Using Oral Joint Supplements with Injectable Joint Medications

I have a wonderful vet who just put my horse on Adequan which I am very happy about. My only question is can I now stop with oral joint supplements, this can be very costly. Thanks CS, Florida

Dear CS,

I agree, having a horse on both oral and injectable joint support can get expensive. However, I may be able to explain the differences between the two approaches as well as proper use of each to help you maximize the benefits while minimizing the costs.

Adequan® I.M. is the only disease-modifying osteoarthritis drug on the market approved by the FDA for the treatment of non-infectious degenerative joint disease. It contains polysulfated glycosaminoglycan, a naturally-occurring complex molecule that is the essential building block of the cartilage matrix. It travels into injured joints and stimulates production of new cartilage while relieving the symptoms of non-infectious DJD.

The really important thing to understand about Adequan is that it MUST be given just like it says on the package, which is one 500mg intramuscular injection once every four days for seven treatments. This is the only dose that has been proven to reverse the effects of degenerative joint disease. There is no official maintenance dose from the company such as once-a-month injections. Once-a-month dosing will offer relief for a four day period but is unable to reestablish the cartilage that has degraded from training, conformation or age-related changes. A more effective regime both in terms of cost and benefit to the joints would be a seven dose series twice a year to address DJD that is ongoing.

That is where oral joint supplements come in! Daily supplementation with hyaluronic acid, chondroitin sulfate (a polysulfated glycosaminoglycan) and glucosamine can help keep the building blocks of healthy joint tissue available when needed. Research has shown not only that all three ingredients are absorbed by the horse but also appear in significant amounts in joint tissue. A study by Martha Rodgers that appeared in Intern J Appl Res Vet Med. Vol 4, No 2, 2006, pp155-162 concluded that “consistent use of an oral glucosamine/chondroitin supplement resulted in a decreased need for distal tarsal joint injections to maintain soundness in a group of show hunters/jumpers.”

Now, this particular study refers to the injection of hyaluronic acid and or steroids directly into the joints, but what it says to me is that there is a place for both types of joint support in the horse: daily oral supplementation and injectable medication. Just make sure you give the oral joint supplement on a consistent, daily basis to maintain optimum levels of active ingredients in the body (SmartPaks are great for this!). As always, follow the manufacturer’s directions on the proper use of injectable joint medication. I hope that with this combined approach to joint health you are able to enjoy your horse for many years to come!

Lydia Gray, DVM MA, is the Staff Veterinarian for SmartPak. Prior to joining SmartPak, Dr. Gray served as the first-ever Director of Owner Education for the American Association of Equine Practitioners. She has authored numerous articles in publications such as The Horse, Horse Illustrated, Western Horseman and a variety of veterinary journals and magazines. Dr. Gray is also a frequent speaker at horse expos, veterinary conventions and other events. After graduating with honors from the University of Illinois College of Veterinary Medicine and receiving her Master's Degree in Interpersonal and Organizational Communication, she practiced at the Tremont Veterinary Clinic for several years. Dr. Gray is active in the American Veterinary Medical Association and Illinois State Veterinary Medical Association. She enjoys training and showing her Trakehner, Newman, in both combined driving and dressage, and is a USDF “L” Program Graduate (with distinction). Find Dr. Gray on Google+

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6 comments on “Using Oral Joint Supplements with Injectable Joint Medications
  1. Anne says:

    What are the recommended daily doses of hyaluronic acid, chondroitin, and glucosamine that should be administered orally via a supplement for best effect?

    • SmartPak SmartPak says:

      Hi Anne, there are so many different variables that affect what levels your horse should receive for best results such as age, workload, any history of injury, etc. For that reason unfortunately there is no simple answer to your question. However if you’d like help choosing a joint supplement with the right levels, please feel free to call us at 1-888-752-5171 or check out our online SmartFlex Finder below.

      www. SmartPak.com/SmartFlexFinder

  2. Stephany says:

    Have you ever heard of ICHON, from Kinetic Vet (www.kineticvet.com)? It is another injectible, much, much less costly than Adequan…and you will see the results, trust me. I put my 13 y/o Appendix gelding who suffers terribly from arthritis due to an old injury on his near side front. He hardly limps or favors that side now, got his pep back in his step, and wants to go, go, go! I use joint pain management daily with B&L Pellets. He is virtually pain free and No Side effects!

    • Jamie says:

      How did you administer the Ichon? Was it like the adequan with an injection every 4 days for 28 days then a monthly dose ? I just purchased it am I am awaiting the arrival . How quickly did you see results ?
      Thank you !!

  3. Emili says:

    Are Horse Raisin Has 2 inflamed knees. We don’t know what else to do for her. We done grain after grain, nothing works. We need to know what we can use that will stick and work. She a QH 15.00hh, 17 years old.

    • SmartPak SmartPak says:

      Hi Emili – Thank you for your question! We encourage you to have your veterinarian examine this mare and prescribe a complete regimen of care that will bring her comfort. Most likely the program will include a variety of therapies including injectable medications, oral joint supplements, prescription and natural pain relievers, corrective trimming/shoeing, and physical therapy such as topical products, bandaging and cold/heat.

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