# Pentosan IM Joint Injections



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

I've never used Pentosan (I am a huge Adequan fan though) but after a bit of research it appears to be a well proven product, and a fraction of the price of Adequan.
I would be cautious with the 6mL dose all in one site, I would be tempted to re adjust the needle partway through the injection to reduce infection risk associated with a >5mL IM injection, but talk to your vet.
I'm also cautious on any claims on anything being effective once monthly. Adequan is not effective once monthly, it must be injected at least every 4 days, per manufacturers instructions. Pentosan claiming to be effective once monthly to me sounds sketchy.

Finally the last skeptical thing I'm going to say - it appears that Pentosan also advises the use of oral glucosamine with its use. Studies have shown that horses are unable to digest and absorb oral glucosamine. Why a company would contradict science and suggest use of a specific brand name product (Coseqin) is weird to me. IMO scrap the oral supplement, its nothing more than expensive molasses. But talk to your vet.

Good luck and report back your findings!
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## CLaPorte432 (Jan 3, 2012)

My vet wants me to do a loading dose of the Pentason for the first one or two injections. Then go down to the regular dose, and then once a month after the initial 4 doses. Ill see what doses my vet has me doing once i pick the shots up, and ill definitely document my results.

When i was looking into Adequan, they say to use it every 4 days for 7 treatments, and then drop down to once a month.

I have had success with one specific oral joint supplement called Regenex. It has 5000ml gluclosamine, and 5000ml msm, plus 1000ml of chondriotin. Horses are large animals and they need high doses in order to see an effect. If people and other animals have success talking orals, why wouldnt an equine? It just has to be the right dose is my thinking. Then again, im not a vet. 

I would like to not have to give oral joint meds though because i do not grain every single day. So im really hoping that IM shots is the way to go. 

Can i ask why there is the risk on infection with putting the 6ml all into one site? Im even thinking i may have 10ml-12ml to inject depending on what my loading dose is. I was having to give 30ml penicillin (broken into 2 15ml shots) twice a day, and 30ml gentamicin all into one site. So the measley 6ml doesnt seem like much to me compared to the antibiotics Rumor was on. ;-)
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## ~*~anebel~*~ (Aug 21, 2008)

CLaPorte432 said:


> My vet wants me to do a loading dose of the Pentason for the first one or two injections. Then go down to the regular dose, and then once a month after the initial 4 doses. Ill see what doses my vet has me doing once i pick the shots up, and ill definitely document my results.
> 
> When i was looking into Adequan, they say to use it every 4 days for 7 treatments, and then drop down to once a month.
> 
> ...



Glucosamine and Chondroitin molecules are actually too large to absorbed through the horse's digestive tract. You probably were seeing results from the MSM. Humans and horses digest foods in completely different ways so no, oral supplements do not affect horses the same way they do humans. Yes glucosamine is beneficial to horses, but only when given in a way that they can absorb it, this is to say IM. My vet has told me that he feels bad the clinic he runs out of sells these oral supplements at the front desk but that if people are dumb enough to spend hundreds of dollars on that stuff, it's money. He has never recommended an oral supplement for any of my horses suffering from joint disease either degenerative or acute. Always IM IV or IA.

Adequan does not recommend monthly use of their product, it is right in their FAQ at To get the maximum benefit use Adequan i.m. 1/4/7
I quote "Once a month dosing is not clinically proven to be effective."

I can't find the article right now, but to reduce the risk of a Clostridial Myonecrosis (CM) infection (google it) the dose should not be larger than 5mL. That is one of the risk factors of the infection (injecting large volumes). When administering antibiotics I have always been advised by my veterinarian to split the doses into multiple injection areas.
6mL might be pushing it, but 10-12mL is begging for complications. Antibiotics are not as much of an issue I don't think, but I would definitely be splitting a loading dose up. As well I haven't seen the need for 2x the volume for a loading dose in any joint treatments. Pentosan seems very clear with the dosage requirements:
Administer at a dose rate of 3 mg/kg body weight (1.5 g / 500 kg horse), by intramuscular injection, at 5 – 7 day intervals for four injections. 

But anyways, good luck!


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## CLaPorte432 (Jan 3, 2012)

Thank you Anabel! As ever, you are very insightful and full of great information.  
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## ~*~anebel~*~ (Aug 21, 2008)

CLaPorte432 said:


> Thank you Anabel! As ever, you are very insightful and full of great information.
> _Posted via Mobile Device_



Or just scarily used to shooting horses up with drugs haha who are we kidding?
You're welcome, I'm interested to hear how the Pentosan works. It would be nice to finally have a bit of a less expensive alternative to Adequan for OA support and cartilage repair!!
I will also be bugging my vet about this


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## CLaPorte432 (Jan 3, 2012)

Oh absolutely. My horse is recovering from a bacterial infection, developed into cellulitis, bacteria travelled into her big rocker joint in her hock. Shes had 2 joint flushes. She is still quite swollen, a little sore due to the dilution of her joint fluid. So we are hoping the shots will rebuild the fluid, decrease the swelling and not break my bank anymore then it already has been. HaHaHa. 

I will keep you informed of how the Pentosan works for her. My vet is excited to try it.
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## ~*~anebel~*~ (Aug 21, 2008)

CLaPorte432 said:


> Oh absolutely. My horse is recovering from a bacterial infection, developed into cellulitis, bacteria travelled into her big rocker joint in her hock. Shes had 2 joint flushes. She is still quite swollen, a little sore due to the dilution of her joint fluid. So we are hoping the shots will rebuild the fluid, decrease the swelling and not break my bank anymore then it already has been. HaHaHa.
> 
> I will keep you informed of how the Pentosan works for her. My vet is excited to try it.
> _Posted via Mobile Device_


Yes, have you tried Legend IV yet?? I would also probably want to do a few shots of that. Being that she has had such an infection I would be wary of doing IA Legend, but that might also benefit her.

Good luck!! Yay vet bills (not)!!


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## CLaPorte432 (Jan 3, 2012)

No i have not tried the Legend IV. Ill have to research it and see what it does and if itd benefit her. It has been a very long 5 weeks. *sigh*
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## CLaPorte432 (Jan 3, 2012)

Anabel, i wanted to update you on how Pentosan is working on my mare.

Its flat out...AMAZING! I am so happy with the results im seeing by using this injection. Rumor occassionaly has moderate swelling when she is due for another shot, within a day of giving her the injection, the swelling is very minimal, and she moves very fluidly. 

A few weeks ago, she still had a slight hitch to her transition into the trot, now i dont notice any hitch at any gait.

She had muscle atrophy on her left hind hip due to the way she limped for so long, and now you can visibly see where she is rebuilding muscle tone to that hindend.

I also give MSM daily but my miracle drug has been the Pentosan. I highly recommend giving it a try. I pay $19 per 6ml shot. It was $38 for the 12ml loading doses.

To start we did 4 loading doses, once a week, because of the severity of my mares injury. And now i am giving one 6ml shot every 2 weeks.

http://www.horseforum.com/horse-health/3-months-later-how-lame-she-145407/ is a link to recent videos of her. Those were just a few weeks ago. Now, i dont see any hitch to her stride...

http://www.horseforum.com/horse-health/completely-freaking-out-136441/ is a link to her entire injury, recovery and treatments. Lots of pictures if your interested in seeing her at her worst. It'll make you appreciate how well she is moving and looking now. 
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## CCH (Jan 23, 2011)

With various horses, I have done the legend IV and found it to have minimal results. Adequan given 6 doses every 4 days and then as recommended seemed to work well in conjunction with IA injections of legend/kenalog/amikacin. Then I switched to hylartin for joint injection and they lasted 6-12 months easily instead of the 3-6.

I just started a round of pentosan in 2 of mine. They will get 6mL every 6 days for 6-7 shots as a loading dose and then I will try a shot every 2-4 weeks depending on the results and the individual. I was super leery of pentosan when I heard about it early last year. My policy is not to use unapproved drugs, but I had several reputable friends tell me about how it worked for them. I decided to try it.

As for the risk of clostridium infection, that is present with ANY break of the skin. That is why you must practice aseptic techniques and monitor the injection site. 6mL is not a large shot and the pentosan itself is very viscous, much thinner than injecting penicillin for example. Neither of my horses had any issue. I will be rotating injection sites though.

I almost think I'm already seeing some improvement, but I'm trying not to say anything to see if other people notice what I *think* I see.
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## CCH (Jan 23, 2011)

And just saw this was an update to an older thread. Oh well... I'm liking the pentosan so far too is the point I guess.
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## Canterklutz (Jul 20, 2012)

I've had my gelding on monthly Pentosan for 2+ years and it's worked wonders on him. Way cheaper than Adequan and works just as well. I always alternate the injection site every month. Personally, I think joint supplements are a waste of money...:-|


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## CLaPorte432 (Jan 3, 2012)

CCH, its good to hear someone with such amazing horses using Pentosan. That really makes me feel good in my decision to trust my vet.

The FDA just recently approved it for use in the USA my vet said. Sometime last year maybe?

But yes, i am seeing results with my girl. Im my vets first client with using the stuff and so far, id say success.  She is now using it on other clients as well, but have not heard much feedback from them. 

Once my Paint mare foals and is weaned, ill be starting Pentosan injections with her. After numerous lameness exams, xrays, chiropractic care, she still seems "stiff" and "off" in her hindend. So, why not try this with her? It certainly cant hurt. But i have no idea of effects on pregnant and lactating mares so im not touching her with it right now.
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