Noltrex®Vet is a synthetic hydrogel comprised primarily of 3-dimensional polyacrylamide (4%) with a high molecular weight of 10 million daltons.
To put that into context, Noltrex®Vet has a molecular weight 3-5 times greater than high molecular weight hyaluronic acids or HA (a large component of normal joint fluid). A higher molecular weight molecule will take longer to break down in the joint of the horse, therefore maintaining effectiveness for longer than a product with a lower molecular weight. Thus, Noltrex®Vet has a substantial advantage over previous equine joint therapies.
Noltrex®Vet substitutes for the lack of lubricating properties of compromised joint fluid to reduce friction and provide physical protection to the cartilage. Protecting sensitive cartilage is critical in order to maintain healthy and pain free joints in horses.
There are many types and variations of therapies available to today’s practitioner. However, in a recent survey of experienced veterinarians familiar with Noltrex®Vet, it was considered very effective, and was most often their “go-to” second treatment if an initial standard treatment had poor results.
The short answer is any joint. Initially, Noltrex®Vet was recommended for high motion joints. Common examples would include coffin joints, fetlocks and stifles. However, other joints considered low motion joints (limited movement, but important) have also shown great improvement from Noltrex®Vet therapy. The most common example of a low motion joint would be lower hock joints.
Response to treatment with Noltrex®Vet will vary between horses. Some horses show improvement within days after injection, while others may take up to 30 days. Generally, gradual improvement is seen over a 1-3 week period. If a horse makes improvement from a single injection, but is not 100%, then a second injection after 5-6 weeks should be considered.
There have now been over 1 million doses of Noltrex® used in humans. In the United States, Noltrex®Vet usage is becoming commonplace in the equine athlete, with no concerns any greater than other therapies used by veterinarians. As with all joint treatments, great care and skill is required on the part of your veterinarian to minimize any risks from direct joint injection.
The short answer is yes. Remember to understand your whole horse, not just the joint condition. Horses with Cushing’s like syndrome, stomach ulcers (EGUS) or prior laminitis events are all sensitive to certain other products that could be used in joint treatment. Noltrex®Vet is a safe, effective substitute in these horses.
Most veterinarians with experience using Noltrex®Vet consider it an excellent go-to treatment for joints that do not respond to other initial therapies. Currently it is not necessarily an initial recommendation, but it is often part of the conversation for horses requiring more than one treatment or long-term management of a joint condition.
Joint treatment decisions are complex. Not every case and horse can be treated the same with identical results. Noltrex®Vet may be used by itself or some veterinarians may choose to use it in various combinations. In certain protocols, experienced practitioners believe Noltrex®Vet works synergistically to lengthen the duration and effectiveness of other equine joint treatments.
Over time, Noltrex®Vet is broken down into smaller pieces due to normal friction within the joint. Once the particles are of small enough size, they are removed from the joint by a naturally occurring absorption and removal process at about 30-60 days post-injection. This function ensures no residual Noltrex®Vet (polyacrylamide) particles remain in the joint once it is no longer of benefit. In comparison, hyaluronic acid concentration decreases within hours after injection.
Noltrex®Vet is sold only to licensed veterinarians the United States and Canada and must be purchased directly from Nucleus ProVets by licensed veterinary account holders. To order, simply log into your account or call 888-550-0071.
Noltrex®Vet is similar in price to other equine intra-articular therapies. It also important to consider is how long Noltrex®Vet lasts in comparison to conventional therapies. A longer duration joint therapy means less injections over the horse’s lifetime and less time lost from training and competition due to lameness.