Joint maintenance, supplements, or injections?

[4horses]

My mares are both in their late teens. One mare has pretty noticeable cow hocks and I’m definitely noticing some clicking in her joints when she walks. Given her age I would like to start her on something as a preventative. My vet suggested I get her a lameness exam before they would recommend anything but I don’t really want to pay that. She’s not lame- no head bobbing. She’s not jumping or doing anything super strenuous. I was hoping to try maybe pentosan injections? I know we could x ray/inject individual joints but why not treat the whole horse, rather than focusing on a specific joint?

Any thoughts on injectables vs supplements?

[JB]

Cow hocks are quite rare in horses. Do you mean she toes out behind, more than normal, or that she’s sickle-hocked?

Preventive joint things don’t have any research to show they can help prevent arthritis, unfortunately, it’s just too many moving parts.

There’s nothing wrong with using an IM drug, whether Pentosan or Adequan. Those do support healthy joint spaces.

If I were to go the route of a supplement, especially preventive, I would go with ActiFlex 4000. It’s got nice levels of ingredients with reasonable research behind them, at those amounts, and it’s not a bank-breaker.

I would definitely not inject joints on a sound horse

[LovieBird]

Might be worth an exam even if she isn’t overtly lame. If $ is a concern, as it is for most of us, maybe you could do Adequan im. I’m not sure I would waste money on supplements, to honest. The joint supplements can be really expensive. Having said this, I do have both of mine on MSM because it’s dirt cheap. I’m not sure if it really does much, but it can’t hurt and it’s only $10 a month.

[beau159]

@4horses

My mares are both in their late teens. One mare has pretty noticeable cow hocks and I’m definitely noticing some clicking in her joints when she walks. Given her age I would like to start her on something as a preventative. My vet suggested I get her a lameness exam before they would recommend anything but I don’t really want to pay that. She’s not lame- no head bobbing. She’s not jumping or doing anything super strenuous. I was hoping to try maybe pentosan injections? I know we could x ray/inject individual joints but why not treat the whole horse, rather than focusing on a specific joint?

Any thoughts on injectables vs supplements?

Please have a lameness eval with your horse with a good performance vet. It seems ridiculous to me that people will waste money on supplements that may or may not help their horse b/c they don’t have a clue on WHERE their horse needs the help.

A good lameness vet will find something. Always. Then it’s up to the two of you to decide if the findings are clinical (affecting the horse) or not.

Remember that lameness doesn’t mean the horse is walking around head bobbing. It just means they have aches and pains somewhere.

For example, if your vet uncovers that your horse has fusing hocks (hypothetical here), then your best bet might be to do Adquan or Equioxx or a combination. Because you know what the potential problem is and can be better focused to treat it.

I would absolutely choose an injectable (adequan, pentosan, summit, legend, etc) over a feed through when talking about a joint supplement.

I have one horse with issues where pentosan every 2 weeks (after a loading dose) has been an absolute miracle. I have another horse that I don’t think it helped him at all. So remember that all horses are individuals and what works for one may not work for another.

so before you waste your money on buying a treatment, find out what you need to treat. Go get the lameness eval.

[TWH_Girl]

Adequan and Pentosan are both Rx only and a vet would probably want to evaluate first anyhow before prescribing. Summit and Movex are injectable CS that doesn’t require a Rx if that is an option you’re comfortable with. Research aside, oral joint supplements probably won’t do much to help a late teenage horse but there are plenty out there to try! Take your pick. I’ve usually looked for one that’s had 10,000 glucosamine, 1200 CS, HA, MSM and maybe a few other anti inflammatory ingredients like bosweilla, devils claw or yucca.

[Pico_Banana]

I don’t disagree with anything said above, but if you are considering a supplement, my old vet swore by Phycox granules. I have my 28 year old horse on it and I do think it helps her be more comfortable.

[JB]

I don’t see a need for a lameness exam for an older horse, who is sound or “sound” for the work being done, who will almost by default “fail” the exam. What then? Xray joints to see where the arthritis is? How far does someone “have” to go in order to do something that may well help the overall horse?

A vet should have noooooo problem Rxing Adequan or Pentosan for an owner who just wants to use it, especially for an older horse. No arthritis? No harm. Got some inevitable arthritis in the hocks? It won’t hurt and sure might help, especially since it will impact the whole body as well, where there are undoubtedly some other age-related creaks.

[candyappy]

A basic lameness exam with a few x-rays will be better in the long run than just randomly injecting or using a supplement?

Your vet may see something you need to target or that may be an issue in the future.

That is just me.

[SpicyPRE]

Any invasive procedure, ie. joint injection, needs to have a diagnosis or the vet is at risk for malpractice. Have you tried any oral supplements or Adequan/Legend?

[JB]

@candyappy

A basic lameness exam with a few x-rays will be better in the long run than just randomly injecting or using a supplement?

The most likely thing you’d find on an older horse is hock arthritis. The only question is - how bad does it look. Does it matter how good or bad it looks if the horse is serviceably sound? To me it doesn’t. The nice thing about those IM injections is they impact more of the body than most anyone is willing to xray. And, aside from injection site reactions (very uncommon), what’s the harm?

@candyappy

Your vet may see something you need to target or that may be an issue in the future.

I’d guarantee there would be something seen in an older horse. The hocks may look terrible - does that matter for the serviceably sound horse? How far should someone xray looking for that One Thing that is most likely the cause of some minor unsoundness?

@SpicyPRE

Any invasive procedure, ie. joint injection, needs to have a diagnosis or the vet is at risk for malpractice.

It doesn’t, and they aren’t. A client can absolutely say “Hey vet, I really want to have the hocks injected”. Plennnnnnty of owners do that, without any reason other then prevention, there’s no need for an actual diagnosis of arthritis, or sketchy joint fluid. I WOULD make sure there are xrays before doing it, because if you find out your sound horse has (nearly) fused hock joints, there’s no point in injecting, and you couldn’t anyway, there’s no joint space. But most of the time there will be space.

My vet has had no problem Rxing Adequan for me to use on my WB when he was 11-12-ish with an undiagnosed RH lameness. She said “you could start doing xrays of both hocks, and you might see some weirdness, but that doesn’t mean they are the problem. You could xray the stifles, and you might see weirdness, but that doesn’t mean that’s the problem, especially since you can’t flex hocks without stifles involved. You’d have to take him to NCSU to start looking higher up in his hip. OR, you can do a course of Adequan, which will impact more than just those parts, and if you see improvement, who cares what the cause was.” No diagnosis, and how does that equate to malpractice?

I’m ALL for judicious use of xrays to try to narrow down the source of an unsoundness. I’m all for flex tests, blocking, narrowing down where you want to start xraying, but none of that is required to want to do a course of Adequan/Pentosan, or a joint supplement with reasonable ingredients at reasonable amounts to see if they work after a few months.

Digging into xrays of a serviceably sound, older horse, is hunting for a reason to use a solution for a “problem” that might not even be a problem.

[SpicyPRE]

@JB

It doesn’t, and they aren’t.

I will first say that I am not a vet, however, any invasive procedure has the risk of infection. And as such a vet could possibly need to defend him/herself as to why the injection was performed. In my area a vet got into a lot of trouble for doing injections with no diagnosis.

[JB]

@SpicyPRE

In my area a vet got into a lot of trouble for doing injections with no diagnosis.

Way more info is needed. The vet saying “we should inject” without a reason, and the client simply agreeing, is a very different situation from a client saying “I want to make sure Fluffy’s hocks are in prime shape, I want to inject” and the vet says “We don’t know there’s any arthritis or anything to actually help, here are the risks of any joint injection, are you ok with that?” and client says “Yep, still want to”.

[Amy3996]

@TWH_Girl

Summit and Movex are injectable CS that doesn’t require a Rx if that is an option you’re comfortable with.

Summit does not belong in the same conversation as Adequan and Legend. It’s a sketchily-manufactured product being sold over the counter as part of a multi-level marketing scheme. It’s supposedly Chondroitin Sulfate, but there’s no regulation and no guarantee that the contents of those vials are safe or legitimate.

Adequan and Legend are prescription medications dispensed under supervision of a licensed veterinarian.

[RedHorses]

If you want to try an oral supplement the advice I got (from the vet) was to pick one, double dose for two weeks, and if I didn’t see any difference to pick a different one.

That was for the second red horse, some twenty years ago. I read up and at the time the combination of 10,000mg of glucosamine and 10,000mg of MSM was the ideal. I read all the labels on all the supplements in all the local tack shops, chose one and felt that my horse was more comfortable. It was most noticeable during his farrier visits, and his farrier commented on the difference.

Then the package label changed, the product looked and smelled different despite the content being unchanged (according to the label ) and I noticed a change in my horse. I did a lot more reading, chose a different product and noticed a difference in three days. I did wonder if I was imagining things, but he kept getting better and better for a couple of weeks.

When my super horse reached his teens I decided to try him on glucosamine (he’d been on MSM for years) and see if I noticed anything. I picked one, added it to his supplement tubs, and kind of forgot about it. About ten days later I was wondering why he was feeling ready to trot after 5-6 minutes of walk work instead of the usual 10-12 minutes. It took me another couple of days to realize it had to be the glucosamine.

Not every supplement will work the same on every horse. I have a theory that part of that difference in effect is due to the horse’s individual issues. If it’s helping, and you’re paying attention, you’re going to notice a difference.

[TWH_Girl]

Offering options. Not everyone has to agree or like them. I’ve used all of these products and Summit and Movex have worked great. To each their own.

[Obsidian_Fire]

In an older horse already showing signs of issues, ‘preventative’ only means hopefully preventing it from getting worse, whatever ‘it’ is.
That said, I would go with Adequan, Pentosan, over anything else. As to whether or not your vet will prescribe for you without seeing the horse first, that depends on your relationship with them, and when the last time they saw your horse, etc. Vets risk their license by rx’ing for an animal they don’t know, haven’t seen, off label, things like that. Some vets are more risk-averse than others.
When was the last time your vet saw this horse for any exam? How much of a client are you? - meaning does this vet see you for other things on a regular enough basis?
Feed-through, things like the Gut-X products (Joint-X) with high levels of HA seem to make a difference. I’ve seen Devils Claw Plus work too. It all depends on the animal.

[JB]

Re: Summit - I have no problem with an injectable Chondroitin 4 Sulfate, which is what that is. It’s been done before in research trials.

I do think everyone has the right to know there is no FDA approval for a drug (not a supplement like they claim) that you’re injecting into muscle tissue. Is that C4S truly free of BSE (causes mad cow disease)? Is the facility they use to make it actually producing sterile product? Of course they’re not going be so slack that they’re regularly producing stuff that causes reactions all over the place. But with Adequan, you have recourse with the company if there are issues. No such thing with Summit.

It’s up to “you” to decide if you want that risk.

[TWH_Girl]

Agreed JB.

[candyappy]

@SpicyPRE

I will first say that I am not a vet, however, any invasive procedure has the risk of infection. And as such a vet could possibly need to defend him/herself as to why the injection was performed. In my area a vet got into a lot of trouble for doing injections with no diagnosis.

While I am not experienced with having my horses injected, I commented to have the vet out first because ( honestly) injecting the joints on a healthy , sound horse just seems wrong to me.

As you say above^^^ is that something a good vet would do on just the whim of the owner without first seeing the need?

[JB]

@candyappy

is that something a good vet would do on just the whim of the owner without first seeing the need?

How do you define “good” here? There are many, many horses who are injected annually with “because they’re showing” as the only “need”