Re: Adequan for prevention

[Guest guest]

Hi ,

I routinely use Adequan for prevention in “at

risk” dogs. So my target population other that clinically lame dogs

is 1) Working dogs: Agility/fly ball/dock jumpers/lure coursers/police dogs/field

trialers 2) Chondrodystrophic/chondrodysplastic breeds 3) Toy

breeds with patellar luxation 4) Anyone with radiographic evidence of hip

dysplasia or elbow dysplasia. I am still in the no oral glucosamine camp.

I always go back to the saying that OA comes from “normal stresses on

abnormal joints” or Abnormal stresses on normal joints”. So I may

as well be as proactive on both as I am able!

I do use a full loading dose and then

boosters prior to or after competitions or increased workload.

Hope that helps, can’t wait to hear

other opinions! Pam

Pam Nichols DVM, CCRP

Animal Care Center

K-9 Rehab Center

West Bountiful, Utah

From: VetRehab [mailto:VetRehab ] On Behalf Of Orenbuch

Sent: Thursday, May 06, 2010 9:05

AM

To: VetRehab

Subject: adequan for

prevention

Hi,

I’m

curious if anyone is using adequan for prevention. I have a client who had such

great success with it on two other dogs with significant arthritis that she is

interested in using it for a 9 yo competition agility border collie who has

“fair” hips but is showing no signs right now. The dog is

already on a glucosamine supplement.

And, if you

would use it as a preventive, do you do the full loading dose?

Thanks,

Orenbuch DVM, CCRT, CAVCA, CVA(pending)

evelynvetcomcast (DOT) net

cell

home GA

www.evelynvet.com

Vice Pres -

American Assoc. of Rehab Veterinarians - www.rehabvets.org

[Guest guest]

Can dogs tolerate flax?Sent from my iPodle Robbins,MS,PTCertified Canine Rehab Therapist

,

I think using Adequan in this way makes a lot of sense. In the early 80's I first used the Adequan in young race horses in effort to protect articular cartilage from the trauma induced by racing. It was actually marketed in this manner. Because actions of Adequan are thought to aide in the prevention of cartilage degradation and inhibition of catabolic enzymes, at least in-vitro, its presence in a athlete's joints that are exposed to trauma, at least has a pathophysiologic argument that can be made. I attended an OA meeting last week with a number of DVMs including some surgeons who were recommending it in a more proactive role in any young dog with any degree of joint laxity of the coxofemoral joint.

I might also consider diets rich in EPAs due to their anti-inflammatory and anti- cartilage degradation properties. My prefer diet is j/d that delivers about 70mg/kg EPA to the dog.

Rick Wall

[Guest guest]

,

I think using Adequan in this way makes a lot of sense. In the early 80's I

first used the Adequan in young race horses in effort to protect articular

cartilage from the trauma induced by racing. It was actually marketed in this

manner. Because actions of Adequan are thought to aide in the prevention of

cartilage degradation and inhibition of catabolic enzymes, at least in-vitro,

its presence in a athlete's joints that are exposed to trauma, at least has a

pathophysiologic argument that can be made. I attended an OA meeting last week

with a number of DVMs including some surgeons who were recommending it in a more

proactive role in any young dog with any degree of joint laxity of the

coxofemoral joint.

I might also consider diets rich in EPAs due to their anti-inflammatory and

anti- cartilage degradation properties. My prefer diet is j/d that delivers

about 70mg/kg EPA to the dog.

Rick Wall

[Guest guest]

Thanks Dr Wall

Sent from my iPod

le Robbins,MS,PT

Certified Canine Rehab Therapist

> le,

>

> Flax seed is actually higher in omega 3 FAs than fish oils however

> the omega 3 FAs are in the form of alpha-linolenic acid that must be

> converted to EPA (eicosapentanoic acid) and DHA (docosahexaenoic

> acid). It is not certain if all dogs can convert ALA. Regarding

> osteoarthritis EPA is the only omega 3 shown to be effective and the

> fish oils, especially cold water tend to contain high levels.

> Approx. 50 to 100mg/kg per day EPA is needed to prevent cartilage

> degradation.

>

> Rick Wall

>

>>

>> Can dogs tolerate flax?

>>

>> Sent from my iPod

>> le Robbins,MS,PT

>> Certified Canine Rehab Therapist

>>

>>

>>

>> On May 6, 2010, at 10:46 AM, " Rick Wall, DVM "

>> wrote:

>>

>>>

>>> ,

>>>

>>> I think using Adequan in this way makes a lot of sense. In the

>>> early 80's I first used the Adequan in young race horses in effort

>>> to protect articular cartilage from the trauma induced by racing.

>>> It was actually marketed in this manner. Because actions of

>>> Adequan are thought to aide in the prevention of cartilage

>>> degradation and inhibition of catabolic enzymes, at least in-

>>> vitro, its presence in a athlete's joints that are exposed to

>>> trauma, at least has a pathophysiologic argument that can be made.

>>> I attended an OA meeting last week with a number of DVMs including

>>> some surgeons who were recommending it in a more proactive role in

>>> any young dog with any degree of joint laxity of the coxofemoral

>>> joint.

>>>

>>> I might also consider diets rich in EPAs due to their anti-

>>> inflammatory and anti- cartilage degradation properties. My prefer

>>> diet is j/d that delivers about 70mg/kg EPA to the dog.

>>>

>>> Rick Wall

>>>

>>

>>

>

>

>

> ------------------------------------

>

>

[Guest guest]

Rick,

I am curious about where the 50 to 100mg/kg EPA dosing comes from. In

discussions with scientists at Hills they have told me there are 394 mg

EPA/cup of J/D which would deliver much closer to 1200 mg EPA as fed for a

60 lb Labrador which is pretty close to Freeman's anti-inflammatory

dose of EPA.(40mg/kg per day) Purina has told me that JM contains 290mg EPA

per cup. We often have clients that would like to use other foods than J/d

or JM (or we would like to use a weight management diet) so we have been

using her dose.

I wonder if you can share your reference for the higher dose for cartilage

preservation?

All the information you have stated regarding poor conversion of the Omegas

3's in flax to the long chain has been supported in the references I share

with our referring Drs.

Thanks much,

Ken Lambrecht DVM

Medical Director Westside Family Pet Clinic

Fitness & Rehab Director 4 Paws Swim & Fitness

westsidefamilypet.com

Re: adequan for prevention

le,

Flax seed is actually higher in omega 3 FAs than fish oils however the omega

3 FAs are in the form of alpha-linolenic acid that must be converted to EPA

(eicosapentanoic acid) and DHA (docosahexaenoic acid). It is not certain if

all dogs can convert ALA. Regarding osteoarthritis EPA is the only omega 3

shown to be effective and the fish oils, especially cold water tend to

contain high levels. Approx. 50 to 100mg/kg per day EPA is needed to

prevent cartilage degradation.

Rick Wall

>

> Can dogs tolerate flax?

>

> Sent from my iPod

> le Robbins,MS,PT

> Certified Canine Rehab Therapist

>

>

>

>

>

>>

>> ,

>>

>> I think using Adequan in this way makes a lot of sense. In the early 80's

I first used the Adequan in young race horses in effort to protect articular

cartilage from the trauma induced by racing. It was actually marketed in

this manner. Because actions of Adequan are thought to aide in the

prevention of cartilage degradation and inhibition of catabolic enzymes, at

least in-vitro, its presence in a athlete's joints that are exposed to

trauma, at least has a pathophysiologic argument that can be made. I

attended an OA meeting last week with a number of DVMs including some

surgeons who were recommending it in a more proactive role in any young dog

with any degree of joint laxity of the coxofemoral joint.

>>

>> I might also consider diets rich in EPAs due to their anti-inflammatory

and anti- cartilage degradation properties. My prefer diet is j/d that

delivers about 70mg/kg EPA to the dog.

>>

>> Rick Wall

>>

>

>

------------------------------------

[Guest guest]

le,

Flax seed is actually higher in omega 3 FAs than fish oils however the omega 3

FAs are in the form of alpha-linolenic acid that must be converted to EPA

(eicosapentanoic acid) and DHA (docosahexaenoic acid). It is not certain if all

dogs can convert ALA. Regarding osteoarthritis EPA is the only omega 3 shown to

be effective and the fish oils, especially cold water tend to contain high

levels. Approx. 50 to 100mg/kg per day EPA is needed to prevent cartilage

degradation.

Rick Wall

>

> Can dogs tolerate flax?

>

> Sent from my iPod

> le Robbins,MS,PT

> Certified Canine Rehab Therapist

>

>

>

>

>

>>

>> ,

>>

>> I think using Adequan in this way makes a lot of sense. In the early 80's I

first used the Adequan in young race horses in effort to protect articular

cartilage from the trauma induced by racing. It was actually marketed in this

manner. Because actions of Adequan are thought to aide in the prevention of

cartilage degradation and inhibition of catabolic enzymes, at least in-vitro,

its presence in a athlete's joints that are exposed to trauma, at least has a

pathophysiologic argument that can be made. I attended an OA meeting last week

with a number of DVMs including some surgeons who were recommending it in a more

proactive role in any young dog with any degree of joint laxity of the

coxofemoral joint.

>>

>> I might also consider diets rich in EPAs due to their anti-inflammatory and

anti- cartilage degradation properties. My prefer diet is j/d that delivers

about 70mg/kg EPA to the dog.

>>

>> Rick Wall

>>

>

>

[Guest guest]

Ken,

It is rather confusing is it. I am a speaker for Hill's/Novartis

Oseteoarthritic Advocate Program and I had to ask several people at Hill's to

finally get how much EPA is in j/d and the answer was 126.4mg/100 kcal. Using

an estimate of 61 kcal/kg/day maintenance a 60 lb (27kg) dog would consume 1647

kcal/day thus about 2085 mg of EPA or approx 75mg/kg. If what Hill's told me is

correct then a cup of dry j/d would contain 356 kcal/cup thus 454 mg EPA.

Regarding the dose for EPA, their are several out there for numerous problems

however the 50 to 100mg/kg dose is from Hill's and is referenced in a pa;er from

Dr. Philip Roudebush at their 2008 Global Mobility Summit and again in the 5th

edition of Small Animal Clinical Nutrition, Chapter 34, page 703 " Nutritional

Management of Osteoarthritis " Towell TL, DC. Now this is referenced

as the level that should be in a therapeutic diet.

Rick Wall

[Guest guest]

Rick

Thanks for sharing the reference!

It seems we are much closer on dose when calories consumed

are taken into consideration, which is the real issue in using these EPA rich

foods, in my opinion. We have followed many dogs through CCL rehab and with

90% of them over their ideal weight we have worked with the owners closely to

get them to their ideal weight at a slow, safe pace (2 to 4% weight loss per

week). What we have found is that many of these dogs (ranging from 80 to 100

lbs) only need to consume around 1000-1200 kcal daily to get to ideal weight.

With the info Hills has given you that would come out closer to the 40mg/kg

dose so that has been our dilemma, how much do we need to supplement the food,

if at all? We have traditionally gone to 40mg/kg but based on this I think we

will need to increase our dosing. Apparently , and I admit I haven’t studied

it closely enough yet, their multicentric study published in JAVMA this Jan

didn’t include obese dogs so this remains a bit of a challenge for us involved

in achieving ideal weight in a rehab setting i.e. do we dose based on ideal

weight or current weight? We have found J/D ineffective as a diet food and

sometimes use JM if the dog is only 10 to 20% over ideal. It would be

interesting to see what the folks at Purina have to say!

I know this thread began with a cartilage protection and we

can’t go there in this short conversation but just to acknowledge that the

“building block” theory of using Adequan, glucosamine, chondroitin sulfate

and/or Perna that may help the cartilage rebuild is the “other side” of this

discussion that needs to be considered in our OA dogs in addition to our anti-inflammatory.

Thanks always for your evidence based perspectives!

Ken

Ken

Lambrecht DVM

Medical

Director Westside Family Pet Clinic

Rehab

& Fitness Director 4 Paws Swim & Fitness

www.westsidefamilypet.com

From:

VetRehab [mailto:VetRehab ] On Behalf Of Rick

Wall, DVM

Sent: Thursday, May 06, 2010 8:13 PM

To: VetRehab

Subject: Re: adequan for prevention

Ken,

It is rather confusing is it. I am a speaker for Hill's/Novartis

Oseteoarthritic Advocate Program and I had to ask several people at Hill's to

finally get how much EPA is in j/d and the answer was 126.4mg/100 kcal. Using

an estimate of 61 kcal/kg/day maintenance a 60 lb (27kg) dog would consume 1647

kcal/day thus about 2085 mg of EPA or approx 75mg/kg. If what Hill's told me is

correct then a cup of dry j/d would contain 356 kcal/cup thus 454 mg EPA.

Regarding the dose for EPA, their are several out there for numerous problems

however the 50 to 100mg/kg dose is from Hill's and is referenced in a pa;er

from Dr. Philip Roudebush at their 2008 Global Mobility Summit and again in the

5th edition of Small Animal Clinical Nutrition, Chapter 34, page 703

" Nutritional Management of Osteoarthritis " Towell TL, DC.

Now this is referenced as the level that should be in a therapeutic diet.

Rick Wall

[Guest guest]

Rick, it is rare that we get someone with such a wealth of knowledge and passion to share it, thanks! It is always a pleasure to read your posts. I'm glad you did not decide to leave that time so long ago...

I'm sure many feel the same way!

Sincerely, Robby

J Porter III, VT, LMT, CCRPAnimal Rehabilitation CenterMandeville, LA70448

To: "VetRehab " <VetRehab >Sent: Thu, May 6, 2010 6:14:41 PMSubject: Re: adequan for preventionle,Flax seed is actually higher in omega 3 FAs than fish oils however the omega 3 FAs are in the form of alpha-linolenic acid that must be converted to EPA (eicosapentanoic acid) and DHA (docosahexaenoic acid). It is not certain if all dogs can convert ALA. Regarding osteoarthritis EPA is the only omega 3 shown to be effective and the fish oils, especially cold water tend to contain high levels. Approx. 50 to 100mg/kg per day EPA is needed to prevent cartilage degradation.Rick Wall> > Can dogs tolerate

flax?> > Sent from my iPod> le Robbins,MS,PT> Certified Canine Rehab Therapist> > > > > >> >> ,>> >> I think using Adequan in this way makes a lot of sense. In the early 80's I first used the Adequan in young race horses in effort to protect articular cartilage from the trauma induced by racing. It was actually marketed in this manner. Because actions of Adequan are thought to aide in the prevention of cartilage degradation and inhibition of catabolic enzymes, at least in-vitro, its presence in a athlete's joints that are exposed to trauma, at least has a pathophysiologic argument that can be made. I attended an OA meeting last week with a number of DVMs including some

surgeons who were recommending it in a more proactive role in any young dog with any degree of joint laxity of the coxofemoral joint.>> >> I might also consider diets rich in EPAs due to their anti-inflammatory and anti- cartilage degradation properties. My prefer diet is j/d that delivers about 70mg/kg EPA to the dog.>> >> Rick Wall>> > > ------------------------------------

[Guest guest]

Ken,

You bring up excellent points. In the obese osteoarthritic patient it is my

opinion that it is of more therapeutic value to remove the weight first, thus

not only decreasing mechanical stress on dysfunctional joints but also, and

perhaps more importantly, reducing the numerous pro-inflammatory mediators

released by adipose tissue. A supervised weight loss program with a therapeutic

diet designed for weight loss or the use of Slentrol for appetite suppression to

gain desired weight and body condition score. Once weight loss is accomplished

I then recommend beginning EPA supplementation via therapeutic diet. Adequan a

" disease modifying osteoarthritic drug " (DMOAD) can begin immediately.

I continue to be amazed at how well most therapies work combined with weight

loss and how they are destined for failure without.

Excellent Discussion!

Rick Wall

[Guest guest]

Robby,

Wow! Thank you for the kind compliment! I gain much more from participation in

discussion groups such as this, and the IVAPM listserv, than I could every

possibly add. I encourage all to participate!

Rick Wall

>

> Rick, it is rare that we get someone with such a wealth of knowledge and

passion to share it, thanks! It is always a pleasure to read your posts. I'm

glad you did not decide to leave that time so long ago...

> I'm sure many feel the same way!

> Sincerely, Robby

>

>

> J Porter III, VT, LMT, CCRP

> Animal Rehabilitation Center

> Mandeville, LA

> 70448

>

>

>

>

> To: " VetRehab " <VetRehab >

> Sent: Thu, May 6, 2010 6:14:41 PM

> Subject: Re: adequan for prevention

>

> le,

>

> Flax seed is actually higher in omega 3 FAs than fish oils however the omega 3

FAs are in the form of alpha-linolenic acid that must be converted to EPA

(eicosapentanoic acid) and DHA (docosahexaenoic acid). It is not certain if all

dogs can convert ALA. Regarding osteoarthritis EPA is the only omega 3 shown to

be effective and the fish oils, especially cold water tend to contain high

levels. Approx. 50 to 100mg/kg per day EPA is needed to prevent cartilage

degradation.

>

> Rick Wall

>

> >

> > Can dogs tolerate flax?

> >

> > Sent from my iPod

> > le Robbins,MS,PT

> > Certified Canine Rehab Therapist

> >

> >

> >

> >

> >

> >>

> >> ,

> >>

> >> I think using Adequan in this way makes a lot of sense. In the early 80's I

first used the Adequan in young race horses in effort to protect articular

cartilage from the trauma induced by racing. It was actually marketed in this

manner. Because actions of Adequan are thought to aide in the prevention of

cartilage degradation and inhibition of catabolic enzymes, at least in-vitro,

its presence in a athlete's joints that are exposed to trauma, at least has a

pathophysiologic argument that can be made. I attended an OA meeting last week

with a number of DVMs including some surgeons who were recommending it in a more

proactive role in any young dog with any degree of joint laxity of the

coxofemoral joint.

> >>

> >> I might also consider diets rich in EPAs due to their anti-inflammatory and

anti- cartilage degradation properties. My prefer diet is j/d that delivers

about 70mg/kg EPA to the dog.

> >>

> >> Rick Wall

> >>

> >

> >

>

>

>

> ------------------------------------

>

>

[Guest guest]

We use Adequan often as a preventative. In fact it is best great and works well as part of a multimodal approach to osteoarthritis or it's prevention. Diets rich in EPA and weight control combined with preventative exercise are all on our list for preventative measures. We do use the full loading dose.Just my two cents.Blair hollowell DVM CCRTSent from my iPhone

Hi,

I’m curious if anyone is using adequan for prevention.

I have a client who had such great success with it on two other dogs with

significant arthritis that she is interested in using it for a 9 yo competition

agility border collie who has “fair†hips but is showing no signs

right now. The dog is already on a glucosamine supplement.

And, if you would use it as a preventive, do you do the full

loading dose?

Thanks,

Orenbuch DVM, CCRT, CAVCA, CVA(pending)

evelynvetcomcast (DOT) net

cell

home GA

www.evelynvet.com

Vice Pres - American Assoc. of Rehab Veterinarians - www.rehabvets.org

[Guest guest]

 

Hi,

 

I’m curious if anyone is using adequan for prevention.

, I have never used it as such, but it is a chondroprotectant, so I don't really see an issue with doing so.  Of course its the same old problem of trying to prove a negative:  If you give it and it does well, would the dog have done well anyways?  I have spoken with the Luitpold people before and they will let you know if any studies were ever done using it as a protectant.  They seem pretty honest about stating what it can and cannot do.  I buy my adequan directly from them.  They sell the equine label in a large multidose bottle which I just find easier having around.  If you do talk to them, please follow up with me and let me know what they say.

 

 

And, if you would use it as a preventive, do you do the full

loading dose? My guess is no unless you want protection asap.  Best regards, Mike

 

Thanks,

 

Orenbuch DVM, CCRT, CAVCA, CVA(pending)

evelynvet@...

  cell

  home GA

www.evelynvet.com

Vice Pres - American Assoc. of Rehab Veterinarians - www.rehabvets.org

 

-- Mike Petty, DVMDiplomate, American Academy of Pain ManagementPresident-Elect, International Veterinary Academy of Pain ManagementArbor Pointe Veterinary Hospital

Canton, MI

[Guest guest]

" I routinely use Adequan for prevention in “at risk” dogs.  So my target population other that clinically lame dogs is 1) Working dogs: Agility/fly ball/dock jumpers/lure coursers/police dogs/field trialers  2) Chondrodystrophic/chondrodysplastic breeds  3) Toy breeds with patellar luxation 4) Anyone with radiographic evidence of hip dysplasia or elbow dysplasia "

 

So, if you are doing this long term, like say you are starting with a young agility dog, or a toy breed puppy in which you have identified  patellar luxation, and you plan to continue potentially for life, what sort of protocol are you using? Since the label dose is " for up to 4 weeks, maximum 8 injections " , at what frequency do you continue after the first four weeks?

 

I am intrigued with the idea of getting these populations on this (think I should start my own radiographically dysplastic, completely non clinical, excessively athletic and energetic 9 yr old agility border collie), although I have to say in our clinic we haven't even been successful in getting the overtly arthritic labs to use it. Most owners just balk at the cost and the need for so many repeat visits.  Also, we had a lecture by a Novartis rep recently in which she told us that if the OA is chronic and pronounced, Adequan is unlikely to be beneficial because it is too late, there is no cartilage to nurture.

 

Pamela Mueller PhD DVM

 

[Guest guest]

Hey guys,

I am completely confused as to your use of Adequan for prevention or long term

use? There is nothing in the literature nor does the manufacturer have any

evidence that it can safely be used long-term. Why would you not use Adequan as

a loading dose for 4 to 8 weeks while staring the dog on Dasuquin for long-term

maintenance or prevention? Dasuquin contains chondroitin sulfate which is

essentially the active ingredient in Adequan (we had this discussion a few years

ago on this listserve so it should be in the archives). We preformed the only

clinical study that I am aware of on the use of Glucosamine and Chondroitin

Sulfate for " protective / preventative " effects using a synovitis model….Canapp

S, et al, AJVR 1999.

There is also ZERO evidence that Adequan can be administered SQ despite all the

reports. The initial studies were IM and they have no data on bioavailability

nor have they radiolabeled the product to see that it even gets into the joint

in a SQ fashion.

Until someone shows me an objective study on Adeuqn SQ or " prevention or

maintenance " usage I do not recommend that mode of therapy (probably wasting the

clients money and stabbing the dog for no reason).

On a more positive note, we are about to start an FDA clinical efficacy trial on

the use of a product (similar to Adequan) that can be administered once a week

SQ with excellent results in New Zealand and Australia for the use of OA in

dogs.

Happy Mother's Day!!!,,

Sherman

Sherman O. Canapp Jr., DVM, MS, CCRT

Diplomate ACVS

Veterinary Orthopedic &

Sports Medicine Group

10975 Guilford Road

polis Junction, MD 20701

Phone:

Fax:

http://www.vosm.com

> " I routinely use Adequan for prevention in " at risk " dogs. So my target

> population other that clinically lame dogs is 1) Working dogs: Agility/fly

> ball/dock jumpers/lure coursers/police dogs/field trialers 2)

> Chondrodystrophic/chondrodysplastic breeds 3) Toy breeds with patellar

> luxation 4) Anyone with radiographic evidence of hip dysplasia or elbow

> dysplasia "

>

> So, if you are doing this long term, like say you are starting with a young

> agility dog, or a toy breed puppy in which you have identified patellar

> luxation, and you plan to continue potentially for life, what sort of

> protocol are you using? Since the label dose is " for up to 4 weeks, maximum

> 8 injections " , at what frequency do you continue after the first four weeks?

>

> I am intrigued with the idea of getting these populations on this (think

> I should start my own radiographically dysplastic, completely non clinical,

> excessively athletic and energetic 9 yr old agility border collie), although

> I have to say in our clinic we haven't even been successful in getting the

> overtly arthritic labs to use it. Most owners just balk at the cost and the

> need for so many repeat visits. Also, we had a lecture by a Novartis rep

> recently in which she told us that if the OA is chronic and pronounced,

> Adequan is unlikely to be beneficial because it is too late, there is no

> cartilage to nurture.

>

> Pamela Mueller PhD DVM

>

> >

> >

>

[Guest guest]

Mike,

Actually I did call the company (Maker of Adequan) and they had no data to share

with me regarding safety of long-term use, intermittent use, or SQ

administration. And while they have been riding the wave of their 1980's IM

studies and making millions of dollars another company has done their homework

and created a product that can be administered once a week SQ and has already

made it through FDA safety studies.

You are also correct Dasuquin does not require FDA approval since unlike Adequan

it is not a drug. However, Nutramax is currently spending a ton of money

performing 3rd party bench top and clinical trials to show if it is safe and

effective.

I too support the use of products extra label (IAHA), off-label (Fosamax for OSA

in dogs), complimentary medicine (acupuncture, and chiropractic) etc, however

there can be a huge placebo effect for both clinicians and owners regarding

supplements, drugs and treatments……..where is the current evidence based

medicine regarding stem cell therapy for OA (based on 2 non-placebo controlled

subjective vet therapeutic studies authored by Vet Stem)…….yes, many studies are

currently under way, however in the meantime we must look out for our patients,

clients and the veterinary profession……….

Just my 1 cent…….

Cheers,

Sherman

Sherman O. Canapp Jr., DVM, MS, CCRT

Diplomate ACVS

Veterinary Orthopedic &

Sports Medicine Group

10975 Guilford Road

polis Junction, MD 20701

Phone:

Fax:

http://www.vosm.com

>

> >

> >

> >

> >

> > There is also ZERO evidence that Adequan can be administered SQ despite all

> > the reports. The initial studies were IM and they have no data on

> > bioavailability nor have they radiolabeled the product to see that it even

> > gets into the joint in a SQ fashion.

> >

> > Until someone shows me an objective study on Adeuqn SQ or " prevention or

> > maintenance " usage I do not recommend that mode of therapy (probably wasting

> > the clients money and stabbing the dog for no reason).

> >

> > --

> Mike Petty, DVM

> Diplomate, American Academy of Pain Management

> Certified Medical Veterinary Acupuncturist

> President-Elect, International Veterinary Academy of Pain Management

> Arbor Pointe Veterinary Hospital

> Canton, MI

>

[Guest guest]

Rick,

This is what I love about this forum.....it keeps us thinking and we can learn a

lot from each other.

Thanks for sharing the papers from the 1980's, unfortunately that's what I was

talking about. My bigger concern is the " unpublished data " that you sited which

interestingly was perform by two co-authors who work for the companies.....I can

only assume this was an " in-house " study. Why did they never publish such a

critical finding?

Yes, Pentosan has had mixed reviews (as has SAME, MSM, etc) but that is way we

are performing a multi-center placebo controlled, blinded, randomized

prospective clinical trial which is FDA directed, so we can see if there is any

efficacy to the product....if not, we will not be recommending it to our

patients.

Lastly, I am a huge fan of Adequan....every single joint procedure I perform

daily gets referred back to their RDVM for a series a Adequan injections as do

our OA cases. My only concern (or even frustration) is that I wish I had a

better handle on what to tell RDVMs when they ask me at National conferences or

following a referral as to the use of SQ or intermittent use.....I just have no

facts or concrete evidence to go on (just antidotal reports that we have all

stated through this tread)....I can only report the facts and therefore look

like " Debbie Downer " regarding these other " protocols " ......

Have a great day.

Sherman

Sherman O. Canapp Jr., DVM, MS, CCRT

Diplomate ACVS

Veterinary Orthopedic &

Sports Medicine Group

10975 Guilford Road

polis Junction, MD 20701

Phone:

Fax:

http://www.vosm.com

>

> It is interesting the " life " discussions such as this take on and thus the

fascination with discussion groups. This discussion in particular began with a

simple question – is anyone using Adequan in an attempt to prevent

osteoarthritis. An interesting question, and one that many of us probably have

and more importantly one many more would like the answer. The peer review

nature of this discussion group has additionally posed several new and valid

questions.

>

>

> First I would like to express the bias I have toward Adequan. I am not an

employee of Novartis (company that markets Adequan) nor Luitpold (company that

manufactures) however on a rather routine basis I am paid by Novartis to share

with other DVMs how I manage osteoarthritis in both my primary care practice and

my pain management and rehab practice. It is impossible to be paid by a company

and not be biased. However, my real bias towards the benefits of Adequan in

dogs, and its extralabel use in cats, comes from clinical observations,

improvement in client subjective patient pain evaluations and observed

improvement in functional abilities of OA patients that have received Adequan.

My bias continues to be reinforced by communications with many respected

practitioners, like Mike Petty, who are observing similar clinical outcomes. It

is of shame that the movement toward " evidenced based medicine " tends to

disregard positive clinical outcomes observed by respected clinicians.

>

>

> Regarding SQ administration of Adequan two items come to mind;

>

> 1) In 1987 Hannan, et. al published in the Journal of Orthopedic Research

results of a small study of the benefits of Arteparon – the Adequan for people

in Germany. This study at least shows some articular benefit to the use of this

drug when administered SQ to dogs.

>

>

> J Orthop Res. 1987;5(1):47-59.

>

> Systemic administration of glycosaminoglycan polysulphate (arteparon) provides

partial protection of articular cartilage from damage produced by meniscectomy

in the canine.

>

> Hannan N, Ghosh P, Bellenger C, T.

>

> Bilateral medial meniscectomy was undertaken in 14 mature beagles. Another two

underwent arthrotomy (sham-operated controls). One week after surgery, six of

the meniscectomised animals were administered glycosaminoglycan polysulphate

(Arteparon) (2 mg/kg) subcutaneously three times a week for 3 weeks, then twice

weekly until killed 23 weeks later. Two months before death all animals were

given Na2(35)SO4 (1.0 mCi/kg) intravenously. At autopsy, articular cartilage

(AC) from the medial and lateral compartments, as well as from the femoral

trochlear groove and femoral head, was sampled. Proteoglycans (PGs) were

isolated by 4.0 M Guanidine hydrochloride (GuHCl) extraction of AC and purified

by ultracentrifugation. The PG monomers were assayed for hexuronic acid,

protein, and hexosamines (galactosamine/glucosamine), and their ability to

aggregate. The results indicated that Arteparon provided some protective effect

to AC in the meniscectomised compartment as demonstrated histologically by

reduced surface fibrillation, diminished chondrocyte cloning, and maintenance of

alcianophilia. The levels of PGs and hexuronate-protein ratios in medial AC of

drug-treated meniscectomised animals were found to be comparable to sham

controls, whereas these parameters in the nondrug-treated meniscectomized group

were depressed.

>

>

>

> 2) More recently in a non-published investigation, ----Flourescein-Lableled

Polysulfated Glycosaminoglycan In a Feline Acute Traumatic Knee Model----,

sponsored by Novartis and Luitpold – Heidrich JE (Quatros LLC), Fox SM (Novartis

Animal Health), Royer R (University of New Mexico), Vander Jagt D (University of

New Mexico), Doyle S(University of Toronto), Tokars M (Luitpold Pharmaceuticals)

concluded intramuscular and subcutaneous injections of Adequan followed similar

kinetics and both routes placed Adequan in the target tissues within the joint.

The flourescein labeled PSGAG allowed for histological examination of articular

uptake sites.

>

>

> Regarding safety;

>

> It would seem that due to the length of time this drug has been approved

should it be unsafe numerous reports would exists. Since I am unaware of any

serious complications with its use and only very few minor adverse events in my

patients, I feel that it is a very safe product. I am most interested however

if other information exists.

>

> Now to come back to the original question, can it be used in prevention?

There is no evidence that I am aware of that can support that claim and the drug

is not labeled for such. However one can look to the label of this FDA approved

drug and perhaps get some pathophysiologic support for it use as an OA

prevention. According to the label the specific mechanism of Adequan is unknown

however it is thought to inhibit numerous substances that are involved with

articular cartilage degradation. If this be the case its presence within the

articular tissue at the time of injury could have a positive effect. No

question further studies are needed and I hope they will be performed.

>

> The mention of a new injectable disease modifying osteoarthritic drug in

clinical trial is always of interest. Anything that can help fight this

destructive and often life shortening disease will be readily accepted.

Currently a pentosan polysulfate sodium is approved in Australia and New Zealand

for osteoarthritis in dogs. It actually has been around for some time and

results are mixed. One recent systemic review of 68 papers, on treatment of

osteoarthritis in dogs suggested the evidence for its use is weak to none.

Systemic reviews can sometime be misleading due to the lack of publication on a

particular therapy but perhaps this new product mentioned in a previous post

will be an improvement on Pentosan.

>

> Lastly, ---------------- " (probably wasting the clients money and stabbing the

dog for no reason) " -----------------. I would be my sincere hope that I would

never be guilty of such claims.

>

> Rick Wall

>