In my experience it really depends on the horse. My late TB did dramatically better on Legend, but I've had others where the opposite was true. Try 'em, one at a time, and pick whichever helps your horse more.
"The standard you walk by is the standard you accept."--Lt. Gen. David Morrison, Austalian Army Chief
Sodium hyaluronate has been investigated as a therapeutic since 1970. It is primarily effective in treating synovitis (inflammation of the synovial membrane). Although the exact function of sodium hyaluronate is still being elucidated, evidence suggests that it acts to help “normalize” the environment around the synovial membrane. This may be accomplished in several methods. Sodium hyaluronate may help scavenge the radical oxygen present during the inflammatory response thus acting as a mild anti-inflammatory agent. It may also prevent access of inflammatory enzymes to the cartilage by simply “taking up space”. It has also been suggested that sodium hyaluronate helps stabilize the viscosity of synovial fluid aiding in joint lubrication, although this role of sodium hyaluronate in joint lubrication is still subject to debate.
Polysulfated glycosaminoglycans act to inhibit the destructive enzymes associated with the breakdown of articular cartilage. In a sense it acts as a decoy by binding to the articular cartilage surface and sacrificing itself to spare the proteoglycans in the hyaline cartilage. In addition it may stimulate hyaluronic acid synthesis.
To summarize these two types of drugs, sodium hyaluronate is primarily an anti-inflammatory that may help stabilize the environment in and around the synovium along with stabilizing the viscosity of the synovial fluid. Adequan protects the articular cartilage (chondroprotective) from the destructive enzymes released in joint inflammation. In both instances neither drug has been shown to reverse damage incurred by hyaline cartilage. That leads us to the next generation of drugs that, in conjunction with anti-inflammatory treatments has been shown to regrow the articular surface, reversing the effects of DJD.
I used Adequan on my horses in the past and this year I am using it for my dog. My dog is young and had a leg that was broken and never set. Consequently she has arthritis in both the knee and shoulder. I started her on Canine Adequan and, contrary to a post above, my vet said it would lubricate as well as rebuild. Whatever it does it works and she will get it for the rest of her life.
"Adequan is an injectable substance known as a "polysulfated glycosaminoglycan," and is very similar to the more familiar oral supplement known as glucosamine. Adequan has been proven to be preferentially taken up by inflamed joints when injected into the dog's muscles. It soothes and lubricates the joint, naturally reducing inflammation and pain by reducing friction. Even better, instead of just masking pain as NSAIDs do, it actually helps to rebuild cartilage in the damaged joint. It's not just pain control, it's therapy."
Forty-six horses with lameness in either the carpal or fetlock joints were treated intravenously or intro-articularly with Legend Injectable Solution in a well controlled clinical field trial conducted at four locations. One, two or three injections were given based on clinical improvement.
Overall clinical improvement was judged as excellent or good in 90% of the cases treated intravenously and 96% of those treated intra-articularly with Legend Injectable Solution.
LeeB, what is the source of your quote about Adequan?
Anecdotally, I had a horse who had been "worn out" by his previous owners. You couldn't tell which leg was lame because when you blocked out one, another went off. Legend was an absolute miracle worker for this horse... it was like 5 years of hard work had just been taken off his body.
Found several pages that say Adequan helps to rebuild cartiledge:
Adequan works to fight and stop any injurious activity that may commence as a result of the inflammation. It also immobilizes the enzymes and the free radicals responsible for destroying the joint's fluids and tissues. As a complimentary function, Adequan Equine stimulates the synthesis of cartilage building compounds and stops the production of chemicals that cause pain. As such the joint function of the horse acquires improved efficiency. Adequan therefore stands out as the only product in the market that serves the functions of relieving pain while stimulating cartilage repair action.
No, what you see is clever marketing. Adequan has never been shown to rebuild hyaline cartilage. It has been shown to diminish the degradation of hyaline cartilage and to maintain joint spaces. Yes, in cell and tissue culture it has been shown to increase compound synthesis but that does not mimic the living mechanically loaded environment. It can not be directly related back to what happens to joints in a clinic.
There is no recent study (last 10 years) that specifically states or shows that Adequan builds or creates hyaline cartilage in dogs or horses.
"That leads us to the next generation of drugs that, in conjunction with anti-inflammatory treatments has been shown to regrow the articular surface, reversing the effects of DJD."
Reed - any info on this next gen of drugs that reverse DJD?
That is sadly the $64 question. There are therapies that will regrow hyaline cartilage (but they are a tad expensive at around $5000 per treatment). HOWEVER, most drug companies are not following up on this. Why? It is not financially beneficial to the company. I know of 2 specific instances where a drug company killed positive trials because the accountants decided the return on investment was too low.
Suffice to say, drugs and molecules such as IGF-1, and -2, IGFbp-1 through 5 and pentosan polysulfate have regrown cartilage when used synergistically. The key was managing the joint environment.
Joints are insanely complex at the biological level and we are still just figuring out how a fraction of that biology works.
Many of our hardest working or horses vet thinks need it get a 7 series pack 1 or 2 times a year and monthly shots after. All the harder working or older horses get Legend every month or at the show that month.
I would be VERY concerned if you were giving this amount to any horse. These molecules are heparin-like and can also cause thinning of the blood vessel walls etc. when given at high dosages. There is evidence that the sudden deaths of horses from "aortic rupture" can be brought about by excessive administration of drugs such as Legend, Adequan, MAP-5, or any other PSGAG.
I have a personal case as well that may have bleed out due to administration of multiple doses of Adequan and Legend every 2 weeks.
More does NOT mean better. Sometimes, a horse is done and needs to be retired.
A horse may get a 7 series dose of Adq which is every 4-5 days one time a year (we had 2 older horses who will get the series in spring and fall) and when series is over 1 adq a month and one legend a month. We try and have the legend fall at the shows which for many of the event horses is one time per month.
NOT seeing where that is a gross level of the product. Sorry if the amounts above were not clear in original posting
To be more clear
Lets say BOB the horse will start on a 7 series pack in Jan and then march through dec he receives 1 adq per month and one legend per month.. Pretty standard actually.
ADEQUAN® I.M. Rx Luitpold Brand of Polysulfated Glycosaminoglycan (PSGAG) Solution 500 mg/5 mL For Intramuscular Use In Horses
TOXICITY Toxicity studies were conducted in horses. Doses as high as 2,500 mg were administered intramuscularly to 6 horses twice a week for 12 weeks. This dosage is 5 times the recommended dosage and 3 times the recommended therapeutic regimen. Clinical observations revealed no o reness or swelling at the injection site or in the affected joint. No animal had any clinical or laboratory evidence of toxicity.
DOSAGE AND ADMINISTRATION The recommended dose of Adequan® i.m. in horses is 500 mg every 4 days for 28 days intramuscularly. The injection site must be thoroughly cleansed prior to injection. Do not mix Adequan® i.m. with other drugs or solvents.
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Reed, are you saying that the data does not support a regular program of biweekly or monthly adequan or legend given the other risks? Or that you wouldn't repeat the loading dose of adequan yearly? And does the same concerns extend to polyglycan?