Adequan and Legend - Healing Your Horse's Joints

In the quest to keep your performance horse health and happy, joint health is always a primary concern. A horse’s joints go through mild to moderate  repetitive trauma in most sports, and often need to be supported with medical therapies in order to prevent or decrease the rate of degenerative joint disease. It’s easy to visualize the trauma a horse’s joints are subjected to – just go to Youtube.com and search for “slow motion horse” or “slow motion dressage“. Below is a great video of show jumping at the 2012 Olympic Games in London. Keep your eyes on the horse’s fetlocks and hocks to see the most dramatic joint movement.

Adequan and Legend are both joint therapies that are useful in preventing and treating inflammation in joints. However, they’re used by the body in different ways. Some horse’s joint issue may respond to Adequan, some may respond to Legend, and some may need both therapies. They are not interchangeable medications. Truly, the only similarities between the two products are:

  • They are both indicated for inflammation of joints;
  • Both are legal in competition.

Indications

Adequan is a polysulfated glycosaminoglycan. It is utilized by the cartilage matrix of the joint and also affects the Hyaluronic Acid (HA) concentrations in the joint significantly increasing from 24 through 96 hours. Adequan is incorporated directly into the cartilage where it helps with the compression capabilities of the joint. It has been shown to help heal and aid in the long term health of articular cartilage.

Legend is pure Hyaluronic Acid that is utilized by the synovial cells that line the joint capsule. Synovial cells produce the fluid that supports the joint structures. Legend helps the joint as a whole by improving the health of these synovial cells. Legend improves the quality of the joint fluid by decreasing the production and release of inflammatory mediators, it helps reduce joint inflammation and the resulting pain and lameness.

Administration

Historically, Adequan was started with a loading dose of one 5cc IM injection every four days for 28 days, for a total of seven treatments, and then once a month. Now, the recommendation is to do the seven “loading dose” treatment twice a year. The reasoning behind this change is that the cumulative effect is greater by doing the two pulses rather than doing a smaller amount on a monthly basis.

Legend is used as an intravenous injection, as opposed to the IM injection with Adequan. This 4cc IV injection is administered once weekly, for four weeks, and then on a monthly basis.

Cost

Costs can vary drastically for both Adequan and Legend. With either drug, you need to account for the cost of a veterinary farm call in addition to medication cost.

A single Adequan dose can range in price from $40 bought in bulk, to $100 when including injection fees from your veterinarian.

A single Legend dose can range from $80 when bought in bulk from a distributor, to $130 when purchased from your veterinarian, and including the injection fee.

Take-Away

Depending on what joint malady your horse is suffering from, Adequan, Legend, or both may be an appropriate treatment choice. Work with your veterinarian to determine the best option for your horse. Understand that though the two are often spoken about as though they are “a horse a piece”, they are very different medications and they are not interchangeable.

Have more questions? Let me know in the comments.

By Howard Ketover, DVM