*This is the second in a series introducing and educating readers on the Adequan® i.m. (polysulfated glycosaminoglycan) product and its proper use. The first article introduced you to the company behind the product (link). Stay tuned to HorsesDaily.com as the series continues.* The morning of the big show, you walk up to your horse’s stall and lead him out for a morning walk. He comes out stiff, gingerly stepping up and over the stall entrance. There’s a little swelling around his knees and fetlock. The veterinarian says your horse is suffering from non-infectious degenerative joint disease (DJD), a condition also known as equine arthritis.
What is DJD?
At the end of the long bones (the knee joint, for example), there is a specialized cartilage known as the articular cartilage. In a healthy horse, this cartilage should be thick—the thicker it is, the more able it is to hold fluid and is able to displace the load that comes down onto the joint. But don’t think this means articular cartilage acts as a shock absorber; instead it dissipates the load easily down through the long bone and through the soft tissue. This then radiates the load as energy throughout the outside of the leg. “We want the cartilage to be as healthy as it possibly can,” explains Senior Manager of Professional Veterinary Services for Luitpold Animal Health, Victoria Maxwell, DVM, MBA. Luitpold makes Adequan® i.m. (polysulfated glycosaminoglycan), a prescription joint medication with FDA approval to help treat the effects of non-infectious degenerative joint disease for equines.
If your horse is suffering from DJD, this means the cartilage is going through some adaptive changes and isn’t as healthy as desired. What can affect your horse’s cartilage? Dr. Maxwell explains that cartilage doesn’t care for repetitive load exercises such as working for long periods of time on the lunge line, standing in the trailer for six hours, or jumping an excessive number of jumps in a day. These types of exercises can put the cartilage in a net negative state leading to a diminished or thinning cartilage over a period of time. Non-infectious degenerative joint disease is where the cartilage cells have fallen off in their ability to keep pace with the changes and demand on the cartilage.
Not all stresses are equal as different horses can be affected by DJD in different ways and at different ages—a 10-year-old dressage horse is different from a 16-year-old equitation horse, which is different than a 3-year-old Thoroughbred. “They’re just not the same horse. They all have DJD at varying stages,” says Dr. Maxwell.
Critical to successful outcomes with DJD is a lameness exam with your veterinarian. A lameness exam is needed to figure out what’s best for your particular horse--their workload, their shoeing, the footing, and conformation. All of these variables go into evaluating your horse’s DJD.
DJD = The End?
Just because your horse has been diagnosed with DJD doesn’t mean it’s time for retirement. Under a veterinarian’s supervision you can begin a treatment series of Adequan® i.m. (intramuscular) to address the joint dysfunction. Adequan® i.m. stimulates cells in articular cartilage known as chondrocytes to increase production of key elements of the cartilage. The cartilage is in a net positive state and returning to a normal homeostasis, remarks Dr. Maxwell.
The treatment series of Adequan® i.m. is outlined on the package label and recommends for the horse; 500 mg every 4 days for 28 days intramuscularly. The labeled series is imperative to the best outcome because, “What you’re trying to do is maintain a steady state of that drug in the cartilage for the treatment series,” explains Dr. Maxwell.
“When Adequan® i.m. is administered in the muscle,” continues Dr. Maxwell, “our data supports that the drug will be in the blood stream within 20 minutes, then it gets to the articular cartilage in two hours. Once it’s gotten to the articular cartilage, it remains at a therapeutic level in the cartilage for 96 hours (four days).”
At the end of the series, Dr. Maxwell says the cartilage is in a net positive state and returned to a level closer to homeostasis.
Dr. Maxwell is quick to point out that horse owners need to follow the package label for treatment of DJD. Adequan® i.m. is the only drug approved by the Food and Drug Administration (FDA) to treat the effects of DJD. “There is quite a bit of data that we have to support the label claims of Adequan® i.m. and we know that the best patient outcomes are realized after the labeled instructions are followed,” she says.
Side Effects of Adequan®?
The drug label is important to read as it outlines the proper treatment regime, as well as proper storage of the drug and other pertinent information, including safety precautions. The value to the veterinarians and the horse owner when utilizing FDA-approved drugs is that a tremendous amount of research is behind these drugs. There is effectiveness of the drug, as well as safety data, post marketing reports, and yearly reporting to the FDA, as well as clear and accurate marketing. “Currently, there are several joint injection products on the market that have not gone through the FDA drug approval process and it’s disappointing to see them used as FDA equivalents,” comments Dr. Maxwell. “Education is key to understanding a complex disease process like DJD and then researching the FDA-approved drugs will lead to the best result.”
Adequan® i.m.: For the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses. 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. Each 5 mL contains 500 mg Polysulfated Glycosaminoglycan. 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.
SEE PRODUCT PACKAGE INSERT FOR FULL PRESCRIBING INFORMATION by going to www.adequan.com, or by calling (800) 458-0163. Adequan® is a registered trademark of Luitpold Pharmaceuticals, Inc. ©LUITPOLD PHARMACEUTICALS, INC., Animal Health Division, Shirley, NY 11967. © 2014