Joint Supplements in Horses
written by Jeremy D. Hubert, BVSc, MRCVS, Diplomate ACVS
Assistant Professor, Equine Surgery, Equine Health Studies Program
School of Veterinary Medicine, Louisiana State University www.equine.vetmed.LSU.edu

Your vet has just taken a look at your 14 year old gelding that has been getting a little stiffer than usual recently; he’s been a little reluctant to break into a canter and sometimes shies going to the right. The usual has occurred; there is nothing serious wrong, the hock x-rays show some mild arthritis, his one ankle has always looked thicker than the other and seems a little stiff when you pick his foot up.  The vet mumbled something before he left saying that you should make sure he’s on a joint supplement and if he continues then he’ll think about injecting his joints.  You wander off and look in the back of your national horse magazine, then online, then you call your feed store; and finally you are left confused and totally unenlightened.  What is a good joint supplement?  What is proven? What is even absorbed? And how do these products work?  This article will try to dissect out the wheat from the chaff to provide an insight as to what is needed, what helps and how it helps.

Most joint supplements involve combinations of several substances all of which are purported to assist in slowing down joint degradation.  Joint degradation refers to the inflammatory changes that occur and resultant breakdown of the articular cartilage in a joint and the subsequent changes that lead to development and progression of arthritis. 
By definition arthritis simply means inflammation of a joint.  If cartilage is injured because of a traumatic event or if there is long standing wear and tear that causes cartilage damage, then an inflammatory cascade occurs within the joint leading to further damage to the cartilage matrix.  Ultimately, it changes the cartilage with respect to its ability to its normal functions. The changes noticed early may be as simple as just a warm joint with mild effusion or increased amount of joint fluid.  If the joint is not rested and the cycle of inflammation is not broken or stopped, then continued damage can occur.  This could result in a thinning of the cartilage, thus its ability to resist
concussive forces becomes diminished.  At this point, there is the potential that the bone directly beneath the cartilage (subchondral bone) can become damaged.   Bony changes may start as the bone becomes remodeled in response to trauma or concussion that is not absorbed by normal healthy cartilage. 

The term arthritis is generally used for long standing or chronic changes as opposed to acute changes which can are often referred to as synovitis or simply a stress/strain.  However; when there are signs of inflammation in the joint the terms degenerative joint disease (DJD) or osteoarthritis (OA) are often used by veterinarians.
It would then make sense to observe your horse and treat when the earliest signs are first noticed, but is should be realized that joint supplements can still be useful for horses that are convalescing or undergoing strenuous activities. So there are really three scenarios in which joint supplementation might be helpful: (1) the older arthritic horse, (2) the horse convalescing from an orthopedic injury and (3) the hard working, competing horse with no obvious signs of joint
disease.

But what do you give? There are literally a myriad of different commercially available products all purporting to have amazing abilities to resolve your horses’ lameness problems.  So it is worth looking at each of the components individually to assess their usefulness. Of all the oral anti-arthritic products marketed there are really only two (glucosamine and chondroitin sulfate) that are justified to use in treating joint disease in horses; these products are referred to as chondroprotectants.

Glucosamine
Glucosamine is essentially a type of sugar – a 6 carbon amino sugar – that is found concentrated in joint cartilage. Glucosamine is a substrate for components of the cartilage matrix as well as hyaluronic acid, which is an important component of cartilage. It acts as a precursor for the building block units found within articular cartilage. These building blocks have special biomolecular properties that enable the cartilage to absorb large quantities of water providing it with sponge-like characteristic, resulting in its normal function. Glucosamine is a small water-soluble molecule that is absorbed easily if taken orally and has been shown to be non-toxic. Cartilage cells themselves can synthesize glucosamine from glucose.  However, when available glucosamine is preferred over glucose as a food source by articular cartilage cells. When administered orally, glucosamine hydrochloride yields greater quantities of the active form of glucosamine than glucosamine sulfate. It is the active form of glucosamine that directly determines the availability of the glucosamine supplement made available to the body. Studies in rats, dogs, and humans have shown that 95% of glucosamine hydrochloride is absorbed and available to the body for use by the articular cartilage after oral administration. Laboratory studies have shown that glucosamine appears to have stimulating effects upon cartilage cells, causing them to increase their production of substances which comprise cartilage matrix. In similar laboratory studies, glucosamine has been shown to provide some anti-inflammatory effects and thus protect the cartilage. Cartilage cells treated in vitro with glucosamine resulted in decreased markers of inflammation such free radicals and showed less cell death than those with no glucosamine treatment. 

Studies in live animals have demonstrated uniform incorporation of glucosamine into newly synthesized building blocks of articular cartilage, which demonstrates it use and role in cartilage repair and synthesis. There are multiple studies in people comparing glucosamine with non steroidal anti-inflammatory drugs, specifically ibuprofen; these show that glucosamine results in better clinical responses in people suffering from knee arthritis.  Further electron microscopic studies examining cartilage biopsies from in human subjects affected by degenerative joint disease treatment with oral glucosamine sulfate or placebo, demonstrated evidence of articular cartilage repair and a mild decrease in inflammation; giving the affected cartilage an appearance more similar to that of healthy cartilage.
To date, there have been no studies documenting the bioavailability and tropism for cartilage in horses: most studies in equine cartilage are still assessing the effects of glucosamine on cartilage cells in vitro.  However, the results are similar and encouraging to those reported in other species in that it appears that there is solid evidence for chondroprotection.
All this scientific data leads to a growing body of evidence that if your average 1,000 pound horse has an oral intake of 10,000 mg (10grams) of glucosamine hydrochloride on a daily basis it will slow down the degeneration of cartilage and even help repair in conjunction with other traditional therapies.  Glucosamine has been shown to have anti-inflammatory effects as well as it’s being a precursor molecule for the cartilage matrix.

Chondroitin sulfate

Chondroitin sulfate (CS) is the predominant glycosaminoglycan found in adult articular cartilage. Laboratory studies have illustrated the effectiveness of CS to inhibit the enzymes associated with inflammation and tissue destruction. However, absorption of CS has been reported for man, dogs, and rats and less than 15% of the molecules are absorbed as intact CS molecules. The majority of the CS absorbed was only after degradation to smaller CS molecules without the active sulfate group. It has been demonstrated that the chondroprotective activities of CS require the intact CS molecules, and the effect of smaller CS molecules and other degradation products associated with digestion and absorption remains unknown and untested. Thus the availability of oral CS to the body after ingestion remains to be the main stumbling block – is it absorbed by the horses gastrointestinal tract? It is unlikely since the large intestinal bacteria utilize CS directly as an energy source and remove the active sulfate group.

Most CS products are marketed in combination with glucosamine with or without added vitamins and minerals; therefore, any positive clinical response to oral administration of CS may be secondary to the biological activity of the CS degradation products or more likely from the activity of other substances present in the supplement. As such, although CS has shown some potentially positive chondroprotective properties it is unlikely that it is a useful supplement because of its poor bioavailability (absorption from GI tract and subsequent passage into circulation) as an oral supplement.

Many of these commercial products have additional compounds such as vitamin C, manganese and methylsulfonylmethane (MSM) added to them. Some of these additional components may seem logical; vitamin C has important properties in collagen and thus may be beneficial for cartilage, tendon and ligament health and function; manganese is believed to be important for enzyme reactions synthesizing cartilage matrix from glucosamine, and MSM has direct anti-inflammatory activities.  However; if your horse has a nutritionally balanced diet it is usually unnecessary to supplement with these extra components. The quantities of glucosamine in a normal balanced diet are unknown, but probably minimal if any is present in the diet, thus making it a logical addition to an already balanced diet. There is little work examining the activities or effect of these compounds when administered in combination. Thus, the bottom line is often based upon economic factors.

When reviewing the scientific literature it would appear that the sensible decision is to buy the most cost effective product that contains at least 10,000 mg or 10 grams of glucosamine hydrochloride on a daily basis to your horse. In most cases, the effect of glucosamine is noticed after about two weeks of administration. You will not be stunned by dramatic changes such as those observed after administration of nonsteroidal anti-inflammatory drugs such as phenylbutazone, but you will notice your old arthritic friend becoming a little easier and happier to do what he has always done, the hard working youngster will be less likely to damage or degrade his weight-bearing cartilage and the horse that has had arthroscopic surgery will likely heal in a better fashion if they are supplemented in such a manner. 



Contact: New Market Joint Supplement
by H & H Supplements, LLC
8946 Vidalia Road
Pass Christian, Mississippi 39571
Phone: 800-578-1594
Email: info@jointsupplement.com
Website: www.jointsupplement.com

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