The clinic I am using apparently does not compound Pentosan. Their onsite pharmacy is an accredited compounding pharmacy so I am a little baffled at this. She would prescribe PentAussie. I did not get into a discussion with her as to why, because I was just texting her. I ended up getting Pentosan from Horse Prerace, which honestly I am not entirely comfortable with. But I am not sure what my other options are at the moment; PentAussie is a lot more expensive and as I understand a weaker dose.
As I undertand it there is really only one source for pentosan polysulfate sodium - a German pharmaceutical company. It was first made in 1947, so it is no longer under patent but the process for extracting/synthesizing it is complex. Compounding pharmacies probably have differing purchasing relationships by which they can offer pentosan, PentAussie or something else.
I may be wrong here, not being well versed in legal matters, but pentosan isnāt approved by the FDA for use in treating horses or dogs, right? which is one reason why some vets may be reluctant to prescribe it. But since itās not approved, and itās not illegal for any reason, there is no reason why it canāt be sold in the US without a prescription. In fact, itās rather odd that these pharmacies require a prescription for it. Or maybe itās illegal to sell it at all because itās not approved? the FDA has a little ranting page about unapproved animal medicines being sold, but it doesnāt say outright they are illegal.
My 19yo schoolmaster came to me with a history of stifle issues. I started him on an oral supplement and had his hocks and his left stifle injected. For a year, he was āserviceablyā sound. During that year, we also did the Adequan and Legend thing. Over this past winter, he needed more injections which did not improve his soundness. I thought it was going to be time to retire him permanently.
Because retirement wouldnāt really work well for this horse, we decided to try him on Pentosan. I did a 6.5ml shot of 250mg/ml (I think) pentosan once every 5 days for a month. Within 2 weeks, I had a sound horse! During that time, he was also on bute to try to reduce the inflammation in his joints.
He has now been off bute for a month or more. He was sound until last Friday when he was just āserviceablyā sound. He was a few days out from being due for his once a month Pentosan shot. So, I gave him his pentosan. I rode last night and he was getting better!
Mocha did so well on it that I started my 12 yo dog on it for his spondylosis of the spine. He was starting to show improvement too (alas, he blew his one good knee out in spectacular fashion and had to be put to sleep two weeks ago so I canāt tell if it would have continued to be helpful)
It isnāt approved for horses and dogs in the US, but it is approved for horses in Australia and (in oral form) for humans in the US. Both by prescription.
Two separate issues there: prescription vs. OTC and approved or non-approved. It is entirely OK to use drugs off-label by a veterinarianās order, if the drug is approved in any form and otherwise available. I also am not very well-versed on all the legal subtleties, but there is nothing inherently āillegalā about prescribing pentosan the drug. The compounding vs. ābrand nameā issue is separate.
for human drugs/medications, the FDA goes after the manufacturer/marketer of the unapproved drugs and hits them with hefty fines and stops them from selling the drug- because itās illegal. See some here: http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/SelectedEnforcementActionsonUnapprovedDrugs/ucm238675.htm
but for animal drugs, all they say is this:
http://www.fda.gov/AnimalVeterinary/GuidanceComplianceEnforcement/ComplianceEnforcement/UnapprovedAnimalDrugs/default.htm
note they do use the āillegalā term: animal drugs illegally marketed in the United States that have not been approved by the Food and Drug Administration (FDA).
But Pentosan is FDA approved in the US . . .
good article on pentosan, including historical use outside US and discussion of risks
Nice article. Wish the author didnāt constantly (mis)use the term āthrombolyticā when āthromboticā or āantithromboticā were more correct. But thatās a total clotting weenie nerd quibble. 
Also wish heād been a LOT more generous with citations in the form of a real bibliography. Still a good bit of infoāthanks. 
[QUOTE=Discobold;6961062]
Maybe Iām overly suspicious, but has anyone else noticed that horsecatcher joined the forum the same day davistina67 was banned?[/QUOTE]
I logged in specifically to ālikeā your postā¦ :rolleyes:
can you replace Legend with Pentosan? I dont see much difference in my OTTB with the Legend and its expensiveā¦
We were using it more as a preventative as he raced quite a bitā¦ would pentosan be a good substitute?
Iām new here and I just found this thread. It has some awesome informationā¦thank you so much.
My event mare has acute osteoarthritis as the result of an old injury (before I got her) in her left front fetlock. It was first diagnosed in 2008 and she has been on Legend since then. She had the joint injected immediately after the initial diagnosis and then we did the loading dose for Legend (1) 4ml shot 1/week for 3 weeks. Since then she has been on one shot every 8 weeks. This course of treatment was effective up until about a year or so ago. At that time, I started noticing that she seemed to be āoffā more and more in that left joint. So I (at the vetās suggestion) started giving her the Legend shots once every 6 weeks and then once every 4 weeks but it hasnāt helped. In January, the vet injected the joint again (2nd time in 4.5 yrs). This seemed to help for about a month, and then it was back to the same.
Iāve talked to my vet about other options, but he is very hesitant to take her off the Legendā¦he prefers it for arthritis in the fetlocks and back and thinks that Adequan is more effective for the knees, hocks, and stifles. He prefers Polyglycan as a surgical lavage only and wonāt write Rxs for that.
In February, I had someone recommend that I look into the Pentosan (Iād never heard of it), so I started researching it and have been for the past few months. I really liked what I found out about itā¦seemed to have very good results and very little side effects and risks. So, I talked to my vet about it and he will not prescribe itā¦not even the PentAussie available here in the states.
My mare is 13 and has no other issues, so I am very hesitant to āretireā her now:(. I feel like there has to be something else that can be done to treat this. She is also on an oral joint supplement, MSM, and has equipak and aluminum shoes on the front. So, I decided to order the Pentosan anyway. I got it straight from Australia from horsemedsonline.com. If it works, I will probably try a new vet that is willing to prescribe it for my mare as I would be more comfortable doing that. It arrived a lot faster than they said it would (in 10 days vs 30 days they said). So Iāll start her on it in June as I had just given her the last Legend shot I had last week thinking it would take 30 days for the Pentosan to arrive. I have my fingers and toes crossed and will say many prayers that it will have the same results for her as it ahs for so many others:).
[QUOTE=myhorsesibylla;6987096]
Iām new here and I just found this thread. It has some awesome informationā¦thank you so much.
My event mare has acute osteoarthritis as the result of an old injury (before I got her) in her left front fetlock. It was first diagnosed in 2008 and she has been on Legend since then. She had the joint injected immediately after the initial diagnosis and then we did the loading dose for Legend (1) 4ml shot 1/week for 3 weeks. Since then she has been on one shot every 8 weeks. This course of treatment was effective up until about a year or so ago. At that time, I started noticing that she seemed to be āoffā more and more in that left joint. So I (at the vetās suggestion) started giving her the Legend shots once every 6 weeks and then once every 4 weeks but it hasnāt helped. In January, the vet injected the joint again (2nd time in 4.5 yrs). This seemed to help for about a month, and then it was back to the same.
Iāve talked to my vet about other options, but he is very hesitant to take her off the Legendā¦he prefers it for arthritis in the fetlocks and back and thinks that Adequan is more effective for the knees, hocks, and stifles. He prefers Polyglycan as a surgical lavage only and wonāt write Rxs for that.
In February, I had someone recommend that I look into the Pentosan (Iād never heard of it), so I started researching it and have been for the past few months. I really liked what I found out about itā¦seemed to have very good results and very little side effects and risks. So, I talked to my vet about it and he will not prescribe itā¦not even the PentAussie available here in the states.
My mare is 13 and has no other issues, so I am very hesitant to āretireā her now:(. I feel like there has to be something else that can be done to treat this. She is also on an oral joint supplement, MSM, and has equipak and aluminum shoes on the front. So, I decided to order the Pentosan anyway. I got it straight from Australia from horsemedsonline.com. If it works, I will probably try a new vet that is willing to prescribe it for my mare as I would be more comfortable doing that. It arrived a lot faster than they said it would (in 10 days vs 30 days they said). So Iāll start her on it in June as I had just given her the last Legend shot I had last week thinking it would take 30 days for the Pentosan to arrive. I have my fingers and toes crossed and will say many prayers that it will have the same results for her as it ahs for so many others:).[/QUOTE]
Did the Pentosan vial have the NatureVet label on it, or a generic label on it?
I was just a bit suspicious of that website, so wonderingā¦
It is a heck of a lot more expensive than the compounded Pentosan, but if itās directly from NatureVet, I would be more inclined to get that than compounded.
[QUOTE=NorCalDressage;6987113]
Did the Pentosan vial have the NatureVet label on it, or a generic label on it?
I was just a bit suspicious of that website, so wonderingā¦
It is a heck of a lot more expensive than the compounded Pentosan, but if itās directly from NatureVet, I would be more inclined to get that than compounded.[/QUOTE]
Yep! It has the Nature Vet (Ceva brand) on the label and the little NV with the kangaroo logo too! It wasnāt too, too bad price wise, but shipping was $50 so that stung a little.
The Horse Prerace had it cheaper with much cheaper shipping, but thatās the website that gave me a bad vibe. I read several not so great reviews about it tooā¦people not receiving what they ordered or the orders were incorrect, and they couldnāt get anyone to return their calls or emails. A couple of people even said the phone number was disconnected when they called. Thatās why I ended up going with horsemedsonline. Thus far Iām pretty happyā¦got exactly what I ordered and its indeed the name brand (Nature Vet) and got it much faster than expected.
Iāll give an update as to how she does on it! Fingers, toes, eyesā¦all crossed
So my vet tells me that Pentosan was removed from the FDA approved list this week. What RX are you using if you are having success?
[QUOTE=ultimateshowmom;6987620]
So my vet tells me that Pentosan was removed from the FDA approved list this week. [/QUOTE]
What does this mean? Can it still be prescribed? My vet was here this week, and just ordered Pentosan for me (well, technically for my horse!), supposed to be drop shipped direct to me. No mention of any issue.
[QUOTE=ultimateshowmom;6987620]
So my vet tells me that Pentosan was removed from the FDA approved list this week. What RX are you using if you are having success?[/QUOTE]
Nothing on the FDA website mentions this. For a drug to have FDA approval revoked would be a colossal thing.
When I went to horsemedsonline.com and looked at the pentosan page, there was a very informative video with Australian vets and included a āhow it worksā section. Iāve been considering this for my senior gelding and just may give it a try if my vet will write a scrip for the compounded formula or if not, order from this website.
Pentosan isnāt FDA approved in the US I thought? Pentaussie is FDA approved as a surgical lavage but it is not the same drug as Pentosan because of the added acetyl d glucosamine. Your vet may be misinformed?
Pentosan isnāt FDA approved in the US I thought?
Yes it is, in oral form for human use for a disorder called interstitial cystitis. This allows (as with MANY other drugs) the off-label use of the drug, even in another form and in another species, by a licensed practitioner.
Using ājoint lavageā products as injectible drugs is a similar off-label use, or (depending on your view) another way to dodge the strict FDA approval process for bringing a new drug to the state of approval.
