Part Three
Equine Joint Supplements
Nutritional supplements aimed at helping joints; seek products with research from reputable companies
What are Joint Supplements?
Joint supplements are products that have been alleged to decrease inflammation, increase mobility, provide the “building blocks” for articular cartilage synthesis, or contribute to the overall health of range of motion of joints by some other mechanism. Joint supplements can be given orally, intravenously, intramuscularly, or intra-articularly (i.e., directly into the joint). The mechanisms of action and efficacy of most oral joint health supplements remain to be fully determined.
Oral Joint Health Supplements
Oral joint health supplements are classified as nutritional supplements that contain one or more non-nutrient, non-drug ingredients. These include glucosamine, chondroitin sulfate, methylsulfonylmethane (MSM), avocado/soybean unsaponifiable extracts (ASU), cetyl myristoleate, and hyaluronic acid. Some oral joint health supplements also include vitamins, minerals, and herbs such as devil’s claw, grape seed extract, yucca, and/or garlic. Oral joint health supplements are readily available from tack shops, online, and they can be administered without the approval or advice of a veterinarian, although this approach is not recommended.
Based on the available research, most of these ingredients are said to work by providing precursor molecules needed to produce articular cartilage, exert anti-inflammatory effects, inhibit enzymes that break down cartilage, and/or promote the synthesis of various components of the articular cartilage matrix.
How They Benefit Horses
Limited numbers of clinical studies with live horses have been performed. This is primarily due to the economical and logistical issues involved with experimenting with live horses. Even so, a handful of studies have been conducted over the past decade showing promising results for oral joint health supplements. The most intensively studied oral joint health supplements in vet medicine are glucosamine and chondroitin sulfate. Clinical studies have demonstrated that supplementation with these ingredients is beneficial in horses with arthritis and navicular syndrome, and when used post-traumatically (i.e., following an acute injury or due to general wear and tear).
In addition, some evidence in dogs suggests that glucosamine/chondroitin sulfatecontaining oral joint health supplements might be useful prophylactically—prior to injury or trauma. While this has not been specifically evaluated in horses, many owners and trainers administer oral joint health supplements to young, healthy, athletic horses with the intention of “protecting” the joints from damage. Further research is necessary to confirm or refute this use of oral joint health supplements.
Injectable Joint Products
In contrast to the oral joint health supplements, supplements formulated as injectable products are pharmaceutical drugs approved by the FDA. These products must be administered by, or under the supervision of, a licensed veterinarian. Only two products are currently included in this class: polysulfated glycosaminoglycans (PSGAGs)- Adequan and hyaluronic acid (HA)- Legend.
Adequan (PSGAGs) is intended for either intramuscular or intravenous administration. PSGAGs function to decrease harmful enzymes the deteriorate cartilage, stimulate activity of the synovial membrane to improve joint function, and increase the viscosity of synovial fluid in damaged joints. No contraindications are associated with the intramuscular administration of PSGAGs; however, the intra-articular product should not be used if a joint infection is suspected.
Legend (Hyaluronic Acid) is a ubiquitous substance in mammals that is found in connective tissues, skin, and synovial fluid. Its mechanism of action remains unclear, but research has demonstrated that HA possesses anti-inflammatory properties and decreases degeneration of the joint. No adverse events have been reported following either the intravenous or intra-articular administration of HA.
Polyglycan is a formulation of hyaluronic acid, sodium chondroitin sulfate and N-acetyl-D-glucosamine used for post-surgical lavage (flushing) of synovial joints. Polyglycan is designed to replace synovial fluid lost during surgery. However, there are many veterinarians that are using and prescribing this product off label to be used intravenously. In simple terms it is like using a combination of Legend and Adequan with less than optimal performance. Evidence to date that the product works is strictly anecdotal and awaits further studies when used outside of surgery.
Problems with Joint Supplements
Since oral joint health supplements are not manufactured like pharmaceutical drugs (using quality assurance/quality control or current Good Manufacturing Practices), and they are unregulated by the FDA, poor-quality products are abundant. This includes products
that do not contain the type or amount of product as listed on the label, have or recommend sub-therapeutic dosages, and are potentially contaminated with harmful chemicals or other nutritional supplements manufactured in the same facility due to inadequate cleaning of the equipment. One study analyzing 23 commercially available oral joint health supplements found that 9 (39.1%) contained less glucosamine than indicated on the manufacturer’s label. This means that more than one-third of tested products were delivering sub-therapeutic dosages of glucosamine. Poor-quality products are unlikely to be effective and are an economic drain on you the owner. Additional concerns exist regarding the lack of a federal adverse event reporting system for nutritional supplements. While joint supplements are widely construed as safe based on studies performed in mice, rats, and horses, potential safety issues do exist. The primary concerns associated with oral joint health supplements are contamination, allergic reactions, and drug interactions (these have been reported for many commonly administered herbs such as yucca, ginseng, flaxseed, and Echinacea).
Joint Supplement Caveat
There is published, scientific evidence supporting the use of Adequan and Legend given intramuscularly, intravenously or intra-articularly. However, the quality of studies on some oral joint health supplements has been questioned. Even in the human medicine where these products have been more extensively tested, the overall clinical impact and efficacy of these products remains under debate.
Veterinarian Recommended Supplements
Both products listed below are personal recommendation based on clinical use, owner compliance, and results seen by trainers and owner in horse performance. Both products are developed and backed by top veterinarians in the US and are available only through your veterinarian. A primary concern of mine is to keep it simple. I am not a “mixer” of supplements and these products have made it easy to feed and take with you on the road.
Platinum Performance CJ (Complete Joint) is at the top of my list. Veterinarian, Doug Herthel, of Alamo Pintado, California, developed this product that is a comprehensive wellness and performance formula designed to support the total health of the horse. In addition, this formula also contains Glucosamine, MSM, ASU, Hyaluronic Acid, Boswellia and Cetyl Myristoleate. www.platinumperformance.com
Myristol is a comprehensive joint supplement for horses. Formulated by Dr. Gayle Trotter, former professor and joint health researcher at Colorado State University Veterinary Teaching Hospital, Myristol combines the following top quality ingredients: Cetyl myristoleate fatty acid complex, MSM, glucosamine HCL, and hydrolyzed Collagen. Myristol is available in alfalfa-based equine pellets. www.myristol.com
Fast Facts
■ Joint supplements are used to promote and maintain a healthy joint environment.
■ Oral joint health supplements are nonnutrient, non-drug-containing products such as glucosamine, chondroitin sulfate, methylsulfonylmethane (MSM), avocado/ soybean unsaponifiable extracts, cetyl myristoleate, and hyaluronic acid.
■ Oral joint health supplements are indicated in horses with osteoarthritis, navicular syndrome, post-traumatically, and potentially also prophylactically.
■ While FDA-approved injectable joint products are produced like pharmaceutical drugs, oral joint health supplements are not. Therefore, there are concerns regarding safety and efficacy of some oral joint health supplements.
Mandi Holland DVM
CSR Equine Sports Medicine Team
copperspringranch.com