Joint Supplements

By Dr. Daniel Grove

Joint supplements are always a hot topic. Most people are concerned about the athletic performance of their horses and anything they can do to keep them going at their maximum performance level. This month I am going to discuss the most common ingredients, how they are given, and what we think they do.

Hyaluronic Acid (HA) – HA is found naturally throughout the body. It is used to improved the lubricity (viscosity) of the joint fluid and to reduce inflammation. Cartilage in the joint is like a sponge. The joint fluid fills it up and pressure from weight on the joint expels the fluid. If the fluid is more viscous or thicker, it is harder to expel from the cartilage, and therefore absorbs more concussion. Inflammation makes the joint fluid more watery or less viscous. This aims to combat that. It is commonly given intravenously (IV), intraarticularly (IA, or in the joint), and orally.

Polysulfated glycosaminoglycans (PSGAGs) – Most commonly known as Adequan, PSGAGs are said to stimulate cartilage repair, increase synovial (joint) lubrication, and inhibit enzymes that breakdown cartilage. PSGAGs are best when used IA, but that requires your veterinarian. They are also commonly given intramuscularly (IM).

Methylsulfonylmethane (MSM) – MSM is thought to work by reducing oxidative stress by being a free radical scavenger. That is a fancy way of saying it can reduce inflammation. It is most commonly given orally. Its closely related cousin DMSO is used topically and IV.

Chondroitin Sulfate – Chondroitin is a part of the cartilage matrix, bone and connective tissues. Its use is thought to be similar to HA and PSGAG’s but may not be as effective. It is commonly given orally and sometimes also IV and IA.

Glucosamine – Glucosamine is probably the most common orally supplemented joint supplement. It is found in cartilage and all other connective tissues. It is thought to reduce inflammation and promote healing. It is most commonly given orally but is also given IV, IA, and IM.

Avocado/soybean unsaponifiables (ASU) – ASU inhibits the breakdown of cartilage, and is supposed to promote cartilage repair. It is a mix of fatty acids and vitamins. It is usually administered orally.

These are the main ingredients. They are commonly formulated together and with other ingredients. Oral joint supplements typically fall under “nutraceuticals” and therefore are not as regulated as FDA approved products. When choosing a product, I like to go with companies that actually do research on their products and that stand by them. Here are some key ideas to take away from this when using joint supplements:

1) While these items can help existing problems, they probably are best used as preventatives rather than expected marked results from their use.

2) When given orally, they have to go to the liver first. The liver breaks down many things and this action may result in less of the supplement getting to where you want it. I prefer to use an injectable form when available.

3) Talk to your veterinarian. See what products they have seen work. I have products I have used and the owners went back to riding horses they had retired. I truly believe these products have a place in our equine friends.

4) These products are expensive to manufacture. This is not an area where you want to find the least expensive product and expect it to have the best performance.

This was just a quick overview of joint supplements. They can play a role in keeping your equine athlete happy and pain free while doing their job. Hopefully, this helps you understand them a little more.

#HVCjointsupplements

Questions and Answers

1. My horse is young (OTTB) with arthritis. He gets a half tablet of Previcox daily. If where to ask my vet to try something such as Adequan, could I forego the daily Previcox? Dr.Daniel Grove…… If it were me, with your horse being so young, I would try it with a good oral supplement and see how it works.
2. Opinions on Pentosan? This has been mentioned several times in passing but i have no knowledge of it. This would be for a 19 yr mare with some mild arthritis, but did not respond to Equiiox. Dr. Daniel Grove ……..Pentosan is thought to increase proteoglycan synthesis, stimulate the joint to make more hyaluronic acid, and breakdown fibrin. It can be given orally, IM, IV or IA . I do not think it will give more pain relief than Equioxx.
3. I have a PPID and EMS 24 year old coblet. The vet tells me he has tense stifles and possibly some arthritis in his hocks. He had a very high maintenance life prior coming to me . Is there anything apart from Nsaids that can help him? He is still under saddle and is fine in all 3 gates the problem is when you ask him to lift his back legs ie to pick out feet or farrier. Dr. Daniel Grove….. Joint supplements can help decrease swelling and inflammation in the joints, leading to the horse being more comfortable when flexing the legs. Platinum performance CJ and Cosequin ASU are two that I like
4. My gelding has recently had his cartilage stripped back to the bone in his stifle as it was heavily damaged, I am using 2 joint supplements to assist with rebuilding the cartilage, have you seen anything like this work before and do you have any tips on other ways to assist this? Dr. Daniel Grove…. The best things after surgery like that would probably be PRP or stem cells. IA adequan is good also. That being said, if those are not in the budget, the oral supplements should be beneficial.

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