# 2 Questions - Adequan for hocks anyone? & Equishure vs. Succeed



## tpup (Oct 14, 2010)

Hi everyone - looking at options for my older gelding. Hock injections have taken my older gelding off feed the last 2 times. Never knew it but apparently the steroids can affect a horse systemically - not common but it happened twice now in a year to my ulcery gelding. SO...vet is recommending either 1/4 Previcox but spaced every other day (he was on it a few years ago - I know it CAN cause stomach issues but we think in his case the hock injections were worse...) So...Previcox or Adequan. In 4 years Adequan has never been recommended?? but now they are saying to try it as an option. Xrays showed both lower hock joints about to fuse, and he has a small bone fragment in left joint. He also has mild neck arthritis and due to his age, most likely other areas. He is in his low to mid 20's, happy in work (light flatwork, short trail rides) until the hocks start bothering him. We used to go 9 mos. between injections...then 6. Now we are at 4  Has anyone used Adequan successfully for hock arthritis? Recommended is loading dose and then once monthly.

Question 2 - suspicious of hind gut ulcers. He is gassy, has sour smelling manure (this is a marked change that comes and goes). Vet mentioned KER Equishure or Succeed. Can't decide. Both are pricey. He is currently on Smartgut and was on Ulcerguard every other day. And has had 2 full treatment times of Gastroguard since June (2 full months!) Vet said he likely has hind gut issues as well. Succeed is oat flour based and from what I understand, Equishure acts as more of a buffer for grain. Leaning toward KER Equishure because of the trials and research behind it, and he does have lots of TC Senior because he also has bad teeth and can't eat a whole lot of hay. His diet consists of the Senior, straight free choice alfalfa in his stall 12 hrs a day, very good pasture seasonally, and cocosoya. So any opinions on either product?


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## 1RedHorse (May 3, 2011)

Did the injections he recieve contain a steroid? If so just inject the joint with pure HA.

Since your horse has digestive tract issues Im at a loss as to why a vet woud reccomend a feed through supplement for his joints??? The chances of him digesting and absorbing the meds properly to utilize them are slim to none.

Ask your vet about what he was injecting with. I suspect it was dpo and HA....if so ask him to leave the dpo out.

Hindgut acidosis (hind gut ulcers/enzyme upset) causes foregut ulcers...only way to cure that is Equishure. For the foregut use Prescision paste...its pure omeprazole in a dosage formulated for equines. Uguard is junk...Succed is more of a probiotic.

Have you gone over a meal plan for your horse with your vet?


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## 1RedHorse (May 3, 2011)

Oops just saw what he was getting fed LOL.

Since he has poor teeth I would replace the cocosoya and alfalfa with: Empower boost fat supplement-2 lbs per day and cut back his feed ration(less is more for an ulcery horse...need calories not quantity) and soak his alfalfa or replace it with beetpulp. Too much rich forage can upset the gut too dont forget


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## tpup (Oct 14, 2010)

Yes, he has always gotten steroids with his injections.

Vet is not recommending a feed-through joint supplement. Adequan is IM.

Equishure is a feed-through gastric supplement that would coat his digestive system and reduce hind gut acidosis, gas, etc.

I started 1/4 tab Previcox today, for now will be Mon/Wed/Fri and will see how he does. He seemed quite uncomfortable at the trot and canter today :-(


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## 1RedHorse (May 3, 2011)

tpup said:


> Hi everyone - looking at options for my older gelding. Hock injections have taken my older gelding off feed the last 2 times. Never knew it but apparently the steroids can affect a horse systemically - not common but it happened twice now in a year to my ulcery gelding. *SO...vet is recommending either 1/4 Previcox* but spaced every other day (he was on it a few years ago - I know it CAN cause stomach issues but we think in his case the hock injections were worse...) So...Previcox or Adequan. In 4 years Adequan has never been recommended?? but now they are saying to try it as an option. Xrays showed both lower hock joints about to fuse, and he has a small bone fragment in left joint. He also has mild neck arthritis and due to his age, most likely other areas. He is in his low to mid 20's, happy in work (light flatwork, short trail rides) until the hocks start bothering him. We used to go 9 mos. between injections...then 6. Now we are at 4  Has anyone used Adequan successfully for hock arthritis? Recommended is loading dose and then once monthly.
> 
> Question 2 - suspicious of hind gut ulcers. He is gassy, has sour smelling manure (this is a marked change that comes and goes). Vet mentioned KER Equishure or Succeed. Can't decide. Both are pricey. He is currently on Smartgut and was on Ulcerguard every other day. And has had 2 full treatment times of Gastroguard since June (2 full months!) Vet said he likely has hind gut issues as well. Succeed is oat flour based and from what I understand, Equishure acts as more of a buffer for grain. Leaning toward KER Equishure because of the trials and research behind it, and he does have lots of TC Senior because he also has bad teeth and can't eat a whole lot of hay. His diet consists of the Senior, straight free choice alfalfa in his stall 12 hrs a day, very good pasture seasonally, and cocosoya. So any opinions on either product?





tpup said:


> Yes, he has always gotten steroids with his injections.
> 
> *Vet is not recommending a feed-through joint supplement.* Adequan is IM.
> 
> ...


Actually he did reccomend a feed through supplement.

Adequan is reccomended to give IV.

I know how Equishure works.

I would do the Adequan and request that your vet not use a stroid along with his hock injections.

Of course hes uncomfortable. he has ulcers and joint problems. If hes in pain and you continue to ride him it wiill make his ulcers flare up WORSE.


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## tpup (Oct 14, 2010)

Wow why the snarkiness?? And why are you arguing semantics? My vet recommended Adequan IM, not IV. Previcox is not a joint supplement. It's an NSAID, like Bute, but easier on the belly than bute.

I came here for help and have always found this board welcoming and helpful.

This is my heart horse - no one loves and cares for him more than I, which is why I am always looking for what is best for him. Anyone who knows me knows I go above and beyond for him and always will. I will never sell him or give him away, even if he becomes unsound and/or needs to be retired to pasture. I don't appreciate the condescending sarcasm.


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## 1RedHorse (May 3, 2011)

tpup said:


> Wow why the snarkiness?? And why are you arguing semantics? My vet recommended Adequan IM, not IV. Previcox is not a joint supplement. It's an NSAID, like Bute, but easier on the belly than bute.
> 
> I came here for help and have always found this board welcoming and helpful.
> 
> This is my heart horse - no one loves and cares for him more than I, which is why I am always looking for what is best for him. Anyone who knows me knows I go above and beyond for him and always will. I will never sell him or give him away, even if he becomes unsound and/or needs to be retired to pasture. I don't appreciate the condescending sarcasm.


Im not being snarky??? just blunt with the facts. HUGE difference.

Youre correct about Previcox...I do believe it has some joint supplement qualities as well-glucosamine/chondroitin.

It took awhile for me to type that out for you...perhaps I didnt appreciate youre unappreciative tone? It kills me how people ask for advice...you give it...then BAM thats not what they want to hear or youre being snarky.

If he hasnt even recommended adequan to you in the 4 years youve been seeing this vet..Id find another. Plus the fact that he uses a steroid on an ulcery horse...hello just inject the joint with HA.

With any IM shot you risk abcessing the muscle. Adequan IV is absorbed more efficiently bc its given directly into the bloodstream.

So how about we get over "semantics" and focus on helping your horse?


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## CCH (Jan 23, 2011)

Adequan is IM. Legend is IV or intra-articular. (though I much prefer hylartin) I have used adequan, and it did help some, but for the money, direct injections get better results.

Steroids in the joint injections are what really make them work. In people, they strictly do steroids and no HA. OP, are you sure it was the steroid that put your horse off of his feed and not just pain in general? Joint injections can really hurt, particularly if the joint is already degenerated.

Also, previcox, is not a supplement, it is a drug. It is actually the dog version of the drug though some vets prescribe it "off-label" for horses because it is less expensive. The actual horse version is Equioxx (paste or injectible)

If 60 days of gastroguard did not help your horse's ulcers, not much will. What has worked best for me is 24/7 high quality alfalfa (RFV of 120+), which you can't really do for an easy keeper, and removing all "sweet feeds" I just feed strategy or ultium with an antacid supplement. I will give ulcerguard in conjunction with any NSAID to reduce the symptoms of exacerbated ulcers. You may want to double check that ingredients in your supplements don't contain highly acidic compounds or anything that will lower the pH of your horse's gut.

You may want to try Surpass cream, it is a topical NSAID. I have excellent results when it is stacked with either Equioxx of banamine. I rarely use bute because the injectible has to be refrigerated and I find it upsets ulcers in my horse's the most.
_Posted via Mobile Device_


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## 1RedHorse (May 3, 2011)

Adequan can be given IV and has always been recommended to me by various performance vets to administer it as such. I actually use polyglycan.

Uguard is JUNK. Wish I had the documentation handy. 

Precision omaprazole paste is the only way to go to cure ulcers and it's cheaper too.

Alfalfa acts as an antacid.....why do you feed an antacid supplement in conjunction?


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## ~*~anebel~*~ (Aug 21, 2008)

I can't comment on the ulcer medication. With ulcery horses it is important to remove stressors. Full turnout with buddies would be best, and reducing the joint pain. Once you get the horse out of pain his ulcers will probably be easier to manage.

I have never had it recommended to me to use Adequan IV, nor have my friends/colleagues/various veterinarians and I have never heard of it being used that way, even in Fla. during WEG qualifications where horses were being injected up to 4 times a week.
The risk of muscle atrophy with Adequan IM is very, very low.

Adequan and Polyglycan are also NOT similar in mechanism. Polyglycan is more similar to Legend or HA, but with added glusocamine. Adequan is the only drug proven to improve the cartiledge in the joint.

I think your horse's hocks are a bit far gone for IM/IV shots, personally. His jhock joints need to fuse, either by surgical intervention or time and pain management. There are some veterinarians who are using an IA shot which will help fuse the joint it is injected in, but I have never done this.
Basically you are now into the point of arthritis where you are doing pain management. There are some expensive therapies like Tildren, IRAP and stem cell (A cell may also be available on a "test" or "experimental" basis near you..) which may help, but at this point you would need to bring the joints back from the grave. Right now you need to be encouraging them to fuse. Adequan may help the milder arthritis in his neck and other joints though. And IV Legend or polyglycan can also serve to help these joints out too. Overall, what I would recommend (just based on personal experience, I am not a vet) is to have the horse on full turnout with buddies and that he is encouraged to walk, usually by having the food and water sources far apart. I would also have him on meds to manage his pain. NSAIDs are great if you can find something that wont upset his stomach. I have found Asprin to work and be less upsetting than bute. You should also try to consistently work him as you have been, not that he is sore, but to get him moving. I would also really try to keep up with the IA steroids if at all possible. Try a round of Adequan (5ccs per dose every 4 days for 6 doses) and see if that helps him at all. 
Once the joints are fused, he should be far more comfortable.

Good luck!!


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## upnover (Jan 17, 2008)

Excellent post Anabel! 

I've heard that Adequan can be offered IV, but I can't for the life of me remember why I've also heard it's not recommended. My vet won't do it, just IM. We have a fairly large hunter/jumper show barn with several older horses which means *A LOT* of our horses are on Adequan and I have never seen a negative reaction. I'm not saying that it never happens but of the 30-40 or so horses that get a shot every month... they seem to be just fine. We have several horses that were much sounder once their hocks fused too and like Anabel said, it's just a waiting game. And while his joints may be beyond "fixing" I would still recommend keeping him on Adequan just to keep him more comfortable. I imagine he is sore in other places then his hocks.

A horse in our barn who had bad ulcers got Equioxx (previcox) before shows and did just fine. But I don't know how he'd do if it was given regularly.
The Surpass is an idea too. It's a topical ointment and fairly effective and you'd be bypassing the stomach all together. Although, I think I've heard it causes liver (kidney?) issues over time if used frequently. I'd look into that.

I don't have a lot of experience with ulcers but most people I know have said that GastroGuard is one of the few things that are truly effective for bad ulcers. If you've gone through 2 treatment rounds (YIKES that stuff is pricey!), again, what Anabel suggested with environmental factors may be your best bet. 

Good luck!


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## ~*~anebel~*~ (Aug 21, 2008)

The other thing I just thought too is talk to your farrier about getting wedges on his hinds to get him more comfortable, and like upnover mentioned, topical pain relievers might also help him.
_Posted via Mobile Device_


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## tpup (Oct 14, 2010)

Thanks everyone - to answer a few questions, yes, his hock injections have always included steroids. I never had even a glimpse of an idea that hock injections could cause upset in the gastro system, but my vet explained the steroid goes throughout the body and can, in rare cases, actually strip the lining of the belly. A drug called Misoprostol can fix that issue, which we did have to use for 7 days after 7 days of Gastroguard post-injection (in November) helped some, but he wasn't back to 100% eating wise.

About his ulcers, he was treated successfully with a month of Gastroguard after scoping revealed grade 2 chronic. In the past, he has gone off feed with Banamine and antibiotics. We have to be very, very careful. Had I known steroid injections to the hocks could cause an upset belly, I would have "buffered" him prior with Sucralfate and few days of Gastroguard. In Nov. him going off feed was more pronounced - the vet had injected an extra "area" and recommended coffin joint injections as well (all after lamenes exam and flexions). He had never received that many injections at once. If we ever do them again, we can space them apart by a week or two to be safe. When the vet told me about the injections bothering his belly, I checked back to my calendar from 6 months prior. Shocked to see that when he went off his feed then, it was 7 days AFTER the last injections...he started losing appetite the day after...and by 7 days it had gotten worse and vet said "let's scope". It was only then that we made the connection of "injections = ulcer flare up".

Thanks for the idea on the pain causing inappetite - that could very well be true and contributing. The only NSAID he can have is Previcox.

The interesting thing is that this horse runs and gallops around the field like crazy. You would never, ever know he is in his 20's. He is in fantastic shape. He is turned out in small herd and is very happy with him, so no stressors there. He is with 2 two-year olds and they play and move around alot - I believe they have really kept him young! We have only trailered to a few small schooling shows - a CT and dressage. He absolutely loves going places - trails, etc. and we never ride for more than an hour - 2 max if we are trailering somewhere, and nothing steep or rocky. I ride him 2-3 times a week, plus a half hour light lesson. He is THE BEST trail horse. Likes to lead, walks out beautifully and is about as bombproof as they get. He is the horse that others have asked to ride with when theirs is acting silly or green.

His diet is excellent - vet has recommended the alfalfa for his belly and it's really the only hay he can chew. He has worn down back teeth. He is on TC Senior, which is low NSC. The only gastric supp he is on is Smartgut.

As for my vet, he is tops in his field. All decisions are being made based on Xrays, flexions and full lameness evaluation.

He is shod and farrier comes today - will ask about doing something different with the hinds.

Thanks again everyone!


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## ~*~anebel~*~ (Aug 21, 2008)

Your vet sounds like he knows what he is doing. Maybe get him to talk to your farrier too?

Good luck!
_Posted via Mobile Device_


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## pattyschuler (Nov 25, 2011)

I am about to start my yearling on adequan (he had surgery for OCD and a subchondral bone cyst) and my vet said to do a 10 day regimen. 5cc every 4 days. I was also told that adequan IM is the best for joint issues. Sorry I can't help on the gastro issue. I havent had to deal with that issue.


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