Equine Joint Supplements
Look for equine joint supplements backed by science and research.
Lameness in the horse leads to diminished performance and has an economic impact on the people who are wanting to ride, show, compete, or race. With only one FDA-approved drug, Adequan, to treat osteoarthritis or degenerative joint disease in horses, and another, Legend, which treats inflammation of the synovial lining of the joint, over-the-counter joint supplements have emerged onto the market as a preventative approach to delaying or avoiding the disease.
“In other words, don’t let my horse become part of an advanced case of osteoarthritis,” said Victoria Maxwell, DVM, MBA, Platinum Performance. “We’re trying to have a very proactive way to get that done. That’s the common mindset is to try to have that on board.”
While the FDA has very high standards for the animal drug approval process, the standards are not as stringent for nutraceuticals.
“The veterinarian has the advantage of having access to these FDA-approved drugs and either dispensing them when they make the diagnosis of degenerative joint disease or writing a prescription for them,” Dr. Maxwell said. “With the over-the-counter products, it is a little more complicated because there are a lot of owners who have access to the Internet and a lot of times will circumvent their veterinarian when it comes to most oral supplements.”
Making sure the veterinarians are included in the conversation is important.
“First, it’s important the proper diagnosis is actually being treated,” Maxwell said. “In other words, there’s no sense in wasting money on a product, regardless of what it is, if a horse isn’t suffering from the condition. Finances are tied to the return on investment, so a proper diagnosis is paramount. As I’m treating a horse with a confirmed case of degenerative joint disease, or a horse at high risk for it, I’m certainly looking at oral supplements as well. Not all are created equal, however.
“There are compounds or companies that I have a lot of faith in that are doing quite a bit of research and independent research that is making the trade publications when it comes to oral products,” Maxwell said. “So those are the things that I’m going to look at to substantiate my decision making. A) does the patient have the disease process? And B) when I’m going to the oral products, is there science to support what is out there – bioavailability, ingredient sourcing, banned substance testing, substantiating research, and such are all important questions to ask before choosing an oral.”
It’s important to keep in mind the joint environment is considered an organ, according to Maxwell.
“It is a rather complex environment where it has the synovial lining, which is like a vitamin E capsule,” she said. “It has the hyaluronic acid fluid inside, which is sort of the lubricating or the viscosity that happens, where the two bones are able to glide over each other. At the end of those long bones, there’s something called articular cartilage and that is a very compressive cartilage that bears the load and concussion of movement. Each element of the joint does something different.”
Most supplements provide a combination of components.
Glucosamine
“Glucosamine is a natural compound found in cartilage – the tough tissue that helps cushion joints,” Maxwell said. “It is integral to the synthesis inside of the actual cartilage itself. It’s very common to see glucosamine commercially available in a lot of different products. The outside of the shellfish, like shrimp, is a very common source for glucosamine.”
Chondroitin sulfate
“Chondroitin sulfate is a building block inside of the articular cartilage and helps with the stiffness that we want that cartilage to have,” said Maxwell. “It’s that ability to absorb and dissipate shock down into the bones. Several products that you’ll see out there will have a combination of glucosamine and chondroitin sulfate, with others combining glucosamine with nutrients like MSM.”
Methylsulfonylmethane
“Also known as MSM, methylsulfonylmethane is a granular version of something called dimethyl sulfoxide, or DMSO,” Maxwell said. “MSM is what’s called an organosulfur that is a free radical scavenger, with free radicals causing oxidative damage that we think of as ‘rust’ to the cell membrane. This ‘rust’ is an example of oxidation-reduction (redox) where oxygen steals electrons from iron. We know MSM is something that’s trying to stabilize the redox reactions that are occurring in the joint. While there’s still a lot to learn in terms of how exactly MSM is metabolized in horses, the ingredient is widely used and has shown results.”
Hyaluronic acid
“You’ll also see something called hyaluronic acid or HA, which is a viscous fluid that lives inside of the joint,” Maxwell said. “We know horses that are in a high workload or a high training regimen, or even as they age, we see that viscosity begin to break down, and instead of becoming a thick gel-like substance, it becomes very thin and watery. So the idea of trying to supplement with hyaluronic acid is to try to create a more viscous fluid inside of the joint.”
Additional ingredients found in joint supplements include Creatine monohydrate, Perna canaliculus (Green-Lipped Mussel), Omega-3 fatty acids, Vitamin E, Manganese, and Zinc.
Look at the science
Maxwell said when recommending joint supplements, she focuses on companies and products that put an emphasis on research and science to support their products.
“For example, Platinum Performance has a foundation where they’re very much looking at a lot of the anti-inflammatory components on a systemic level,” she said. “They look at a lot of the omega-3s, especially from a flaxseed base. Their proprietary blends include hyaluronic acid, MSM, and ASU, or avocado/soy unsaponifiables. ASU is a key ingredient for joint support and cartilage health. These ingredients and their effect are examined at a cellular level to create a healthier cellular environment for the different needs inside of the joint environment.”
Even with research-backed products, supplements are not a magic pill to prevent degenerative joint disease, but a prophylactic way to support good management of the horse and complementary therapy to accompany other clinical treatments, Maxwell said.
“The hypothesis is that we believe that if we’re able to keep up with the demands on the joint of a horse that’s in a high training regimen, we’ll delay the onset of the disease,” she said. “With that being said, it is a long-term commitment, especially on a horse that is involved in active training and competition.”
Joint supplementation should fit the needs of the individual horse
“If I’m asking a racehorse to have a very high workload on that joint environment beyond its normal capacity, then the idea is to try to supplement and keep up with the demands that are on that particular joint environment,” Maxwell said. “The key is to manage these horses on an individual basis.”
Good management is important
When evaluating a horse who may be susceptible to degenerative joint disease, Maxwell said to look at management factors like weight management, farrier work, workload, and working surface.
“First thing I want to look at is whether or not he’s overweight,” she said. “A lot of times with horses with degenerative joint disease, I find they’re just like humans – they’re carrying a little too much load. So I would like to get him a little bit more streamlined.”
In addition, having good farrier work will help balance the joint environment.
“The hoof is certainly the basis and the foundation for holding up the entire structure of the animal,” Maxwell said. “Good farrier work can help keep the joints in alignment – both medial and lateral, inside to outside and front to back.”
It’s also important to find a realistic workload on each particular horse.
“I come from the hunter-jumper world, as well as show racing and thoroughbred racing,” she said. “We look a lot at the footing. We want to make sure the footing is ideal to help absorb the concussive load the horses are going through. Not only am I looking at the feet, but I’m also looking at the surface that my horses are actually working on.”
The bottom line is it comes down to good management.
“We know the joint environment loves to be on the move,” Maxwell said. “Horses were really designed to be moving about 18 hours a day in small increments. So horses that are stuck in the stall for hours at a time are actually not good for the joint environment. The joint likes to be able to move and to be able to circulate fluid and blood and all that sort of through the environment. Walking is a very good flushing action for the joint environment. So moderate exercise on a daily basis is suggested.”
Take home message
It’s a good opportunity and important for DSRs to include the veterinarian in the conversation about joint supplements.
“I think they want to talk about this,” Maxwell said. “There’s a part of them that feels the Internet has gotten between the client and the veterinarian. I still see the veterinarian constantly reading, constantly learning, and continuing education to find and tie these ends together about the value of over-the-counter and oral supplementation.”
DSRs are disseminating information, and including the veterinarian in this conversation is essential to get the right products into the right hands.
“I don’t think veterinarians want to leave it to the Internet or the feed store or something like that,” she said. “The veterinarian very much wants to be included in everything that’s happening into the horse’s daily regime.”
Joint supplements offer a preventative measure for the overall wellness of the horse. “There’s a shift I think we’re seeing in human medicine at the same time, and that’s this idea of wellness. As veterinarians, we have, over the years, learned how to put out fires. ‘Come in and fix this problem with a steroid or a nonsteroidal anti-inflammatory’ or whatever the case may be. In general, we’re understanding that as healthcare providers, we need to have a much more proactive component into the wellness of our patients and extending a healthy life, not just fixing an ill life, if you will,” said Maxwell. “This oral category fits into there.”
Research and science-backed products provide the most value.“This is a billion-dollar industry,” Maxwell said. “People want to have that wellness and we want it to be based on science and the right decisions. It’s coming a lot slower than most people want, but it is coming. I think the shift has happened into the equine side.”
Photo cutline: istockphoto.com/nevarpp
