Oh, No! What Do We Do Without Adequan®?

Oh no  

I don’t know if you’ve heard, but Adequan® is on manufacturer’s backorder.  That’s because the company that makes the product is renovating their manufacturing facility to, “Address observations made by the U.S. Food and Drug Administration(FDA).”  According to information that I got in the mail – along with, presumably, every other veterinarian on the planet – that means that Adequan® isn’t going to be available until sometime in 2014 (obviously, given that this is their big product, the manufacturer hopes it will be sooner than later).

As a result of this, a few people have asked me, “What do I do?” They’ve wondered about substitutes.  The fact of the matter is that there is no other product that is exactly Adequan®, so, for better or worse, you’re not going to be able to give your horse the same thing (assuming that you want to give your horse the stuff – more on that later).  Anyway, here, I think, are what are pretty much your options.

The pharmacy staff is at your service

The pharmacy staff is at your service

1.  You can get a compounded product of some sort.  Compounded drugs are a very controversial area in medicine (both human and veterinary – you can CLICK HERE to see lots of information from the American Association of Equine Practitioners about drug compounding).  Controversial because of things like quality control, and mistakes such as the one that killed 21 polo ponies in Florida a few years back.  But even if you get a completely safe compounded product, you’re not going to get Adequan®, since that’s an FDA approved drug, and no one else but the company can make it.  If you get a compounded product, you’re probably going to get something like compounded Pentosan®, which, as a labelled drug, is a product that is legally produced and sold in Australia, or something like N-acetyl-glucosamine, which also isn’t a substitute for Adequan® and who-knows-if-it works.  You pays your money and you takes your chances.

My idea of a "device," in this case, an automatic napkin

My idea of a “device,” in this case, an automatic napkin

2.  You can use a “device.”  The latest thing to show up on the what-can-we-inject-into-your-horse-now scene are products that are labelled as “devices.”  For a thorough description of what constitutes a device, you can go to the FDA website that talks about them if you CLICK HERE.

The curious thing about these liquid products that are called “devices” (I know, it seems weird to me, too – I tend to think of a device as a thing) is that, according to the FDA, “If the primary intended use of the product is achieved through chemical action or by being metabolized by the body, the product is usually a drug.”  Chemical action, or being metabolized by the body, is, of course, just exactly what is expected of Adequan®, or, for that matter, just about anything that you’d put into your horse in an effort to treat or prevent arthritis.  So, by labeling a product as a “device,” the company is essentially claiming that is isn’t metabolized by the body, and isn’t a drug.  Then they can sell the heck out it, and if someone happens to use it for a purpose other than which it was intended, it’s not their problem.

Sometimes, you just gotta throw your hands up in the air

Sometimes, you just gotta throw your hands up in the air

There are at least three such “device” products out there that may be offered to you as some sort of an Adequan®-like experience.  In no particular order, they are called MAP-5® (it’s supposed to be used for embryo transfer), Polyglycan®, and PentAussie® (both of those are supposed to be used to help replace fluid that’s lost during joint surgery).  And whatever they are (they’re not the same), they also aren’t Adequan®.  Of those three products, there have actually been a couple of studies done on Polyglycan®, which showed some effect in experimental models of osteoarthritis.  But if you ask me if these products actually do any good for your horse, my response would be, “I have no idea,” and, “They really aren’t Adequan® anyway.”

As far as I can tell, the principle virtue of these products is that they’re generally cheaper than the products for which they are often substituted (one of those products would be intravenous hyaluronon – Legend®).  I say that’s the principle virtue because, like I said, if you were to ask me to provide you some good, solid evidence for their use in preventing or treating arthritis in horses, I’d have to throw my hands up in the air.  There just isn’t any.  You can be pretty sure they won’t kill your horse, I guess, but that’s not exactly a ringing endorsement.

They're waiting for you, in your favorite color and flavor

They’re waiting for you, in your favorite color and flavor

3.  You can give your horse some sort of an oral supplement.  By now, if you’ve read anything on my website, you’ll know that I am no fan of oral joint supplement products, and for a lot of reasons.  CLICK HERE if you want to refresh your memory.  But you can go out and buy buckets or bottles of this, that, or the other, all of which have lots of vague claims, and most of which lack any data to back those claims up.  I have no idea how many of these arthritis prevention products there are out there but I can assure you of two things:

  • There are lots of them
  • After a couple of decades of relentless promotion, arthritis is still a problem (for horses and people).

Fugetaboutit 4.  You can forget about it.  I don’t know if you have had a chance to read my post on Adequan®, but if you haven’t, you can see it if you CLICK HERE.  I pretty much don’t bother with the stuff in my practice, a fact that has undoubtedly cost me a lot of money over the years.  On the happy side, I’ve had lots of clients thank me for saving them the oodles of dollars that they would have spent chasing after the wonderful effects that have been claimed for the stuff.  It’s nice to get compliments, even if you can’t go to Starbucks® and buy anything with them.

Of course, you may be thinking, “I have to do something,” because you love your horse, and you want to do everything that you can to help prevent him from having joint problems.  So, understanding that, here are a few tips, and especially if you’re getting frustrated waiting for the Adequan® ship to come in.

  • BlessingKeep your horse at a good weight.  Extra weight is bad for joints, tendons, ligaments, hearts, and, well, just about everything that makes up a horse.
  • Don’t ride him too hard. Wear and tear creates problems for joints (and tendons, and muscles, and pretty much everything else).
  • Exercise your horse regularly.  Horses were made to run around in big, open spaces.  Keeping them cooped up all the time makes them stiff and sore (as any office worker knows).  The more he can move around, the happier he (and you) will be.
  • Be sensible in your exercise program.  If you’re competing him in athletic competitions, get him in shape before you go to the show.
  • Pay attention to him.  I can’t tell you that extra brushing, fussing, and scratching will prevent health problems, but your horse will like it, and you’ll feel good, too (an extra benefit, for sure).

So, there you go.  For better or worse, Adequan® will be back, eventually.  In the meantime, you can try any number of things that haven’t been shown to do much of anything (sort of like Adequan®, actually), or you can do nothing at all, and see if you see any difference.  Who knows, this whole thing might end up being something of a blessing of disguise.

 

 

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