Friday, April 20, 2012

Time For Injections

My vet came out this morning to give Lilly her EE/WE and West Nile vaccines. Lilly was a good girl and I'm hoping we don't see any adverse reactions like we did with the Rabies. We'll do the Flu/Rhino shot sometime early next week and then we'll finally be done with vaccinations until the fall. I took Lilly out for an easy bareback ride after the vet left and will give her the day off tomorrow. Because of the weather, there won't be a show for me this weekend, which is probably just as well. Giving vaccines on the Friday before a show would be a bad idea anyway. So now we look ahead to the show on the 29th!

While my vet was there, I asked her again about injections for Lilly's apparent joint issues. I've given up completely on the Cosequin and even physically cut it out of my current SmartPaks. The new Paks came in today and they are void of Cosequin, but I still have 9 left and I can't take it anymore. Lilly didn't touch her breakfast this morning and it's driving me crazy. So no more joint supplements... I'm turning things up a notch.

I'm ignorant when it comes to joint injections. Whether those injections are given IM (intramuscular), IV (intravenous), or IA (intra-articular), I'm clueless. AJ is the only horse of mine who has ever received injections for joint related issues and I can't remember what exactly we did for him. I think I was about 12 or 13 at the time, so the memories are a bit fuzzy. Whatever we did wasn't effective for him because we still ended up retiring him at 6, but I'm sure Adequan has come a long way since 1993.

I know a lot of people who use Adequan and have great success with it. They give the 1/4/7 dosage (one shot, every four days, until the 7 vials are gone) and then typically give their horses maintenance shots every month after that forever and ever. In my mind, that's what I'd probably do with Lilly. I know people who have skipped the loading dose or only used one shot every week for four weeks (or some variation thereof, probably recommended by their vet), but Adequan has been proven to be most effective with the 1/4/7 schedule.

When I was speaking to my vet today, however, she said anything other than 1/4/7 is considered "off label" and she wouldn't recommend it. She suggested we do the 1/4/7 for Lilly and then supplement it with Legend if she needs some kind of "booster" or if we had a month coming up with heavy work/showing. No accompanying joint supplements were recommended either.

So I was stumped because nearly everyone I know has started with the 1/4/7 and then gives another shot every month. They say it works miracles and they can tell when their horse needs his/her monthly shot... and here is my vet telling me that she doesn't recommend it simply because it's off label. I mentioned those things to her and she repeated that it really is off label and she wouldn't recommend it.

Okay...

So I told her I would discuss it with her some more when she comes out again to give the Flu/Rhino and go from there. I wanted some time to research before I commit to the $300 I'm ultimately going to spend on these injections.

I spoke with my friend about what the vet said and she said I should get a new vet. She gives her horse Adequan shots every month and thinks it's crazy that the vet would say the monthly maintenance shot is off label because that's what everyone does. So I started doing some research and as it turns out, my vet is correct.

The 1/4/7 isn't a loading dose, it IS the dose. Anything beyond the 1/4/7 is considered off label because they have not tested the effectiveness of the monthly "maintenance" doses everyone gives their horses after the "loading" dose. They actually recommend repeating the 1/4/7 every 6 months as needed. So there are a lot of people out there using this product off label...

Polyglycan was suggested to me by a friend and I've heard my vet mention it as well, but using Polyglycan for joint supplements would be WAY off label since it's actually a surgical lavage drug. So if we're trying to stay on label here, Polyglycan is out.

So I guess unless my vet and I determine otherwise next week, my plan will be to give the seven Adequan shots and go from there. Hopefully it'll be just what she needs and she'll be good to go for a whole year... I don't mind giving the Adequan every year if that's what works best for her. If we're not seeing any results from the Adequan, though, I'll have to regroup.

Also, just want to make sure everyone knows I'm not doing the actual joint injections, just the Adequan IM. Joint injections are definitely not even on my radar.

17 comments:

  1. I'm VERY GLAD that I can't help you at all, but I'll eagerly follow along with what you try! Statistically, Dixie's going to need Adequan at some point, but not yet.

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    1. I've heard it's a great preventative too... Dixie's logging a lot of miles! :)

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  2. Sounds like you have done your research and obviously need to start with the first set of shots, before having to worry about how to proceed. Hock injections (IA) have become way to much 'the norm' in the barrel horse world for me and after watching the whole process and how nasty some horses are about it...I can't say that I would ever go that route.

    It has crossed my mind that Moon might benefit from the Adequan shots. He's 14 this year and has been running barrels for several years. He's not made the strongest through the stifles and it did cross my mind that even though he appears to be sound, maybe his resistance has to do with some pain when he performs. I'm going to wait to see how he acts once he is more fit and will go from there.

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    1. While doing my research I found a forum where some lady said, "My two year old needs hock injections..." Seriously? Your TWO year old needs hock injections? It really is crazy how often it's done.

      I'm concerned that a lot of Lilly's back issues are related to her hocks too, so I'm really hoping this will help her out. I was hoping with increased fitness Lilly would start to feel better, but I noticed she kind of peaked and then started to get sore again. It might be something to discuss with your vet for Moon too if the exercise/fitness doesn't help him.

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  3. I know the barn I was last at had a couple horses on the Adequan shot...I remember they got it only like twice a year, so sounds like they did the initial, then after six months...But I also was told by the BO where Im currently at that the old horse there (that died in January who was on Adequan) got it monthly. He has seven left and told me I can have them if I want, which I have only mildly considered. So...sounds like the previous barn was on the right track with it.

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    1. Yep, sounds like they're doing it as recommended. I hope I don't have to give Lilly the 1/4/7 every 6 months... that'll get pricey!

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  4. I think your vet is on the right track. If you think that the shot is the way you want to take Lilly follow her decision. Knowing what I know about joint injections I wouldn't recommend them unless you knew it was a single joint issue. They are extremely painful, and you will need follow up injections.

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    1. I'm not doing the actual joint injections... I should have made that more clear. I'm just starting her on the Adequan IM.

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    2. Joint injections are not extremely painful - they can be extremely beneficial in the right circumstances and can make a very lame horse very comfortable very fast. That being said, putting steroid directly into a joint can cause joint fusion to occur more rapidly over time. And you do not necessarily need follow up injections... that is a myth. My mare's stifle got jammed during an accident and she had lameness and pain in her stifle that only showed up via nuclear scintigraphy. We injected the joint once, she came sound, off she went and we never did it again.

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  6. Hi,

    I am a faithful reader of your blog, but haven't commented previously.I have a 15.3hh paint mare (mostly TB if you look at the papers) and i used in alot of local reining shows when she was younger. She's 12 now, but I have had her on legend shots for the past 3 years. I wanted to let you know that they have been very succesfull for me and Belle. She was 'off' on hind quarters, but the vet couldn't find anything, or pinpoint a cause. You couldn't see anything visually, or otherwise. I just felt a hitch in her step. My Vet (who is also the local track vet) recommended IV Legend shots. We did the intial loading doses of 1 shot per week for three weeks. After that I have maintained succesfully with a shot every 6 months. She did advise that that maintnance shots could be anywere from every 3 to 8 months, depending on the horse. There is no longer a hitch in my mares steps, her hind end feels like a well-oiled machine. I highly recommend legend. In Alberta it is about $120 per shot.

    On the otherside of things, I have had success with a certified equipne osteopath. Belle dislocated her stifle, which sounds horrible and it looked horrible, but wierdly she wasn't lame. My vet consulted with several other vets. The only recommendation that kept comping back was surgery, as we could not manipulate it back into place. I refused to cut open a horse that was not taking a lame step, even though I also couldn't ride her. After 6 months of trying to figure out what to do, I was referred to an osteopath. I thought it seemed hokey but i was at the end of my rope. She worked on Belle, and after 6 months and only two appointments she had Belle's Patella back in place, and we were working as normal. My vet was amazed, as was I. She gave us several stretches to do, and we did alot of hand walking. But i thought an osteopath might also be an option for you.

    Sorry this has taken on a bit of length. Best of luck with solving the sore back issues.

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    1. Thank you for taking the time to comment and share your experience with Legend. I really appreciate it! I've read good things about Adequan, so I definitely want to start there, but I may in the future end up using Legend as well and it's good to know it has worked for your mare. Belle and Lilly sound quite similar in regards to what's going on in the hind end.

      I've done some stretching with her, but have also been thinking about a body balancing type therapy as well. If the Adequan seems to help her joints, but she's still sore in her back, I think I'll try that route. It sounds pretty much like the osteopath you suggested.

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    2. That sounds very much like the osteopath route I went. Good luck with everything!

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  7. My old mare started to show noticeable arthritic changes by around 13 or 14 so it's maybe not crazy that Lily is ready for something. We did the IA injections for my mare (many years ago) and it was night and day. I hadn't realized that my girl was barely able to flex her hocks! But just like that she no longer went disunited at the canter and she was a happy girl. IA injections are scary, though (potential complications). I wish that Adequan IM had been among the suggestions for her but I'm not sure it existed.

    I've known quite a few people who have gone with Adequan and they all sing it's praises. I often think I'd like to try it but I'm too chicken to give shots by myself!

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    1. Yeah, I guess since Lilly just turned 12, it's probably time to start thinking about this kind of stuff. She hasn't been worked very hard throughout her life, but that doesn't mean she shouldn't have sore hocks.

      I don't do shots either! Everyone laughs at me, but I just do.not.do.shots! My BO is going to give the Adequan shots for me on the days when Lilly is due. :)

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