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There was a study in 2008 on cat knees and found no significant difference between IM and SQ. Also, there have been some studies that seem to say that it can possibly slow cartilage loss and argue for its use as a preventative for normal wear-and-tear "arthritis". I've always told clients the idea is something like using synthetic oil in your car to lessen engine wear. If money is no object, and with the extreme conditions our guys endure, it seems like a reasonable thing to try.
Yeah, I've seen that. Cats ain't dogs. Pharmacokinetics are probably similar but...? I've also seen some studies that showed clinical improvement with SQ injection but never a comparison between SQ and IM efficacy. Why mess with what works. IM just isn't that hard.

I do agree that prophylactic use could be beneficial. It seems that clients are more open to that with glucosamine/chondroitin than injections. I'm OK with that non-proven oral supplementation as there are no significant side effects. I have seen occasional minor diarrhea probably associated with this supplement, but never anything else... Cost not being an issue.
 

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I just made an appt to get my 11 year old boy started on these injections and I’ll be honest, I want the injections given IM. In my dogs case the arthritis is advanced, to the point where he takes a long time to get up and his pain and mobility are getting worse and worse. I want to make sure I do everything I can to try to help him and since the drug is recommended for IM injection, I would feel much better with that method. Maybe once it comes to maintenance dose I’ll consider giving the injections myself SC, but I want to make sure he’s getting as much as he can of the loading doses. Maybe SC works just as well, or maybe it works better for earlier stage disease, I just don’t see any reason (besides convenience) to take even the slightest risk of the medication not working as well. And unless my vet can show me documentation or studies that show SC injections work just as well as IM, I’ll have to insist on IM injections. They’re going to hate me, I know..but my intentions are good and it’s not for me.
 

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And unless my vet can show me documentation or studies that show SC injections work just as well as IM, I’ll have to insist on IM injections. They’re going to hate me, I know..but my intentions are good and it’s not for me.
The response I got from Dr. J about IM vs SC injection.

Stan,

The original Adequan labeling stated that the product was for IM (intra-muscular) use only. In later years, the company, as well as several veterinarians, went on to perform clinical trials using subcutaneous injection of the product and found that the blood levels were exactly the same. The company was going to re-label the product, but the FDA wanted 5 million dollars to do this, so the company decided to forgo the re-labeling and simply advise veterinarians that the research was available showing that it can be given IM or SC. Unfortunately, many primary vets are not familiar with the product because they don’t use it as much as orthopedic/rehab vets do, so I spend a lot of time educating them when they give me kick back about using the product “off-label.”

Dr. J




Jennell Appel, DVM, CCRT
SPORTVET Canine Rehab & Sports Medicine
(850) 296-6866
 

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Generally speaking the only difference between intramuscular and subcutaneous injections is time of absorption, since muscle is much more vascular absorption from im injections is faster. Most injectables can be given both ways with some exceptions based on idiosyncrasy of the individual product. If not sure always follow manufacturers recommendation. As Dr. Appel stated Adequan works equally well by either route.
 

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Generally speaking the only difference between intramuscular and subcutaneous injections is time of absorption, since muscle is much more vascular absorption from im injections is faster. Most injectables can be given both ways with some exceptions based on idiosyncrasy of the individual product. If not sure always follow manufacturers recommendation. As Dr. Appel stated Adequan works equally well by either route.
I really appreciate you taking the time to respond, Drs. He got his first injection this evening. Unfortunately, the vet I saw today isn’t his normal vet and she insisted the injection be given IM. When I inquired about SC injection she rejected the idea immediately and then sent in a vet tech to show me how to administer the injections into the muscle. She also became annoyed when I asked if I should continue his normal dose of meloxicam which he’s gotten daily for months. It was my understanding that I was to ask due to possible liver/kidney toxicity, as per the medication instructions. When I asked that outright she said he probably would have had liver issues already but she can do a blood panel if it would make me feel better. Needless to say, I will never take either of my dogs to see that particular vet again. Maybe I got spoiled with their normal vet, but I assumed it was ok to ask basic questions about medication interactions. I just love my dog and want to ensure he’s safe after reading that warning. I’m assuming now that it’s only a precaution and that it’s not a normal side effect, but I didn’t know that.
 

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I couldn’t administer it intramuscularly, I just couldn’t. I put the needle in and he jumped and jerked away, and rather than waste it I injected it SC. The prescribing vet wants no part of SC injections and I don’t know how he’s going to get the remaining 6 injections because I can’t do IM and the vet closes at 6 and that’s what time I work until. Plus the vet gave me 22g 1” needles and they aren’t the best for SC injections. I’m going to look into one of those mobile vets to administer the remaining injections, which I’m not sure they’ll do and would no doubt cost a fortune. I got this to help my golden walk better and unfortunately it seems like the injections just aren’t working out with my vet. Thank you all for your help and best of luck with your fur babies.
 

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I couldn’t administer it intramuscularly, I just couldn’t. I put the needle in and he jumped and jerked away, and rather than waste it I injected it SC. The prescribing vet wants no part of SC injections and I don’t know how he’s going to get the remaining 6 injections because I can’t do IM and the vet closes at 6 and that’s what time I work until. Plus the vet gave me 22g 1” needles and they aren’t the best for SC injections. I’m going to look into one of those mobile vets to administer the remaining injections, which I’m not sure they’ll do and would no doubt cost a fortune. I got this to help my golden walk better and unfortunately it seems like the injections just aren’t working out with my vet. Thank you all for your help and best of luck with your fur babies.
Find different vet to prescribe and give the injections yourself.
 
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On the box that my adequate came in it says the following:

“inject under the skin 1 time a week for 4 weeks, then once monthly.”
 
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Started with IM back when that's what it was. IM to give sucks; much harder and to me the medicine must have something in it that stings when injected the muscle making it painful, you had to pretty much tackle the dog; to get the whole dose in. As time went talking to many horse people they were doing SC and it worked, so I did SC and it works the same. Now most vets recommend SC. Will say that the drug works better for some animals than others in my experience, but worth a try and it really can help in certain animals. Also Adequan is name brand there are other manufactures of the drug ICHON etc. which is same active ingredient; but off brand use; works the same.
 

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The manufacturer would not post that because subq administration was not included in the clinical trial submitted for FDA approval. That does not mean that it is not absorbed subcutaneously
It is, as Dr Janell explains in the the email in post #24
 

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Discussion Starter · #38 ·
When I asked this question ~4 years ago I was trying to keep a dog who severely injured his shoulder as pain free as possible. Have used Adequan (and injected it SC each time) and that dog just turned 13 years old. At the time I was nursing a broken wrist that happened when I stepped on the check cord of my young dog while standing on gravel - not very bright on my part. That young dog is now a high drive talented dog with a mediocre trainer who won't be stepping on their new puppy's check cord any time soon :)

Congrats to Alvin Hatcher and Luke for their win today (go Whopper pups)!
 

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Give the injections subq, 22 gauge one inch needles are normal and standard for injections
If the 22g, 1inch needles are ok for SC injection then I will absolutely just administer the injections myself, as my only concern was without the proper needles he could possibly get lumps and bumps under his skin. I had no problem injecting the last one SC myself, I just lifted his skin into a tent and injected it once I knew I was clear of the skin. I researched Adequan for weeks before calling into my vet and asking if I could try it. I recommend it to them, not the other way around, so I’m not sure she gets a ton of clients who ask for this medication because they had to order it and read the label, and she also doesn’t want me using it for maintenance, only the initial loading dose.
 

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If the 22g, 1inch needles are ok for SC injection then I will absolutely just administer the injections myself, as my only concern was without the proper needles he could possibly get lumps and bumps under his skin. I had no problem injecting the last one SC myself, I just lifted his skin into a tent and injected it once I knew I was clear of the skin. I researched Adequan for weeks before calling into my vet and asking if I could try it. I recommend it to them, not the other way around, so I’m not sure she gets a ton of clients who ask for this medication because they had to order it and read the label, and she also doesn’t want me using it for maintenance, only the initial loading dose.
Most dogs on maintenance, if they respond well, receive a single injection every 3-6 weeks. There is no plausible reason to not continue because a relapse would typically require repeating the loading dose procedure which is costly.
 
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