Sub Q Adequan

[Ruthe and Smokey (GA)]

I found some older posts that noted some are giving Adequan sub -q. My vet had never heard of that before. But as I was reading I read that some gave it just like an insulin shot and I had previously thought they it was being given with sub q fluids. Can anyone that is treating with Adequan let me know how you are administering at home? I am giving sub q fluids to my kitty Wheezer. She is also going to be starting on Pred and my vet has said we can't use Pred and metacam together and I have been treating her arthritis with metacam for a while now. Since we stopped it, she is not moving all that great. It's all about quality ya know!

Thanks!

 

[Karen & Angus(GA)]

Hi Ruthe!

Angus passed in March, but I gave him Adequan his last 6 months. I gave the injection just like an insulin injection. The needles were a bit larger, but otherwise just the same. It did help with his jumping.

Karen

 

[Vicky & Gandalf (GA) & Murrlin]

"Sub-Q" is short for subcutaneous, which means directly under the skin. So the term is used interchangeably with shots and fluid administration to mean given under the skin, as opposed to injecting in to a muscle, which is not done with fluids or insulin.

If the accepted administration of Adequan has changed, could someone please provide a link to an article about that. I have read here several times that people are giving Adequan under the skin, rather than injected in to the muscle, as I was directed to do by my veterinarian, so I am reluctant to agree that sub-Q is correct administration of Adequan.

Gandalf currently receives his Adequan injections from a licensed acupuncture vet. She gives it to him in the muscles on either side of his hips, straight in, not sub-Q. It does not cause him pain or discomfort.

But it wouldn't be the first time vets weren't versed on the latest accepted techniques.

 

[Ruthe and Smokey (GA)]

I seem to remember that Lynette had posted on the old board about being able to shoot the Adequan into the port when given sub-q fluids...that could be where I got the connection between sub q fluids administration being the same as sub q injection...that was just my brain have a fart!

Karen, I am sorry to hear about Angus! It is so hard to lose these precious furry ones. My Rugly is now diabetic - which completely blows my mind since all my cats are still on the canned diet that I switched them to when Smokey was diagnosed. I know it isn't all about the food, but here I am again! Wheezer barely weighs 5 pounds and is in kidney failure and just started getting fluids. She ain't impressed with it at all. We stopped her Metacam and I can see a noticable difference in her mobility since then and can't stand it! She is going to be on pred for a period of time due to some other issues and from past experience with pred and her, it didn't help her arthritis at all. It's all about quality of life and I want her to be comfy. Was there a noticeable difference pretty quick with the sub q injections?

Looking forward to hearing what others are doing so I can present it to my vet. I live an hour away from his office and it would be really expensive and stressful to have to take her in for a shot or series of shots during our insane rush hour traffic if I could avoid it.

 

[Karen & Angus(GA)]

If the accepted administration of Adequan has changed, could someone please provide a link to an article about that. I have read here several times that people are giving Adequan under the skin, rather than injected in to the muscle, as I was directed to do by my veterinarian, so I am reluctant to agree that sub-Q is correct administration of Adequan.

Do you have access to VIN? My vet found articles on VIN that indicated sub-Q was just as effective as IM. Since I do not have access to VIN, I cannot provide a direct link. The FDA trials were conducted using IM so that is what the label must say. The label also says it is only approved for dogs and horses, not cats.

 

[Nina and KB]

When my vet administered the adequan, she went into the muscle, but KB had little muscle tone at the time and it was hard for me to feel safe avoiding the nerves back there - she said it was ok to give SubQ, that it just might not be as effective as quickly. It's my understanding that the optimal way is still IM.

 

[Vicky & Gandalf (GA) & Murrlin]

If the accepted administration of Adequan has changed, could someone please provide a link to an article about that. I have read here several times that people are giving Adequan under the skin, rather than injected in to the muscle, as I was directed to do by my veterinarian, so I am reluctant to agree that sub-Q is correct administration of Adequan.

Do you have access to VIN? My vet found articles on VIN that indicated sub-Q was just as effective as IM. Since I do not have access to VIN, I cannot provide a direct link. The FDA trials were conducted using IM so that is what the label must say. The label also says it is only approved for dogs and horses, not cats.

Thank you very much. No, don't have access, but I know what it is and that the info there often supersedes what is "officially" approved, since approval is based on the FDA trials, as you described.

Appreciate the info. Thanks.

 

[Jess & Earl]

Hi Ruthe

As a side note, when you start the pred that will get your kitty moving again. It is a powerful anti-inflammatory and can do wonders for arthritic joints. (Not that it should be used for age-related arthritis; it's a nice side effect if you need to use it anyway.)

 

[Ruthe and Smokey (GA)]

Thanks Jess. I sure hope that the pred will help. It's sad to see her so sad.

 

[Dale]

I give it sub-q route. Remember, it should not be given with other NSAID's or anticoagulants. Thins the blood.

 

[Jess & Earl]

I give it sub-q route. Remember, it should not be given with other NSAID's or anticoagulants. Thins the blood.

The problem with NSAIDs and Adequan is theoretical at best; it's used in dogs all the time, more often than using Adequan solo. They don't work on the same bleeding/clotting mechanism. I would be cautious using aspirin and Adequan in cats, but I'd be cautious using just plain aspirin in cats too. I would not be concerned about them conspiring to inhibit clotting, actually, but rather that the aspirin could cause an ulcer which the Adequan (again theoretically) could 'help' bleed. I would also not use it in an animal with a known bleeding problem (rat poison exposure, immune-mediated platelet disorder, etc.) because those are serious issues which need no encouragement, theoretical or not.

 

[Dale]

Plumb's Veterinary Drug Handbook Fifth Edition.

"Drug Interactions: ...There is some concern that since PSGAG is a heparin analog that it should not be used in conjunction with other NSAIDs or other anticoagulants. Clinical significance is unclear, but use together with caution."

FWIW.

 

[Jess & Earl]

Hi Dale

Using with caution (foreknowledge and evaluation of risk/benefit) is different than a 'never use together' rule. Also, I think the caution is at least in part due to what I mentioned: NSAIDs carry a risk of GI ulceration and a drug related to a drug that can inhibit clotting could theoretically encourage bleeding in an animal who has developed this known side effect of NSAID use. Certainly I think it's reasonable to start them separately to screen for problems, if it's a concern. But they are usually started together in animals for whom quality of life has become an issue, and the benefit of treatment could be enormous. There are literally tens of thousands of dogs on the NSAID/Adequan combination, if not more, and there are no reported cases of problems AFAIK.

It's curious, chondroitin sulfate and glucosamine are both in the same family (the glycosaminoglycans) but I haven't seen any cautions about them, I wonder what's different.

Ruthe, I dont' know if you're following this side-track, but if it makes any difference I was actually going to start Adequan two weeks ago on my dog and he's on pred; I ended up not doing so because he's also on chemo now and his blood work got all wonky and I just didn't want to put a new element into the mix until we figured out what was going wrong. But I do plan to start it next week if things are better, fingers crossed.