Systemic Equine Joint Treatments

By: Dr Brandee Baker

Horses are living much longer lives now due to advancements in healthcare and knowledge. With use and age, horses experience boney changes such as arthritis and the discomfort that comes with it. Many horses, especially those in work, receive routine joint injections that help keep them comfortable and able to perform maximally. However, there are many other treatments and adjunct therapies that improve joint health and therefore improve the horse’s performance and quality of life.
Arthritis, or degenerative joint disease, is essentially “wear and tear” of a joint. The cartilage that covers the bone starts to get worn, and when this happens it causes inflammation within the joint capsule. The synovial fluid (fluid that lubricates inside of the joint) becomes inflamed, and the nerve endings within the joint become irritated. This is a painful, chronic, condition that can happen in any joint. When the bones meet each other and are not protected, we commonly see osteophytes, or “bone spurs.”

There are 3 systemic injections Jackpot offers to improve the joints:


Adequan, a polysulfated glycosaminoglycan, is an intramuscular injection given every 4 days for 7 treatments and then as needed. Many clients choose to do it once monthly after the loading dose. It is labeled to reduce the swelling and inflammation associated with joint disease to improve lameness, restore synovial lubrication , repair cartilage and aid in the production of new cartilage, and inhibit harmful enzymes that attack cartilage and synovial fluid.


Legend, hyaluronate sodium, is an intravenous injection given once weekly for 3 treatments then as needed like Adequan. It is labeled to reduce production of inflammatory mediators, joint inflammation, and the resulting lameness for at least 45 days, stimulate endogenous hyaluronic acid production, and create a physical barrier to get rid of inflammation. Both Legend and Adequan are very similar substances to what is naturally produced in the body.


Pentosan, a heparin-like substance derived from beechwood, is a mild anticoagulant, with anti-inflammatory, fibrinolytic, and hypolipidemic properties. It is usually given intramuscularly once per week for 4 treatments, or once monthly. It works to improve the cartilage and exclude inflammatory cells. Pentosan is frequently compounded, meaning there is not an official FDA regulated product.
Another systemic therapy for the joints is a joint supplement. Two great brands are Platinum Performance CJ and Cosequin. Both of these products are research based and from reputable companies. Many companies will sell joint supplements that have fillers and ingredients that potentially are not helpful. Joint supplements are a great adjunct therapy to keep the joints healthy with vitamins, minerals and other ingredients like MSM. MSM is thought to repair cells and cartilage.
Lastly, NSAID therapy is used to systemically treat pain in equine joints. Phenylbutazone, or “bute” and Equioxx (firocoxib) are NSAIDs that work to decrease prostaglandin and therefore decrease inflammation of tissues. NSAIDS work to block COX-1 and COX-2. COX-2 is more associated with inflammation and COX-1 helps maintain the normal lining of the stomach. Equioxx is selective, and only targets COX-2 , while bute targets both. With this being said, bute is more of a powerful pain reliever, but long term bute use is not safe. Not only can it lead to gastric ulcers but it has a greater impact on the kidneys as well.
A lameness evaluation performed by a veterinarian which includes palpating the limbs of the horse, evaluating the feet, flexing the joints, performing local blocks, radiographs and/or ultrasound can help identify where the horse is sore and then allow for a tailored treatment protocol.

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