Don’t Let Degenerative Joint Disease Bring Your Horse to a Halt
Corporate partner Adequan® tells us how to help ease Degenerative Joint Disease.
By Marian G. Little, DVM, Technical Services Veterinarian, Luitpold Pharmaceuticals, Inc. | September 21, 2017
In the equine athlete, overuse is a significant cause of a variety of lameness problems. Over time, the wear and tear of daily use or “use trauma,” exerts abnormal forces on a horse’s joints and disrupts the natural cycle of "wear and repair.” Once the natural balance of a joint is disrupted, the joint is susceptible to non-infectious degenerative joint disease (DJD). Equine DJD (also commonly referred to as Osteoarthritis, or OA) is specifically defined as “a group of disorders characterized by a common end-stage in which progressive deterioration of the articular cartilage is accompanied by changes in bone and soft tissues of the joint.”1
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In horses suffering from DJD, any of the following changes may occur and can cause lameness which may be noticeable by an owner, rider, trainer, or veterinarian2:
- Inflammation of synovial membrane and/or joint capsule with associated heat, pain, swelling
- Fibrosis or thickening of the joint capsule
- Thinning of joint fluid and impaired lubrication
- Loss of articular cartilage and matrix components
- Bone remodeling and structural changes
- Loss of joint mobility over time
A comprehensive veterinary physical and lameness exam is always recommended for an appropriate diagnosis of any cause of lameness. Depending on the problem, the lameness exam may include a standing evaluation, moving exam, gait analysis, flexion tests, application of hoof testers, diagnostic analgesia (nerve blocks), and diagnostic imaging (radiographs, MRI, ultrasound, etc.)
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If a diagnosis of DJD is confirmed, your veterinarian may choose to treat your horse with one or more of the four therapeutic categories of products listed below. FDA approved products within these categories of treatment are routinely used in the management of lameness associated with degenerative joint disease or osteoarthritis. (Note: FDA approved products are those products that are rigorously tested for safety and efficacy through required clinical studies.)
Therapeutic Categories for DJD:
Polysulfated glycosaminoglycan (PSGAG): PSGAG is a naturally-occurring complex molecule that is an essential building block of the cartilage matrix. Adequan® is the ONLY FDA-approved equine PSGAG recommended for the intramuscular treatment of non- infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses. After intramuscular injection, Adequan® has been shown to diffuse into the bloodstream, which transports the drug into synovial fluid, where it is absorbed by articular cartilage at therapeutic levels that inhibit cartilage degrading enzymes within the joint.
Sodium Hyaluronate products, or Hyaluronic Acid (HA): These products help restore the lubricating properties of the synovial fluid within the joint, have anti-inflammatory properties, and are thought to stimulate enhanced natural production of HA. They may be administered IA or IV.
Corticosteroids: Corticosteroids are potent anti-inflammatory agents that rapidly decrease pain and inflammation when given IV, IM, or IA. They are beneficial in significantly reducing the initial inflammation that occurs with joint injury but should be used judiciously in certain cases.
Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs act rapidly and are easily administered for the short term potent relief of pain and inflammation as occurs with joint injury, disease in multiple joints, as well as other systemic medical conditions. They may be administered orally, IV, IM, or topically. High doses, chronic use, or use in compromised animals may potentiate systemic side effects involving the blood, GI tract, kidney, or liver. NSAIDs should be used judiciously in certain cases.
Many other products marketed and sold are not supported by sound scientific research or manufactured under strict FDA guidelines. These may include injectable chondroitin sulfate, oral supplements/nutraceuticals, compounded acetyl-d-glucosamine and compounded pentosan. It is particularly important to understand that compounded products are not subject to the same rigorous testing and manufacturing requirements as FDA approved products, and they are not generic drugs. Please consult your veterinarian for further information on treatment of lameness associated with DJD, and ask which FDA approved products may be most appropriate for your horse.
Adequan® i.m. The ONLY FDA approved equine PSGAG for the intramuscular treatment of non-infectious degenerative joint disease of the carpal and hock joints proven to:
• DIMINISH the destructive processes of degenerative joint disease
• REVERSE the processes which result in the loss of cartilage components
• IMPROVE overall joint function and associated lameness
Available for order! For more information about equine joint health and treatment with Adequan® i.m., please visit www.adequan.com.
Dosing and Administration
• Administer 1 intramuscular injection (500 mg)
• Every 4 days
• For 7 treatments
• Consult with your veterinarian regarding any questions on dosing
INDICATIONS For the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses. IMPORTANT SAFETY INFORMATION There are no known contraindications to the use of intramuscular Adequan® i.m. brand Polysulfated Glycosaminoglycan in horses. Studies have not been conducted to establish safety in breeding horses. WARNING: Do not use in horses intended for human consumption. Not for use in humans. Keep this and all medications out of the reach of children. CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. Please see Full Prescribing Information
References: 1. McIlwraith CW. Traumatic Arthritis and Posttraumatic Osteoarthritis in the Horse. In: Joint Disease in the Horse. Frisbee DD,
Kawcak CE, McIlwraith CW, van Weeren PR, ed. 2nd ed. St. Louis, MO: Elsevier, 2016;33.
2. McIlwraith CW, Frisbie DD, Kawcak CE. The horse as a model of naturally occurring osteoarthritis. Bone Joint Res. 2012; 1(11): 298-300. Adequan® and the Horse Head design are registered trademarks of Luitpold Pharmaceuticals, Inc. © Luitpold Animal Health, division of Luitpold Pharmaceuticals, Inc. 2016. AHD250 Iss. 6/2016