Horse Health 101: Equine Joints

Horse Health 101: Equine Joints

The FAQ’s of degenerative joint disease and Adequan® i.m. (polysulfated glycosaminoglycan).

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Q: Is there a specific equine conformation type that may be more likely to develop non-infectious degenerative joint disease (DJD)?

A: Conformation can greatly influence the degree of wear and tear that a joint undergoes. Conformational abnormalities alter the forces applied to a joint and can potentially lead to joint instability, injury and DJD. The mature equine athlete that is performing well has likely adapted to whatever conformation issues that exist. However, if you are considering purchasing a young, unproven horse, avoiding horses with significant conformational flaws will increase the likelihood of the chosen horse staying sound. In young foals and growing horses, conformational abnormalities should be addressed as early as possible through proper nutrition, balanced farriery, adequate training and muscle development, and in some cases, surgical intervention.

Q: With respect to different disciplines, would a cutting horse or reining horse be more susceptible to DJD than a hunter-jumper?

A: Any horse can develop DJD regardless of age, breed or discipline. However, the horse’s discipline may predispose the horse to developing DJD in particular joints. For example, cutting or reining horses put significant stress on their hocks and stifles, and these can be locations where DJD occurs more frequently; whereas hunters will frequently experience more front-limb lameness, such as in the coffin or fetlock joints. It is important to understand that DJD can occur within any joint that consistently experiences wear and tear, known as “use trauma,” and can occur in any performance horse, regardless of discipline.

Q: What is the best Adequan® i.m. (polysulfated glycosaminoglycan) dosing regimen for a horse that is diagnosed with DJD?

A: When experiencing a lameness problem, it is important to first obtain an accurate diagnosis from your veterinarian in order to determine the appropriate course of treatment. Initiating a medical treatment without a firm diagnosis can lead to a poor outcome and unnecessary expense. Adequan® i.m. is Food and Drug Administration (FDA) approved for the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints. 1 If a horse has been diagnosed with DJD, your veterinarian may prescribe Adequan® i.m. (polysulfated glycosaminoglycan). The labeled dose of Adequan® i.m. is 500 mg every 4 days for 28 days intramuscularly (for a total of 7 injections). 1 The series should be repeated as needed upon recurrence of the clinical signs of DJD in your horse. There is no FDA approval for, and no published data to support, maintenance dosing regimens for Adequan® i.m.

Q: In your opinion, what is the importance of using FDA-approved products in your horse versus other options?

A: I cannot over-emphasize the importance of using FDA approved products. FDA-approved products have been rigorously tested for safety and efficacy through required clinical studies. It should always be preferable to use FDA-approved products over other products circulating in the equine marketplace, such as compounded medications and medical devices, which are not required to demonstrate safety or efficacy, are not necessarily routinely monitored and are not regulated with the same level of scrutiny.

Q: Adequan® i.m. is an intramuscular injection – how does it work its way to my horse’s joints?

A: Adequan® i.m. is well-supported by published safety and efficacy studies that led to initial FDA approval and has since served the equine industry for more than 27 years. After intramuscular injection, Adequan® i.m. has been shown to diffuse into the bloodstream, which transports Adequan® i.m. into synovial fluid, where it is absorbed by articular cartilage at therapeutic levels that inhibit cartilage degrading enzymes within the joint. 2 Adequan® i.m. diminishes the destructive processes of DJD, reverses the processes which result in loss of cartilage and improves overall joint function and associated lameness. Adequan® i.m. is the only FDA-approved equine PSGAG recommended for the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses. 1

Consult your veterinarian if you notice any changes in your horse that may signal the onset of DJD and discuss whether Adequan® i.m. is right for your horse. For more information on Adequan® i.m., please visit

Adequan® i.m.:  For the intramuscular treatment of non-infectious degenerative and/or traumatic joint   dysfunction and associated lameness of the carpal and hock joints in horses. There are no known contraindications to the use of intramuscular Adequan® i.m. brand Polysulfated Glycosaminoglycan in horses. Studies have not been conducted to establish safety in breeding horses. WARNING: Do not use in horses intended for human consumption. Not for use in humans. Keep this and all medications out of the reach of children. CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian.

Dr. Marian G. Little earned her DVM from The University of Tennessee in 2000. She completed an internship in Equine Medicine and Surgery at Mississippi State University. Following her internship, Dr. Little engaged in 100% equine ambulatory practice in Tennessee and Virginia. Her clinical interests include lameness, laminitis, endocrinology, and geriatrics. In 2005, she joined veterinary industry where she has supported launch of several market-leading equine pharmaceuticals and vaccines. In 2015, Dr. Little joined the Animal Health Division of Luitpold Pharmaceuticals as Technical Services Veterinarian, Medical Affairs.

Dr. Little has repeatedly served as program speaker at national and regional veterinary conferences throughout the US. Dr. Little is a current Member of the American Association of Equine Practitioners and Kentucky Veterinary Medical Association.  She resides in Paris, Kentucky.


    1. Adequan® i.m. [package insert]. Shirley, NY: Luitpold Animal Health; 2008.
    1. Burba DJ, Collier MA, Default LE, Hanson-Painton O, Thompson HC, Holder CL: In vivo kinetic study on uptake and distribution of intramuscular tritium-labeled polysulfated glycosaminoglycan in equine body fluid compartments and articular cartilage in an osteochondral defect model. The Journal of Equine Veterinary Science 1993; 696-703.

This is a paid advertisement by Luitpold Pharmaceuticals, Inc., maker of Adequan® i.m. (polysulfated glycosaminoglycan). Dr. Marian Little, DVM, is the Technical Services Veterinarian and employee of Luitpold Pharmaceuticals Animal Health Division.

About Adequan® i.m. (polysulfated glycosaminoglycan)

American Regent Animal Health, maker of Adequan® (polysulfated glycosaminoglycan), is thrilled to be the title sponsor of the Adequan Select AQHA World Championship Show again this year. To learn how FDA-approved Adequan may help your horse or your dog visit