Injectable Support

As equestrians almost all of us are familiar with the various joint injections as well as maintenance that some horses need. The past couple of days I have been doing a lot of searching on various joint support options for Houston in addition to his regular actual joint injections(all pending our vet appointment that is probably occurring as you read this).

The key players that I have always known about are:

  • Adequan
  • Legend
  • Pentosan
  • Polyglycan

One that I hadn’t heard much about but that I know a friend has used with success is Ichon – yes I know that technically Ichon is produced for another purpose but I wanted to include it nonetheless to this discussion incase any of you had first hand experience.

What I am most curious about is finding research (if it exists) on if one can use a joint supplement almost preventatively for support – in regards to Annie. Does that then make it less effective when your horse actually needs it? Do any of you know if there are studies to support either theory of thought? I am curious about this topic not only for Houston but also for Annie. Her current work load is very reasonable but I do want to make sure that I do everything I can to keep her comfortable well into old age!

I am not much on feed through supplements though I did have a lot of luck with SmartSox as well as a Magnessium supplement in the past with Houston. With how expensive most joint injections are I want to make sure to provide extra support if I can. With how pricey supplements get anyways I would prefer to know that every last drop is going where it needs to instead of only being partially ingested.

Houston has been like clockwork getting his hocks and stifles done every 12 months for a couple of years now but missed his most recent round and at about 7 months over due I can’t help but wonder if it has affected his performance. I will definitely share the answers that I get when I take him to the clinic today. Goodbye money – Hello answers!

I would love to hear about everyones personal experience on the matters!

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  1. No personal experience, but Dr. Marks taught us in college that injecting the joints causes a feedback loop to shut down – the body sees that there’s synovial fluid there that it didn’t produce and goes “Welp, my work here is done,” and then the horse stops producing its own, similar to what happens when a human goes on hypothyroid medication. So she said once you start injecting joints, you have to keep doing it forever on a regular schedule. I think she said every six months, but I could be wrong, college was an embarrassingly long time ago!

    1. No. This is not how joints work. Joint fluid is not a hormone. And the thyroid hormone is a unique and special butterfly all unto itself, and absolutely cannot be compared in this way. The idea that joints stop making synovial fluid because of injections is simply NOT TRUE.

      What IS true is:
      1. Corticosteroids (the most common joint injection, often combined with hyaluronan)may cause a joint to stop repairing damage to itself. While a joint cannot re-grow cartilage, it can do some things to help heal bone issues and tissue connections within the joint. Steroids MAY decrease the body’s ability to do this, but there is simply NOT enough evidence to support this is true with typical treatments in previously damaged joints (arthritis). In the case of a damaged joint, the steroid decreases inflammation, and thereby decreases the further damage caused by excessive inflammation. These types of injections should not be done excessively or to healthy joints.

      2. Hyaluronan IS NOT joint fluid. It’s basically Legend. It does not “lubricate” joints. It’s an anti-inflammatory. Short acting. You actually get better long-lasting anti-inflammatory response from the steroid. Don’t jump on this.

      3. The Polysulfated Glycosaminoglycan (Adequan, et al) will NOT help your horse support new joint growth. Like I said before. That is never going to happen. (But if you wanna invent something that could actually regrow joints, I guarantee you will be the richest and most popular person in the history of the world.)
      HOWEVER! Polysulfated Glycosaminoglycan drugs are incorporated somehow into the cartilage of the joints, seemingly causing a suppression of Prostaglandin and other enzymes in the joint. In other words, it works as an anti-inflammatory. Albeit and incredibly roundabout and slightly less invasive one. Very useful! I would suggest this for maintenance of a highly active horse with probably wear and tear on joints. I would also stay up to date with new research looking into possible side effects from Adequan use on the heart, as far as I know this research is still very preliminary and isn’t indicating any kind of danger from occasional use.

      There you have it. All the knowledge I have on joint injections. Clearly I have a problem with over-researching things and using my doctor husband to translate. 😉

  2. Yes its true that injecting a joint interrupts the horse’s own maintenance process with that joint, but when a horse’s performance is affected because of a less than stellar joint often injections are the best option. Injection time varies from horse-to-horse. I get my horse’s hocks done every 6 months generally. This is accompanied by a lameness exam to show he would benefit from the injection (also so I know its worth the money!) but for me its all about being observant and sensitive to any changes, so that I can react before any small, preventable issues become big problems. So my horses generally gets evaluated every 6 months. Maybe its time for a lameness eval if you have the chance?

    I haven’t read any studies linking the products you’ve mentioned with preventative measures, but I will say I have had a lot of success with Adequan as a maintenance option. Adequan does have a few studies that says its mildly successful at slowing joint degeneration, but not preventing it. The problem with adequan IMO is the huge costs associated. I only use it if I have a lot of shows coming up. That said, adequan’s studies also show that the benefits usually only are seen within 4 days of administration which is why they advise 7 injections one every four days. So if you go that round plan strategically!

    On prevention, I read an article on The Horse the other day that shows joint supplements to help in some cases prevent young horses from getting arthritis. Their advice is to act early… which I agree with. It’s best to stay alert and on top of your horse’s care so you can potentially prevent or quickly react to any potential problems. Sorry that was a rant… I’ve had a lot with joint issues, so I’ve become obsessive! Good luck 🙂

    1. Thanks for sharing your experience. I actually brought Houston to the clinic today and had a full eval done. He needed what I anticipated and will be on a Adequan like substance (but significantly less expensive) at the vets recommendation.

      I am definitely going to try to investigate joint supplements for Annie to make sure I do whatever I can to support her as her workload continues to increase.

  3. i’ve heard anecdotally that prevention is easier than treatment, and that IM joint supps can help there, but haven’t seen research on it

    1. I would image that’s true. Seems true in most cases that prevention is way easier than reaction to a joint that already has a problem. Would be interested to see research on it!

    2. Yeah prevention is always going to be better than treatment but Houston has needed injections from relatively early on and as they are given annually I don’t think that there is much super usual about that.

      I am looking forward to seeing how the IM supp works for him and will be considering it for Annie in the future.

  4. It’s all pretty anecdotal in the vet med world. They really love Cosequin for preventative, and it’s really the only fed joint supplement that I’ve seen my professors recommend.

  5. I leased a couple of horses in their late teens when I was still a teenager myself and Legend did help them. I have a friend who used to give her horse regular Adequan injections for her previous horse and it did seem to help that horse quite a bit too.

    Dexter currently just gets MSM as a preventative. I don’t do a lot of feed through supps either, but I figured that one won’t hurt and it’s pretty cheap also.

  6. I’ve used Legend and Adequan in the past, but with my current horse have been much happier just injecting the specific joints that are causing the issue.

    1. Thanks Lauren. I think my post might be confusing people. I am more talking about using something like legend or adequate in addition to joint injections. Houston actually had his hocks and stifles done today and we decided on something like adequan as a monthly support as well. 🙂

  7. Again, no research here. But we used Adequan on an older TB I did jumpers with as a teen who wasn’t actually off, but was just slightly NQR and injected I think every 6 months. There was definitely improvement in the NQRness, and I think it did well to help prevent further issues since he hadn’t done much for several years before we bought him and his work load increased significantly.

  8. I am completely anti joint injections and think it would take an extreme case to convince me otherwise. I’m not a vet or a vet student, nor do I have any medical background but I know for me and my horse if it ever came to the point that she needed something injected directly into a joint there would have to be something fundamentally wrong with my riding/program. I know it’s not the popular opinion but I think joint injections are handed out like candy as opposed to looking deeply into your riding/program to fix things. I just don’t see how they are necessary.

    Like I said, not the popular opinion, just how I feel. For the record my horse has been on an oral joint supplement with careful riding/a program designed to keep her strong and sound for over 10 years. She did get a round of Adequan this past year which I was not thrilled about doing but it was due to her body being absolutely wrecked by chronic COPD.

    1. I think that there is a very big difference in injectable joint supplements (such as Adequan, Legend, etc) and actually injecting a horses joints… That said it is very personal and everyone has wildly different opinions falling in the hate it or accept it camp.

      My personal opinion is not that there is necessarily something specific wrong wth my riding or my program (though H hasnt been with me) but rather that Houston is a very large horse that by default puts more stress on his joints in addition to heavier work loads. It would be one thing for me to be injecting him every 3/mo to keep him sound but he gets injected annually and I personally will not inject more frequently than every 6 months.

      Thanks for sharing your opinions 🙂

  9. Interesting to read the comments! I’d be curious the know the name of the Adequan version you’re going with! We did Ellie’s stifles a few months back and think she would benefit from more regular maintenance as well!