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[RC] [Consider This] Joint supplements - a vet's perspective - John Teeter

Question:"what are the best and least expensive joint supplements to use on my horse for healthy joints?"

Answer by Susan Garlinghouse, DVM, MS:

Here’s my opinion about joint supplements, both oral and injectable.

There’s no data to support that providing any sort of supplement prior to actual clinical signs of degenerative joint disease actually delays its eventual onset. However---if we consider what we ask these horses to do, even the best conditioned, most intelligently managed horse is going to have *some* degree of inflammation in its joints after a ride, and even though that inflammation may be insufficient to appear on an x-ray or in a lameness exam, it makes sense to protect those joints as much as possible. As such, I give my horses joint supplements when they’re working hard; and the 17-year-old campaigner I’m currently riding is getting practically marinated in the stuff, even though he doesn’t have a whisper of lameness, just because he’s working hard and is seventeen years old.

Of the oral forms of supplements, the best data available is from NutraMax Labs, that developed and markets the original oral supplement, Cosequin. They do show a measurable benefit provided by regular dosing, BUT---even the most expensive, name brand stuff out there only has a bioavailability of about 3-4%---which means you have to feed boatloads of it to get a smidgen of it into the circulation where it can eventually be taken up by inflamed joint tissue. Pretty expensive stuff for most of it to end up in a poop pile (though I’m happy to report the flies on my property feeding on that poop have never looked so spry). The bioavailability goes down when you get into the generic versions---even though the ingredient label may still say “chondroitin sulfate”, the label doesn’t tell you the Daltons (size, more or less) of the molecule in question. The bigger (read “cheaper”) the molecule, the less likely it is to be absorbed in the GI tract and thus get used effectively. There’s a good bit of data that supports the notion that most of the generic joint supplements available at Costco don’t do a darn thing, just because the molecule is too big to be absorbed. And remember, the very BEST source out there is only 3-4% available when fed orally.

That being said, I hugely prefer going the injectable route, because then I’m bypassing the GI tract entirely and most of the injected dose is getting to inflamed tissue where it belongs. Yes, I know the injectables are more expensive per dose, but I’d rather pay more for a vial of liquid gold that’s almost entirely bioavailable, then paying a lot less for an oral supplement that’s mostly ending up in the manure dumpster. Even I can do that math. I’ve heard differing things about the oral hyaluronates, but still prefer going the direct injectable route with that as well, for basically the same reasons.

Because I own an animal hospital and mostly work on companion animals for a living, I use the injectables in a whole lot of different species and it helps a bunch, especially in creaky, arthritic old dogs. Sometimes it’s hard to see a tangible difference in horses that are still pretty much moving okay, but I know a dog is feeling better when he starts asking to go for walks again, jumping into the car without help, whatever. I always tell my owners not to expect a miraculous improvement overnight, because we’re not just masking symptoms with a painkiller, we’re approaching the source of the disease process directly, and that takes some time. I usually dispense enough for the initial loading period of six weeks or so and sometimes then I’ll ask the owners if they saw an improvement and would they like a refill. Sometimes they tell me they didn’t see much benefit, so nope, they’ll skip the refill. I can pretty much set my watch that a month later, they’ll be calling for that refill, because they didn’t realize how much better old Duffy was until they STOPPED giving him the Adequan. I’d guess I probably have about a hundred patients on it in my practice at any given time.

I couldn’t tell you the efficacy of the generic injectables. I know they’re out there, but I use the brand name Adequan and/or Legend in my practice, just because I’m positive those are effective, and I need to use that not only for my own animals, but also for my clients.

So, I know you’re looking for something inexpensive to feed, but I’m going to go out on a limb and also assume you want the most bang for your buck. My advice would be to skip all the oral supplements entirely, with the possible exception of some source of omega-3 fatty acids, which have a different mode of action but are still pretty good for assorted inflammatory conditions, including those affecting the joints. The most cost-effective source of the O-3s is maybe a cup or two of freshly ground whole flax seed---grind it up yourself in an electric coffee grinder, stick it in baggies into the freezer and give your horse a baggie once a day.

Take whatever your annual budget is that you were planning on spending on oral joint supplements and figure out how much Adequan, or Legend, or both, that you can afford. Do that. Resis the urge to feed something other than the aforementioned flax seed. You’ll get more benefit from an Adequan or Legend injection once a month, or twice a year, or whatever suits your budget, than you will by feeding the oral supplements on a daily basis---especially if the oral supplement is one of the cheap ones that oh-by-the-way, has such low bioavailability that 99% of it is going into the dumpster.

Hope this helps. BTW, all the above comments also apply to arthritic dogs, kitties, bunnies and darn near every other species out there. I won’t comment publicly on its applicability to humans, because I’m not licensed for that species and the DEA would be sending me nastygrams as soon as they finished tracking down whoever it was that sold propofol to Michael Jackson.

Susan Garlinghouse, DVM, MS

Posted By Endurance.Net to Consider This at 7/21/2009 01:22:00 PM

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