months only.

I do know for some horses it just doesn’t seem to be effective and I’m prepared for that too. But I’m at least a little hopeful. When my ancient Golden Retriever was with me, Adequan changed her whole life for a few years at the end.

[EmilyM]

I noticed a big difference for my dog too. I think it really is individual. I hope it helps!!

[Dutchmare433]

For some of them I swear I feel improvement after shot 4-5 but some not til after the last one.

[Fiesta01]

[quote=“hybriseris, post:3, topic:762490”]
One injection every four days for seven injections. I know there is lots of debate about whether a once a month injection is useful after that but for now, vet is recommending doing the injection series every six months only.
[/quote

I believe this is now the manufacturer’s suggested dosing. My gelding was on it for years, once a week. Then about 8 or 9 years ago, my vet said the dosing recommendations had changed to your suggestion. Worked wonderfully for him. He was totally sound despite quite a bit of arthritis in his hocks until I lost him at 38.

[hybriseris]

That’s fantastic to hear. Did you notice improvement over the series of shots, or did it take all 7 before you noticed his comfort level was improved each time?

[EventingMaff]

I have a young mare that was showing discomfort behind. Vet work up found extremely mild changes in her hocks. Vet suggested combination of Adequan + 60 days Equioxx.

We followed the same regime as you, I didn’t notice any difference. A week or two after finishing the Adequan regime we put shoes on her (all around) and I left the country for 3 weeks. I’d scheduled a follow up for while I was gone because I hadn’t noticed any improvement – vet came out the last week I was away and couldn’t find a thing wrong with her. All of the resistance, soreness, etc that had been there was gone.

Hard to determine if the Adequan / Equioxx kicked in, shoes made an improvement, or time off helped (hadn’t in the past)…or most likely some combo of all three. She’s now doing great and is fully back in work happily.

But when I was asking around waiting for results to kick in after starting, I was told that the Adequan can take some time even after finishing the loading dose to have effect.

[hybriseris]

Very interesting! She has been on Equioxx and we’re going to continue that, and vet suggested shortening her current six week shoeing schedule to five as she’s a bit of a special case and keeping a closer eye on her growth might help. So somewhat the same in our case.

Wish we had a magic button to figure it all out because in my lease mare’s case, the Equioxx makes a very noticeable difference in about five days so I would have assumed to see the same in yours and yet it seemed to take some combination and time.

Guess what I’m learning is, like most things in horses…it all depends.

[JB]

The labeled dosing, as in what has been studied to have optimal effect, is 1 injection every 4 days for 7 injections.

IME, improvements start showing up around dose 4, maybe 5, IF you have lightened the workload appropriately to allow the inflammatory pain issue to die down. My vet has always told me if you don’t notice anything at all by 5, it’s unlikely you’re going to see anything at all. But I’m sure there are outliers. But it does take all 7 to get the full effect,

Every other maintenance protocol is based entirely on what seems to work for a given

[hybriseris]

This is great info, thank you. We have significantly cut back on work in general in the two weeks prior to the lameness exam because she just wasn’t enjoying herself. We are now mostly walk/trotting with a little polework once or twice a week until we see whether the Adequan helps.

[cayuse]

I’ve only used it on three, one horse and one pony and one mini. Horse had slight improvement after 3/4 doses with no further improvement going forward. Pony responded pretty much the same. However, the mini responded after 2 doses and was a new little man by the end of the treatment . Hope this helps.

[scrbear11]

I had a conversation with my vet about Adequan dosing this morning!

She recommends the loading dose every six months at the minimum. She personally only gives a repeat dose two days before she shows. The “recommended” maintenance of once a month has proven to be ineffective since Adequan is only in the joint for a maximum of 96 hours, with a peak at 36/48 hours.

I personally give it weekly, doing a loading does every six months. My horse does not get any oral joint supplements either (none are effective).

I do think by treatment number four I felt a difference when doing the loading.

[WildGooseChase]

My Mom’s AQHA pleasure gelding who is about the same age, is on it. They did 1 injection a week for 4 weeks and then once a month. I don’t feel like it does anything. The vet has told us he has another 18-24 months on his knees before he his arthritis isn’t manageable. She had his knees injected this spring and saw a difference in 10 days.

[JB]

@scrbear11

She recommends the loading dose every six weeks at the minimum.

I would really like to understand her thought process (ie the science) behind this. $300+ every 6 weeks? Just inject the joint at that point

@scrbear11

Adequan is only in the joint for a maximum of 96 hours, with a peak at 36/48 hours.

That isn’t what the study showed. They only collected samples up to 96 hours post injection:

Scintillation analysis of serum and synovial fluid, collected from both middle carpal joints at specific predetermined times up to 96 hours post-injection, revealed mean 3H-PSGAG concentrations peaked at 2 hours post-injection. 3H-PSGAG was detected in cartilage and subchondral bone 96 hours post-injection in samples from all eight horses.

HA assay of synovial fluid revealed concentrations significantly increased at 24, 48, and 96 hours post-injection in both joints. The concentration nearly doubled 48 hours post-injection.

In vivo kinetic study on uptake and distribution of intramuscular tritium-labeled polysulfated glycosaminoglycan in equine body fluid compartments and articular cartilage in an osteochondrial defect model - ScienceDirect

[Posting_Trot]

My previous mare had some arthritis issues, some of which probably related to bouts with Lyme disease, so that may have made her case somewhat different than the average problems with arthritis. (Her x-rays were “unremarkable” according to one vet, and didn’t seem to show much in the way of arthritic changes in the hocks).

In her case, I tried Adequan on two separate occasions, a couple of years apart (different vets). I never saw much of an improvement from Adequan.

What worked the best for her, at least as far as I could tell, was oral supplementation of HA. Liquid or gel forms worked best.

Good luck.

[hybriseris]

This is also great info, thanks. We are in an area known for Lyme so that’s also something to keep on the list.

[Fiesta01]

I remember starting to see a difference around shot 3 and he got progressively more comfortable after that. He was on Adequan for his last 21 years and never had what I would call a soundness problem after we started it. He did dressage until 28 (backed down to 1st level by then), trail until 31, and was then a spoiled pasture puff until 38.

In his 30s, on some mornings just before his next shot series was due, he would come out of his stall a tiny bit stiff behind, but not lame. But by the time we would reach the pasture gate, he was raring to go and would take off bucking and galloping like a 2 year old, literally to the very end of his life. (He died during the day in the pasture of sudden heart failure with his herd around him).

I don’t know if all horses have this experience, but it worked great for him. Hoping you have the same good results and that you are blessed with as many wonderful years with your horse.

[Fiesta01]

@JB

I would really like to understand her thought process (ie the science) behind this. $300+ every 6 weeks? Just inject the joint at that point

I was always told that joint injections should be used judiciously since, in the long-term, they can actually damage the joint.

[scrbear11]

Edited to correct weeks to months. I meant six months.